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Posts Tagged ‘Bioethics’

HEAL Seminar Series: today, Weds 21 October 2015, with Ben Saunders speaking on ‘Why Altruistic Donation May Be (Intrinsically) Bad’

In 2015, Meetings on October 21, 2015 at 9:16 am

Today, we have the second in the 2015/16 HEAL seminar series, with Ben Saunders, Associate Professor in Political Philosophy at Southampton, speaking on ‘Why Altruistic Donation May be (Intrinsically) Bad’, on Wednesday 21 October, 4-5pm, room 4055, building 4 (Law). All welcome.

Abstract
Proposals to introduce incentives for donations, including market payments, for blood, tissues, or organs are often objected to on grounds that such donations should be altruistic.[i] If donors are primarily moved by their own benefit, rather than the recipient’s, motives are often regarded as suspect. Conversely, we usually accept altruistic (other-regarding) motives as morally innocent, even commendable.

These attitudes have recently come under attack. A number of authors have argued that donations need not be motivated by altruism in order to be morally permissible.[ii] In this paper, I question the complacent assumption that altruistic giving is always good. I argue that in some circumstances excessive altruism, or self-abnegation, may be intrinsically bad. If I am right, some altruistic acts of donation may be morally problematic.
I base my argument on Tom Hurka’s account of the relative value of self-interest and altruism.[iii] Hurka holds that, while altruism (love of others’ good) itself is always good, it may be part of a package of attitudes that is on the whole intrinsically bad, where the love of others’ good is disproportionate to the love of one’s own good. Though Hurka is concerned to show that self-abnegation is not always a vice, some cases are intrinsically bad. If this is so, then altruistic donors may be acting from intrinsically bad motives, since their disproportionate concern for the good of others may reflect a lack of concern for their own good, which is itself bad.

[i] Titmuss RM. The Gift Relationship: From Human Blood to Social Policy (London: Allen & Unwin, 1971),  Naqvi A and Rizvi A. Against paid organ donation. Transplantation Proceedings 2001;33:2628.
[ii] Saunders B. Altruism or solidarity? The motives for organ donation and two proposals. Bioethics 2012;26:376-81.
Moorlock G, Ives J, and Draper H. Altruism in organ donation: an unnecessary requirement? J Med Ethics 2014;40:134-8.
[iii] Hurka T. Self-interest, altruism, and virtue. Social Philosophy and Policy 1997;14:286-307.

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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.

Bioethics as a Governance Practice

In 2015, Annual Lecture on May 15, 2015 at 3:33 pm

Jonathan Montgomery gave the inaugural lecture in the annual series of the Centre for Health Ethics and Law on 7 May 2015. Lecture organiser, Associate Professor A.M. Viens said, “We are extremely pleased to welcome Professor Montgomery back to Southampton to deliver the inaugural annual lecture for the Centre for Health, Ethics and Law. His contribution to the development of health care law, both academically and in his public service, is unrivalled in the UK. In recognition of these contributions, the annual lecture series will be named in his honour.”

Jonathan considered different ways of understanding bioethics; as a subject, a discipline, a field, an enterprise, and a governance practice. He suggested that the last was a neglected perspective that deserved greater consideration. He offered a brief history of bioethics governance in the UK, noting that it was a mixture of bodies charged with general oversight, bodies with responsibility for specific sectors, and ad hoc groups convened to look at single issues. He suggested that Bioethics Governance, envisaged by the UNESCO Universal Declaration on Bioethics (2005), had generally been understood as being developed in response either to fears that science was advancing faster than ethical reflection (as exemplified by the establishment of the Nuffield Council on Bioethics in 1991), or to scandal (as demonstrated by the governance of health research through statements of principle, ethics committees, and research governance frameworks). He argued that it was also important to see Bioethics Governance as a response to pluralism (when society is not in agreement about bioethical issues but it is necessary to achieve some degree of closure, at least temporarily, to take regulatory decisions). However, if the idea of Bioethics Governance was to be distinguished from more general political decision-making, he suggested it was additionally necessary to see it as a response to claims of relativism (that there was no basis for distinguishing between views). Bioethics Governance denied that this should determine decisions, looking for some form of public reason or deliberative processes to provide legitimacy for regulatory decisions. A satisfactory account of Bioethics Governance would need to recognise the contingency of the circumstances in which questions arose, explain the legitimacy of the exercise of power that it involved, and show that regulatory responses were effective, efficient and proportionate. In conclusion, bioethics could properly be considered in each of the ways outlined, but characterising it as a governance practice brought issues that needed further examination into the spotlight.

His slides can be seen here:
Bioethics as a Governance Practice

Announcing the inaugural HEAL annual lecture: Prof. Jonathan Montgomery, ‘Bioethics as a Governance Practice’, 7 May

In 2015, Meetings on April 20, 2015 at 9:00 am

We are delighted to announce that Prof. Jonathan Montgomery (Faculty of Laws, UCL) will give the inaugural Centre for Health, Ethics and Law (HEAL) Annual Lecture. This event will be held on Thursday 7 May at 6pm in Lecture Theatre A (Nuffield Theatre, building 6), and is generously sponsored by Health Care Analysis

Jonathan will be speaking on ‘Bioethics as a Governance Practice’. 

ABSTRACT The nature and scope of bioethics has been long debated. Some see it as a descriptor of a field of study; covering topics such as research ethics, death and dying, genetics, reproductive technologies and behavioural control. Others suggest it is an academic discipline, perhaps with its roots in moral philosophy. Others still suggest that it is an academic enterprise bringing to bear a constellation of disciplines to make sense of issues in the field. The public and policy facing aspects of this work have given rise to considerable controversy over the nature and legitimacy of bioethical expertise, giving rise to ‘culture wars’ in the USA. This lecture examines the nature of bioethics as a governance practice. It explores the range of mechanisms that have been adopted for regulation, oversight and mediation of public concerns and discusses some of the implications of this movement of bioethics from academic and clinical contexts into institutions in the public square.

See further the event poster: HEAL Annual Lecture 2015.

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

Methods and Discipline in an Interconnected Bioethics

In 2014, Bioethics on April 29, 2014 at 8:45 am

I’m writing this blog post in a rather august atrium in the University of Vienna (long story), but it actually relates to a talk I gave last week at Monash University’s campus in Prato. It was one of the most stimulating, fun, interesting, and generally enjoyable conferences that I’ve been to , and was the final meeting of a group led at Manchester, looking at the Human Body, its Scope, Limits, and Future (a project on which I was previously employed).

As well as four problem-led strands, considering questions such as the use of bodily materials and human enhancement, the project had a cross-cutting focus on methods in bioethics. Given some activity of mine in relation to this (most notably my co-editorship of a special issue of Health Care Analysis), I was invited to speak to this aspect of the project. I was delighted, but also a little daunted: whilst scholars such as Jon Ives, who was at the conference, and Mikey Dunn are very much ingrained in these discussions, I’ve had more of a ‘reflective’ and ‘external’ interest (hence my heavy use of scare quotes here, even by comparison to my generally high usage).

My talk took as its impetus a few themes, but a key one was found in (ahem) a slightly caricatured representation of a wonderful paper by my former colleague Iain Brassington. It’s a wonderful paper, but one whose emphases have me raise my own questions about what normative theory means within bioethics, and whether we should focus on what individual disciplines bring individually, rather than in some sort of conjoined activity.

Iain sees a great importance for philosophy in bioethics because (as do I) he sees bioethical analysis as being directive; action-guiding. His paper is available open-access, so I’d encourage readers to digest the full argument, but to reduce some of it to Iain’s own words: “philosophers are simply more likely to be good at thinking about problems of (say) justice and just policy than are non-philosophers, just as biologists are more likely to be good at thinking about problems in ecology” (p. 29).

I am not sure about this.

Part of the merit of philosophical analysis, for Iain, is that it allows abstraction from context and thus the better scrutiny of reasons. Yet I am not sure, when we think of ideas concerning obligation, that we can so easily segregate the world we are analysing into components that reflect the ‘silos’ that our disciplinary backgrounds sometimes purport to reflect. My own legal analysis is heavily influenced by works in moral and political theory. But it is also held in some sort of check by a reminder of Raymond Geuss’ pugnacious challenge to moral and political philosophy. When (as often happens in bioethics) the context of obligation is rooted in professional, legal, institutional, social, and other systems, abstraction can remove too much. And actually, despite Iain’s claim, I’m not convinced that philosophers particularly are better at the relevant kinds of conceptual and analytical methods. (It’s an interesting empirical claim, anyway.)

Without the sort of analysis that philosophers can bring, Iain sees a danger of bioethics become plain description or zealtory. And he closes his argument by suggesting that if others do bring the sort of analysis he’s speaking about, it’s probably philosophy that they’re doing after all. So philosophy keeps its pre-eminent position within bioethics.

For me, the importance of practicability in practical ethics suggests a need for much less of a focus on disciplinary prowess, and a far greater need to share ideas; to communicate between disciplines and with others (such as practitioners, folk in policy, and so on). This concept of public ethics resonates with Jonathan Wolff’s ideas, and Iain’s paper read in the light of Wolff’s work here gives, I would argue, a better idea of the role of philosophy within bioethics. The philosophical understanding is important, but no more important than that brought by other disciplines and some sort of qualified resignation to the status quo.

To be clear, my apparent bioethical ecumenicalism here is not based on a concern rooted in bland respect for different disciplines. Rather, it is based on the view that the universe, its orders, and its inhabitants are, when dragged into theory, conceptually a lot less crisp than abstracted normative analysis often allows. Disciplinary humility is as important as celebration of disciplinary advantage.

As for the upshot in regard to methods: for whatever it’s worth, my view is that there is so much that different disciplines can bring, and so many different sorts of problems to look at, that there is little good to be gained from finding the method for bioethics (not something, to be clear, that Iain was claiming to do). Rather, our focus is better placed on ways of approaching problems, and from there working towards the best engagement of collaborators. In this sense, bioethical analysis will not always require philosophers, and to be action-guiding will need normative theorists who are willing to come back from abstraction to a messy, complex, conceptually compromised world.

John Coggon

Bioethics: Ethics and Law of the Human Body and Body Parts

In 2014, body parts, human body, Human tissue, Organ donation on February 17, 2014 at 8:24 am

I spent my one-semester long Sabbatical (2013-2014) at the Faculty of Law, Thompson Rivers University, Kamloops, British Columbia, Canada (TRU). TRU’s relatively new law school is an exciting place to conduct academic research, and the law school’s faculty is comprised of both established and young legal scholars who are very competent and are already making their mark in various fields of legal scholarship. In addition to the huge stock of relevant materials in their library, they have a very useful and fully-fledged e-library; the law librarian, Mrs Mary Hemmings, was very helpful to me and ensured that I got all the materials I needed for my research. The law school’s move to a new and commodious building, equipped with various teaching and research tools, ensures the comfort and resources necessary to engender useful and original research.

I was privileged to be invited to present weekly seminars on Bioethics at TRU. My seminars focused on the ethical and legal issues arising from the biotechnological utilisation of human cadavers and body parts. Particularly, we focused on the philosophical and theoretical conceptualisations of property, its application to the human body and the ethical implications of such a deployment of property theory. My seminar students were both curious and excited by the various topics I presented, and they asked many questions that heightened the interaction and conversations in class.

A colleague at TRU, Professor Ruby Dhand, kindly invited me to present a lecture to her health law class based on my recent article (Body Parts in Property Theory: An Integrated Framework (2014) 40 J Med Ethics 33) published by the JME, which was part of her lecture materials. Her students read the article and asked critical questions that showed strong engagement with the piece.

The Vice President (Academic) of TRU, together with the Faculty of Law, honoured me with an invitation to present a university-wide lecture on the ethical and legal problems surrounding separated human organs. The arrangement for this lecture could not be finalised before I left, but it is still in process.

Remi Nwabueze

This week’s HEAL event: Jonathan Montgomery on ‘What is Medical Law “For”?’

In 2013, Key Legal Concepts, Meetings on October 28, 2013 at 7:00 am

Jonathan‘s swansong before he moves to pastures new, namely the Faculty of Laws at UCL, is a HEAL seminar where he will speak on ‘What is Medical Law “For”?’

Abstract  Should Health Care Law seek to resolve issues of bioethics or merely regulate the ways in which they are addressed? Does it matter that conflicting ethical advice can be said to leave patients’ rights unprotected (Miola, J., ‘Medical law and medical ethics – complementary or corrosive?’ (2004) 6 Medical Law International 251-274)? Is Health Care Law doomed to develop into a value-neutral subset of consumer law (Brazier, M. and Glover, N., ‘Does Medical Law have a Future’ in Hayton, D. (ed) Law’s Futures, (Oxford, Hart Publishing, 2000) 371-388)? This paper considers whether it is acceptable for health care lawyers to accept that there may be ‘no right answer’, or whether any theory of Health Care Law that accommodates indeterminacy represents a betrayal of the rule of law. It develops arguments explored in Montgomery, J., ‘The Legitimacy of Medical Law’ In McLean, S. (ed) First do no harm: Law, ethics and healthcare (Aldershot: Ashgate, 2006), 1-16, and Montgomery, J. ‘Law and the demoralisation of medicine’ (2006) 26 Legal Studies 185-210, in order to address some of the challenges identified in those papers. It considers whether an analogy with judicial adjudication might be instructive. 

This event will run from 4-6pm in 2007/4 (Highfield). If you would like to attend please confirm by email to A.M.Viens@soton.ac.uk, thank you.

Prof Hazel Biggs debates ‘ranking’ patients for organ donation

In 2013, Organ donation on July 11, 2013 at 1:38 pm

This morning, on BBC Radio 4’s Today programme, Prof Hazel Biggs debated the ethics of ‘ranking’ patients for organ donation with Prof Bobbie Farsides of Sussex University.

A key question under consideration in the media this week (see also the Jeremy Vine show on Radio 2 this lunchtime, circa 1pm) is whether patients in need of organs – who themselves are on the organ donation register – should be ‘ranked’ higher than those who are not when a suitable organ becomes available; ie a form of prioritising patients according to their willingness to be an organ donor, as opposed to solely considering clinical needs.

Hazel spoke broadly in favour of this approach as a means (among other factors) to incentivise people to join the organ donor list, thereby producing more organs for donation; and raised questions around fairness and equity – ie, people needing organs who were not willing (as opposed to unable) to donate their own to others.

The programme can be accessed here.