Archive for the ‘Bioethics’ Category


In 2015, Bioethics, Gratuitous self-promotion, Publications, Reproduction on August 10, 2015 at 9:14 am

We’re delighted to flag up that Dr Natasha Hammond-Browning’s article on ‘ETHICS, EMBRYOS, AND EVIDENCE: A LOOK BACK AT WARNOCK’ has been accepted for publication in Medical Law Review, and was published online on August 1st, 2015. The article can be accessed here (subscription required).

The Report of the Committee of Inquiry into Human Fertilisation and Embryology, the Warnock Report, forms the basis of the UK legislation on embryo research, and its influence continues to be felt, even though over 30 years have passed since its publication. The Warnock Committee was the first of its kind to consider how advancements in human fertilisation and embryology should be regulated. This article examines the evidence submitted to the Warnock Committee, upon which its members ultimately reached their conclusions. With ongoing debate as to the status of the human embryo, it is important to recognise that the legislative position is one that was reached after extensive consultation and consideration of submitted evidence by the Warnock Committee. This article considers the differing ethical viewpoints that were expressed by organisations both prior and post-publication of the Warnock Report, and how the Committee used that evidence to reach their conclusions, and ultimately calls for a new Warnock-style committee.

Southampton event: “Taking Pregnancy Seriously in Metaphysics I: The Foetus and the Maternal Organism”, 21 July 2015

In 2015, Bioethics, Events, Reproduction on July 10, 2015 at 1:50 pm

Elselijn Kingma and Fiona Woollard are running a research project ‘Taking Pregnancy Seriously in Metaphysics, Ethics and Epistemology” – the third in a series of four workshops is being hosted this month.

Taking Pregnancy Seriously in Metaphysics I: The Foetus and the Maternal Organism 21 July, University of Southampton, UK.

Eric Olson (Sheffield): ‘Is the foetus a part of the mother’s body?’
John Dupre (Exeter): ‘Pregnancy as a bifurcating process’
Rohan Lewis (Souhtampton): ‘No going back: biological perspectives on the emergence of biological identity in reproduction’
Barry Smith (Buffalo): ‘Embryontology’

Although philosophers have explored metaphysical questions related to pregnancy – most obviously abortion and the metaphysical status of the fetus – little philosophical attention has been paid to pregnancy itself. This workshop explores on of the main metaphysical questions posed by pregnancy: how do the entities involved in pregnancy – the embryo or fetus and the maternal organism relate to each other? Should the fetus be regarded as part of the mother, or as ‘merely inside ‘ or ‘surrounded by’ the mother?

This workshop is one of a series of four in the project Taking Pregnancy Seriously in Metaphysics, Ethics & Epistemology, funded by the Southampton Ethics Centre and the University of Southampton ‘Adventures in Research’ Scheme, with added support from the British Society for Philosophy of Science and the Aristotelian Society. It will be followed by another workshops on Metaphysics on the 18th of September and was preceded by two workshops on Ethics and Epistemology on the 18th of June 2014 and the 13th of April 2015.

Registration is free of charge, and will include tea/coffee/refreshments. Delegates must provide/pay for their own meals; there is an option to sign up for a buffet lunch (cost: GBP 8.50) when registering via the online store.
Please register by July 12th. If you would like to attend but childcare duties render your attendance difficult, please contact the organisers (as far in advance as possible).

For more information, program, accessibility information & registration, see here.

Exporting gametes: like Blood, but different.

In 2015, Bioethics, Cases, Reproduction on June 30, 2015 at 3:49 pm

Some twenty years after the death of Stephen Blood, whose situation gave rise to the first litigation on the posthumous use of gametes (see Blood; but also L v HFEA and Secretary of State for Health and Warren v Care Fertility (Northampton) Ltd and HFEA), we have a case concerning the posthumous use of eggs.

Earlier this month, Mr Justice Ouseley, decribed on the judiciary website as the ‘judge in charge of the Administrative Court’ (working on a project about case biographies gets you interested in who people are and how cases ‘fit’ in their bios), found that the HFEA’s refusal to grant permission to export a deceased woman’s eggs out of the UK – to the US – was lawful. R (on the application of IM and MM) v HFEA is a case concerned with an undoubtedly sad set of circumstances. In 2008, during a period of remission from bowel cancer, the applicants’ daughter, AM, had three eggs removed for storage, for her future possible use. Appropriate consent was provided and there was no issue regarding the storage (for ten years, at [26]). However, no further forms were signed. There was some evidence of discussions that, if necessary, AM’s mother, IM, might act as a surrogate; but nothing was put in writing. Sadly AM died in 2011. The question then arose as to whether or not IM and MM might ‘carry out her deepest wishes, as they believe them to be’ (at [1]), i.e., to arrange for fertilisation of their daughter’s eggs, for IM to carry the embryos (assuming the success of the procedure), and bring up any resulting child(ren) with MM).

According to the judgment:
‘export was necessary “because only an overseas centre has agreed to provide treatment”. IVF Hammersmith had refused to treat the mother in the way proposed; the unit felt “that this is beyond what the patient might have consented to and we can not assume that these would have been her specific wishes, as there is no documented confirmation for them.” Before reaching that conclusion, the unit had consulted the Imperial College Ethics Committee which had been unable to reach a consensus or definitive conclusion, which was one of the reasons for that refusal.’ (at [24]).

In the absence of any written directions and/or other clear evidence that this was indeed what AM wished to happen following her death (see [42] re the HFEA’s decision, including at [37] of that extract, some possible steps that might have been taken to evidence this intent), the HFEA’s Statutory Approvals Committee, under its delegated powers (under HFEA 1990 and 2008), refused – three times – to grant permission for the eggs to be exported to New York for fertilisation with an anonymous donor’s sperm, and (assuming success) subsequent implantation in IM.

Perhaps unsurprisingly, given the clear statutory provisions and emphasis on ‘effective consent’ (see Sch. 3 of the HFEA 1990), the decision of the HFEA’s Committee was not found to be either irrational or unlawful (re the scope of powers to issue a Special Direction, akin to Blood, cited above), nor did its decision breach the Article 8 rights of IM and MM. As a statement from the claimants’ lawyers, Natalie Gamble Associates – experts in fertility law: ‘The UK’s original fertility law firm’ – makes clear, only a different decision by the Court of Appeal will enable IM and MM to export the eggs for use; otherwise at the end of the storage period (stated to be 10 years in the judgment, noted above), the eggs can no longer be lawfully stored and will be allowed to perish/destroyed (the language is interesting but has been covered elsewhere by other folk).

A different outcome is, of course, what happened in Blood at the CA, albeit under European Law principles rather than on matters of ethical policy, and in somewhat different circumstances regarding future use. Media reports of this recent case have drawn attention to the intergenerational kinship aspects, see e.g., The Guardian, ‘Mother loses bid to use dead daughter’s frozen eggs to give birth to grandchild’. And similarly, the (non-)marital status of the respective applicants was highlighted by the judiciary. Note, for example, the opening gambit of Lord Woolf MR in Blood: They had married according to the rites of the Anglican Church, using the traditional service contained in the 1662 book of common prayer with its emphasis on the importance of the procreation of children within a marriage’ (at [1]); vs. Ouseley J’s in R (on the application of IM and MM) v HFEA: ‘She was not married and had no partner during any of this time’ (at [2], – see also ‘As I have said, AM had been single then, and remained so at the time of her death’ (at [26]), and ‘She had no partner‘ (at [44])). I am not suggesting for a moment that marital status will or should have any impact on the outcome of the case, but simply wish to flag up the emphasis placed on this aspect in the judgments.

It will be interesting to see if the case does proceed to the CA. If it does not, might it become an example of a ‘shadow case’, as discussed by us in the context of ‘hidden law-making’ – a case that otherwise might have been, and thus may have been significant for the development of this area, but for various reasons (often practical/financial) simply did not proceed?

Caroline Jones

Infection Control Measures and Debts of Gratitude

In 2015, Bioethics, Public Ethics, Publications on May 26, 2015 at 9:00 am

Health care workers (HCWs) returning home from Ebola-infected regions are subject to various infection control measures (ICMs), including investigative, diagnostic, and liberty-restricting measures. Public health laws justifying the use of ICMs, such as quarantine, have been invoked in recent cases involving HCWs returning home from areas affected by Ebola. In a recent commentary in the American Journal of Bioethics, Diego Silva and A.M. Viens argue that we may owe HCWs subjected to ICMs a debt of gratitude, but it is unclear what the basis of that debt is or how that debt should be paid.

The first 50 people to click here will get free access to the commentary. After the first 50 clicks, only a summary will be made available.

Final HEAL seminar in this academic year’s series: Elselijn Kingma speaking on “Can a Gestator Harm her Gestatee? Physical Indistinctness and Deontological Distinctions”

In 2015, Best interests, Bioethics, Meetings, Reproduction on May 5, 2015 at 3:27 pm

We would like to welcome you to our last HEAL seminar in the series for the 2014-15 academic year. It will be held tomorrow, Wednesday, May 6th at 4pm in Room 4/4053. Our speaker will be Dr. Elselijn Kingma, who will be speaking on “Can a Gestator Harm her Gestatee? Physical Indistinctness and Deontological Distinctions”. Abstract below.

We hope you will also be able to join us for the inaugural HEAL Annual Lecture on Thursday, May 7th at 6pm.

Dr. Elselijn Kingma (Southampton)

Can a Gestator Harm her Gestatee? Physicical Indistinctness and Deontological Distinctions

ABSTRACT It is commonly asserted that pregnant women can harm their unborn child, for example by smoking or drinking alcohol. On these grounds pregnant women are increasingly not just socially, but also criminally held to task for such behaviour. In this paper I argue women cannot harm their foetuses in these particular ways. This is because the concept bringing about harm relies on a particular kind of deontological distinction that underlies both common sense morality and much of the law. This distinction is not able to accommodate the physical intertwinement and interdependence that characterises the maternal-fetal relationship. Harm-talk is therefore inappropriate, and the effects of maternal behaviour on their foetus cannot be analysed within current moral and legal frameworks.

This year’s Postgraduate Bioethics Conference: Call for papers

In 2015, Bioethics on April 13, 2015 at 2:34 pm

In 2014, Emma Nottingham and Alex Chrysanthou organised the annual Postgraduate Bioethics Conference (PGBC2014) here in Southampton. In 2015 the baton has passed on to a team of PGRs in Manchester. The focus for PGBC2015 is ‘Binaries in Bioethics: What role should they serve?’. The call for papers has been issued:

The 9th Postgraduate Bioethics Conference will be held in Manchester on the 7th and 8th of September 2015. It is a prestigious annual conference aimed at doctoral researchers whose research involves bioethical analysis. Over the past eight years, it has become established as a leading environment for doctoral candidates to meet, network, and present their work. This year’s theme is ‘Binaries in Bioethics: What role should they serve?’ Bioethical thought frequently utilises binaries to explore and understand experience, practice, and ethical challenges. Binaries such as mind/body, male/female, health/illness, therapy/enhancement, and disability/giftedness permeate bioethical debate. We would like to invite colleagues to submit papers addressing binaries in bioethics; and would welcome papers, whether from a historical or contemporary perspective, that explore the values, limitations, and possibilities offered by binary approaches. Abstracts are welcome from healthcare practitioners, bioethicists, the medical humanities, and anyone working in related fields.

The Conference is a two-day event, designed to give opportunities for doctoral researchers involved in bioethical research to present their current work. The conference will also include four keynote addresses from senior scholars in their respective fields, a lecture from another leading scholar and two workshops. Please refer to the website for further information. The Conference organisers welcome submissions from a range of disciplines relevant to bioethics including, but not limited to, medical ethics, medicine, healthcare, life sciences, philosophy, social sciences, law and public policy.

Abstracts should be in English, no more than 300 words, and in Word or preferably PDF format. Please note that you must be a registered postgraduate student, and we will only accept abstracts sent from a valid institutional email address.

Those wishing to simply attend can register now but please be aware that capacity is limited. Please note that submitting an abstract does not secure your attendance at the event so you are advised to register early in order to avoid disappointment.

Registration will be free for participants and attendees but please be aware there are limited spaces available. The Postgraduate Bioethics Conference cannot cover the cost of travel and accommodation. Additional details regarding accommodation are detailed on the website.

Submissions should be e-mailed to the conference organisers, Sacha Waxman and David Lawrence, by 30th June 2015: postgrad.bioethics@outlook.com.

We are also currently awaiting confirmation with the Editors from a selection of leading bioethics journals regarding whether the winning papers from the conference could be published as such (subject to peer review of course). If you have any questions please email us at postgrad.bioethics@outlook.com .

Kind regards,
Sacha Waxman and David Lawrence
The Postgraduate Bioethics Conference 2015

Email: postgrad.bioethics@outlook.com
Website: http://www.postgradbioethics.com/
Twitter: @PGBC2015
Venue: http://www.conference.manchester.ac.uk/venues/search/details/?property=8

This week’s HEAL event: Lisa Forsberg speaking on ‘Enhancement and lifestyle interventions, and the lawfulness of medical treatment’

In 2015, Bioethics, Meetings on March 16, 2015 at 12:57 pm

We’re delighted to be welcoming Lisa Forsberg to Southampton on Wednesday 18 March, to present on ‘Enhancement and lifestyle interventions, and the lawfulness of medical treatment’. Lisa’s seminar will run from 3-4pm in room 4055/4. All welcome.

Abstract ‘Enhancement’ procedures, or interventions that are claimed to go beyond the mere restoration of health, have received considerable attention in the ethics literature and in popular fora, but the law’s ability to accommodate such interventions has remained an underexplored topic. Parties to the ‘enhancement’ debate often proceed from the assumption that ‘enhancement’ either ‘should be legalised’, or should not be. However, it is not in fact the case that ‘enhancement’ interventions are not currently regulated. Moreover, intervetions would not, under the current legal regime, be unlawful on the basis that they were ‘enhancement’ interventions, that is, whether an intervention is appropriately designated as an ‘enhancement’ or a ‘treatment’ is not determinative of its lawfulness. Rather, decisions about whether an ‘enhancement’ intervention should be provided are largely delegated to the medical profession, or indeed individual physicians, to be made on an ad hoc basis, in accordance with their ‘professional judgement’. It remains unclear, however, how physicians’ ‘professional judgement’ is expected to help them arrive at answers that track morally relevant considerations. It is argued here, that in the absence of guidance regarding how and on what basis such decisions should be made, physicians’ decisions are unlikely to track morally relevant considerations, and that where this is the case, this may unjustifiably interfere with patient autonomy.

Southampton Event: Taking Pregnancy Seriously in Ethics II (April 13)

In 2015, Bioethics, Meetings, Reproduction on March 16, 2015 at 9:08 am

We’re delighted to spread the word re the forthcoming event on “Taking Pregnancy Seriously in Ethics and Epistemology Workshop II”, to be hosted at Avenue Campus, University of Southampton, on April 13th, 2015.

The speakers are Rebecca Kukla (Georgetown), Sally Fischer (Warren-Wilson), Lindsey Porter (Sheffield), and Fiona Woollard (Southampton).

In applied ethics, much has been written in relation to pregnancy – based either on a conception of pregnancy as the ‘hosting of a stranger’, or focusing on the rights of the foetus whilst disregarding that foetus’s existence as intertwined with that of its mother. Neither of these two approaches takes the unique physical, relation and transformative state of pregnancy seriously. Pregnancy also raises epistemological issues. Does the radically transformative character of pregnancy mean that those who have never been pregnant are excluded from certain kinds of knowledge about pregnancy and its consequences? And are pregnant women taken seriously now as knowers and testifiers? These epistemological issues have important implications for the appropriate way to approach the ethical debate.

This workshop is one of a series of four in the project Taking Pregnancy Seriously in Metaphysics, funded by the Southampton Ethics Centre and the University of Southampton ‘Adventures in Research’ Scheme. It will be followed by two workshops on Taking Pregnancy Seriously in Metaphysics and was preceded by a workshop on Taking Pregnancy Seriously in Ethics and Epistemology on the 18th of June 2014.

For more information, program, abstracts and registration: http://www.southampton.ac.uk/philosophy/news/events/2015/04/13-pregnancy-workshop.page.

Registration is free of charge, and will include tea/coffee/refreshments. Delegates must provide/ pay for their own meals; there is an option to sign up for a buffet lunch (cost: GBP 8.50) when registering via the online store: http://go.soton.ac.uk/6ce

Please register by April 1st. If you would like to attend but childcare duties render your attendance difficult, please contact the organisers (as far in advance as possible).

Elselijn Kingma, Lecturer in Philosophy, University of Southampton

The Making of British Bioethics

In 2015, Bioethics, Publications on March 6, 2015 at 9:00 am

Earlier this week, Jonathan Montgomery and I met with Duncan Wilson to discuss the ‘Test Case Biographies’ project which is nearing completion (more on that in a future post). In his own words, Duncan is a ‘modern historian, whose work investigates changing notions of health, disease and morality during the nineteenth and twentieth centuries’. October 2014 saw the publication of Duncan’s latest book, on ‘The Making of British Bioethics’, by MUP. Some of the thinking behind the book can be found here, and the official description is included below. Leaving aside the excellent content for a moment, the book has a fabulous retro cover, viewable here and here, and a great story behind it (if you meet Duncan ask him). MUP are asking for the sum of £25 for a hardback copy, but there is a less-well advertised free pdf version of the book, here. This is a superb resource for those interested in the modern emergence of British bioethics, and the open access option will make it especially attractive as a teaching tool/companion. (Belated-)Congratulations to Duncan on the conclusion of this particular project, and best of luck with the next one!

Description: The making of British bioethics provides the first in-depth study of how philosophers, lawyers and other ‘outsiders’ came to play a major role in discussing and helping to regulate issues that used to be left to doctors and scientists. It details how British bioethics emerged thanks to a dynamic interplay between sociopolitical concerns and the aims of specific professional groups and individuals who helped create the demand for outside involvement and transformed themselves into influential ‘ethics experts’. Highlighting this interplay helps us appreciate how issues such as embryo research and assisted dying became high-profile ‘bioethical’ concerns in the late twentieth century, and why different groups now play a critical role in developing regulatory standards and leading public debates. The book draws on a wide range of original sources and will be of interest to historians of medicine and science, general historians and bioethicists.

Innovating at the Frontiers: The Postgraduate Bioethics Conference 2014

In Bioethics, Meetings on September 24, 2014 at 2:30 pm

Last week Alexander Chrysanthou and I hosted the 8th Postgraduate Bioethics Conference 2014. The theme of the Conference was ‘Health Law and Bioethics at the Frontiers of Innovation’. We were thrilled to organise the conference this year after a very successful seven years of Postgraduate Bioethics Conferences. We can report that the PGR bioethics community is alive and vibrant! This year’s Conference was attended by a range of academics from different disciplines, including philosophy, law, sociology, humanities, medicine and biomedical science, at different stages of their career from masters and doctoral students, members of the medical profession and renowned bioethics professors. We were very honoured that international delegates travelled from countries including Belgium, Ireland the Netherlands and the US to attend the event.

The first day of the Conference began with a keynote from Professor Bobbie Farsides who gave a fascinating account of her career and engaged with the importance of ‘frontiers’ in bioethical research and gave advice and tips on working with people in bioethics. One of the most important things being how to make someone’s day by bringing cake!

Bobbie then chaired the first parallel session of PGR papers in which I presented my paper ‘Testing the health of adolescent’s rights in healthcare’ followed by Anna Sierawska from the University of Aberdeen who spoke about ‘Prenatal diagnosis: do prospective parents have the right to know?’ Meanwhile, Professor Anneke Lucassen chaired a fantastic session, which included papers from Chris Blunt (LSE) ‘Personalised medicine and the ethics of stratified treatment: genomics, xalkori and distributive justice’ and Katherine Burke (Cardiff University) ‘Informed consent in the clinical genomics era: practical, ethical and sociological perspectives’.

One of the afternoon sessions of PGR papers was chaired Dr Remigius Nwabueze and included papers from Caroline Harnacke (Utrecht University) ‘The relation between disability models and social policy claims’ and Sam Walker (University of Manchester) ‘Body modification and contractarian harm’. The parallel session was chaired by Professor Jonathan Montgomery. Alexander Chrysanthou (University of Southampton and co-organiser of the Conference) delivered a paper entitled ‘Frozen embryo disputes: perception, technology and evolution’, which considered the possibility of a maternal-fetal attachment existing in IVF. Rachel Warren (University of Manchester) discussed ‘What is moral parenthood?’ and engaged in an excellent discussion of virtue ethics to aid her analysis of what it means to be a good parent. All papers were followed by superb academic discussion and fully engaged the audience.

Up next was a fantastic workshop with Professor Jonathan Montgomery ‘Bioethics in Practice’, which gave the PGRs inspiration and ideas about the importance of bioethical research and how to make an impact with research. The workshop involved group discussion and feedback and encouraged delegates to discuss and debate ideas about spreading research beyond the academic environment, such as using social media to disseminate research, blogging, newspapers articles, getting involved in an ethics committee, responding to public consultation documents and accepting television invites (including an entertaining story from Jonathan and fellow keynote speaker Professor John Harris about their appearance on Newsnight earlier in the week).

The next keynote speech was given by Professor John Harris and David Lawrence entitled “Hot baths and cold minds: neuroscience, mind-reading and mind misreading” and was presented from a make-shift lectern created out of furniture from the conference room. As well as thought-provoking questions about mind-reading and information on the internet, the talk featured lots of poetry and discussions about how many email accounts to have with one PGR admitting to having 5 twitter accounts and 6 phone numbers.

Following an excellent presentation from Dr Elselijn Kingma on “Taking pregnancy seriously: ethics in birth”, we all headed to the Conference dinner to continue ideas and discussion from the day (accompanied by a few glasses of wine …).

Day 2 of the conference began with an excellent variety of PGR papers from Lisa Diependaele (Ghent University) ‘Intellectual property rights: data exclusivity’, John Rumbold (Keele University) ‘Research exceptionalism, paternalism, and the Saatchi Bill’ and Abin Thomas (KCL) ‘Suffering and managing the individual self: the politics of death and religion in Kerala, India’, all chaired by Dr Sara Fovargue. In the other room Professor Ruth Chadwick chaired papers by Daniel Tigard (Tulane University) ‘Emergency preservation and resuscitation trials: a philosophical justification for involuntary enrolment’, Laura Downey (University of Edinburgh)‘ Identifying identity in Law and Bioethics’ and Jean Menard (UCL) ‘Normativity in the wards: legal pluralism as a conceptual framework for clinical ethics’.

Next was the second training workshop of the Conference, “Publishing in Bioethics”, a panel session made up of journal editors Professor Ruth Chadwick, Dr Sara Fovargue, Professor David Hughes and chaired by Professor John Coggon. Each spoke in turn and gave fantastic advice about how to get published in bioethics and the etiquette and procedures involved followed by a Q and A discussion with the PGRs.

Professor John Bryant chaired the next session of PGR papers on the theme of surrogacy, with papers by Gulzaar Barn (University of Oxford) ‘Commercial Surrogacy: a coercive offer’, Tung LeXuan (University of Southampton) ‘Surrogacy considerations in Vietnam’ and Aikaterini Neofytou (University of Kent) ‘‘’How I met my mothers’- Surrogate motherhood and the law: a comparative socio-legal analysis of the responses to surrogacy in Greece and the UK’. Dr David Gurnham chaired papers by Katherine Furman (LSE) ‘Is Thabo Mbeki morally responsible for his AIDS denialism?’, David Gibson (University of Manchester) ‘Assessment of mental capacity as negotiation of narrative identity’ and Caroline Somers (University College Cork) ‘Manufacturing certainty: best interests and end-of-life decision making’.

We were honoured to have Paul Woodgate from the Wellcome Trust attend the Conference and give a talk about funding at the Wellcome Trust, which got everyone thinking about postdocs and obtaining funding for future research projects.

The final session of the day was a keynote speech from Professor John Bryant, “Innovation and Ethics at the start of life”, which involved group discussion about different well-known historical ethical dilemmas including the first IVF baby Louise Brown, Dolly the sheep and more recent technological develop of three-parent embryos. John gave a brilliant presentation assisted by PowerPoint, in which he impressed us with not only his bioethical expertise but also his excellent photography skills.

We are very grateful for the generous financial support of the Wellcome Trust, the Society of Applied Philosophy, the Analysis Trust and the Southampton Ethics Centre. We are also grateful to the members of HEAL, Southampton Law School and Director of Postgraduate Research, John Coggon, for their academic support.

For further information about the Postgraduate Bioethics Conference, see the Conference website: http://www.postgradbioethics.com. We hope to update this in the near future with some pictures from the Conference.
Follow us on twitter @PGBC2014: https://twitter.com/PGBC2014
Join our Linkedin group: http://www.linkedin.com/groups/Postgraduate-Bioethics-Conference-8135542

If you have any ideas for next year’s conference or are interested in participating either as a speaker or an organiser please email postgrad.bioethics@outlook.com.

Emma Nottingham