You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

Julian Sheather

Julian Sheather: Time to claim kin with the volcanologists?

30 Oct, 12 | by BMJ Group

No, I am not about to declare myself a closet trekkie. I have in mind the decision by Judge Marco Billi to jail six Italian seismologists for giving ‘false assurances’ before an earthquake hit L’Aquila in 2009, a decision, as the BBC just couldn’t help saying, that sent “shockwaves” through the scientific community. What made the alleged assurances false was not scientific mendacity but the complexity and unpredictability of the world. As Bill McGuire, professor of geophysical and climate hazards at University College London, put it: “Most of the time, small seismic shocks, such as were experienced in the L’Aquila region for months before the ‘big one’, are not indicative of a larger quake to come. Franco Barberi was absolutely correct, therefore, to announce – a few days before the magnitude 6.3 quake that flattened much of the city – that there was “no reason to believe that a swarm of minor events is a sure predictor of a major shock.”‘ Personally I cannot spot an assurance there, false or otherwise, just an honest statement of scientific uncertainty. more…

Julian Sheather: Safeguarding adults—respecting freedom, maximising welfare

18 Oct, 12 | by BMJ

I was in Bromley recently at an adult safeguarding conference. It was in some respects a melancholy day. We heard about Brent Martin, a 23 year-old with learning disabilities and a mental disorder beaten to death by members of a gang who temporarily befriended him, though largely for access to his benefits. He had been in psychiatric care since 16 and was discharged three months before he was killed. The proximate cause was a five pound bet on a 16 year old being able to knock him out with a single punch. We heard a lot about “hate crime,” where attacks are motivated at least in part by the victim’s membership of a particular social group. Being black, being disabled, even being a “goth” were enough to make people targets. We were also given a copy of The little book of big scams. I have grown accustomed to the phishing emails that drop with tedious regularity into my inbox. I had no idea quite how ingenious the fraudsters had become. It reminded me of something VS Naipaul said about our capacity to see human beings as prey. It also reminded me how easy it is, viewed in a certain light, to fall out of love with our kind. more…

Julian Sheather: What’s wrong with moral enhancement?

12 Sep, 12 | by BMJ

The question of whether biotechnology should be deployed to improve human beings morally is starting to climb out of the pages of recondite publications and dip a quizzical toe in mainstream media. A recent article in the Telegraph quotes Professor Julian Savulescu from the Oxford Uehiro Centre for Practical Ethics saying that, should it ever become possible, the use of genetic technology to screen out morally unworthy characteristics should be morally obligatory. “When it comes to screening out personality flaws, such as potential alcoholism, psychopathy, and a disposition to violence, you could argue that people have a moral obligation to select ethically better children.” “We’re routinely screening embryos and foetuses for conditions such as cystic fibrosis and Down’s syndrome,” he continues, “and there’s little public outcry.” more…

Julian Sheather and Vivienne Nathanson: Todd Akin, rape, and “doctors”

3 Sep, 12 | by BMJ

Vivienne Nathanson

According to the historian Tony Judt, the Red Army, after raping and brutalising its way across Europe in the closing stages of the Second World War, left behind, in Germany alone, somewhere between 150,000 and 200,000 “Russian babies.” These figures, he writes, “make no allowance for untold numbers of abortions, as a result of which many women died along with their unwanted foetuses.” Recently, asked his views on whether abortion should be banned even if the pregnancy resulted from rape, Todd Akin, a US Republican congressman running for the Senate, replied that such pregnancies were “really rare.” Despite being a member of the House Committee on Science he stated that “from what I understand from doctors…if it’s a legitimate rape, the female body has ways to try to shut the whole thing down.” It is tempting just to leave those juxtaposed sentences standing there, to permit the fatuity of that last statement to speak for itself, but the more you think about it the more the buried assumptions in it, the more the meretricious misuse of science and morality clamour for a voice.

more…

Julian Sheather: Doping in sport—thoughts on another Olympic legacy

16 Aug, 12 | by BMJ

Every once in a while I dust off my old road bike and head out onto the North Downs to take in a few hills. Panting up a short sharp rise is about as close to elite athleticism as I get—and it is not unusual for me to get off and push. It is from these foothills that I look across to the distant Himalaya of Olympic sports. Draw a veil over the grubby politics, forget about the ticketing problems—I only got three in the end, for the men’s volleyball—inure yourself to the corporate takeover: the heart of the matter surely lies in that look upwards—here is a kind of human excellence at its fullest reach, perhaps the one excellence that in these egalitarian times we are permitted to contemplate without misgiving. This is what a human being at full stretch is capable of. more…

Julian Sheather: Anders Breivik and the social uses of psychiatry

16 Jul, 12 | by BMJ

I have been gripped by the trial of Anders Breivik and was intrigued to see the BMJ hosting a Maudsley debate this week about, loosely speaking, Breivik’s “sanity.” The debate ran under the headline question of whether fanaticism is a form of madness which gave a slightly odd spin to the proceedings. As Tom Fahy hints, given that few football fans are incarcerated in secure institutions I am not sure fanaticism in and of itself is necessarily the problem. If political and religious fanaticism are the real problems—mortal threats to the west—then what follows if fanaticism is diagnosed as a mental disorder? What advantage, analytical or practical, could it possibly bring? Can medicine really help frame this debate? more…

Julian Sheather: Happy-ology

12 Jul, 12 | by BMJ

It is possibly the oldest of all philosophical questions. Although academic specialisation has tended to brush it to the wings—embarrassed perhaps by the sheer indeterminate unwieldiness of it—the question of what constitutes a good or flourishing life and how we can live one will not, for good human reasons, go away. And if academic philosophers have tended to ignore it, politicians, particularly liberal ones, have often been embarrassed by it. For if there is such a thing as a good life, rather than just an infinite variety of lives each of them good according to its lights, then surely society has some role, however attenuated, in promoting it? And this can give liberals a headache. To give a domestic example, should I acquiesce in my son’s decision to forego school today in favour of spending fourteen hours playing Halo—should I see it as the autonomous expression of a legitimate lifestyle choice—or am I justified in telling him that if he doesn’t haul his backside off the sofa I’ll throw his X-box out the window? more…

Julian Sheather: Vulnerable adults, coercion, and the inherent jurisdiction of the High Court

3 Jul, 12 | by BMJ

In law, the capacity to make a specific decision has a binary quality. Somewhat like a light it is either on or off, you either have it or you don’t and there are no intermediate states. Yes capacity can fluctuate, the bulb can wink on and off, but at any one time we either have the ability to make a specific decision or we do not. For strong liberty promoting reasons, the law is jealous of the right of adults to make decisions. This is reflected in the legislation around incapacity: it imposes an obligation on those assessing capacity to make all reasonable efforts to enhance it; the burden of proof of incapacity also falls on those who assert it. more…

Julian Sheather: Autonomy and the anorexic patient

21 Jun, 12 | by BMJ

There was extensive media comment this weekend about the Court of Protection’s decision to authorise the force-feeding of a seriously anorexic former medical student with a critically low BMI. The woman, referred to only as “E,” is 32 and following sustained sexual abuse as a child has suffered from an eating disorder since she was 11. Without urgent medical treatment, including involuntary feeding, she will die. She has had four episodes of treatment in specialist eating disorder units and one in an alcohol treatment unit. With great reluctance, E, her parents, and the professionals involved in her care came to the conclusion that all available treatment options had been exhausted. She was transferred to a community hospital for palliative care and put on an “end of life” care pathway. After five weeks on the pathway, her Local Authority bought her case to the Court of Protection concerned that it needed further investigation. more…

Julian Sheather: Autonomy and the right to refuse life-sustaining treatment

19 Jun, 12 | by BMJ

The recent case of a young Jehovah’s Witness in a sickle cell crisis refusing essential blood products and being allowed to die confirms what should by now be widely known: a competent and informed adult has a right to refuse medical treatment even where the refusal will result in his or her death. Although there were some concerns that the young man’s choice was being influenced by his mother, also a Witness, an independent doctor confirmed that he had capacity and was making a free choice. A clear restatement then of established law: outwith mental health legislation a doctor providing treatment in the face of a competent adult refusal is effectively assaulting the patient. As Lord Donaldson stated in an influential judgment Re:T: more…

BMJ blogs homepage

The BMJ

Helping doctors make better decisions. Visit site



Creative Comms logo

Latest from The BMJ

Latest from The BMJ

Latest from BMJ podcasts

Latest from BMJ podcasts

Blogs linking here

Blogs linking here