Healthcare ethics has a gap...
Cross post from the Uehiro Centre blog.
Last month, the Guardian reported on a healthcare crisis in the country. If you live in the UK, you may have already had an inkling of this crisis from personal experience. But if you don’t live here, and particularly if you are professionally involved in philosophical ethics, see if you can guess: what is the latest crisis to engulf the publicly funded National Health Service (NHS)?
Call for Abstracts. Thresholds in Healthcare: MANCEPT 2022
Alex Miller Tate (KCL) and I are organising a MANCEPT panel on the use of thresholds in healthcare.
We welcome abstracts of 200-300 words on any topic that might fall in this category - more details here - to firstname.lastname@example.org.
The deadline is 5pm (UK time) on 1st June 2022. The conference will take place 7-9 September 2022.
Are electoral pacts undemocratic?
Cross-post from the Uehiro Centre's Practical Ethics blog.
In the early hours of Friday morning last week, the long-Conservative UK constituency of North Shropshire caused some political upset (and no little political joy) by electing a Liberal Democrat, Helen Morgan.
It is hard to exaggerate quite how significant a swing this was: the previous Conservative MP, Owen Paterson, whose resignation around accusations of corruption promoted the by-election, had a majority of nearly 23,000 when he was re-elected in 2019. Morgan beat the new Conservative candidate by nearly 6,000.
How was all this possible? One factor will likely have been Conservative voters staying at home, and a few switched to other right-wing parties. But at her acceptance speech, Morgan acknowledged that it was highly likely that voters who would have preferred a Labour MP (the party saw a collapse in its vote share) or a Green MP, lent her their support in order to have the best chance of avoiding a Conservative win. This will lead some to call again for a more formal electoral pact at the country’s next General Election, whereby Labour, the Liberal Democrats and the Greens agree to stand down candidates in seats currently occupied by a Conservative, and where there is a reasonable chance of one of these three parties winning if their anti-Tory rivals stand aside.
In praise of 'casual' friendship
Cross-post from the Uehiro Centre's Practical Ethics blog.
Academics, especially early in our careers, move around quite a lot. Having done my PhD in London, I have also lived or worked in Leeds, Liverpool, Oxford, and rural Pennsylvania; I am far from the most well-travelled academic I know. In many cases, when we arrive at a new job, we know that it is likely to only last a short period, perhaps less than a year.
This blog post isn’t about how hard it is to be an academic (though there are plenty of real problems that arise from the precarity in which many early career researchers find themselves). Instead, I want to consider something which all this moving around necessitates: casual friendship.
Daunte Wright: Policing and Accountability
Cross post from the Uehiro Centre's Practical Ethics blog. Co-written with Jake Wojtowicz.
On April 11th, Daunte Wright was pulled over by police in Brooklyn Center, Minnesota. Shortly afterwards, he was shot and killed by police officer Kim Potter. Police Chief Tim Gannon described this as an ‘accidental discharge’. But framing events like this as accidents can be misleading and is just one way the police may insulate themselves from appropriate accountability.
The word ‘accident’ can bring to mind what we might call ‘sheer accidents’: bad fortune, acts of god, cars hitting the ice and veering off of the road. Even the language of an ‘accidental discharge’ can sound like Potter had the gun in her hand and it just somehow went off. But that isn’t what happened. Potter pointed the gun at Wright and pulled the trigger. She claims she meant to fire her taser.
Priority Vaccination for Prison and Homeless Populations
Cross-post from the Uehiro Centre's Practical Ethics blog
Last week brought the news that an additional 1.7m people in the UK had been asked to take additional ‘shielding’ measures against COVID-19, following new modelling which considered previously ignored factors such as ethnicity, weight and deprivation. Since many of this group have not yet been vaccinated, they were bumped up the priority list for vaccine access, moving into group 4 of the government’s vaccine plan.
Two other groups, however, have not yet been incorporated into this plan despite appeals from some quarters that they should be. First, new figures reinforced the sense that the virus is disproportionately affecting prisoners, with one in eight of the prison population having had COVID-19, compared with roughly one in twenty in the wider population (in the United States, the prison figure has been estimated to be one in five).
Second, some GP groups and local councils have offered priority vaccination to homeless residents, despite their not officially qualifying for prioritisation on the government’s plan. There have also been calls for the government to incorporate this into national plans, rather than being left to more local decision-making.
Selectively saving Christmas?
Cross-post from the Uehiro Centre's Practical Ethics blog. Co-written with Gabriel De Marco.
The UK governments in Westminster and the devolved nations (Northern Ireland, Scotland and Wales) have made a recent about-turn regarding Christmas. Where there were previously plans to relax Covid-related restrictions for five days, they will now be relaxed for only Christmas itself, and not at all in some parts of the country.
The planned relaxations were extensive. And even following the recent changes, Christmas is being treated in a way that is considerably different to other major religious festivals: no relaxation of lockdown was seen for Sikh festival Vaisakhi, Muslim celebration Eid (where more extensive lockdowns were announced just the day before), Jewish Hanukkah, or Hindu Diwali.
Although it has not explicitly been posed as such, it seems reasonable to think that saving Christmas has been a long-term plan. The timing of the recent ‘second lockdown’ in England is also suggestive. In order to avoid many going into Christmas with infections, and many leaving with new infections, the thought may have been that we needed this “circuit-breaker”; indeed, when Johnson announced the lockdown at the end of October, one hope he expressed was that “taking action” at that point would make Christmas gatherings more likely. And even amid the recent reversal, communal worship can continue even in the new ‘Tier 4’ locations.
Consent without alternatives
Cross-post from the Uehiro Centre's Practical Ethics blog, written with Joshua Parker.
“COVID-19: Do not resuscitate orders might have been put in place without consent, watchdog says”. This recent headline followed an investigation by the Care Quality Commission into Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) decisions early in the pandemic. In a recent post, Dominic Wilkinson highlights two misconceptions in the coverage of this report, one of which is the ‘consent misconception’.
Dominic’s view is that “there is no ethical requirement…to seek the agreement of patients not to offer or provide a treatment” which a medical professional judges inappropriate. Of course, his position is not that consultation and discussion around CPR is inappropriate, only that consent is not necessary. This is the standard view on consent in this context and, due in part to the Tracey judgment, reflects doctors’ practice. Thus, an important distinction emerges between consenting to the withholding of some treatment, and discussion of that decision. Doctors may be ethically required to discuss a decision without also having an obligation to seek the patient’s consent. The absence of consent, then, does not signal that the DNACPR was unethical, whereas a failure to consult probably will.
Rhodes Must Fall: Oxford's Institutional Response
Cross post from the Uehiro Centre's Practical Ethics blog.
I recently watched an excellent panel discussion, ‘Statues, Slavery and the Struggle for Equality’ with Labour MP Dawn Butler, historian David Olusoga, philosopher Susan Neiman, chaired by writer Yassmin Abdel-Magied. The discussion was wide-ranging but, as the title suggests, included a focus on the recent resurgence of demands to remove various statues of figures associated with the slavery and colonialism. One example that will have escaped few readers of this blog is the University of Oxford’s own statue of Cecil Rhodes, which has been the subject of the ‘Rhodes Must Fall’ movement since 2015 and is once again in the headlines. Since initially writing this blog, Oriel College has voted to remove the statue; but it is still important to interrogate the university’s (rather than the college’s) initial response.
That response from university leadership was not promising. The university’s chancellor, Chris Patten, suggested that calls for removal are hypocritical, and that focus should be on “more fundamental” issues such as education and health. Vice-chancellor Louise Richardson claimed that removal of the statue would constitute ‘hiding’ our history, and that we should instead learn from it. She also advised that morally repellent views need to be seen in their historical context.
In these two responses there are at least four arguments against the removal of Rhodes’ statue. I want briefly to explain why none are very plausible. It’s worth noting from the outset, though, that little which I have to say has not already been said by others, including by those involved in the Rhodes Must Fall campaign. Nonetheless, I think it is important as someone employed at Oxford to write about ethics to engage the recent arguments of its institutional leaders.
This is a cross-post of a blog written by me and Josh Parker on Justice Everywhere, based on our recent paper in the Journal of Applied Philosophy.
Consider the following case, hypothetical but not uncommon. Hamza, a junior doctor working in the UK’s National Health Service (NHS) is working a night shift when he mis-prescribes a large dose of morphine to a patient who doesn’t need it. Fortunately, this error is caught by another member of his team, but at worst it could have killed the patient. Hamza was tired, stressed, and relatively inexperienced, but at his stage of training should have known to double check the dose. How should Hamza’s colleagues, and NHS institutions, respond to his serious mistake?
There has been a shift in the NHS in recent years to the idea that in responding to medical errors, institutions should adopt a ‘no blame’ culture. In our recent paper, we take a critical look at this idea, arguing that the no blame approach may throw the baby of responsibility out with the bathwater of blame.