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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:

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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.

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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…

Coercion, compulsion and immunisation

The former head of the British Medical Association, Sir Sandy Macara, has called for the Measles Mumps and Rubella immunisation (MMR) to be a compulsory requirement prior to school entry. The UK has seen a surge in cases of measles over the last couple of years because of a fall in the immunisation rate. Many parents have chosen not to immunise their children as a result of the supposed (and now completely discredited) link between MMR and autism. Immunisation rates have fallen to 70% in some parts of the country. Is compulsory immunisation the answer, and if so, what degree of compulsion should we adopt?

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Shining monkey, sadistic conclusion?

Japanese researchers have genetically modified marmoset monkeys, and demonstrated that the modification can be inherited by their offspring. The modification was the standard green fluorescent protein making the monkey's glow green under UV light, a marker to demonstrate that the modification worked (BBC shows a picture of their feet glowing "an eerie green", while the picture in Nature's News and Views shows the cute monkeys in normal light and the original paper shows both). The long-term aim is to be able to produce transgenic primates that could act as disease models for humans – many conditions do not map well onto mice and rats. But is it acceptable to introduce heritable illness conditions into animals?

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The flu paradox: is the WHO focusing too little on flu?

The WHO is in the news these days thanks to the H1N1 epidemic (alias the swine flu, or the Colbert flu), and it is doing an admirable job coordinating various national agencies in fighting a pandemic. Historically it has been at the forefront of fighting epidemic disease, whether tuberculosis or AIDS. However, since Gro Harlem Brundtland's director-generalship 1998-2003 there has been an increased emphasis on public health, in particular fighting alcohol and tobacco use but also traffic accidents. Has the WHO aimed at the right or wrong problems?

Read More »The flu paradox: is the WHO focusing too little on flu?

Pandemic ethics: The boy who cried ‘flu’!

The headlines in the last week have been dramatic. California has declared a state of emergency. The World Health Organisation has raised its pandemic alert status to level 5 – its second highest level. The UK government is about to post leaflets to every household providing information on how to reduce spread of an outbreak of H1N1 influenza (swine flu).

It is not clear whether the threatened pandemic will eventuate. But the response to a possible or to a real pandemic raises a number of ethical questions. This blog will hopefully address some of those questions in the coming days. But here is one to start with. How ought the government to respond to the threat of pandemic influenza?

Read More »Pandemic ethics: The boy who cried ‘flu’!

Just lose it?

A recent
study by researchers from the Harvard Medical School concludes that getting
angry at work, contrary to common opinion, may not be a bad thing, but may
actually be beneficial to your career and your overall happiness (as reported by BBC News and the Guardian among others). The researchers nevertheless issue a few caveats: in order for anger to be
beneficial, one ought to remain in control when expressing it and be able to
“positively channel” it. On the other hand, they advise against outright fury,
which they describe as “destructive”. There is indeed an important lesson contained in these statements; one might have wished, however, that the researchers had been a little more specific in the provisos they add to their main idea.

Read More »Just lose it?