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Is Life-Sustaining Treatment Being Lawfully Withdrawn From Patients In Prolonged Disorders Of Consciousness? Nobody Seems To Know

Is Life-Sustaining Treatment Being Lawfully Withdrawn From Patients In Prolonged Disorders Of Consciousness? Nobody Seems To Know

By Charles Foster

From the time of the decision of the House of Lords in Airedale NHS Trust v Bland (1993) until the decision of the Supreme Court in An NHS Trust v Y (2018) (which I will refer to here as ‘Y”) it had been understood that the withdrawal of life-sustaining treatment (typically clinically assisted nutrition and hydration – ‘CANH’) from patients in a vegetative state should be endorsed by the court. Over the years, this practice had been extended to cover such withdrawals in Minimally Conscious States too.

In Y, the Supreme Court held that there was no requirement for court review or endorsement. Why?Read More »Is Life-Sustaining Treatment Being Lawfully Withdrawn From Patients In Prolonged Disorders Of Consciousness? Nobody Seems To Know

Stowaway, Self-Defense, and the Sheriff Case

Written by Hazem Zohny.

You and your two fellow astronauts are on your way to Mars when you uncover a stowaway in your spaceship. His mere presence means there won’t be enough oxygen for anyone to survive the journey. You toss him out the spaceship, of course. But what if that stowaway is there by accident – through absolutely no fault of his own? Would you still throw him out, though perhaps feel extra bad about it?

That, without giving too much of the plot away, is the moral dilemma on which the recent Netflix film ‘Stowaway’ is built. It’s an enjoyable watch, especially if you are into the kind of old school science fiction that involves those tense but fairly long scenes of someone just walking on the outside of a spaceship in a spacesuit. Crucially, as films go, it deals with its moral dilemma fairly thoughtfully.

Read More »Stowaway, Self-Defense, and the Sheriff Case

Ambient Intelligence

Written by Stephen Rainey

An excitingly futuristic world of seamless interaction with computers! A cybernetic environment that delivers what I want, when I want it! Or: A world of built on vampiric databases, fed on myopic accounts of movements and preferences, loosely related to persons. Each is a possibility given ubiquitous ambient intelligence.Read More »Ambient Intelligence

Cross Post: Vaccine passports: why they are good for society

Written by Barbara Jacquelyn Sahakian, University of Cambridge; Christelle Langley, University of Cambridge,

and Julian Savulescu, University of Oxford

person holding a mobile phone displaying a Covid-19 vaccinated message
Prostock-studio/Shutterstock
 

As more and more people get vaccinated, some governments are relying on “vaccine passports” as a way of reopening society. These passports are essentially certificates that show the holder has been immunised against COVID-19, which restaurants, pubs, bars, sports venues and others can use to grant them entry.

Israel currently operates a “green pass” system, which allows vaccinated people access to theatres, concert halls, indoor restaurants and bars. The UK government, had to roll back plans to trial vaccine passports after some of the venues involved experienced significant backlash against the proposals.

This is perhaps not surprising – vaccine passport schemes are controversial, with some arguing that they will reinforce inequalities. But there is an ethical case for using some form of certification of COVID status, as long as it is designed properly and as long as everyone has access to vaccines.

Let’s look at the ethics of vaccination and certification.Read More »Cross Post: Vaccine passports: why they are good for society

A Juror’s Guide to Going Rogue

Written by Doug McConnell

A jury recently acquitted several activists charged with causing £25,000 worth of damage to Shell’s HQ in London despite the defendants admitting that they caused the damage and the judge informing the jury that the defendants had no legal defence. In other words, if the law were applied correctly, the jury had no choice but to find them guilty. When juries deviate from the law and “go rogue” like this, it is known as “nullification”. But when, if ever, should juries behave in this way?Read More »A Juror’s Guide to Going Rogue

Crosspost: Immunity Passports: A Debate Between Jay Bhattacharya and Alberto Giubilini

By Alberto Giubilini (University of Oxford) and

Jay Bhattacharya (Stanford University)

 

crosspost with Lockdown Sceptics

 

[Prof Jay Bhattacharya (Professor of Medicine, Stanford University) and I collaborate on Collateral Global, a new project that aims to evaluate the impact of lockdowns and other pandemic restrictions. We have the same view on lockdown and pandemic restrictions, but we do have our own internal, healthy disagreement. Most people who are skeptical and critical of lockdowns (as both Prof Bhattacharya and I are) are also against immunity passports (as he is), often for the same reasons. I disagree on this point and I think some form of immunity passport should be introduced. In this exchange published on Lockdown Sceptics, we try to explore exactly where our disagreement lies and try to identify possible areas of agreement on the matter. AG]

 

The Case For Immunity Passports

by Alberto Giubilini

Having read the excellent piece in the Wall St Journal by Prof. Bhattacharya and Prof. Kulldorff, I have the impression that they take many of the reasons against lockdowns to also be reasons against immunity passports. Among these, individual liberty is prominent.

I disagree.

Read More »Crosspost: Immunity Passports: A Debate Between Jay Bhattacharya and Alberto Giubilini

Lockdown Erodes Agency

By Charles Foster

A couple of lockdown conversations:

  1. The other day I met a friend in the street. We hadn’t seen one another for over a year. We mimed the hugs that we would have given in a saner age, and started to talk. ‘There’s nothing to tell you’, she said. ‘Nothing’s happened since we last saw you. And that’s just as well, because, as you’ll find, I’ve forgotten how to talk, how to relate, and how to read ordinary cues. We’ve not been out. We’ve not changed anything. I wonder if we’ve been changed?’
  1. Another friend. ‘Zoom’s great, isn’t it? You switch off your camera and your microphone, and the meeting just goes on perfectly happily without you. Everyone thinks you’re there. Your name’s up on their screen. But you are just getting on with your own business.’

And a lockdown fact: Lockdown has been great for book sales. 2020 saw an estimated rise of 5.2% in volume sales of print books in the UK compared with 2019 sales. This was the biggest annual rise since 2007: Read More »Lockdown Erodes Agency

Vaccine Nationalism: Striking the balance

Written by Owen Schaefer and Julian Savulescu

This is an updated cross-post of an article published in MediCine

On 2 February 2021, the Director-General of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, issues a broadside against COVID-19 vaccine nationalism, calling it “morally indefensible” and “tantamount to medical malpractice at a global scale.” Rich countries representing 16% of the global population have snapped up 60% of the global supply of COVID-19 vaccines. [1] Meanwhile, India, which has only vaccinated 10% of its population, is facing a catastrophic COVID-19 surge.[2] And the COVAX facility – an international effort to get COVID-19 vaccines equitably distributed around the world – currently only projects capacity to offer vaccines amounting to about 3% of participating countries’ populations by mid-year.[3]

COVID-19 vaccine nationalism is not the exception to normal practice. In almost all matters, countries spend the vast majority of budgets on local needs, and only a small fraction of that foreign aid, even when the latter represents much greater need. But the fact that this is normal or expected does not amount to a moral defense.

Here, we explore a question of practical ethics: what is the appropriate extent to which a country can prioritize its own people over those in other countries in the securing of vaccines for COVID-19?

Read More »Vaccine Nationalism: Striking the balance

Cross Post: End-of-Life Care: People Should Have the Option of General Anaesthesia as They Die

Written by Dominic Wilkinson and Julian Savulescu

KieferPix/Shutterstock
Dying patients who are in pain are usually given an analgesic, such as morphine, to ease their final hours and days. And if an analgesic isn’t enough, they can be given a sedative – something to make them more relaxed and less distressed at the end of life. We have recently written about a third approach: using a general anaesthetic to ensure that the dying patient is completely unconscious. This has been described previously, but largely overlooked.

There are two situations when a general anaesthetic might be used in dying patients. The first is when other drugs have not worked and the patient is still distressed or in pain. The second is when a patient has only a short time to live and expresses a clear wish to be unconscious. Some dying patients just want to sleep.Read More »Cross Post: End-of-Life Care: People Should Have the Option of General Anaesthesia as They Die

Making Universities (Even) More Unfair

Written by Neil Levy

Unsurprisingly, I’m a big believer in universities and higher education. I think research, of all kinds, is important for a whole range of reasons and that being educated is very often conducive to a good life. But we shouldn’t pretend that universities are institutions wholeheartedly devoted to genuine education and to research. They’re also businesses, and their business motivations often play a more important role in their decisions than any academic considerations. Beyond that, they play a role in society that’s independent of their role as educators, and that role explains some of their grubbier behavior.Read More »Making Universities (Even) More Unfair