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Defaults, status quo, and disagreements about sex

Defaults, status quo, and disagreements about sex

Scott Alexander has a thoughtful piece about who gets to set the default in disagreements about what is reasonable. He describes a couple therapy session where one member is bored with his sex life and goes kinky clubbing, to the anger of his strongly monogamous partner. Yet both want to stay together at least for the sake of the kids. Assuming the answer is an either-or situation where one has to give up on their demand (likely not the ideal response in an actual couple therapy setting), the issue seems to boil down to who has the unreasonable demand.

It resonated with another article I came across in my news flow today: What It’s Like to Be Chemically Castrated. This article is an interview with a man who wanted to be chemically castrated in order to manage his sex addiction and save his 45-year marriage. Is this an unreasonable intervention?

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Video Interview with Professor Jeff McMahon on Increasing Airstrikes in Syria — The Ethics of War

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In the first of a series of video interviews by Dr Katrien Devolder hosted by the Practical Ethics in the News blog, Jeff McMahan discusses the war in Syria. In the aftermath of the Paris terror attacks, the US and France increased the number of airstrikes in Syria. Is this increase justified? See the full interview here: https://www.youtube.com/watch?v=Rd3-YrtVMoU

Engineering a Consensus:   Edit Embryos for Research, Not Reproduction

Written by Dr Chris Gyngell, Dr Tom Douglas and Professor Julian Savulescu

A crucial international summit on gene editing continues today in Washington DC. Organised by the US National Academy of Sciences, National Academy of Medicine, the Chinese Academy of Sciences, and the U.K.’s Royal Society, the summit promises to be a pivotal point in the history of the gene editing technologies.

Gene editing (GE) is a truly revolutionary technology, potentially allowing the genetic bases of life to be manipulated at will. It has already been used to create malaria-fighting mosquitoes, drought resistant wheat, hornless cows and cancer killing immune cells. All this despite the fact GE only become widely used in the past few years. The potential applications of GE in a decade are difficult to imagine. It may transform the food we eat, the animals we farm, and the way we battle disease.Read More »Engineering a Consensus:   Edit Embryos for Research, Not Reproduction

The Ethics of Genetically Modified Mosquitoes and Gene-Drive Technology

Written by Jonathan Pugh

This is an unedited version of a paper by Dr Pugh which was originally published on The Conversation:

please see here to read the original article

In a startling development in ‘gene-drive’ technology, a team of researchers at the University of California have succeeded in creating hundreds of genetically modified mosquitoes that are incapable of spreading the malaria parasite to humans, and which could potentially spread this trait rapidly throughout mosquito populations in the wild. This success has the potential to be translated into a huge global health benefit. Although global malarial deaths have been in decline over the past decade or so, WHO estimates that malaria has been responsible for over 400’000 deaths this year alone. The Anopheles genus of mosquito acts as the vector for malaria, as infected Anopheles mosquitoes transmit Plasmodium parasites to humans via their bites, and it is these parasites that cause malaria.Read More »The Ethics of Genetically Modified Mosquitoes and Gene-Drive Technology

Podcast: Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

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Dr Jonathan Pugh’s St Cross Special Ethics Seminar on 12 November 2015 is now available at http://media.philosophy.ox.ac.uk/uehiro/MT15_STX_Pugh.mp3 Speaker: Dr Jonathan Pugh Although a central tenet of medical ethics holds that it is permissible to perform a medical intervention on a competent individual only if that individual has given informed consent to that intervention, there are… Read More »Podcast: Justifications for Non-Consensual Medical Intervention: From Infectious Disease Control to Criminal Rehabilitation

How much would you pay to live an extra year?

Dominic Wilkinson, University of Oxford

@Neonatalethics

Medical science continues to push at the boundaries of life and death with new drugs and technologies that can extend life or improve health. But these advances come at a cost. And that inevitably raises difficult questions about whether public health systems should pay for such treatments – and, if so, how much. For example, should the NHS fund the new breast cancer drug Kadycla which comes with a £90,000 price tag per patient?

Some countries make these difficult decisions by looking at the cost-effectiveness of new treatments. How much does the new treatment cost and how effective is it compared with existing treatments? Treatments may help patients live longer, or they may improve a patient’s quality of life (or both). Kadycla appears to extend life by about six months.

One mathematical way of combining these elements uses the concept of a Quality-Adjusted Life Year saved, or QALY. As an example, a treatment that extends life for one year but at a “quality” level of half normal it said to save 0.5 QALY. When treatments are assessed this way, health systems can then use a threshold to work out a maximum cost that is affordable. The National Institute for Health and Care Excellence (NICE) uses a threshold of £20,000-£30,000 for each Quality-Adjusted Life Year saved (QALY). This would mean (assuming full quality of life), that the NHS would be prepared to pay £10,000-15,000 for a course of Kadycla.

Saving time.
Bank by Shutterstock

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Loebel Lectures and Workshop, Michaelmas Term 2015, Lecture 1 of 3: Neurobiological materialism collides with the experience of being human

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The 2015 Loebel Lectures in Psychiatry and Philosophy were delivered by Professor Steven E. Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard as well as Harvard University Distinguished Service Professor of Stem Cell and Regenerative Biology. Both the lecture series and the one-day workshop proved popular and were well-attended.Read More »Loebel Lectures and Workshop, Michaelmas Term 2015, Lecture 1 of 3: Neurobiological materialism collides with the experience of being human

Doping: Russian Cheats or a Failed System?

A stunning report from a WADA Commission, led by former head of WADA Dick Pound has made a series of allegations against Russian athletes and authorities, including that 1400 samples were deliberately destroyed ahead of a visit by WADA. It recommends the suspension of all Russian athletes over the period including the Rio Olympics, and lifetime bans for five individual athletes and five coaches. It says the London Olympics was “sabotaged”, not only by the Russian authorities, but also by the inaction of the IAAF.

While this report focuses on Russia, early independent analyses of leaked blood profiles estimated at least 1/3 of medals involve doping or raised suspicions of doping. So the problem extends way beyond Russia. Arson Wenger, Arsenal Football Club’s manager, recently claimed doping was widespread in football, a sport which has so far had few scandals.

Back in 2012, there was more confidence in the ability to enforce the rules: speaking ahead of the Olympics, the UK Minister for Sport and the Olympics Hugh Robertson  said:

“We cannot absolutely guarantee that these will be a drug-free games,” he said.

“But we can guarantee that we have got the very best system possible to try and catch anybody who even thinks of cheating.””

Mr Robertson may have been correct that it was the best system possible. But today’s report, and earlier analyses of leaked blood data show that doping is likely to have nevertheless been widespread, amongst both Russian athletes and those of other nations.

I have argued that in the light of the proven inability to enforce a zero tolerance approach to sport, we should instead take a pragmatic approach. As a very brief and incomplete overview, I argue that we should allow doping within safe, measurable physiological parameters. For example, if an athlete’s haematocrit is under say 50%, we should not worry about whether she reached that level by altitude training, hypoxic tent use, genetic good luck, or EPO. We should focus resources on drugs which are unreasonably risky for athletes, or which are against the spirit of the individual sport (by which I mean they substantially remove the human component of a given sport). The doping we allow should be supervised by a medical professional, within prescribed safe ranges, and tested by independent accredited and monitored laboratories. You can read in more detail here or throughout this blog in the Sport category.

This position remains controversial. But its opponents imagine an Eldorado where sport is mainly clean, and that the few athletes who do dope are likely to get their comeuppance. They argue that allowing doping would be unfair to clean athletes who would not be able to compete. They argue that it would push young athletes into doping. But we now know that doping is not a rare aberration. It was not rare in the 90s for cycling, and it is not rare, 20 years later for athletics.

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