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Rebecca Brown’s Posts

Antenatal Care During The COVID-19 Pandemic: Couples As Dyads

Written by Rebecca Brown

 

During the pandemic, many healthcare services have been reduced. One instance of this is the antenatal care of expectant mothers. Ordinarily, partners of pregnant women are permitted to attend appointments. This includes the 12 week scan: typically the first opportunity expectant parents get to see the developing foetus, to discover whether it has a heartbeat and is growing in the right place. This can be very exciting and, if there’s bad news, devastating. It also includes scans in mid pregnancy and (for first-time mothers) at 36 weeks, as well as the entirety of labour.

During the pandemic, many healthcare providers have restricted attendance at antenatal appointments as well as labour and postnatal care. Even when lockdown restrictions were eased, with pubs, zoos and swimming pools re-opening and diners in England being encouraged to Eat Out to Help Out, some hospitals continued to exclude partners from all antenatal appointments and all but the final stage of labour, requiring them to leave shortly after birth. This included cases where mother and newborn had to remain on wards for days following delivery. With covid cases rising, it seems likely that partners will once again be absent from much antenatal, labour, and postnatal care across the country.Read More »Antenatal Care During The COVID-19 Pandemic: Couples As Dyads

Ecological Rationality: When Is Bias A Good Thing?

By Rebecca Brown

Many people will be broadly familiar with the ‘heuristics and biases’ (H&B) program of work, made prominent by the psychologists Amos Tversky and Daniel Kahneman in the 1970s. H&B developed alongside the new sub-discipline of Behavioural Economics, both detailing the ways in which human decision-makers deviate from what would be expected of homo economicus – an imaginary, perfectly rational being that always aims at maximising utility. For instance, in a famous experiment, Tversky and Kahneman gave people the following information (1983: 297):

Linda is 31 years old, single, outspoken and very bright. She majored in philosophy. As a student, she was deeply concerned with issues of discrimination and social justice, and also participated in anti-nuclear demonstrations. 

Participants were then asked which of the two alternatives was more probable:

1. Linda is a bank teller.

2. Linda is a bank teller and is active in the feminist movement.

Read More »Ecological Rationality: When Is Bias A Good Thing?

Bad Ads And Stereotypes

Written by Rebecca Brown

In June this year, the Advertising Standards Authority (ASA) brought into effect a ban on harmful gender stereotypes in advertising. In response to public outcry about adverts such as the 2015 ‘Are you beach body ready?’ campaign by Protein World, and growing discomfort with outdated depictions of gender roles in the media, the ASA undertook a project to consider whether existing regulation is fit for purpose. They concluded that “evidence suggests that a tougher line needs to be taken on ads that feature stereotypical gender roles and characteristics, which through their content and context may be potentially harmful to people.” (ASA, 2017: 3)

Read More »Bad Ads And Stereotypes

Criticising Stigma Whilst Reinforcing it: the Case of the Response to CRUK’s Anti-Obesity Campaign

Written by Rebecca Brown

There has been recent concern over CRUK’s (Cancer Research UK) latest campaign, which features the claim ‘obesity is a cause of cancer too’ made to look like cigarette packets. It follows criticism of a previous, related campaign which also publicised links between obesity and cancer. Presumably, CRUK’s aim is to increase awareness of obesity as a risk factor for cancer and, in doing so, encourage people to avoid (contributors to) obesity. It may also be hoped to encourage public support for policies which tackle obesity, pushing the Overton window in a direction which is likely to permit further political action in this domain.

The backlash is mostly focused around the comparison with smoking, and the use of smoking-related imagery to promote the message (there is further criticism of the central causal claim, since it is actually quite difficult to establish that obesity causes cancer). 

Read More »Criticising Stigma Whilst Reinforcing it: the Case of the Response to CRUK’s Anti-Obesity Campaign

Responsibility Over Time And Across Agents

Rebecca Brown and Julian Savulescu

Cross-posted from the Journal of Medical Ethics blog, available here.

There is a rich literature on the philosophy of responsibility: how agents come to be responsible for certain actions or consequences; what conditions excuse people from responsibility; who counts as an ‘apt candidate’ for responsibility; how responsibility links to blameworthiness; what follows from deciding that someone is blameworthy. These questions can be asked of actions relating to health and the diseases people may suffer as a consequence. A familiar debate surrounds the provision of liver transplants (a scarce commodity) to people who suffer liver failure as a result of excessive alcohol consumption. For instance, if they are responsible for suffering liver failure, that could mean they are less deserving of a transplant than someone who suffers liver failure unrelated to alcohol consumption.

Read More »Responsibility Over Time And Across Agents

Medical Nihilism: When A Dose Of Scepticism Can Be Healthy

In his 2018 book, the philosopher of science, Jacob Stegenga defends the view “that we should have little confidence in the effectiveness of medical interventions.” (Stegenga 2018) On the face of it, he acknowledges, this position seems unreasonable: most of us can think of myriad ways in which modern medicine has improved – perhaps saved – our own lives and the lives of those close to us. The asthma attack I had as a baby, effectively treated at the time and subsequently managed through the use of seemingly magical medications which relax the muscles around the airways, opening them up and allowing air to pass freely again. Or the schoolfriend whose ruptured appendix could have resulted in a fatal infection, but for emergency surgery and the administration of antibiotics. Or the countless lives made less painful by the availability of cheap and safe painkillers. 

Medical sceptics tend to get a bad rep – anti-vaxxers who risk the lives of children by regurgitating debunked myths about the links between vaccines and autism, leading to dips in herd immunity and disease outbreaks; credulous folk who believe in the mystical powers of homeopathy and eschew conventional therapies in favour of potions that contain little more than water. This is not the sort of company one wishes to associate with.Read More »Medical Nihilism: When A Dose Of Scepticism Can Be Healthy

Cross Post: Philosophy Can Make the Previously Unthinkable Thinkable

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Written by Dr Rebecca Brown

In the mid-1990s, Joseph Overton, a researcher at the US think tank the Mackinac Center for Public Policy, proposed the idea of a ‘window’ of socially acceptable policies within any given domain. This came to be known as the Overton window of political possibilities. The job of think tanks, Overton proposed, was not directly to advocate particular policies, but to shift the window of possibilities so that previously unthinkable policy ideas – those shocking to the sensibilities of the time – become mainstream and part of the debate.

Overton’s insight was that there is little point advocating policies that are publicly unacceptable, since (almost) no politician will support them. Efforts are better spent, he argued, in shifting the debate so that such policies seem less radical and become more likely to receive support from sympathetic politicians. For instance, working to increase awareness of climate change might make future proposals to restrict the use of diesel cars more palatable, and ultimately more effective, than directly lobbying for a ban on such vehicles.Read More »Cross Post: Philosophy Can Make the Previously Unthinkable Thinkable

Music Streaming, Hateful Conduct and Censorship

Written by Rebecca Brown

Last month, one of the largest music streaming services in the world, Spotify, announced a new ‘hate content and hateful conduct’ policy. In it, they state that “We believe in openness, diversity, tolerance and respect, and we want to promote those values through music and the creative arts.” They condemn hate content that “expressly and principally promotes, advocates, or incites hatred or violence against a group or individual based on characteristics, including, race, religion, gender identity, sex, ethnicity, nationality, sexual orientation, veteran status, or disability.” Content that is found to fulfil these criteria may be removed from the service, or may cease to be promoted, for example, through playlists and advertisements. Spotify further describe how they will approach “hateful conduct” by artists: 

We don’t censor content because of an artist’s or creator’s behavior, but we want our editorial decisions – what we choose to program – to reflect our values. When an artist or creator does something that is especially harmful or hateful (for example, violence against children and sexual violence), it may affect the ways we work with or support that artist or creator.

An immediate consequence of this policy was the removal from featured playlists of R. Kelly and XXXTentacion, two American R&B artists. Whilst the 20 year old XXXTentacion has had moderate success in the US, R. Kelly is one of the biggest R&B artists in the world. As a result, the decision not to playlist R. Kelly attracted significant attention, including accusations of censorship and racism. Subsequently, Spotify backtracked on their decision, rescinding the section of their policy on hateful conduct and announcing regret for the “vague” language of the policy which “left too many elements open to interpretation.” Consequently, XXXTentacion’s music has reappeared on playlists such as Rap Caviar, although R. Kelly has not (yet) been reinstated. The controversy surrounding R. Kelly and Spotify raises questions about the extent to which commercial organisations, such as music streaming services, should make clear moral expressions. 
Read More »Music Streaming, Hateful Conduct and Censorship

Doing Good and Being Bad: The Presidents Club, Charity and Moral Licensing.

Last January, an article in the Financial Times broke a story about a men-only charity event run by the Presidents Club, a charitable trust set up to raise money for “worthy children’s causes.” Allegations were made by undercover journalists who attended the black tie event as ‘hostesses,’ 130 of whom were hired to attend the event where they were required to wear a uniform of short tight black dresses, “sexy” black high heels and matching black underwear in order to “keep [the attendees] happy – and fetch drinks when required.” According to the FT, the selection criteria for women to work at the event were that they be “tall, thin and pretty”. Women interviewed by the FT described being repeatedly groped, propositioned for sex, and instructed to “down that glass, rip off your knickers and dance on that table.” The Presidents Club has closed as a result of the negative attention following the article, and many prominent figures in business, entertainment and politics have been publicly named as attending the dinner, and required to defend their involvement.

Read More »Doing Good and Being Bad: The Presidents Club, Charity and Moral Licensing.

In Defence of Impulsivity

Written by Dr Rebecca Brown

It has become commonplace to identify a lack of impulse control as a major cause of poor health. A popular theory within behavioural science tells us that our behaviour is regulated via two systems: the fast, impulsive system 1 (the ‘impulsive’ or ‘automatic’ system) and the slower, deliberative system 2 (the ‘reflective’ system). Much of our behaviour is routine and repeated in similar ways in similar contexts: making coffee in the morning, travelling to work, checking our email. Such behaviours develop into habits, and we are able to successfully perform them with minimal conscious input and cognitive effort. This is because they come under the control of our impulsive system.

Habits have become a focus of health promoters. It seems that many of these routine, repeated behaviours actually have a significant impact on our health over a lifetime: what we eat and drink and how active we are can affect our risk of developing chronic diseases like type II diabetes, heart disease, lung disease and cancer. Despite considerable efforts to educate people as to the risks of eating too much, exercising to little, smoking and drinking, many people continue to engage in such unhealthy habits. One reason for this, it is proposed, is people’s limited ability to exert conscious (reflective) control over their habitual (impulsive) behaviour.

Given this, one might think that it would be preferable if people were generally able to exhibit more reflective control; that behaviour was less frequently determined by impulsive processes and more frequently determined by reflective deliberation. Perhaps this could form part of the basis for advising people to be more ‘mindful’ in their everyday activities, such as eating, and regimes for training one’s willpower ‘muscle’ to ensure confident conscious control over one’s behaviour.Read More »In Defence of Impulsivity