Professional ethicists seem to love controversy. I myself have been too boring in this regard, but many of my colleagues have provoked heated debate. This often spills out of the safety of academia unto society at large, as many of the past entries in the Practical Ethics blog testify to. And professional ethicists rarely regret… Read More »The Rationalist Prejudice
For those of us doing Catholic moral theology, we most often hear and read the name “Peter Singer” invoked by our colleagues in a dismissive way. Indeed, if one can somehow show that another’s argument is heading in a Singer-like direction, then for many of us one essentially has reduced it to the absurd. Furthermore,… Read More »Peter Singer and Christian Ethics: Beyond Polarization
X, a patient with reliably diagnosed PVS, lies in a hospital bed for years, fed via a nasogastric tube. He has not, and by definition never will have, any capacity for pain, pleasure or any sort of sensation. Devoted family members come each day to sit by his bedside, but he has no idea that they are devoted, or that they exist.
It is expensive to keep him alive. He occupies a bed and consumes a good deal of nursing time.
The NHS Trust responsible for his care has a limited budget. It decides that the money spent on maintaining his merely biological life would be better spent on dialysis machines. It can, and does, justify its decision in purely utilitarian terms. It writes in the minutes of the relevant committee meeting: ‘For the money we spend keeping X alive, we can save the lives of 10 kidney patients, each of whom will have a good quality of life for many years. The QALY arithmetic makes X’s continued existence nonsensical.’Read More »The cost of living and the cost of dying
Like many in the UK, I was gripped last week by the reports from Wales about the search for four trapped miners, and saddened to hear of their deaths. Readers outside the UK perhaps heard nothing, or very little, about this story, thought it dominated the news here. One important reason for that, of course,… Read More »Fellow-Citizens, Foreigners, and Statistical Lives
By Charles Foster
I have just finished writing a book about dignity in bioethics. Much of it was a defence against the allegation that dignity is hopelessly amorphous; feel-good philosophical window-dressing; the name we give to whatever principle gives us the answer to a bioethical conundrum that we think is right.
This allegation usually comes from the thoroughgoing autonomists – people who think that autonomy is the only principle we need. There aren’t many of them in academic ethics, but there are lots of them in the ranks of the professional guideline drafters, (look, for instance, at the GMC’s guidelines on consenting patients) and so they have an unhealthy influence on the zeitgeist.
The allegation is ironic. The idea of autonomy is hardly less amorphous. To give it any sort of backbone you have to adopt an icy, unattractive, Millian, absolutist version of autonomy. I suspect that the widespread adoption of this account is a consequence not of a reasoned conviction that this version is correct, but of a need, rooted in cognitive dissonance, to maintain faith with the fundamentalist notions that there is a single principle in bioethics, and that that principle must keep us safe from the well-documented evils of paternalism. Autonomy-worship is primarily a reaction against paternalism. Reaction is not a good way to philosophise.Read More »Autonomy: amorphous or just impossible?
by Dominic Wilkinson
If a patient’s family refuse to allow withdrawal of breathing machines should doctors provide long-term support in an intensive care unit for a patient who is clinically brain dead? Should doctors provide heart-lung bypass (ECMO) for a child with anencephaly? Should doctors perform a tracheostomy and provide a long-term breathing machine for a patient in a documented persistent vegetative state?Read More »The patient vanishes
By Charles Foster
In North Kentucky, forty miles from its Creation Museum (where you can see Eve riding on a triceratops and videos in which weeping girls blame their moral degeneracy on their failure to believe in the verbal inerrancy of Scripture), ‘Answers in Genesis’ is building a full-size replica of Noah’s Ark. It’s an expensive business. The total bill will be $24.5 million, of which $845,910 has been raised to date. ‘Partner with us in this amazing outreach by sponsoring a peg, plank or beam…’, pleads the website. A peg will cost you $100, a plank $1000, and a beam $5000. But if you buy a beam, you’ll also get a model of the Ark personally signed by Ken Ham, the President of ‘Answers in Genesis’.Read More »On rebuilding Noah’s Ark and drinking old Burgundy
There was a jolly fire in the fireplace. The snow was falling outside the windows, to the delight of children and despair of transport planners. Aristotle sipped on the mulled wine, watching while Kant meticulously wrapped another jar of homemade mustard.
“Dear Immanuel, are you going to give all your friends mustard?”
“Everybody except Georg. He likes to mix it with ketchup; he says it makes a great synthesis. I don’t care much for that idea and I would hate to see it spread. He will get a writing style guide instead.”
“I guess for you it is the thought that counts, when it comes to Christmas presents.”
by David Shipley
A friend of mine is a therapist. She faced the following dilemma.
My friend specialises in enhancing fertility and was approached by a prospective patient who wished to become pregnant but could not afford to pay the standard fee of £45 per treatment as she was on benefits. The woman was aged 40 and had no children. What should my friend the therapist have done?
By Jahel Queralt-Lange
Each year 10.9 million new cases of cancer are diagnosed worldwide, and 6.7 million people die. The good news is that better drugs are developing faster. We all want to hear about “wonder drugs” and the scientific and medical communities feel the urge (and sometimes the pressure) to provide them. However, some ethical problems might appear in our way to this breakthrough. Before being released into the market, any drug has to undergo a trial in which its benefits are tested and weighed up against its adverse effects. Of course, the desirability of increasing our knowledge in order to improve our health is beyond question. What poses problems is that those individuals who participate in the trials are the means by which we achieve that knowledge. Past experiences, like the Tuskegee Syphilis experiment that took place in the US showed that it’s morally outrageous to trade the life of some individuals for the sake of benefiting society. Nowadays the issue is regulated but moral dilemmas persist.
Read More »Data or life? Ethical obligations to present and future patients.
