A couple of weeks ago, the government announced that, from 2013, all nursing staff would have to be graduates.  ”Degree-level education,” said Health Minister for England Ann Keen,

will provide new nurses with the decision-making skills they need to make high-level judgements in the transformed NHS.

I’m not so sure of this. more…

On the 23rd of October I attended a workshop at Keele University (where I am based) focused on the topic of Conscientious Objection. This is a topic which I have some interest in (in 2001 I wrote a short dissertation on the topic within the context of euthanasia) however this workshop interestingly picked up on the topic from within three distinct arenas.

more…

There’s an essay by Diego Gracia called “Palliative Care and the Historical Background” that I frequently use in classes about Care ethics, and there’s a passage in it that always gets a fascinating reaction from students.  In this passage, Gracia claims that

the true goal of medicine has always been curing, rather than taking care of the patient. Caring has never been the goal of medicine.

In fact, in the context of palliative care, he takes this one step further:

Thus, if the type of care specific to medicine is curing, then palliative care has nothing to do with medicine…

more…

If you’re going to fight a war, you need to know whom you’re fighting.  You also could do with knowing when to stop fighting.  Johann Hari is eloquent in this piece on the so-called “war on drugs”: the time to stop is now.

Yes, it is shocking that he was ditched for pointing out the mathematical truth that taking ecstasy is less dangerous than horse-riding and smoking cannabis is less harmful than drinking alcohol. But this is how the war on drugs has to be fought. The unofficial slogan of the prohibitionists for decades has been: The facts will only undermine the war, so invent some that show how successful we are, fast.

[...]

Imagine a country with no drug dealers killing to protect their patch or terrorizing whole estates. Imagine a country where burglary fell by 60 percent. Imagine a Britain where we spent all these billions treating addicts as ill people who need our help, not hunting them down as criminals who need punishment. We can be that country. We just have to come down from chasing the dragon of a drug-free world – and start looking soberly at the facts.

Meanwhile, Drugscope has produced this table of harms:

Table 1 Drug-related deaths in England and Wales 2000 to 2004[4]

Cocaine	575
Amphetamine	384
Ecstasy	227
Solvents	246[3]
Opiates (heroin, morphine & methadone)	4,976
Alcohol	25,000 - 200,000 approx.
Tobacco	half a million approx (UK - [1]

(Hat-tip: Dr Grumble)

Note that we’re talking about drug-related deaths here - so the number of people killed directly by, say, Ecstasy is likely to be lower.  Given the vast number of disco-biscuits taken every week in the UK, it’s not a bad record at all.

Reproduced from the PEA Soup blog:

We are very pleased to announce a new partnership between PEA Soup and the distinguished journal, Ethics.  In addition to our regular postings, PEA Soup’s editors will select one article from each issue of Ethics to be the focus of a featured discussion on our blog.  Ethics, in turn, will make an on-line copy of the featured article available to our readers for free (for three months).  At the time of the article’s publication, we will post a link to the open-access copy, and then a week later an open discussion of it will be introduced with a critical précis by an invited discussant.

We expect that this partnership will give rise to a series of lively and productive conversations.  Stay tuned for details on the first featured article, which will be selected from the next issue of Ethics (Volume 120, Number 1).

Special thanks to everyone at Ethics, especially its Editor, Henry S. Richardson, and Managing Editor, Catherine Galko Campbell, for their help and participation.

Nice idea!

Damn.  I thought I’d published this a couple of weeks ago.  Anyway…

David Nutt tells his side of the cannabis sacking story in The Guardian, based on a longer piece here.

A sample - or, if you will, a ‘teenth:

What we can say is that cannabis use is associated with an increased experience of psychotic disorders. That is quite a complicated thing to disentangle because, of course, the reason people take cannabis is that it produces a change in their mental state. These changes are a bit akin to being psychotic – they include distortions of perception, especially in visual and auditory perception, as well as in the way one thinks. So it can be quite hard to know whether, when you analyse the incidence of psychotic disorders with cannabis, you are simply looking at the acute effects of cannabis, as opposed to some consequence of cannabis use.

[...]

The other paradox is that schizophrenia seems to be disappearing (from the general population), even though cannabis use has increased markedly in the last 30 years. So, even though skunk has been around now for 10 years, there has been no upswing in schizophrenia. In fact, where people have looked, they haven’t found any evidence linking cannabis use in a population and schizophrenia.

[...]

Does deterrence impact on drug use? We don’t know. In fact, the outcome may be the opposite of that predicted. It may be that if you move a drug up a class, it has a greater cachet.

It’s powerful stuff - though I’m not so sure about that last bit.  I’m not sure that classification makes the blindest bit of difference to use, and though I’ve come across plenty of people talking about their consumption of class As, none of them has consumed them because they’re class A.  However, I am pretty sure of one thing: criminalisation forces drugs underground, which forces up prices and keeps users dependent and with a disincentive (or at least an imagined one) to seek support to stop.  Socially, it’s a disaster.

Bristol, 13-15 April.

The aims of this conference are:

To examine the nature, scope, causes, and grounds of progress in medicine.

To provide a forum for developing the unified study of the history and philosophy of medicine, and in particular raising the profile of the philosophy of medicine in the UK and its engagement with the history of medicine.

To create interdisciplinary bridges between the medical, philosophical, and historical professions, enabling medical professionals to become more theoretically engaged, while philosophers and philosophically-minded historians of medicine engage with the actual practice of medical professionals, so that their research reflects the realities and needs of modern medicine.

To facilitate the wider dissemination of research into the philosophy and history of medicine beyond the boundaries of those disciplines, and especially in medical practice.

To identify opportunities for public engagement concerning the relation between medical progress and changing attitudes to medical knowledge, the medical profession, and medical authority.

Conference website (with link to CfP) here.

In the replies to this thread, The Witch Doctor asks this:

A Scenario:

Apparently there are some sites on the web just now claiming that the world is going to end in 2012. Some teenagers are becoming agitated.

I don’t want to be around when the world ends, so I’m going to drink some poison and present to my local A and E department on Halloween 2011. If conscious I will refuse treatment but ask to be kept pain free and as comfortable as possible while I make a “dignified exit” anticipating the end of the world.

I will also carry an AD in case I become unconscious before arriving at A and E.

If conscious, I will be assumed to be competent until proven otherwise. I will pass the competency test. I do not have a mental health problem. I have just been spending too much time surfing the web.

Should the medical staff allow me to die when the time comes and if not, why not?

It’s a good question - though I’d rephrase it slightly to “if so, why; and if not, why not?” at the end.

I’m curious to know what the readership here thinks.  Since I’ve posted my reply in the old thread, I’ll keep out of it as much as possible.

Edinburgh, 20-22 November

Details here

I’ve noted David Nutt’s unhappy relationship with the government that employed him before now - it was he who was told by erstwhile Home Secretary Jacqui Smith to apologise for having the temerity to point out that Ecstasy is probably safer than equestrianism; apparently facts play, and ought to play, no significant role in discussion of drug policy.

As has been all over the news for the last 24 hours, Nutt has been sacked asked to resign by Home Secretary Alan Johnson, again for pointing out that current drug policy isn’t all that well directed, since a disinterested appraisal of the facts would lead one to the conclusion that Ecstasy, cannabis and LSD are all less dangerous than alcohol and tobacco, the drugs of choice for (ahem) “nice” people.  (There’s a nice little piece in the Indy about this here.)

Meanwhile, Chris Huhne, Lib Dem shadow Home Secretary, has accused Johnson of caring little for independent advice, and that ministers

should save public money by sacking the entire group of experts and instead appointing a committee of tabloid editors.

And this might be amusing, were it not for the fact that it’s not so far away from reality: the Daily Fail is already calling Nutt a “serial offender”, and Amanda Platell, in her sorry excuse for a column in that sorry excuse for a newspaper, proclaims that