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Epigenetics and Blaming Pregnant Women: Hasty Conclusions, Control, and Simplified Burden of Responsibility

In a recent (13.8.2014) article in Nature , Sarah S. Richardson and colleagues maintain that careless discussion of epigenetic research on how early life affects health across generations could harm women.

Authors discuss the extensive history of placing the burden of responsibility of a child’s health on the lifestyle of the pregnant mother – and the means for controlling women’s behavior. Authors describe how, for example, evidence of any fetal harm easily lead to zero-tolerance regulatory frameworks and severe informal and formal consequences (e.g. social condemnation for an occasional sip of alcohol despite the ambiguous evidence that very moderate and occasional drinking should harm the fetus), and how the “lack of emotional warmth” of the “refrigerator mothers ” was considered to be the reason to child autism as late as the 1970s. Going even more backwards in the history, various defects were attributed, for example, to the company the mother kept during pregnancy.

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Forgotten Baby Syndrome

Defense lawyers are increasingly calling upon the services of neuroscientists to give evidence excusing, or mitigating the guilt of, their clients. A recent case illustrates some of the risks of doing so, as well (perhaps) of the potential benefits to lawyers and their clients.
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A Wrong Turn, A Hundred Years Ago

Just over a hundred years ago, a car took a wrong turn. It happened to stop just in front of Gavrilo Princip, a would-be assassin. Princip took out his gun and shot Archduke Franz Ferdinand and his wife from point blank range. This triggered a chain of events that would soon lead to the Great War. Millions died in the trenches, and the map of Europe was redrawn. In those few breathless minutes, history had taken a different, more sinister turn.Read More »A Wrong Turn, A Hundred Years Ago

Thank You Luis Suarez!

The world cup is winding down, and a lot of astonishing, surprising things happened throughout the tournament. But nothing offered more to people interested in morality than when Luis Suarez, Uruguayan football star and Premier League player extraordinaire, bit Italian football player Giorgio Chiellini during the World Cup match between Italy and Uruguay. Which is the third time Suarez bit someone on the football pitch. Of course, in the ensuing days, the Twittersphere exploded, the global media jumped on it, and every imaginable joke and pun made the rounds on the internet. And every single person with the slightest claim to expertise was asked one question: How should Suarez be penalized? Their answers provided one textbook example after another of the ways that research in psychology and neuroscience suggests that people make moral judgments, and especially how emotions trump rational arguments.

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Tony Coady – Trusting Emotion, Trusting Reason: A False Dichotomy

In his recent seminar (a recording of which can be found here), Australian philosopher Tony Coady seeks to criticize the entrenched dichotomy of ‘emotion’ and ‘reason’. He argues that this rigid division is outdated and unsophisticated, and that its persistence is limiting the quality of both philosophical debate and wider scientific investigation.

Coady opens his talk by noting the derogatory accusations of ‘appealing to emotion’ that have been levied at opponents in the enhancement debate. He contends that this simply follows in a long philosophical tradition of separating and placing reason above emotion, from Plato’s allegory of the Charioteer (reason) harnessing his Horses (the passions), to the Christian concept of conflict between the higher desires of the Spirit and the desires of the Flesh that must be tamed. Coady claims that this view of reason, which he terms rationalism, has been the dominant paradigm in Western philosophical thought.Read More »Tony Coady – Trusting Emotion, Trusting Reason: A False Dichotomy

Horizon 2020 and The Role of Lay People’s Perspectives in Bioethical Reasoning

By Kimberly Schelle & Nadira Faulmüller

Horizon 2020, the European Union’s 2014-2020 largest research programme ever, includes the call to pursue ‘Responsible Research and Innovation’ (RRI). RRI stands for a research and innovation process in which all societal actors (e.g. citizens, policy makers, business and researchers) are working together in the process to align the outcomes with the values, needs, and expectations of the European Society. In a recently published paper on the importance of including the public and patients’ voices in bioethical reasoning, the authors describe, although in other words, the value of the RRI approach in bioethical issues:

“A bioethical position that fails to do this [exchange with the public opinion], and which thus avoids the confrontation with different public arguments, including ones perhaps based in different cultural histories, relations and ontological grounds […], not only runs the risk of missing important aspects, ideas and arguments. It also arouses strong suspicion of being indeed one-sided, biased or ideological—thus illegitimate.”

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Taking Rape Allegations Seriously: How Should We Treat the Accused?

Last week, the Crown Prosecution Service announced that it would not pursue further action against Oxford Union president Ben Sullivan, due to insufficient evidence arising from an investigation into the two accusations of rape and attempted rape made against him. In early May, Sullivan was arrested and released on bail, prompting a chaotic six-week period for the Union as the Thames Valley Police investigated the claims made against him. After Sullivan refused to resign, a number of high-profile speakers, including the UK director of Human Rights Watch, the Interpol secretary-general, and a Nobel Peace prize winner, pulled out of their speaking commitments as part of a larger boycott of Union events.

In an open letter (which has since been taken down) calling for the boycott, students Sarah Pine, who is Oxford University Student Union’s Vice President for Women, and Helena Dollimor wrote, “Remaining in his presidency continues to offer prestige and power to someone who is being investigated for rape. This undermines the severe nature of allegations of sexual offences.” In contrast, Oxford professor A.C. Grayling penned a response to the letter refusing to cancel his scheduled talk at the Union, noting, “I simply cannot, in all conscience, allow myself to act only on the basis of allegations and suspicions, or of conviction by the kangaroo court of opinion, or trial by press…” In this post, I look at the spectrum of responses in the wake of Sullivan’s arrest, of which these two examples represent the poles. More broadly, I consider how we ought to respond – both as individuals and a society – when those in positions of power are accused of rape or other sexual offences.Read More »Taking Rape Allegations Seriously: How Should We Treat the Accused?

Do Not Attempt Resuscitation orders: should you discuss with the patient?

The Court of Appeal has stated that a statement in a capacitous patient’s medical notes that resuscitation should not be attempted (a ‘Do Not Attempt Resuscitation’ Order – DNAR), should usually only be inserted after consultation with the patient: see R (Tracey) v Cambridge University Hospitals NHS Foundation Trust and others [2014] EWCA Civ 822 (17 June 2014).

The facts have been widely aired in the media: see, for example, here.

Mrs. Tracey had terminal lung cancer. Her clinicians indicated in the notes that no attempts at resuscitation should be made. Her family found out about this, and were outraged, saying that the DNAR order should not have been made without consultation with Mrs. Tracey. Their quarrel was not with the medical appropriateness of the determination that resuscitation would not be in Mrs. Tracey’s best interests, but with the procedure  – the failure to consult.  This, they said, violated Mrs. Tracey’s rights under Article 8 of the ECHR.

The Resuscitation Council, intervening, said that a requirement to consult with the patient would interfere with clinicians’ ability to deliver individual and compassionate care. A patient might, for instance, be very distressed by a discussion about a possible DNAR order.

The outcome can be briefly stated:

  • Mrs. Tracey’s Article 8 rights were engaged by recording the DNAR in the notes. This followed from, inter alia, Pretty v UK (2002) 35 EHRR 1.
  • Her Article 8(1) rights were violated by failing to involve her in the process
  • Article 8(2) required the policy adopted by a Trust in relation to DNAR orders to be sufficiently clear and accessible: see Purdy v DPP [2009] UKHL 45; [2010] 1 AC 345.
  • The absence of a mandatory national DNAR policy was not a violation of Article 8. Local policies would, if properly formulated, satisfy the demands of Article 8(2)
  • The concerns of the Resuscitation Council were real, but could be met by an important caveat: there should be consultation with the patient unless the clinician ‘thinks that the patient will be distressed by being consulted and that distress might cause the patient harm.’Read More »Do Not Attempt Resuscitation orders: should you discuss with the patient?