Archive for the ‘Gratuitous self-promotion’ Category

Global Health Law: Health, Governance, and Justice

In 2015, Gratuitous self-promotion, Publications on November 9, 2015 at 9:20 am

One of the core areas of research activity within HEAL, led by me and A.M. Viens, is Public Health Ethics and Law. As a field, this embraces a huge range of issues. Some of our work is driven by particular practical areas of focus, such as Adrian’s longstanding study of stewardship and antimicrobial resistance. Other aspects of our activity are driven by theoretical concerns, such as work I’ve done asking how the question “what makes health public?” might be answered in a transnational setting. In any instance, the bringing together of legal and philosophical analyses to big, health-related challenges is central to our activity.

I am very pleased, therefore, with the release of a special issue of Health Care Analysis that I have edited. The focal point for the issue is Lawrence O. Gostin’s highly important and influential book Global Health Law (Harvard University Press, 2014). Gostin’s work in this book sets one of the most important agendas in contemporary health, ethics, and law scholarship and practice. The journal issue advances the debate with contributions that bring perspectives from law, philosophy, and economics, with a fantastic line-up of world-leading contributors: Eric Friedman and Lawrence Gostin; Norman Daniels; Jennifer Prah Ruger; Shawn Harmon; Attiya Waris and Laila Abdul Latif; Heather Widdows; and A.M. Viens.

John Coggon

HEAL cited in NCOB Report on ‘Children and clinical research: ethical issues’

In 2015, Gratuitous self-promotion, public consultations, Research ethics on September 7, 2015 at 9:00 am

We’re delighted to say (somewhat belatedly) that HEAL was cited in the Nuffield Council on Bioethics’ Report on ‘Children and Clinical research: ethical issues’, published in May 2015. The Children and Clinical Research Working Party was set up in 2013 with the following terms of reference:

1. To consider whether the current systems for regulating clinical research strike the right balance with respect to: Promoting understanding of childhood conditions and the availability of evidence-based treatments for children The role children themselves should play in research decisions; and The proper protection of child participants

2. To consider, as may be necessary: how it may be ensured that appropriate priority is given to research that is most likely to benefit children how the ethical acceptability of research projects should be determined, and the role of the various parties involved, including parents, in protecting children’s welfare the relevance of a child’s ‘best interests’ or capacity to ‘benefit’ in the context of consent to research, as opposed to treatment the importance of the international context any other aspects of the direct or indirect regulation of clinical research in children that may be relevant.

3. To draft a report and make recommendations as appropriate.

In order to respond to the Consultation Paper (one of a number of evidence gathering activities), HEAL members met in October 2013 to discuss and draft a co-ordinated response (in a meeting colloquially referred to as ‘Experimenting on children?’). Our response can be read here: HEAL response to NCOB Children and Clinical Research ethical issues FINAL.

HEAL’s contributions were quoted at para 2.8 in a section on Research proposed in traumatic, highly emotional, or sensitive situations:  “… research into the use of drugs or sexual relationships, where involvement of the parents or other family members may be problematic” (fn 112); and cited at para 2.10, fn 118, with regard to: ‘The challenging question of parental involvement in decisions about young people’s participation in such research was highlighted by respondents to the Working Party’s consultation both in the UK and in Africa’.

It is clear that the NCOB has actively sought to ensure the voices of children are heard as part of the consultation and the findings, from the cover of the Report (link above) provided by drawings from children on their views and perspectives on research, to short films, and in the media coverage.  One of the summary findings – that ‘research should always be carried out with children, not on children’ – may seem obvious, yet it is vitally important for children to be involved in research as subjects rather than objects if we are to treat them with the dignity and respect that we, in turn, expect as adults.

Caroline Jones


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.

Is Antimicrobial Resistance a Slowly Emerging Disaster?

In 2015, Disaster management, Gratuitous self-promotion, Public Ethics, Publications on July 10, 2015 at 9:39 am

The problem of antimicrobial resistance is so dire that people are predicting that the era of antibiotics may be coming to an end, ushering in a ‘post-antibiotic’ era. A comprehensive policy response is therefore urgently needed. A part of this response will require framing the problem in such a way that adequately reflects its nature as well as encompassing an approach that has the best prospect of success.

A.M. Viens and Jasper Littman have recently completed a paper – available freely as an open-access article in Public Health Ethics – which considers framing the problem of antimicrobial resistance as a slowly emerging disaster, including its potential benefits and difficulties, from a conceptual and policy perspective.

A.M. Viens is also a member of the University of Southampton’s new Network for Anti-Microbial Resistance and Infection Prevention (NAMRIP). NAMRIP aims to become the first port-of-call for UK Government for the interdisciplinary approach to research and collaboration in combating the increasing resistance that microbes display to countermeasures.

A.M. Viens

Final Summary Report for ESRC series on ‘Criminalizing of Disease Transmission’

In Conferences, funded research, Gratuitous self-promotion, Meetings on January 19, 2015 at 8:30 am

David Gurnham (HEAL and ICJR, University of Southampton) has recently completed an ESRC-funded series of seminars in collaboration with colleagues at the University of Manchester (Catherine Stanton and Hannah Quirk) focusing on the criminalization of disease transmission. Their final summary report is now completed and will be available via the HEAL and ICJR websites, and direct from this link: Criminalizing Contagion_summary_report_Nov_2014. The seminars, which took place at the Universities of Southampton and Manchester from January 2012 until September 2014 addressed a series of questions: how should the law treat a person who transmits a serious infection such as HIV, or exposes others to the risk of infection? For example, should such a person be treated as a criminal, in the same way as someone who injures another?

In this seminar series, we have tried to highlight and explore some of the most pressing implications that the deprivation of a person’s liberty in response to infectious disease transmission has for a number of professional and public organisations. While we did not identify any one view on criminalization, we heard and read strong criticism of the use of criminal sanctions in this context, as well as defences of criminal sanctions in some circumstances.

As well as academic scholars approaching the subject from criminal law and criminal justice, healthcare and ethics perspectives, the seminars establish a link with four key organizations, all of which are involved in one or more of relevant policy engagement, legal reform and clinical practice. These are Amnesty International, the British Association for Sexual Health and HIV (BASHH – an organization made up of professionals working in sexual health), the Crown Prosecution Service (CPS) and the Law Commission. With the exception of Amnesty, we have had representations from each of them, alongside participants across a range of other relevant organizations and institutions at the seminars.

A number of different sorts of publications have arisen from the seminars: academic papers presented at the seminar have been or will soon be published across a number of formats (special journal issues, a book of collected essays); article contributions by practicing medical and healthcare experts have been published in response to a call for papers in three British Medical Journal Group journals; papers have been published by David Gurnham and Catherine Stanton in response to the themes explored in the seminars. For full details of publications and paper presentations, see the Criminalizing Contagion_summary_report_Nov_2014.

At Tale of Two Citadels travels to SLSA Aberdeen

In 2014, Gratuitous self-promotion, Testing project on May 8, 2014 at 11:33 am

In April 2014 I travelled up to Aberdeen for the annual SLSA conference, hosted by the Law School, Robert Gordon University, to deliver our paper on ‘Two Citadels’ in the Medical Law stream. Aberdeen is a great, albeit expensive city to visit (well, mid-week anyway – that’s oil money for you). There was a huge array of papers in parallel streams, with the inevitable difficult choices that this invokes for attendees – there are always papers you would have liked to hear but – in the absence of Potter-eqsue ‘Time Turners’ – the timing did not permit. The full programme can be found here ParallelSessionSummarySLSA2014.

Glenys Williams, convenor of the Medical Law & Ethics stream, put together an excellent programme. The first session focused on various and fascinating aspects of abortion, space, community, history and conscientious objection (and more), featuring Joanna Erdman (Dalhousie), Ruth Fletcher (QMU) and Michael Thomson (Leeds). It was a lively and engaging session, and a superb start to the conference.

After coffee, Claire Lougarre (UCL) and I shared the next session, giving plenty of time for questions and discussion for both papers, which was a real gift. Claire gave a thought-provoking and engaging account of her PhD research on the scope of the ‘right’ to health, something that she and Jonathan have already and I’m sure will continue to enjoy discussing ‘up’ at UCL. With Jonathan in Warsaw on NCOB business, and in the absence of a cardboard cutout of him (to direct any awkward question to …) it was left to me to present the latest iteration of our work in progress: ‘A Tale of Two Citadels: Competing Narratives in a Case Biography’, drawn from our British Academy/The Leverhulme Trust funded project ‘Test case biographies as a method for studying hidden law-making’.

The case study in this paper, focusing on the decision in AC v Berkshire West PCT [2010] EWHC 1162 (Admin) and on appeal [2011] EWCA Civ 247, starts from the position that legal cases are complex social phenomena. They have histories – and they link past and future events in a present encounter. There are established doctrinal approaches to ‘understanding’ cases, and situating their significance within a legal context according to institutional rules (ratio decidendi, obiter dicta, stare decisis, and per incuriam, for example). However, it seems valuable to us to seek to understand alternative ways of mapping cases in the Health Care Law context; exploring, for example, the parties’ understanding of the dispute (a specific dispute, or part of a campaign? Possibly a legal campaign, but alternaively one of a different character again?); also the lawyers and judges involvd have careers in which a specific case will play a part.

Our desk based research, for this case conducted largely by Alex Chrysanthou, has sought to explore the chain of case law leading into and(less significantly, currently) leading out of the AC case, and the network of legal personnel directly involved in this case (which will need further reflection). Our third line of enquiry, undertaken by me, has been to examine the interpretation of this case by legal reports and commentators. This research indicates that the choice of competing narratives began to take shape long before the issue is argued before a judge – i.e., is this about NHS resource allocation, or about transgender legal rights?

The questions, comments and responses from those at the Medical Law and Ethics stream were thought-provoking and will be invaluable in moving the project forward (not least in terms of encouragement as people said how interesting they thought the project was). Also, we look forward to presenting this work again at Southampton next week, at a dedicated event on Hidden Law-Making and Case Biographies – and for the opportunity for further reflection on the next phase of the project – but more on that event to follow in a future blog post.

Caroline Jones

How and why do we value scientific freedom?

In 2014, Conferences, Gratuitous self-promotion, Publications on April 7, 2014 at 12:54 pm

With teaching over, it’s good to have a bit of time for writing and going to conferences. I’ve just got back from a trip to Rome, where I attended the third meeting of the World Congress for Freedom of Scientific Research. The meeting is a key event hosted by the Luca Coscioni Association, which aims to eradicate undue bars to science and innovation. With Simona Giordano and Marco Cappato, I edited a book on Scientific Freedom following the first of these Congresses. As well as existing in hard copy, it is available here open access.

The Congress that just took place focused on the relationship between science and politics. In my own paper, I raised issues about the central place that the public interest should take in our analyses and evaluations of scientific freedom. This cuts against some of the received wisdoms amongst members of the scientific community, who are wary of the public interest (or in related literatures on the national interest). The wariness is born of concerns that the public interest will simply be given as a dogmatic, knock-down argument against good science, with no sound rationale behind it. Whilst we should be alive and responsive to such concerns, if we are to advance scientific programmes, we also need to be able to explain how these serve the public interest.

Scientific freedom is not just a ‘negative right’; a right to be left alone (and even in instances where it is, it can still impose positive claims and costs on the State and others). And really, advocates for scientific freedom are anyway asking governments not only to permit, but also to protect and indeed promote science. In doing this, we see important roles for law and regulation, providing both a shield, where defences are needed of scientific activity, and a stage, where publicity and education are needed. In my paper, I aimed to capture the reasons for this, and to explain that those in the scientific community need to understand why the public interest may at times legitimately constrain, as well as advance, science.

The event in its entirety was quite intense, with a great range of speakers and papers. Although it was built around a shared agenda, there was nevertheless a fascinating variety of perspectives. Furthermore, the span of insights afforded was astounding. Speakers included scientists and other academics, but also activists, politicians, people working in policy, journalists, and jurists. I left with a sense that many of the practical upshots of the meeting will arise as individual developments. ‘Science’ is vast and varied. But the general movement, and the added momentum that can be found when people with associated interests come together, will add to the power of such developments.

John Coggon

(More) HEAL teaching outside the Law School

In 2014, Genetics, Gratuitous self-promotion, Reproduction, Teaching on March 24, 2014 at 8:31 am

Following on from John’s post last week, about teaching on the MSc in Public Health Nutrition, I recently led a session on ‘identity’ for the CIP module Ethics in a Complex World. The module is led by Dr Julie Wintrup and therefore ‘housed’ in Health Sciences. But, it draws in (a lot of) contributions from the Law School, not least from our current Head of School, Professor Hazel Biggs, who co-led a number of the initial large-group sessions this semester, alongside Professor Roger Ingham (Psychology), and Dr Angela Fenwick (Medicine). Both John Coggon and A.M. Viens will also be making cameo appearances later this semester.

As the list of names and disciplines in the preceding paragraph suggests, this is a truly inter-disciplinary module. For the teaching team this demands some reflection on ‘our’ respective disciplinary boundaries and assumptions – not only in setting up the overarching aims and objectives, but down to the detail of selecting the ‘what and how’ of discrete sessions/topics, and indeed the assessment(s). In turn, the diverse student body bring their own disciplinary, and other, assumptions, life experience and questions to the table, both in the large and small group sessions – raising some excellent questions for further engagement, analysis and reflection. The other colleagues can be quite challenging with their questions too, which can only be a good thing! Further, the team actively engages with social media throughout the course, and as I was speaking Fiona was ‘Scoop’ing, and Julie tweeting.

I was part of the core group that set up this module, but had to step aside this year due to other commitments, so it was a real pleasure to return for a ‘guest’ spot, and to (re-)consider donor conception, mitochondrial donation and identity matters (after thinking about hidden law-making for a fair while – more news on that project to follow in a future post). As John made clear last week, these types of sessions are not about ‘instructing’ people as to the ‘correct’ answers to ethical issues, but rather to provoke reflection.

Certainly, in terms of academic study, legal developments and policy-making, interest in donor conception has waxed and waned over the decades. We seem to be in a ‘waxing’ phase, inasmuch as this area was the subject of a dedicated NCOB Working Party and Report in 2013, and is linked to the debates around mitochondrial donation, including a 2012 NCOB Report and the current DH consultation on the Draft Regulations on mitochondrial donation (i.e., how should we treat egg/mitochondria donors in this context?). I was privileged to be asked to give evidence on the regulatory aspects of donation to the former Working Party, and to have my research referenced within its Report (fn 112, 397); further, being involved in an evidence session for the latter Working Party, and being invited to comment on the draft Report.

But, no matter what can be said about the academic treadmill – whether for the good, the bad, or with indifference – it is still the greatest privilege to introduce people to new areas and/or ideas, and ask them to have a re-think about their assumptions, and in doing so to continue to challenge your own thought processes and rationale(s).

Caroline Jones

Ethics, Politics, and Georgetown Public Health Law

In 2014, Gratuitous self-promotion, Public Ethics on February 10, 2014 at 11:42 am

Last week I was delighted to visit Georgetown University. In particular, it was a great pleasure to meet up with Larry Gostin in the O’Neill Institute for National and Global Health Law. Larry’s work has been crucial in shaping contemporary understandings of public health law and ethics; my main areas of research. It was fantastic to have the opportunity to discuss with him my own teaching and research agendas, including the work that A.M. Viens and I are up to in HEAL developing specialist teaching in Public Health, Law, and Ethics for Southampton’s new MSc in Public Health.

The primary reason for my visit was to give an invited lecture to JD and LLM students studying public health law in Georgetown Law. The lecture was entitled “Political Theory in Public Health Ethics”. In part, it involved teaching some of the fundamentals (at least as I see them!) in bringing ethical analysis to public health practice and policy. However, my main aim was to challenge the students to consider not just the nature, but also the scope, of normative claims made in the name of public health. Having examined the necessary relationships between public health and law, I invited the students to think about two distinct modes of ‘doing’ public health ethics.

In relation to the first, we studied the work of scholars who are interested in theorising: we looked at ideas concerning conceptual coherence, normative and analytical rigour, and theoretical bounds (or lack of them) to claims made in public health ethics. The lecture surveyed some of the many different ethical theories that are brought to bear on public health, and scrutinised their bases and conclusions. As regards the second, we looked at ethics in public advocacy, referring to ideas such as ‘nudge’, ‘stewardship’, and the human right to health. Here we asked not just how robust these positions are in theory, but how robust we really want or need them to be in practice.

My hope with the class was that the students would address the very basics of whatever motivates their ideas about good practice in public health law and policy; to think about what makes health promotion desirable, or even an imperative (and what brakes there ought to be on health promotion). But I also hope that it left them thinking about the potentially distinguishable roles of academic and activist, and which (neither, either, or both) they would wish to assume, and on what terms.

John Coggon

Happy New Year from HEAL!

In 2014, Gratuitous self-promotion, News on January 3, 2014 at 8:58 am

Having had a much needed break, things are starting to kick off again at HEAL. There are plenty of plans unfolding, both in the shorter and longer term. Whilst a month’s extension on the holiday would have been welcome, there’s a lot to be pleased to come back into work for.

There are various things happening in January. We are delighted to be playing host to Malcolm Oswald on the 8th, when we’ll hear his paper “Drawing the line between identifiable and anonymised health data: dilemmas for a conscientious public servant”. As is so often the case with questions in health policy, it will put some important matters under the spotlight with little by way of promise for helpful guidance from law itself.

The following week, both John Coggon and A.M. Viens are off to Germany for a meeting at the Center for Interdisciplinary Research at Universitat Bielefeld, on “Individual Liberty and Problems of Justice in Public Health Ethics”. It will be a fantastic chance for them to showcase some research on conceptual and normative problems at the intersection of ethics, law, and politics in health policy.

At the end of the month, when semester two starts, Natasha Hammond-Browning is picking up the Health Care Law teaching (to include a cameo from Caroline Jones!). The semester two teaching will be much more issue-led, as contrasted with the more foundational work on law and ethics in semester one. Natasha’s half of the semester will focus on beginning of life matters; questions central to her research interests. Towards the end of term, John will take over and speak to issues concerning the end of life, and public and global health.

We are pleased to announce too that John is becoming the new Editor-in-Chief of Health Care Analysis in January, and that A.M. Viens has joined the editorial board. It is great that this journal, with its strong focus on philosophy and health policy, now has a firm base in HEAL.

Looking a bit further forward, we’re very excited that two of HEAL’s PhD students, Alex Chrysanthou and Emma Nottingham , were successful in 2013 in leading a bid to host the Annual Postgraduate Bioethics Conference in Southampton. The conference theme is going to be “Health Law and Bioethics at the Frontiers of Innovation.” It promises to include some excellent keynotes and top quality papers on a range of bioethical questions.

The next hidden lawmakers event, on ‘Test Case Biographies’, funded by the British Academy and The Leverhulme Trust and run by Caroline, Hazel Biggs, and Jonathan Montgomery, is on the horizon this semester, as is a meeting organised by John along with Jurgen de Wispelaere on the theme: “Towards a Republic of Health? Freedom and Solidarity in Public Health and Health Policy.” A.M. Viens is also co-organising two events in the spring. The first is a workshop on Disaster Justice, co-hosted by European Cooperation in Science and Technology (COST) and the University of Copenhagen. The second is a symposium on the Ethics of Antimicrobial Resistance, hosted by the Brocher Foundation in Geneva.

We’re also between us looking forward to hosting more visitors, making more research visits , and to participating in further public consultation responses.

There’s a lot to look forward to in 2014!