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ethics

The Right Not to Know and the Obligation to Know

By Ben Davies

Most people accept that patients have a strong claim (perhaps with some exceptions) to be told information that is relevant to their health and medical care. Patients have a Right to Know. More controversial is the claim that this control goes the other way, too. Some people claim, and others deny, that patients also have a Right Not to Know.

A number of considerations (harm to the patient; autonomy; privacy) have been marshalled on either side of this debate over the past few decades (e.g. Laurie 2004; Robertson and Savulescu 2001; Herring and Foster 2012; Takala 2019). In this post, I focus on a distinct argument and its apparently unassailable logic. This is the view that a comprehensive Right Not to Know cannot be justified because in many cases a patient’s ignorance will likely lead harm to third parties (Council of Europe 1997; Rhodes 1998; Harris and Keywood 2001).

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Responsibility, Healthcare, and Harshness

Written by Gabriel De Marco

Suppose that two patients are in need of a complicated, and expensive, heart surgery. Further suppose that they are identical in various relevant respects: e.g., state of the heart, age, likelihood of success of surgery, etc. However, they differ on one feature: for one of these patients, call her Blair, the need for the heart surgery is due to her lifestyle (suppose she was a smoker), whereas the other, Ingrid, has not had this lifestyle, nor any other that would lead to the need for the surgery.

Some people think that:

  1. We can be responsible and blameworthy for our actions and their consequences.

Some of those people also think that:

  1. We can, or should, take this into account when making decisions about how to distribute healthcare resources.

For the purposes of this blog post, let’s assume 1 and 2 are true. Commonly, it is thought that, in order to be blameworthy for something, one must be responsible for it. Further, it is commonly thought that, whatever the appropriate response is to blameworthiness for something or other (assuming that there is an appropriate response), it will be negative in some sense or other. Now further suppose that Blair is blameworthy for her illness. Given 1 and 2, this fact about Blair, combined with the fact that Ingrid is innocent with regard to her illness, suggests that, at least in some contexts, we should treat them differently (or at least it would be permissible to do so). Call a healthcare policy that adopts, and reflects, 1 and 2 a Responsibility-Sensitive Policy, or RSP for short.

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Love Drugs: The Chemical Future of Relationships

Announcement: Brian Earp and Julian Savulescu’s new book ‘Love Drugs: The Chemical Future of Relationships‘, published by (Stanford University Press) is now available.

Is there a pill for love? What about an “anti-love drug”, to help us get over an ex? This book argues that certain psychoactive substances, including MDMA—the active ingredient in Ecstasy—may help ordinary couples work through relationship difficulties and strengthen their connection. Others may help sever an emotional connection during a breakup. These substances already exist, and they have transformative implications for how we think about love. This book builds a case for conducting research into “love drugs” and “anti-love drugs” and explores their ethical implications for individuals and society. Scandalously, Western medicine tends to ignore the interpersonal effects of drug-based interventions. Why are we still in the dark about the effects of these drugs on romantic partnerships? And how can we overhaul scientific research norms to take relationships more fully into account?

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Human Genetic Enhancement Might Soon Be Possible – But Where Do We Draw the Line?

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Written by Tess Johnson, University of Oxford

 

How far will we allow genetic enhancement to go?
vchal/ Shutterstock

The first genetically edited children were born in China in late 2018. Twins Lulu and Nana had a particular gene – known as CCR5 – modified during embryonic development. The aim was to make them (and their descendants) resistant to HIV. By some definitions, this would be an example of human enhancement.

Although there is still a long way to go before the technology is safe, this example has shown it’s possible to edit genes that will continue being inherited by genetic offspring for generations. However, we don’t yet know what effect these genetic changes will have on the overall health of the twins throughout life. Potential unintended changes to other genes is a grave concern which is limiting our use of gene editing technology at the moment – but this limit won’t always be present.Read More »Human Genetic Enhancement Might Soon Be Possible – But Where Do We Draw the Line?

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)

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Diet, Changing Desires, and Dementia

Written by Ben Davies

Last week saw the launch of a campaign (run by the group Vegetarian For Life) that seeks to ensure that older people in care who have ethical commitments to a particular diet are not given food that violates those commitments. This is, as the campaign makes clear, a particularly pressing issue for those who have some form of dementia who may not be capable of expressing their commitment.

Those behind the campaign are quite right to note that people’s ethical beliefs should not be ignored simply because they are in care, or have a cognitive impairment (see a Twitter thread where I discuss this with a backer of the campaign). But the idea that one’s dietary ethics must be ‘for life’ got me thinking about a more well-established debate about Advance Directives. (I should stress that what I say here should not be taken to be imputing any particular motivation or philosophical commitments to those behind the campaign itself.)

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Japan to Allow Human-Animal Hybrids to be Brought to Term

By Mackenzie Graham

The article was originally published at the Conversation

Around the world thousands of people are on organ donor waiting lists. While some of those people will receive the organ transplants they need in time, the sad reality is that many will die waiting. But controversial new research may provide a way to address this crisis.

Japan has recently overturned its ban on the creation of human-animal hybrids, or “chimeras”, and approved a request by researchers from the University of Tokyo to create a human-mouse hybrid.

Scientists will attempt to grow a human pancreas inside a mouse, using a certain kind of stem cell known as “induced pluripotent stem cells”. These are cells that can grow into almost any kind of cell. The stem cells will be injected into a mouse embryo, which has been genetically modified to be incapable of producing a pancreas using its own cells. This hybrid embryo is then implanted in a mouse surrogate and allowed to grow. The goal is to eventually grow a human pancreas in a larger animal – such as a pig – which can be transplanted into a human.

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A Proposal for Addressing Language Inequality in Academia

Written by Anri Asagumo

Oxford Uehiro/St Cross Scholar

Although more and more people see the importance of diversity in academia, language diversity is one type of diversity that seems to be diminishing: English is increasingly dominant in both areas. I would like to argue that people who are born and raised in an English-speaking country should be required to acquire a second language to the level they can write a rudimentary paper and give a presentation in that language in order to apply for international conferences and submit papers to international journals. The purpose of this requirement would be to address the significant inequality between native English-speakers and others. I focus on academia here, but ideally the same thing should be applied to the business world, too.Read More »A Proposal for Addressing Language Inequality in Academia

Cross Post: Ten Ethical Flaws in the Caster Semenya Decision on Intersex in Sport

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Written by Julian Savulescu, University of Oxford

File 20190508 183103 1eva5jd.jpg?ixlib=rb 1.1
Caster Semenya is legally female, was from birth raised as female and identifies as a female.
Jon Connell on flickr , CC BY-NC

Middle-distance runner Caster Semenya will need to take hormone-lowering agents, or have surgery, if she wishes to continue her career in her chosen athletic events.

The Court of Arbitration in Sport (CAS) decided last week to uphold a rule requiring athletes with certain forms of what they call “disorders of sex development” (DSD) – more commonly called “intersex” conditions – to lower their testosterone levels in order to still be eligible to compete as women in certain elite races.

The case was brought to CAS by Semenya, as she argued discrimination linked to a 2018 decision preventing some women, including herself, from competing in some female events.

This ruling is flawed. On the basis of science and ethical reasoning, there are ten reasons CAS’s decision does not stand up.Read More »Cross Post: Ten Ethical Flaws in the Caster Semenya Decision on Intersex in Sport

‘Now Is Not The Time’: Is It Wrong To Engage In Political Debate Following A Tragedy?

Written by Alexandra Couto and Guy Kahane

In the days following the Stoneman Douglas High School shooting in February 2018, many of the surviving students and staff gathered to demand immediate change to the gun laws that allowed Nicholas Cruz to kill so many of their friends and pupils. Many students held banners on which it was written: “We don’t want your thoughts and condolences, we want policy & change!” Speaking at the rally, teacher Melissa Falkowski said “They say ‘it’s not the time’ — Now is the time! There is no other time!”

Was Melissa Falkowski right? Or is it wrong to engage in political and moral debate so soon after such a tragedy? Should we instead just offer our “thoughts and prayers”, postponing public debate to a later time?Read More »‘Now Is Not The Time’: Is It Wrong To Engage In Political Debate Following A Tragedy?