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Autonomy

Dementia and the Social Scaffold of Memory

By Jonathan Pugh

 

The number of individuals suffering with dementia is steadily increasing; as such, the moral issues raised by the neurodegenerative diseases that bring about the symptoms typifying dementia are of pressing practical concern. In this context, Richard Holton’s topic for the first of his three 2018 Uehiro lectures (on the theme “Illness and the Social Self”) is a timely one: What are the ethical implications of the progressive and pervasive loss of memory that is a central feature of dementia?

I shall be blogging a synopsis of each lecture in the series on the Practical Ethics blog – You can find a recording of the lecture here

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Video Series: Tom Douglas Defends the Chemical Castration of Sex Offenders

The Minister of Justice in the UK wants to dramatically increase the use of chemical castration in sex offenders to reduce their risk of reoffending.Dr Tom Douglas (University of Oxford) argues that offering chemical castration to sex offenders might be a better option than current practices to prevent sex offenders from reoffending (e.g. incarceration), and… Read More »Video Series: Tom Douglas Defends the Chemical Castration of Sex Offenders

Should Iceland Ban Circumcision? A Legal and Ethical Analysis

By Lauren Notini and Brian D. Earp

*Note: a condensed version of this article titled “Iceland’s Proposed Circumcision Ban” is being cross-published at Pursuit.

 

For a small country, Iceland has had a big impact on global media coverage recently, following its proposed ban on male circumcision before an age of consent.

Iceland’s proposed legislation seeks to criminalise circumcision on male minors that is unnecessary “for health reasons,” stating individuals who remove “part or all of the sexual organs shall be imprisoned for up to 6 years.”

The bill claims circumcision violates children’s rights to “express their views on the issues [concerning them]” and “protection against traditions that are harmful.”

According to bill spokesperson Silja Dögg Gunnarsdóttir, a key reason for the bill is that all forms of female genital cutting (FGC), no matter how minor, have been illegal in Iceland since 2005, but no similar legislation exists for males.

“If we have laws banning circumcision for girls,” she said in an interview, then for consistency “we should do so for boys.” Consequently, the bill is not specific to male circumcision, but adapts the existing law banning FGC, changing “girls” to “children.”

There is much to unpack here. We first discuss self-determination and informed consent, before addressing claims about potential health benefits and harms. We then explore the religious significance of circumcision for some groups, and ask what implications this should have.

Read More »Should Iceland Ban Circumcision? A Legal and Ethical Analysis

Cross Post: The Discomforts of Being a Utilitarian

Written by Hazen Zohny 

* Please note that this essay was originally published in Quillette Magazine.

 

The Discomforts of Being a Utilitarian 

I recently answered the nine questions that make up The Oxford Utilitarianism Scale. My result: “You are very utilitarian! You might be Peter Singer.”

This provoked a complacent smile followed by a quick look around to ensure that nobody else had seen this result on my monitor. After all, outright utilitarians still risk being thought of as profoundly disturbed, or at least deeply misguided. It’s easy to see why: according to my answers, there are at least some (highly unusual) circumstances where I would support the torture of an innocent person or the mass deployment of political oppression.

Choosing the most utilitarian responses to these scenarios involves great discomfort. It is like being placed on a debating team and asked to defend a position you abhor. The idea of actually torturing individuals or oppressing dissent evokes a sense of disgust in me – and yet the scenarios in these dilemmas compel me not only to say such acts are permissible, they’re obligatory. Biting bullets is almost always uncomfortable, which goes a long way in explaining the lack of popularity utilitarianism enjoys. But this discomfort largely melts away once we recognize three caveats relevant to the Oxford Utilitarianism Scale and to moral dilemmas more generally.

The first of these relates to the somewhat misleading nature of these dilemmas. They are set up to appear as though you are being asked to imagine just one thing, like torturing someone to prevent a bomb going off, or killing a healthy patient to save five others. In reality, they are asking two things of you: imagining the scenario at hand, and imaging yourself to be a fundamentally different being – specifically, a being that is able to know with certainty the consequences of its actions.

Read More »Cross Post: The Discomforts of Being a Utilitarian

Video Series: Should We Pay People to Quit Smoking or Lose Weight?

Should we pay people to quit smoking or lose weight? Would paying them amount to coercion?  Is there a risk that if we start paying for healthy behaviour, its value will be corrupted? Is paying unhealthy people unfair to those who already lead healthy life styles? In this video interview (with Katrien Devolder),  Dr Rebecca… Read More »Video Series: Should We Pay People to Quit Smoking or Lose Weight?

Cross Post: Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery

Guest Post by Nathan Hodson 

* Please note that this article is being cross-posted from the Journal of Medical Ethics Blog 

Research in robotics promises to revolutionize surgery. The Da Vinci system has already brought the first fruits of the revolution into the operating theater through remote controlled laparoscopic (or “keyhole”) surgery. New developments are going further, augmenting the human surgeon and moving toward a future with fully autonomous robotic surgeons. Through machine learning, these robotic surgeons will likely one day supersede their makers and ultimately squeeze human surgical trainees out of operating room.

This possibility raises new questions for those building and programming healthcare robots. In their recent essay entitled “Robot Autonomy for Surgery,” Michael Yip and Nikhil Das echoed a common assumption in health robotics research: “human surgeons [will] still play a large role in ensuring the safety of the patient.” If human surgical training is impaired by robotic surgery, however—as I argue it likely will be—then this safety net would not necessarily hold.

Imagine an operating theater. The autonomous robot surgeon makes an unorthodox move. The human surgeon observer is alarmed. As the surgeon reaches to take control, the robot issues an instruction: “Step away. Based on data from every single operation performed this year, by all automated robots around the world, the approach I am taking is the best.”

Should we trust the robot? Should we doubt the human expert? Shouldn’t we play it safe—but what would that mean in this scenario? Could such a future really materialize?

Read More »Cross Post: Machine Learning and Medical Education: Impending Conflicts in Robotic Surgery

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

By Brian D. Earp (@briandavidearp)

 

Four members of the Dawoodi Bohra sect of Islam living in Detroit, Michigan have recently been indicted on charges of female genital mutilation (FGM). This is the first time the US government has prosecuted an “FGM” case since a federal law was passed in 1996. The world is watching to see how the case turns out.

A lot is at stake here. Multiculturalism, religious freedom, the limits of tolerance; the scope of children’s—and minority group—rights; the credibility of scientific research; even the very concept of “harm.”

To see how these pieces fit together, I need to describe the alleged crime.

Read More »Does Female Genital Mutilation Have Health Benefits? The Problem with Medicalizing Morality

Video Series: Tom Douglas on Using Neurointerventions in Crime Prevention

Should neurointerventions be used to prevent crime? For example, should we use chemical castration as part of efforts to prevent re-offending in sex offenders? What about methadone treatment for heroin-dependent offenders? Would offering such interventions to incarcerated individuals involve coercion? Would it violate their right to freedom from mental interference? Is there such a right?… Read More »Video Series: Tom Douglas on Using Neurointerventions in Crime Prevention

Cross Post: Why you might want to think twice about surrendering online privacy for the sake of convenience

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Written by Carissa Veliz

DPhil Candidate in Philosophy, Uehiro Centre for Practical Ethics, University of Oxford

This article was originally published in The Conversation

Just a click away once you tick this too-long-to-read privacy agreement. Shutterstock

It is inconvenient to guard one’s privacy, and the better one protects it, the more inconvenience one must endure. Enjoying privacy, at a minimum, demands installing software to block tracking online, using long and different passwords for online services, remembering to turn off the WiFi and Bluetooth signals on your mobile phone when leaving the house, using cash, and so on.Read More »Cross Post: Why you might want to think twice about surrendering online privacy for the sake of convenience

Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices

Guest Post by Philipp Kellmeyer

Imagine you had epilepsy and, despite taking a daily cocktail of several anti-epileptic drugs, still suffered several seizures per week, some minor, some resulting in bruises and other injuries. The source of your epileptic seizures lies in a brain region that is important for language. Therefore, your neurologist told you, epilepsy surgery – removing brain tissue that has been identified as the source of seizures in continuous monitoring with intracranial electroencephalography (iEEG) – is not viable in your case because it would lead to permanent damage to your language ability.

There is however, says your neurologist, an innovative clinical trial under way that might reduce the frequency and severity of your seizures. In this trial, a new device is implanted in your head that contains an electrode array for recording your brain activity directly from the brain surface and for applying small electric shocks to interrupt an impending seizure.

The electrode array connects wirelessly to a small computer that analyses the information from the electrodes to assess your seizure risk at any given moment in order to decide when to administer an electric shock. The neurologist informs you that trials with similar devices have achieved a reduction in the frequency of severe seizures in 50% of patients so that there would be a good chance that you benefit from taking part in the trial.

Now, imagine you decided to participate in the trial and it turns out that the device comes with two options: In one setting, you get no feedback on your current seizure risk by the device and the decision when to administer an electric shock to prevent an impending seizure is taken solely by the device.

This keeps you completely out of the loop in terms of being able to modify your behaviour according to your seizure risk and – in a sense – relegates some autonomy of decision-making to the intelligent medical device inside your head.

In the other setting, the system comes with a “traffic light” that signals your current risk level for a seizure, with green indicating a low, yellow a medium, and red a high probability of a seizure. In case of an evolving seizure, the device may additionally warn you with an alarm tone. In this scenario, you are kept in the loop and you retain your capacity to modify your behavior accordingly, for example to step from a ladder or stop riding a bike when you are “in the red.”

Read More »Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices