The BMJ Group journals Sexually Transmitted Infections and Journal of Medical Ethics, in conjunction with academics at the Centre for Social Ethics and Policy (University of Manchester) and the Health Ethics and Law Network (University of Southampton), would like to publish a collection of articles on the criminalization of disease and sexually transmitted infections. We invite article contributions to be published as part of this themed collection.

Funding has also been sought from the ESRC for a seminar series on the same theme and, if successful, authors contributing to this collection may also be invited to present their papers at one of the seminars (which will take place in winter 2012/13 and summer 2013 in Southampton, and winter 2013/14 and summer 2014 in Manchester).

Themes

The use of criminal law to respond to infectious disease transmission has far-reaching implications for law, policy and practice. It presupposes co-operation between clinicians and criminal justice professionals, and that people who infect others can be effectively and fairly identified and brought to justice. There is a potentially difficult relationship between criminal justice and public health bodies, whose priorities do not necessarily coincide. We are interested in receiving papers of broad interest to an international readership of medical ethics scholars and practicing clinicians on any of the following topics:

·      Legislative and policy reform on disease and sexually transmitted infections

·      Health services and the police: privacy, state interference and human rights

·      Evidence and ethics: prosecuting ‘infectious’ personal behaviours

·      Clinicians and the courts: the role of health professionals and criminal justice

·      The aims of criminalization and public health: a compatibility problem?

·      International comparative studies on disease and criminalization: policy, practice and legal issues

More details below the fold. more…

I’m currently working my way through the recently-released report by the Commission on Assisted Dying – it’s a long and appropriately life-sapping document, but a number of commentators has been quicker than I to get through it.  Douglas Noble, writing at the BMJ blog, isn’t impressed.  Based on what I’ve read so far, I’m tempted to agree – though for different reasons.

Anyway: Noble makes a claim that’s a bit puzzling:

In political terms this issue is a dead duck – so why the continual fascination by a minority of vocal campaigners?  The answers are complex.  Perhaps, though, it is ultimately because of an inability to accept that suffering is an integral part of our world, common to all who share the human condition. Dealing a fatal injection and dressing it up as dignity is not a solution to suffering and pain. High quality palliative care is part of the answer, but so too is the effect of the affection, love, and commitment (sometimes over long periods of time) that we can show to one another when the worst hand is dealt.

He may be right in the dead-duck bit.  But his comments about suffering are odd. more…

There’s a slightly curious correspondence taking place in the BMJ at the moment that concerns assisted dying.  Des Spence started things moving with this short piece.  For the most part it is (sorry to say) a slightly pedestrian and simplistic overview of the state of the assisted dying debate.  One of the arguments against AD that he cites, for example, rests on the idea that it violates a doctor’s moral duty – which seems to me to be just the teeniest bit question-begging.  The rest of the anti- paragraph is a shopping list of the standards.  The next paragraph tells us that the pro-arguments are also strong, but he makes the mistake of claiming that it’s autonomy that does the work here.  It ain’t.  Not in respect of assistance.  I don’t violate your autonomy by not helping you to die.

So far, so workaday.  But a potentially interesting point is made next:

[A]ssisted dying is happening every day throughout the NHS. The doctrine of double effect means that doctors give large doses of morphine near the end of life. We know that this will hasten death, but we square this moral circle by accepting that we are relieving suffering. Doctors also widely withhold and withdraw treatment knowing that this will hasten death. Isn’t the reality that we are already actively engaged in assisted dying?

There’s an error here, too, I think: but it’s an interesting one.   more…

It’s a while since I’ve said anything about drug policy, but a story in the BMJ a couple of weeks ago caught my eye.  It would appear that the International Narcotics Control Board, a UN agency, has issued a report in which it advocates the prohibition of whole classes of substance:

National governments need to adopt generic bans to control entire groups of substances that can be used to make designer drugs, a United Nations report has said.  According to the 2010 annual report of the International Narcotics Control Board, designer drugs are being produced faster and in growing numbers than ever before and are easily available over the internet. Designer drugs imitate the effects of ecstasy, amphetamines, and cocaine.

[...]

In the UK the government banned the drug mephedrone last March after several deaths were attributed to it. But the board says that manufacturers get round laws by slightly modifying the structure of drugs, making it difficult for governments to keep pace with changes.

Hamid Ghodse, President of the Vienna based Board, said, “Given the health risks posed by the abuse of designer drugs, we urge governments to adopt national control measures to prevent the manufacture of, trafficking in and abuse of these substances.”

This approach is wrong-headed: banning things does not make the demand go away – it just means that the production evolves. more…

There’s a story in the BMJ about a German surgeon who refused to operate on an anaesthetised patient because he – the patient – had a swastika tattoo.  The surgeon, it’s reported, was a Jew who couldn’t find it in his conscience to operate on anyone with Nazi sympathies.  The head of the German Medical association has said that the surgeon should not be reprimanded.

While I have a fairly visceral dislike of the far right, which extends to anyone with far-right sympathies, I think that this opinion is flawed.  There’s several reasons for this, and they refer to all the players in the scenario. more…

Many readers will be familiar with the “Sokal Hoax”, in which a nonsensical paper was submitted to, and accepted by, the journal Social Text, thereby demonstrating the vacuity of at least some PoMo theorising.  Well, John MacLachlan has repeated the feat, having had a patently absurd abstract accepted for presentation at a conference on integrative medicine.  How absurd?  Well, even I saw through it.

That’s pretty absurd.

He does raise an interesting question, though: more…

An article in a recent BMJ has caught my eye: Yates and James’ “Risk Factors at Medical School for Subsequent Professional Misconduct: Multicentre Retrospective Case-Control Study”.  Based on an admittedly-small sample, it suggests that

male sex, lower estimated social class, and poor early performance at medical school were independent risk factors for subsequent professional misconduct.

A number of comments on the “Rapid Responses” page – and the authors themselves – indicate that the survey isn’t big enough to say much of much importance, but they find it interesting nonetheless.  For the purposes of this post, I’m not all that bothered by questions of statistical significance, or even by any policy implications that such findings may have.  There’s a number of other interesting points to make. more…

Keith Taylor Tayler (sorry!), in a reply to the Purdy post below, raises the question of why journals are so expensive and inaccessible to those who don’t have institutional access.  It’s a very good question – and one that Brian Leiter’s recently been mulling, too.  (UPDATE: This is a point that applies equally well to those who the non-academic and the would-be academic.  There’re plenty of members of the public who would like access to journals… and there’s no shortage of people like me, either.  Five years ago, I was on the dole with a PhD that wasn’t going to generate any papers; I really could have done with online access to journals to keep up with the field and to be able to do some research in my ample spare time.  No job, no access; no access, no new papers; no new papers, no job; no job, no access…  I got lucky enough to be able to break the cycle, but I didn’t like having to rely on luck.  Nor did the person in the dole office understand my predicament.)

Not that I’m complaining about anything published by the gods of the BMJ.  Oh, no.  They’re all beyond reproach, obviously.

Daniel Sokal has been busy again Success from surgical checklists breeds idea for ethical checks suggesting that clinicians ought to consider adopting an ethics checklist to use on their rounds.

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The BMJ is having it’s once yearly wrangle about the regulation of research in the UK: It’s time to change how Europe regulates research

Many of the suggestions made and complaints are to some degree valid, the present system is cumbersome (though I think moving in the right direction in many ways such as the introduction the Intergrated Research Application System (IRAS)). Efficiency could be increased without a significant loss to the quality of scrutiny.

However two counter points deserve to be made:

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