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Guest Post: Is it Time for Ethics Experts in Lack of Consent Cases?

Guest Post: Is it Time for Ethics Experts in Lack of Consent Cases?

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Written by Daniel Sokol

 barrister and medical ethicist at 12 King’s Bench Walk, Temple, London

This article was first published in the Personal Injury Brief Update Law Journal on 12th October 2015 (http://www.pibriefupdate.com)

Following the landmark case of Montgomery v Lanarkshire Health Board [2015] UKSC 11, I have been instructed on several cases of alleged failure to obtain valid consent.

At present, consultants in the relevant specialty are asked to produce expert reports on the quality of the consent process.  The reports are, generally, of dubious value.

Medical expertise is not ethical expertiseRead More »Guest Post: Is it Time for Ethics Experts in Lack of Consent Cases?

If I were you then I wouldn’t say that: The perils of giving and taking advice

Written by Andreas Kappes

The school year just started, but surprisingly, the half-term break is already lurking around the corner, when children have a week off. For a lot of parents this implies seeing their own parents, having them take care of the kids. And whenever families come together, there will be many sentences starting with: If I were you… Adult children don’t hesitate to give unsolicited advice on, for instance, the outfit choices of their partners (“If I were you I would only wear this at midnight, when it is dark and nobody can see you”), parents give advice to their own parents (“If I were you, I would take it slow), and grandparents can’t resist either (“If I were you, I would buy a house and stop renting”). Even outside the family, unsolicited advice is everywhere1. Obama telling the United Kingdom how much money to spend on the military, David Cameron advising Europe on how to handle immigration, or this blog post suggesting ways to offer advice; it is readily available. And all of these different forms of advice – hopefully with one obvious exception – have one thing in common; they backfire. While people love to dish out advice and it seems to them to be a good idea, we are not great in taking it; we rather hate it. So how to give it right?

Read More »If I were you then I wouldn’t say that: The perils of giving and taking advice

Sartre vs The Selfie: An Existentialist Critique of Selfie- Taking

Selfie-sticks are notoriously ubiquitous in modern society, and the art of ‘selfie-taking’ may well be something that future analysts identify as being one of the defining sociological trends of this period of history. In this post, I will discuss some passages from Sartre that help to explain my feeling of unease at this rampant ‘selfie-ism’.Read More »Sartre vs The Selfie: An Existentialist Critique of Selfie- Taking

What’s the moral difference between ad blocking and piracy?

On 16 September Marco Arment, developer of Tumblr, Instapaper and Overcast, released a new iPhone and iPad app called Peace. It quickly shot to the top of the paid app charts, but Arment began to have moral qualms about the app, and its unexpected success, and two days after its release, he pulled it from the app store.

Why the qualms? For the full story, check out episode 136 of Arment’s excellent Accidental Tech Podcast and this blog post, but here’s my potted account: Peace is an ad blocker. It allows users to view webpages without advertisements. Similar software has been available for Macs and PCs for years (I use it to block some ads on my laptop), but Apple has only just made ad blockers possible on mobile devices, and Peace was one of a bunch of new apps to take advantage of this possibility. Although ad blockers help web surfers to avoid the considerable annoyance (and aesthetic unpleasantness) of webpage ads, they also come at a cost to content providers, potentially reducing their advertising revenue. According to Arment, the ethics of ad blocking is ‘complicated’, and although he still believes ad blockers should exist, and continues to use them, he thinks their downsides are serious enough that he wasn’t comfortable with being at the forefront of the ad blocking movement himself.

In explaining his reasons for withdrawing the app, Arment drew a parallel between ad blocking and piracy. He doesn’t claim that the analogy is perfect (in fact, he explicitly disavows this), and nor does he take it to be a knock-down objection to ad-blocking (presumably he believes that piracy is also morally complicated). But he does think there’s something to the comparison.

Like Arment, I think there are considerable moral similarities between ad blocking and piracy. But, also like Arment, ad blocking seems to me, intuitively, to be somewhat less morally problematic. This raises an obvious question: what’s the moral difference?

Read More »What’s the moral difference between ad blocking and piracy?

Guest Post: Should the army abandon their zero-tolerance policy on substance use?

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Written by Anke Snoek

Macquarie University

In the UK around 500 soldiers each year get fired because they fail drug-testing. The substances they use are mainly recreational drugs like cannabis, XTC, and cocaine. Some call this a waste of resources, since new soldiers have to be recruited and trained, and call for a revision of the zero tolerance policy on substance use in the army.

This policy stems from the Vietnam war. During the First and Second World War, it was almost considered cruel to deny soldiers alcohol. The use of alcohol was seen as a necessary coping mechanism for soldiers facing the horrors of the battlefield. The public opinion on substance use by soldiers changed radically during the Vietnam War. Influenced by the anti-war movement, the newspapers then were dominated by stories of how stoned soldiers fired at their own people, and how the Vietnamese sold opioids to the soldiers to make them less capable of doing their jobs. Although Robins (1974) provided evidence that the soldiers used the opioids in a relatively safe way, and that they were enhancing rather than impairing the soldiers’ capacities, the public opinion on unregulated drug use in the army was irrevocably changed.Read More »Guest Post: Should the army abandon their zero-tolerance policy on substance use?

Why are unethical neonatal trials still taking place in developing countries?

By Dominic Wilkinson, @Neonatalethics

Earlier this year, the Lancet published a trial (the ‘ACT’ trial) involving 100,000 babies at risk of being born prematurely in developing countries. Half of the mothers in the ACT trial did not receive a simple cheap medicine that has been previously shown in multiple trials and meta-analysis to reduce the risk of death for premature babies. From the ACT trial results, it appears that 89 additional babies died as a result of their mothers taking part in the trial.

Surely this is an egregious example of unethical research? It appears to be in breach of the World Medical Association Declaration of Helsinki standards. Why did ethics committees allow the research? Why did a major journal like the Lancet publish it? Why aren’t bioethicists and activist and advocacy groups like Public Citizen jumping up and down in outrage?

Read More »Why are unethical neonatal trials still taking place in developing countries?

Gene editing and eugenics

A study published last week in the journal Cell has led to speculation that a powerful new gene editing technique is about to be developed.

Gene editing has received widespread media coverage over the past few months. Most of the excitement has centred on a specific gene editing technique, the CRISPR-cas9 system. Research conducted with CRISPR-cas9 on human embryos has been highly controversial, at least partly because some people fear it will lead to gene editing being used to alter the human germline for clinical applications, and will have unpredictable effects on future generations.

Read More »Gene editing and eugenics

Don’t write evil algorithms

Google is said to have dropped the famous “Don’t be evil” slogan. Actually, it is the holding company Alphabet that merely wants employees to “do the right thing”. Regardless of what one thinks about the actual behaviour and ethics of Google, it seems that it got one thing right early on: a recognition that it was moving in a morally charged space.

Google is in many ways an algorithm company: it was founded on PageRank, a clever algorithm for finding relevant web pages, scaled up thanks to MapReduce algorithms, use algorithms for choosing adverts, driving cars and selecting nuances of blue. These algorithms have large real world effects, and the way they function and are used matters morally.

Can we make and use algorithms more ethically?

Read More »Don’t write evil algorithms

Guest Post: What (if anything) makes extinction bad?

Catia Faria, Pompeu Fabra University

Follow Catia on Twitter here

 Throughout history, countless species have come into existence only to later become extinct. Whether extinction is caused by natural processes or human agency, environmental scientists and the general public seem to agree that extinction is a bad thing and that, therefore, conservation efforts should be made to counteract, and perhaps revert, the losses. Resources are often devoted to the reintroduction of endangered species into ecosystems in which they have long been absent. In other cases, states implement measures to protect autochthonous species (that is, species which are native to a certain natural environment, as opposed to introduced as a result of human activity) which are threatened by the presence of a foreign species by eradicating the members of the latter. There are entire organisations dedicated simply to the aim of preventing the extinction of species whose continued existence is at risk.  However, these practices rely on rather controversial assumptions.

Read More »Guest Post: What (if anything) makes extinction bad?

Mandatory submission of patient information about FGM: a pointless, damaging, discriminatory mess

Brenda Kelly and Charles Foster

Female Genital Mutilation (‘FGM’) is a term covering various procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons (WHO, 2012). It can be associated with immediate and long-term physical and psychological health problems. FGM is prevalent in Africa, Middle East and South East Asia as well as within diaspora communities from these countries

The Government, keenly aware of the political capital in FGM, has come down hard. The Serious Crime Act 2015 makes it mandatory to report to the police cases of FGM in girls under the age of 18. While we have some issues with that requirement, it is at least concordant with the general law of child protection.

What is of more concern is the requirement, introduced by the cowardly device of a Ministerial Direction and after the most cursory consultation (in which the GMC and the RCOG hardly covered themselves in glory), by which healthcare professionals, from October 2015, are legally obliged to submit patient-identifiable information to the Department of Health (‘DOH’) on every female patient with FGM who presents for whatever reason, through the Enhanced Dataset Collection (EDC). The majority of these women will have undergone FGM in their country of origin prior to coming to the UK.Read More »Mandatory submission of patient information about FGM: a pointless, damaging, discriminatory mess