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A not-so-great escape: suicide in prison

Christian Brown is a newly qualified junior doctor with an interest in psychiatry and ethics. 

Early last month, Ariel Castro, convicted kidnapper, rapist, and murderer, used a bed sheet and a window-ledge to commit suicide in his prison cell. He was just four weeks into a life sentence. Recently on this blog, Rebecca Roache wrote a post about the possibility of enhancing prison sentences – today, I’d like to consider the right-to-die of inmates, and the role of medical professionals in their suicidal behaviour.

Inside the walls of our high security prisons, small numbers of prisoners face life-long sentences, deprived of all but the minimum of human contact, and confined for most of the day to their cells. Some people argue that it can be rational to commit suicide – for the purposes of this post, I’ll refer to suicidal acts which are voluntary, informed, and the individual shown to have mental capacity, as ‘rational suicide’. If one accepts this, it is hard to imagine a more subjectively powerful circumstance in which to kill oneself than at the outset of a life sentence. Indeed, suicide rates among prisoners are around six times higher than those of the general male population. Of course, a proportion of these cases will not meet the criteria for ‘rational suicide’, but let’s consider those that do.Read More »A not-so-great escape: suicide in prison

Stress Influences Our Moral Behaviour

All of us are stressed, every now and then. Acute stress can have a profound impact on the human body and mind: both physical and psychological stressors affect the autonomic nervous system and the hypothalamic–pituitary–adrenal axis, leading to changes in cardiovascular and neuroendocrine measures. Stress also is shown to affect cognitive functions like memory and attention. Just recently, however, research discovered that acute stress also can influence our moral behaviour.

Read More »Stress Influences Our Moral Behaviour

Is compassion a necessary component of healthcare?

Last week, the Daily Mail reported on Dr Anna Smajdor’s paper in which she argues that compassion ‘is not a necessary component’ of healthcare. This claim contrasts interestingly with Jeremy Hunt’s recent proposal that all student nurses should have to prove that they are capable of caring by spending a year on wards carrying out basic tasks. This proposal, along with the suggestion that pay be linked to levels of kindness would, according to Hunt, go some way to improving the standard of NHS care.  The motivating idea behind Hunt’s proposals is that lack of compassion amongst NHS staff is partly responsible for poor care and, in some cases, for cultivating a ‘culture of cruelty’.

So is compassion a necessary component of healthcare? Is an adequate standard of care necessarily unattainable when compassion amongst staff is absent? In considering these questions I do not intend to embark on a detailed critique of Dr Smajdor’s paper. Instead, I will begin from her main ideas and use them to motivate a general discussion of the role of compassion in healthcare. According to the report, Dr Smajdor argues for two main claims: 1) that compassion is not a necessary component of healthcare – that acceptable standards can be attained without it – and 2) that compassion can actually be dangerous for healthcare workers, possibly resulting in impaired standards of care. Read More »Is compassion a necessary component of healthcare?

A death on the border

Several days ago, a middle-aged man named Nam Young-ho was shot to death while crossing the Imjin River, which divides North and South Korea.  Such stories are sadly not uncommon, but the particular facts make this case quite unusual: Nam was a South Korean trying to enter the North, and was shot by South Korean soldiers.  This killing received relatively little attention in the news (perhaps in part because it occurred on the same day as a larger tragedy in the US), but it’s hard to view it as anything other than a terrible injustice.  I’ve been racking my brains, and I can’t figure out a plausible justification.  From news reports, it sounds like the South Korean military is standing by the soldiers’ actions and no prosecution is forthcoming.  This makes the killing all the more disturbing – it was not the result of poor training or accident, but a deliberate and pernicious policy to use lethal force on anyone attempting to cross into the North.Read More »A death on the border

Twitter, paywalls, and access to scholarship — are license agreements too restrictive?

By Brian D. Earp

Follow Brian on Twitter by clicking here.

Twitter, paywalls, and access to scholarship — are license agreements too restrictive? 

I think I may have done something unethical today. But I’m not quite sure, dear reader, so I’m enlisting your energy to help me think things through. Here’s the short story:

Someone posted a link to an interesting-looking article by Caroline Williams at New Scientist — on the “myth” that we should live and eat like cavemen in order to match our lifestyle to that of our evolutionary ancestors, and thereby maximize health. Now, I assume that when you click on the link I just gave you (unless you’re a New Scientist subscriber), you get a short little blurb from the beginning of the article and then–of course–it dissolves into an ellipsis as soon as things start to get interesting:

Our bodies didn’t evolve for lying on a sofa watching TV and eating chips and ice cream. They evolved for running around hunting game and gathering fruit and vegetables. So, the myth goes, we’d all be a lot healthier if we lived and ate more like our ancestors. This “evolutionary discordance hypothesis” was first put forward in 1985 by medic S. Boyd Eaton and anthropologist Melvin Konner …

Holy crap! The “evolutionary discordance hypothesis” is a myth? I hope not, because I’ve been using some similar ideas in a lot of my arguments about neuroenhancement recently. So I thought I should really plunge forward and read the rest of the article. Unfortunately, I don’t have a subscription to New Scientist, and when I logged into my Oxford VPN-thingy, I discovered that Oxford doesn’t have access either. Weird. What was I to do?

Since I typically have at least one eye glued to my Twitter account, it occurred to me that I could send a quick tweet around to check if anyone had the PDF and would be willing to send it to me in an email. The majority of my “followers” are fellow academics, and I’ve seen this strategy play out before — usually when someone’s institutional log-in isn’t working, or when a key article is behind a pay-wall at one of those big “bundling” publishers that everyone seems to hold in such low regard. Another tack would be to dash off an email to a couple of colleagues of mine, and I could “CC” the five or six others who seem likeliest to be New Scientist subscribers. In any case, I went for the tweet.

Sure enough, an hour or so later, a chemist friend of mine sent me a message to “check my email” and there was the PDF of the “caveman” article, just waiting to be devoured. I read it. It turns out that the “evolutionary discordance hypothesis” is basically safe and sound, although it may need some tweaking and updates. Phew. On to other things.

But then something interesting happened! Whoever it is that manages the New Scientist Twitter account suddenly shows up in my Twitter feed with a couple of carefully-worded replies to my earlier PDF-seeking hail-mary:

Read More »Twitter, paywalls, and access to scholarship — are license agreements too restrictive?

Political Change and the Olympic Games

by Luke Davies

The upcoming Winter Olympics in Sochi has been in the news a lot recently. The controversy, as you will already know, is a result the introduction of another law discriminating against the LGBT community in Russia—Article 6.21 of the Code of the Russian Federation, the so-called “gay propaganda” law. [1] This law will allow the government to fine anyone who spreads propaganda about “non-traditional sexual relations” to minors. (The meaning of “propaganda” and “nontraditional sexual relations” is left quite ambiguous.) Given the insistence of Sports Minister Vitaly Mutko that competing athletes and visiting spectators must obey the laws of the country, there has been some disagreement about what to do. There are different levels of concern being given priority in the media, some more pertinent from an ethical perspective than others.

Here’s a spoiler: The trivial concerns have to do with the politics of the Olympic Games themselves; the real concern is with the harm to people’s lives in Russia.Read More »Political Change and the Olympic Games

Let’s Talk About Death: Millennials and Advance Directives

Sarah Riad, College of Nursing and Health Sciences, University of Massachusetts Boston

Melissa Hickey, School of Nursing, Avila University 

Kyle Edwards, Uehiro Centre for Practical Ethics, University of Oxford

As advances in medical technology have greatly increased our ability to extend life, the conversation on end-of-life care ethics has become exceedingly complex. With greater options both to end life early and extend it artificially, advance directives have arisen in an effort to preserve patient autonomy in situations in which he or she becomes incapable of making a medical decision. However, most people—especially young adults—do not think to plan for such moments of incapacity and the potentiality of an untimely death. With a youthful sense of invincibility comes a lack of foresight that prevents us from confronting these issues. The reality is that unexpected events happen. When they do, it is often very difficult to imagine what a person would have wanted and make medical decisions accordingly on his or her behalf. In this post, we suggest both a transition from action-based to value-based advance directives and an interactive website that would make the contemplation of these issues and the construction of a value-based advance directive appealing to and accessible for Millennials, the 20-somethings of today. Read More »Let’s Talk About Death: Millennials and Advance Directives

Can Facts Be Racist?

Here is the sequence of events.  1. Richard Dawkins tweets that all the world’s Muslims have fewer Nobel Prizes than Trinity College Cambridge.  2. Cue a twitter onslaught – accusing Professor Dawkins of racism.  3. Richard Dawkins writes that a fact can’t be racist.Read More »Can Facts Be Racist?

Not all philosophers are equal

Not all ethical issues are equally important. Many ethicists spend their professional lives performing in sideshows.

However entertaining the sideshow, sideshow performers do not deserve the same recognition or remuneration as those performing on our philosophical Broadways.

What really matters now is not the nuance of our approach to mitochondrial manipulation for glycogen storage diseases, or yet another set of footnotes to footnotes to footnotes in the debate about the naturalistic fallacy. It is: (a) Whether or not we should be allowed to destroy our planet (and if not, how to stop it happening); and (b) Whether or not it is fine to allow 20,000 children in the developing world to die daily of hunger and entirely avoidable disease  (and if not, how to stop it happening). My concern in this post is mainly with (a). A habitable planet is a prerequisite for all the rest of our ethical cogitation. If we can’t live here at all, it’s pointless trying to draft the small print of living.Read More »Not all philosophers are equal

I’m Too Unsexy For My Shirt

Follow David on Twitter @David Edmonds100

Thinking only of your career prospects now, is it better to be sexy or unsexy?  This person was said to be too sexy and lost her job.   But at Abercrombie & Fitch the allegation is that you can’t get a job unless you’re good looking.  The A&F image of glamour has helped the company make enormous profits:  I once bought a T-Shirt for a godless child at an A&F store, to pay for which I had to sell my wardrobe. Read More »I’m Too Unsexy For My Shirt