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Posts Tagged ‘Public Ethics’

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

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This week’s joint ICJR/HEAL event – Dr John Coggon on ‘Legal Moralism and Long-Game Healthism? – the regulation of smoking’

In 2014, Meetings, Public Ethics on March 11, 2014 at 3:10 pm

This week we have a joint ICJR/HEAL event on Wednesday 12 March 2014, from 4pm in Building 54, Room 10037 (10th Floor), with John Coggon speaking on ‘Legal Moralism and Long-Game Healthism? – the regulation of smoking’.

Abstract This paper is concerned with coercive policies and regulatory strategies that aim at a prohibitionist end whilst avoiding individual legal measures that would individually provide an outright ban on an activity. It compares jurisprudential debates regarding legal moralism, which concerns the use of law as a mechanism for enforcing moral norms, with debates in public health ethics about healthism, which refers to an ideological political agenda aimed at making people behave in ways that (apparently) promote their health. It then takes as its focus the ‘end game’ agenda in tobacco policy; a strategy designed ultimately to mean that smoking will be eradicated. Against the background of ideas designed to legitimise such health policy—such as those entailed in ‘libertarian paternalism’—the paper examines whether long-game strategies avoid or are subject to concerns that apply to immediate prohibitions. In short, it explores the question: if on principled grounds we could not ban smoking overnight, (why) is it acceptable to do so over a decades-long period?

Assisted Dying: Philosophical, Legal and Practice Perspectives

In 2013, Death and dying on February 25, 2013 at 9:00 am

On Wednesday 20th February 2013, sponsored by the International Centre for Nursing Ethics, School of Health and Social Care and the School of Law at the University of Surrey, four experts from different disciplines debated issues related to assisted dying. Focusing on the related themes of autonomy and dignity at the end of life each panel member spoke for ten minutes and offered their own perspective on the topic. The presentations were then followed by a lively debate between the panellists after which the floor was opened up to questions from audience members.

Ray Tallis, former Professor of Geriatric medicine and recently described as ‘one of the top living polymaths’ opened the discussion with an entreaty to autonomy. He argued that the wishes of those who are terminally ill and seek an assisted death ought to be respected and that the law should be reformed to permit that. Hazel Biggs, Professor of Health Care Law at the University of Southampton, then outlined some of the legal aspects of the debate. She explained that the law does not explicitly support autonomy or dignity, other than through the legal right to consent to or refuse medical treatment and used various examples of assisted dying to reveal deep inconsistencies in the legal approach to end of life decision-making. Barry Quinn, MacMillan Consultant Lead Nurse at Ashford and St Peter’s Hospital NHS Trust then introduced some practical perspectives, arguing that today death is remote from the living and encouraging everyone in the audience to think about ways in which they might be with the dying so that people at the end of life feel less alone and better cared for. David Albert Jones, Director of the Anscombe Bioethics Centre and Research Fellow at Blackfriars Hall, Oxford continued the debate on autonomy drawing on philosophical theory to support his argument that in some respects personal autonomy ought properly to be limited.

The animated debate that the individual presentations provoked, demonstrate that assisted dying remains a controversial and emotive topic that is never far from the public consciousness. Such discussions are invaluable in generating informed public opinion.

More information can be found here.

JME Editor’s Choice: John Coggon on Elective Ventilation

In 2013, Death and dying, Public Ethics on February 21, 2013 at 7:27 am

The latest issue of the Journal of Medical Ethics (JME) is a special issue focused on ‘Elective Ventilation’. John Coggon’s paper – which he delivered as a HEAL seminar last year – has been selected as the Editor’s Choice, hence it is open access and can be read in full here.

Abstract This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: ‘basic elective ventilation’; ‘epistemically complex elective ventilation’; ‘practically complex elective ventilation’; and ‘epistemically and practically complex elective ventilation’. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

Jonathan Montgomery’s paper on ‘Public Ethics’ is published

In Public Ethics on January 11, 2013 at 5:32 pm

Jonathan Montgomery’s paper on the nature of ‘ public ethics’ has now been published in the Cambridge Quarterly of Health Care Ethics. Based on a presentation at a seminar on organ donation at the University of Keele, it reflects on the processes by which the Organ Donation Taskforce reached its conclusion not to propose a ‘presumed consent’ model for organ donation. It draws on the Jonathan’s experience as a member of that Taskforce and of other bodies charged with exploring ‘public ethics’, including the working party of the Nuffield Council on Bioethics on Public Health Ethics.

Jonathan argues that ‘public’ ethics is a much more contingent process than academic work and needs to (a) take into account contemporary policy debates, (b) be expressed in terms that are sufficiently close to the prevailing professional discourse to have a reasonable hope of reception, (c) assess how positions will be represented in the media and what behavioural changes will follow in the actual political context, (d) create workable compromise formulations, from which people can reason even if they reach them by different arguments.

Critiques of ‘public ethics’ need to take these features into account. He discusses the way in which a key concept in the Nuffield Council’s Public Health: Ethical Issues report, ‘stewardship’, has been examined and criticised by academics (including fellow HEAL member John Coggon in both his seminal book What Makes Health Public? and articles in the Journal of Medical Ethics and the Northern Ireland Legal Quarterly). Jonathan contends that the approach taken in the report is both explicable and defensible when seen as an exercise in public ethics, even though it may be more difficult to defend as an academic position. Criticism needs also to be sensitive to the fact that pronouncements on ‘public ethics’ are an exercise in persuasion whose audience is not academics. This may excuse the use of familiar but imperfect paradigms for analysis and a degree of compromise between committee members. It does not justify incoherent arguments.

Jonathan goes on to argue that there are some specific issues which present a greater challenge for ‘public ethics’ than for personal academic contributions. He suggests that greater attention must be paid to the difficulties for ‘public ethics’ of dealing with public opinion and seeks to explain how the Organ Donation Taskforce took into account public views it thought were based on flawed assumptions. He examines how bodies charged with considering ‘public ethics’ should address controversies where lay and professional understandings of what counts as evidence diverge. He also considers the implications of the contingencies of the socio-political contexts for ‘public ethics’ for analysis based on comparative work (both over time and between countries). This is a commonly used approach, but fraught with difficulties.

John Coggon on Elective Ventilation for Organ Donation: Law, Policy, and Public Ethics

In 2012, Human tissue on December 5, 2012 at 7:59 am

Our most recent HEAL event was a fascinating seminar with John Coggon speaking on Elective Ventilation for Organ Donation: Law, Policy, and Public Ethics. His paper drew on an article accepted by the Journal of Medical Ethics (forthcoming); abstract kindly provided below.

 

Abstract This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: ‘basic elective ventilation’; ‘epistemically complex elective ventilation’; ‘practically complex elective ventilation’; and ‘epistemically and practically complex elective ventilation’. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.