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Ethics

Umbilical cord blood donation: opt out or work on Sundays?

Umbilical
cord blood (UCB) contains haematopoietic stem cells, which can be used for the
treatment of several lethal disorders, including leukaemia
and several types of anaemia. Other sources of haematopoietic stem cells are bone marrow and ordinary peripheral
blood. Unlike bone marrow donation, which requires general anaesthesia, UCB
donation does not cause any inconvenience or significant risks for the donor. Peripheral
blood contains very few stem cells. Another major advantage of using UCB stem
cells is that less genetic similarity is required between donor and recipient.
This increases the chance of finding a ‘match’ and thus of the transplantation
being successful.

Read More »Umbilical cord blood donation: opt out or work on Sundays?

Oxford Debates Cont’d – Opposer’s Opening Statement

Part of the debate "The NHS should not treat self-inflicted illness"

Opposer: Charles Foster (Barrister & teacher of medical law and ethics at
Oxford. He is attached to the Ethox Centre and is an Associate Fellow
of Green Templeton College)
Opening Statement

'The NHS has shown the world the way to healthcare, not as a privilege to be paid for, but as a fundamental human right', proclaimed the Department of Health in 2008. 'The values of the NHS – universal, tax-funded and free at the point of need – remain as fundamental today to the NHS as they were when it was launched in 1948.'

These values are important. We abandon or dilute them at our peril.

Mark Sheehan suggests that we have to grow up: to shoulder responsibility for our own actions and omissions. Why, he asks, should society pick up the bill for my stupidity?

There are many answers. Some of them will be ventilated over the next few weeks. But here are a few:

Read More »Oxford Debates Cont’d – Opposer’s Opening Statement

Oxford Debates Cont’d – Proposer’s Opening Statement

Part of the debate "The NHS should not treat self-inflicted illness"

Proposer: Dr Mark Sheehan (Oxford BRC Ethics Fellow at the Ethox Centre and
James Martin Research Fellow in the Program on the Ethics of the New
Biosciences)
Opening Statement

We generally think that people are entitled to live their lives in the way that they see fit, in a way that best coheres with what they take to be meaningful and valuable. This is perhaps the central tenet of western liberal society. Liberal society is centred on permitting and perhaps even encouraging, different conceptions of 'the good' and experiments in living. Alongside this freedom, however, comes a responsibility for the decisions that one makes. Because society remains a collective effort the freedom to choose to live in a certain way brings with it responsibilities — here, responsibilities for the consequences of our choices.

Read More »Oxford Debates Cont’d – Proposer’s Opening Statement

Oxford Debates – The NHS should not treat self-inflicted illness (Moderator’s Introduction)

Moderator: Dr Paula Boddington

Should the NHS treat self-inflicted illness? This question raises a plethora of different issues, about science, society, social policy, as well as philosophical questions about human nature and individual freedom.

The best use of health care resources will always be debated. How much money should be spent on health? How efficiently can it be spent? How should it be divided within the healthcare system? These can never simply be questions of economics but also raise vitally important questions about values. This debate about what treatments the NHS should offer is taking place in an economic climate where there is a call to curtail public spending. Would refusing to treat self-inflicted illnesses be a fair place to start to save money?

But money is only one aspect of this debate.

Read More »Oxford Debates – The NHS should not treat self-inflicted illness (Moderator’s Introduction)

More on drugs…

In a recent
entry on this weblog, Roger Crisp discusses the recent and controversial
“Release” advertising campaign on drugs (and its slogan “Nice People Take
Drugs”),
and rightly highlights the need for serious and widespread debate on drug
legislation. My home country, Switzerland, precisely had a debate on this issue
a few months ago, when we were called to vote on a popular initiative
purporting to decriminalize the use, purchase, consumption and possession of
cannabis (not of other drugs) – which would have meant placing the consumption
of this drug on a similar plane with that of tobacco or alcohol. This measure
was supposed to be accompanied by others, notably destined to protect young
people. On the 30th of November 2008, however, the Swiss people
rejected the initiative by quite a large majority.

Read More »More on drugs…

Not better than the alternative: an informal experimentation tragedy

Police are reinvestigating the 2007 death of Yolanda Cox, a woman who collapsed in anaphylactic shock after being injected with an experimental drug by her sister, a GP. The drug was developed by their mother, originally intended to treat diabetes but apparently believed to extend lifespan. After testing on diabetic patients and apparently themselves without any apparent side effects the mother and sister gave it to the woman three times, with tragic consequences the third time. Was it a failure of medical ethics, research ethics – or plain psychological bias?

Read More »Not better than the alternative: an informal experimentation tragedy

Precrime in Camden: using DNA profiles for crime prevention

The UK police has an estimated 5.3 million DNA profiles in its databases, of which about 850,000 are of people who were never convicted of any crime (including 24,000 samples of youngsters who have never been convicted, cautioned or charged with any offence). Although the European Court ruled that a policy of retaining profiles of innocent people is illegal, the Home Office seems keen to retain them anyway, at least for serious crimes. Now it is claimed by a police officer that police in Camden deliberately target young people who have not been arrested yet in order to obtain DNA samples. According to him it is part of a long-term crime prevention strategy to discourage future crime. But does pre-emptive acquisition of DNA profiles make sense as crime prevention?

Read More »Precrime in Camden: using DNA profiles for crime prevention

Disagreement about value or about the facts?

Both within and outside ethics, people often worry about disagreements that are purely about value. Suppose that you and I completely agree about all the empirical facts about some case, yet you think that it’s absolutely forbidden to do something and I think there is absolutely nothing wrong with it. It can seem hard to see how we could ever resolve our disagreement. If after I have carefully considered the case, and still see nothing wrong, what could you possibly say that would make me see things in a different light?

 

Things are often a bit more complicated than this. For example, even if we agree on all the empirical facts, our moral disagreement might be due to disagreement about some metaphysical matter—say, about whether a foetus is a person. Metaphysical disagreements are also extremely hard to resolve. Then there is the old point that the way we frame factual matters, or the way we interpret some empirical evidence, might itself be shaped by our values.

 

Anyway, this is a common worry. But when it comes to many heated disagreements about scientific or technological advances, this worry seems to me to get the situation exactly backwards.


Read More »Disagreement about value or about the facts?

Neonatal euthanasia without parental consent

A
provocative article soon to be published in the Journal of Bioethical Inquiry
argues that parental consent should not be a prerequisite for neonatal
euthanasia. At present, the only country to permit neonatal euthanasia is the
The Netherlands. Medical personnel there are not prosecuted for actively
euthanizing infants in great suffering, provided that they satisfy the
requirements of the Groningen Protocol, which include obtaining consent from
the infant's parents. In the forthcoming article, Jacob Appel argues that the
requirement for parental consent should be dropped. 

Let's first consider the question of whether it
could be ethically permissible for medical staff to end the life of a child
without the consent of the parents.

Read More »Neonatal euthanasia without parental consent