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Maximising Ventilators: Some Ethical Complications

Maximising Ventilators: Some Ethical Complications

Written by Joshua Parker and Ben Davies

One of the impending tragedies of the COVID-19 pandemic is a grave mismatch between the supply of ventilators and the numbers needing them. This situation, as seen in Italy, is predicted to be mirrored here in the UK. Coronavirus can cause acute respiratory distress syndrome for which the management is mechanical ventilation on the ICU. This represents these patients’ only chance at survival. Part of the response to the incoming tsunami of patients requiring ventilation is to produce more ventilators. This is a reasonable way to try to lessen the mismatch between supply and demand. However, producing more ventilators cannot be the solution in isolation. As a complex piece of medical equipment, ventilators need trained staff to operate them and provide the additional care ventilated patients require. There has been a significant push to attempt to ensure enough ventilator trained staff as possible. Both staff and ventilator shortages present significant issues; yet it is shortages of ventilators that account for the bulk of ethical discussion so far. It is therefore worth exploring some of the ethical problems that might arise should there be plenty of ventilators, but not enough staff.

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Guest Post: Pandemic Ethics-Earthquakes, Infections, and Consent

David Killoren
Dianoia Institute of Philosophy
Australian Catholic University, Melbourne

People often seem to be stubbornly resistant to change. Consider humanity’s collective failure to respond adequately to the climate emergency. Consider the lifelong smoker who won’t quit even after an emphysema diagnosis. Consider the meat-eater who watches Dominion, resolves to go vegan, and then falls off the wagon the next day. Even when we feel that we have excellent reasons to change our lives, we often drag our feet.

Yet when the coronavirus appeared in late 2019, our antipathy to change suddenly seemed to evaporate. Medical experts and politicians called for sweeping changes and huge numbers of people simply heeded the call. To be sure, there are dissenters. America’s deeply strange president is among them. But the degree of compliance with new restrictions and requirements that we’ve seen in recent weeks is extraordinary. Work, education, dating, dining, art, sport, even casual conversations with strangers—all of these facets of life have been dramatically altered, canceled, or paused for an indefinite period that may last two years or more, and there’s been little complaining from the people. If nothing else, the coronavirus crisis demonstrates this: When conditions are ripe, we are willing to upend our lives.

I’m not here to criticize or to defend the way we’re responding to the virus. But I want to raise some questions that I think aren’t receiving due attention.Read More »Guest Post: Pandemic Ethics-Earthquakes, Infections, and Consent

The Perfect Protocol? Ethics Guidelines in a Pandemic

Written by Joshua Parker and Ben Davies

One question occupying politicians and healthcare workers in the middle of this global pandemic is whether there will be enough ventilators when COVID-19 reaches its peak. As cases in the UK continue to increase, so too will demand for ventilators; Italy has reported overwhelming demand for the equipment and the need to ration access, and the UK will likely face similar dilemmas. Indeed, one UK consultant has predicted a scenario of having 8 patients for every one ventilator. Aside from anything else, this would be truly awful for the healthcare professionals having to make such decisions and live with the consequences.

Ethics is an inescapable part of medical practice, and healthcare professionals face numerous ethical decisions throughout their careers. But ethics is challenging, often involving great uncertainty and ambiguity. Medics often lack the time to sort through the morass that is ethics.  Many therefore prefer heuristics, toolboxes and a handful of principles to simplify, speed up and streamline their ethics.

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Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Written by Dominic Wilkinson, University of Oxford

This article originally appeared in The Conversation

In a world where the adjective “unprecedented” has become commonplace, the news of British Prime Minister Boris Johnson being admitted to the intensive care unit of St Thomas’ Hospital with COVID-19 seemed to take it to a new level.

There is little information in the public domain about Johnson’s medical condition, but this is clearly a very serious step. He will only have been transferred to intensive care because it is perceived that his condition is potentially life threatening and there is a possibility that he would need urgent medical attention, including the possible use of mechanical ventilation.

What would happen if that became necessary? Would Johnson’s treatment be any different from anyone else with the same condition? Would he receive special treatment because of his political position, because of his importance for the country? Would he be prioritised for a ventilator?Read More »Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Why You Should Not (Be Allowed To) Have That Picnic in the Park, Even if it Does Not Make a Difference

Written by Alberto Giubilini

 

(a slightly longer version of this blogpost will appear in the journal Think. Link will be provided as soon as available)

It’s a sunny Sunday afternoon, early spring. The kind of afternoon that seems to be inviting you out for a stroll by the river. Maybe have a picnic on the green grass, in that spot over there, away from everyone. Why not?

The simple answer is: because there is a pandemic and the Government is enforcing a lockdown. You should stay home. End of the story.

And there isn’t a complex answer. The simple answer really is the end of the story.

But why? You probably understand the reasons for the lockdown. But that is a matter of policy, a general rule for the population. What difference does it make if I just go over there, where there is no one, keeping at distance from everyone? I am not going to harm anyone.

You are (probably) right: it (likely) does not make a difference, and you are (likely) not harming anyone. However, that is not the only relevant question to ask when we ask what we morally ought to do, or what a Government may permissibly require of us.

Let us consider the ethically relevant aspects of this situation.Read More »Why You Should Not (Be Allowed To) Have That Picnic in the Park, Even if it Does Not Make a Difference

What is Your Gender? A Friendly Guide to the Public Debate

What is your gender? A friendly guide to the public debate

Brian D. Earp

 

Note: This is a lightly edited transcript of an informal lecture, based on coursework submitted as part of my Ph.D. It was recorded on Whidbey Island, Washington, and published online on January 15th, 2020. A link to the video is here: https://youtu.be/LZERzw9BGrs. 

 

Video description:  I’m a philosopher and cognitive scientist who studies gender, sex, identity, sexuality and related topics and I am offering this video as a friendly guide to the (often very heated) public debate that is going on around these issues. This is my best attempt, not to score political points for any particular side, but to give an introductory map of the territory so you can think for yourself, investigate further, and reach your own conclusions about such controversial questions as “What does mean to be a man or a woman?” This video is not meant to be authoritative; it is not the final word; experts on these topics will find much to quibble with (and perhaps some things to disagree with outright). But for those who would like to take some first steps in getting a sense of the landscape without feeling intimidated, I hope this will be of some use. Read More »What is Your Gender? A Friendly Guide to the Public Debate

Oxford Uehiro Prize in Practical Ethics: An Account of Attitudinal Duties Towards Injustice

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This essay received an honourable mention in the Graduate Category

Written by University of Oxford Student, Brian Wong

Injustices are ubiquitous around us. From authoritarian regimes’ crackdown on human rights, to exploitative trafficking of illegal migrants, to human-induced destruction of rainforests upon which indigenous groups depend – injustices are negative states of affairs violating moral commitments and duties caused by some level of human agency. Our ability to resist injustices are inevitably constrained, but I argue that even the least able amongst agents still possess attitudinal duties – duties to cultivate and possess particular attitudes towards injustice. Attitudes are mental states; here I focus specifically on explicit attitudes – attitudes that are accessible by introspection and non-automatically/reflexively generated.[1] I open with a pair of cases providing the intuitive preliminaries, prior to offering three interrelated arguments for attitudinal duties, namely from i) functional similarity, ii) relational justice, and iii) aptness. After outlining the plausible contents of such duties, I conclude by examining two objections – i) self-defeasibility, and ii) enforceability.Read More »Oxford Uehiro Prize in Practical Ethics: An Account of Attitudinal Duties Towards Injustice

The Coronavirus: Signs of Hope?

Written by Neil Levy

These are scary times. The death toll from Covid-19 raises hour by hour and in most countries the rate of new infections continues to grow. While most of us know that if we contract the virus the disease will likely be mild for us, we have friends and family who are at much higher risk. As society shuts down and our lives become more and more constrained, our anxiety rises along with it.Read More »The Coronavirus: Signs of Hope?