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Conferences

“NOW’s interest in pharmaceutical gender equity seems to have disappeared with its funding.”

15 Jun, 17 | by Iain Brassington

There’s a remarkable piece on the Hastings Center’s blog by Alycia Hogenmiller about a drug called Addyi.  Addyi is a drug that doesn’t work to treat a condition that doesn’t exist, pushed by campaigners who are actually industry shills.

Sprout Pharmaceuticals, run by Cindy and Robert Whitehead, was determined to obtain regulatory approval for flibanserin (Addyi), an antidepressant-turned-aphrodisiac that had already twice failed to gain approval by the FDA.  To create this fake feminist campaign, Sprout hired Blue Engine Media, a PR firm that created a sham organization called Even the Score. The campaign hired two feminists: a former director of the FDA Office of Women’s Health, and the former president of the Women’s Research and Education Institute – both well-known to women’s groups.  Even the Score recruited and paid consumer advocacy groups to pressure the FDA into approving flibanserin for Hypoactive Sexual Desire Disorder – a condition previously created by industry to sell another drug.

I want to know more about those people hired.  What were they thinking?  What did they think they were doing?  What weren’t they thinking?

It’s sad to see advocacy groups become mouthpieces for pharma.  It is even sadder when those mouthpieces are feminist groups that should be protecting the interest of women but instead are protecting a company’s bottom line.  Every single one of the advocacy groups that don’t take money from pharmaceutical companies opposed Addyi’s approval and use.  For example, the National Women’s Health Network, the Jacobs Institute for Women’s Health, the National Center for Health Research, the Reproductive Health Technologies Project, and the New View campaign all publicly opposed the drug before and after approval.  “This decision to approve flibanserin is a triumph of marketing over science,” said Cindy Pearson, head of the National Women’s Health Network.

[…]

Addyi was never a true symbol for gender equity.  The drug doesn’t work well and was never safe.

Just roll back a bit…

Every single one of the advocacy groups that don’t take money from pharmaceutical companies opposed Addyi’s approval and use.

Whoa.

Several lessons can be learned from the story of Even the Score.  First, don’t trust, support, or listen to purported consumer advocacy groups that take money from pharmaceutical companies.

D’ya reckon?

Go and read the whole thing.  It’s astonishing.

The conference in respect of which the post is written looks good, too.

CfP: IME Summer Conference, Liverpool

5 Jan, 17 | by Iain Brassington

Building on the success of three previous conferences held in Edinburgh, Newcastle and London, the 4th Institute of Medical Ethics Summer Conference will take place on the 15th and 16th June 2017 in Liverpool.

Two changes have been made to the conference format for 2017.  First, the Research Committee will accept proposals for individual papers as well as for panels.  The latter will be allocated 75mins and the time can be used for traditional presentations of 15-20 mins or for more collaborative and discursive interactions.  Second, there is a specific call for contributions from the medical humanities.  The IME’s Research Committee hopes to include a stream of medical humanities papers across both days of the conference.

Confirmed Keynote Speakers are Prof Rosamund Scott (KCL) and Prof. Stephen Wilkinson (Lancaster).

Further information can be found here, and the IME  can be found on Twitta via @IMEweb.

The location and date of this year’s conference have been coordinated with the annual conference of the UK Clinical Ethics Network.  Themed “Family Matters”, this will be their 17th Annual Conference.  It takes place on the 14th June, and there will be a short IME/ UKCEN crossover session on the morning of the 15th. For further details about UKCEN’s conference see http://www.ukcen.net/.

CFA/ Registration: Postgraduate Bioethics, 2016

30 Jun, 16 | by Iain Brassington

“Oi, Iain,” says David.  “Could you put a shout out for the Postgraduate Ethics Conference?”

Indeed I could.  The theme is “Bioethics in Theory: Bioethics in Practice”.  Details – including the call for abstracts (the deadline for which is the 8th July) and the registration form – are here.

IAB 2016: Graeme Didn’t Say “None”…

21 Jun, 16 | by Iain Brassington

Every two years, I write a little post-mortem of the IAB conference, mentioning particular high and low points.  But since I’ve heard near-blanket praise for this year’s Edinburgh fandango, there won’t be too many of the latter.  And everyone with whom I’ve been in contact since has been highly impressed; we’re all still on a bit of a high.

So what was particularly good?  Well, in general, I thought that the standard of argument in most of the papers was high: it’s nice to see really big ideas being grappled with.  Matthias Risse’s paper on IP, particularly in the context of making drugs available to the least well-off, was the keynote on Thursday morning, and was notable in this regard.  Risse was arguing that the current IP regime owes too much to Locke, and not enough to Grotius.  In other words, he made no bones about an appeal to 17th-century political philosophy.  A simple and undemanding rehearsal of principlism this was not.  I’d perhaps have liked to hear more about rights to the medicines in question, as a complement to the point about IP rights – after all, unless there’s a right to the medicines, many of the arguments about IP may be moot; but I’m sure that is, or at least could be, done elsewhere.

Similarly, Gillian Brock’s paper about the medical brain-drain left a few questions unanswered – the proposal that there be some kind of mandatory service for professionals from low-to-middle-income countries arguably places a burden on some people for the misfortune of not having been born in a wealthy part of the world, and leaves open questions about what the point of eduction is to begin with (national needs or personal flourishing?) – but was very good all the same.  I missed Catherine Belling’s “Going Under and Coming Round”, but everyone to whom I spoke was mightily impressed – Stephen Latham seemed genuinely lost for words about how good it was; and I also missed Alondra Nelson’s keynote on the social life of DNA, which seems also to have been warmly received.

Of the parallel sessions, one that particularly stands out is Tamara Kayali Browne’s paper on sex-selection; there’s a different-but-related paper by her currently available as a preview in the JME.

On the Arts and Bioethics theme, Adura Onashile’s HeLa was a thoughtful take on a familiar story, and generated a really interesting Q&A; Vishal Shah’s Vellum was a strange and wonderful thing.

The Early Career Researcher emphasis seems to have been a great success, too.

So were there any down points?

  • Well, there were fewer parallel sessions than there have been in previous iterations of the conference (or at least, so it felt); and that did give the thing a slightly different dynamic.  However, I can’t put my finger on exactly what the difference was, qualitatively speaking; and the fact that there’s a difference doesn’t mean that things should have been done otherwise.  With a lot of people having been offered posters rather than oral sessions (one of my submissions being among them), I think that it’s simply a different way of going about things, and I suspect that any quibbles will boil down to taste.  I don’t think that there’re real grounds for complaint.
  • I was a little saddened that I didn’t get to play my normal game of spot-the-bizarre-paper-that-somehow-got-accepted-with-hilarious-consequences, because there was no bizarre paper, as far as I could see.  (Hmmm.  Maybe that means that my symposium paper was the bizarre one.  Eeeep.)  So that’s a minor disappointment, I guess.  But being denied the opportunity of a good facepalm in the pub afterwards isn’t all that much of a hardship.
  • At the ceilidh, a frightening number of people seemed to be unable to count to eight.
  • I was in Edinburgh a fortnight ago, and it was gloriously sunny and warm.  During the IAB, it was cold and wet.  The word “dreich” shouldn’t be usable in June, but it was this time.  Yet it’d hardly be fair to complain about the IAB on that basis.  Besides, nasty weather reduces the incentive to skive and go for a walk up Arthur’s Seat.  Besides besides… it would have been a shame to miss any of the conference.  So who cares about the rain?

Which is as much as to say: no down points really.  Well – except for that one paper talking about assisted dying that relied on a picture of a child next to a headstone where an argument should have been.  You know who you are.

That aside, though, it was all preternaturally good stuff.

After the closing ceremony, I asked Graeme Laurie how many virgins he’d had to sacrifice in order to make sure that things went as well as they did.  He did not say “none”.  Make of that what you will.

Animal Liberation: Sacrificing the Good on the Altar of the Perfect?

24 Apr, 15 | by Iain Brassington

For my money, one of the best papers at the nonhuman animal ethics conference at Birmingham a couple of weeks ago was Steve Cooke’s.*  He was looking at the justifications for direct action in the name of disrupting research on animals, and presented the case – reasonably convincingly – that the main arguments against the permissibility of such direct action simply don’t work.  For him, there’s a decent analogy between rescuing animals from laboratories and rescuing drowning children from ponds: in both cases, if you can do so, you should, subject to the normal constraints about reasonable costs.  The question then becomes one of what is a reasonable cost.  He added to this that the mere illegality of such disruption mightn’t tip the balance away from action.  After all, if a law is unjust (he claims), it’s hard to see how that alone would make an all-else-being-equal permissible action impermissible.  What the law allows to be done to animals in labs is unjust, and so it doesn’t make much sense to say that breaking the law per se is wrong.

Now, I’m paraphrasing the argument, and ignoring a lot of background jurisprudential debate about obligations to follow the law.  (There are those who think that there’s a prima facie obligation to obey the law qua law; but I think that any reasonable version of that account will have a cutoff somewhere should the law be sufficiently unjust.)  But for my purposes, I don’t think that that matters.

It’s also worth noting that, at least formally, Cooke’s argument might be able to accommodate at least some animal research.  If you can claim that a given piece of research is, all things considered, justifiable, then direct action to disrupt it might not have the same moral backing.  Cooke thinks that little, if any, animal research is justified – but, again, that’s another, higher-order, argument.

One consideration in that further argument may be whether you think that there’s a duty to carry out (at least certain kinds of) research. more…

Conference: Compassion Fatigue: Changing Culture in the NHS

18 Apr, 13 | by Iain Brassington

26-28 June, Woodbrooke Quaker Study Centre, Birmingham

(via Andrew Edgar)

Can the language of compassion capture the moral problems confronted by the NHS, or might it obfuscate and distract us from more subtle and demanding issues?

Through a series of plenary addresses, workshops, panels and shared opportunities for discussion, “Compassion Fatigue” will provide an opportunity to explore the language of compassion, and the impact that it has on the practice of health care provision.

More details below the fold. more…

CFP: “Neurotechnological Interventions: Therapy or Enhancement”

6 Sep, 12 | by Iain Brassington

Submissions (of 300 words max) are invited for inclusion at the TILT authors’ workshop on the theme of “Neurotechnological Interventions: Therapy or Enhancement” in Tilburg on 15-16th November 2012.  The workshop is part of the FP 7 RoboLaw project, and will lead to the publication of a volume with papers.

Abstracts shoud describe briefly how the paper that you intend to submit will shed new light on the traditional distinctions and arguments in the debate on human enhancement.  The use of casuistry from cognitive enhancement, neurotechnology or robotics is welcomed, but not a necessary condition.  Contributions from law, ethics, philosophy of technology, science and technology studies, economics and general regulation studies are especially appreciated, but scholars in the social sciences, science and technology should not hesitate to submit.

Although individual papers may take casuistry from the fields of neurotechnology and robotics as their starting point, the workshop papers and the volume to be published will primarily focus on some often returning fuzzy distinctions and arguments in the debate on human enhancement in general.  The distinction between therapy and enhancement itself is exemplary in this respect.  The distinction is often not meant to merely serve the theoretical purpose of creating definitional clarity; it is also often implicitly used to depict a class of actions  as morally unproblematic (therapy) and a class of actions as morally problematic (enhancement).  The distinction has of course been criticized  because of the blurred lines between therapy and enhancement as it builds on a presupposed vague notion of normal health conditions.  The implicit normative connotations, however, also tend to cause a lot of confusion.  In addition, many of the ethical concerns explicitly put forward in the general debate on human enhancement, especially those in which notions such as unnaturalness, cheating,  injustice, dignity et cetera occur, appear to be multilayered and often overlapping with other arguments.  In their clustered compound guise they can easily obfuscate original intuitions or emotions of indignation, but also block possibilities of resolution and agreement.  When they are meticulously analyzed and reduced to underlying constituents these arguments often become more persuasive or at least manageable.

Authors should email an abstract of their paper (relating to the theme and its elaboration) before 15 September, and upon acceptance on the basis of the abstract, a draft of the full draft paper (in .doc, .docx, or .pdf format) before 1 November 2012, so that the papers can be circulated in due time and the reviewers/ commentators can prepare themselves appropriately.  Only a limited number of external invited contributors to the volume can be reimbursed for their costs. Whether a paper will be included in the volume to be published will be decided after receiving the very final version of the paper after the author’s workshop.

Important Dates

Before 15 September: Send an email to anton.vedder{at}uvt.nl with a 300 words abstract of the paper you intend to submit

22 September: Notification of acceptance

Before 1 November: Submission of full paper

Before 8 November: Circulation of papers

15-16 November 2012: Workshop

7 December: Selected final papers to be handed in.

 

via Sheelagh McGuinness

CONF & CFP: 9th International Conference on Clinical Ethics Consultation

13 Jul, 12 | by Iain Brassington

From Ralf Jox (Munich)

Call for Abstracts: “Clinical ethics: bridging clinical medicine and ethics”.

The Ninth International Conference on Clinical Ethics Consultation (ICCEC) 2013 will take place in Munich, Germany.

The conference’s intention is to strengthen the bridge between clinical medicine and ethics by providing a forum for the exchange of experience and discussions between clinicians, ethicists and ethics consultants.  In particular, the conference will feature
“role model consultations” based on real clinical cases from intensive care, dementia care, and oncology.  In addition, plenary sessions will focus on the needs for
ethics consultation from the perspective of clinicians and connect them to the experience of ethics consultants.  Ample time will also be provided for free oral or poster contributions based on an abstract competition.

All colleagues interested in ethics and medicine from all over the world are invited to
make the ICCEC 2013 a lively experience and a forum for fruitful exchange and helpful information.

The Scientific and Advisory Committees have identified the following four topic areas of interest: more…

IAB 2012: The Aftermath

30 Jun, 12 | by Iain Brassington

There seems to be general agreement among those to whom I’ve spoken, or who’re on Twitter, that this years IAB in Rotterdam was one of the best, if not the best.  Granted, the parallel sessions were very short – there’s not much you can do in 8 minutes – but the organisation was superb, and the range of plenary speakers excellent.  Solly Benatar is always worth hearing; and though Aubrey de Grey is – in my opinion – mad as a box of frogs when he’s on about aging, I could happily listen to him speak all day: he’s excellent.

And there was no magic dancing.  There was a bit of magic in the opening ceremony, and some perplexing dancing in the closing one… but no magic dancing.  Actually, there’s a part of me that regrets that a bit.  I did try to play the game where you try to work out and attend the really bad paper that got selected by accident – but I didn’t notice anything that came close to that.  The quality of the parallel papers was high.  Ditto the posters: I confess that I don’t really understand how poster sessions are supposed to work for ethics and law; but I liked the way they were thematised and treated as stimuli for mini-oral presentations.

For me, John Coggon’s paper at the “nudge” symposium was the best of the conference – and that’s not incestuous promotion of Manchester people, because he’s buggering off to Southampton.  I’d like to have seen Stephen Latham’s paper on political theory, too: I was elsewhere, but Christian Munthe was doing a fine job of live-tweeting everything he saw.

What were other people’s thoughts?  Do say in the comments.

In the meantime, we’ve already opened the #IAB2014 hashtag on twitter.  Mexico, here we come.

Why philosophical theorising about distributive justice in health care (mostly) doesn’t work

28 Jun, 12 | by David Hunter

I had the pleasure yesterday at the IAB 2012 to see Daniel Wikler run a symposium on population level bioethics – which primarily focused on prioritisation decisions. This was useful for me since it helped me coalesce why I think many if not all attempts to give a philosophical account of distributive justice in health care (and perhaps more generally) are doomed to fail. The methodology that Wikler et al adopted was to give a variety of cases which were in his words designed to isolate one element of tension for example fair chances vs efficiency so that we could evaluate and become more clear about what we value and why.

Now I don’t want to suggest such an approach is worthless – I do think it can help clarify what we think is and isn’t important, clarify concepts and so on. However much of the content of the symposium was similar to a symposium run by Wikler et al at the 2006 IAB in Beijing and for those of us who had attended both there was a sense that things hadn’t moved on much since then. I say that with no disrespect intended to Wikler et al – distributive justice in health is notoriously had and intractable so a lack of much progress is no sign of a lack of quality.

One of the cases they pulled up was interesting because it was iterative in nature – in the first case you have enough money to either vaccinate the 800 people who live in the city or the 200 people who live in the mountains. The majority of the audience chose the obviously efficient option. Then more money becomes available and you can now either vaccinate the remaining 200 in the mountains against that disease or vaccinate the 800 in the city against a new equally nasty disease. In this case Wikler reported that the majority of people they show the case to want to vaccinate those missed out in the first round which is puzzling since it is basically the same decision as in the first case but the opposite option is selected.

I think this case is useful to point out some flaws in this methodology and indeed in many approaches to distributive justice in health care. Taking isolated one off cases is of limited use because they make health care decisions too easy, health care decision making is (as I’ve argued elsewhere) inherently iterative if we spend money now to save X then that is likely to generate more health care needs and hence costs from X in the future. Hence decision making in health care prioritisation is embedded in time, and cannot be easily separated from its downstream impacts. As I’ve argued here: in regards to new technology this is unhelpful as a way to approach impacts. As I’ve argued here in regards to new technology this is unhelpful as a way to approach thinking about distributive justice because it prioritises justice at a particular point in time rather than justice overall. This is thinking about healthcare in the wrong way, it is like trying to understand a 3d scene by looking at a 2d snapshot – you can get an idea of what is happening but certainly not a complete understanding.

So what is the way forward in philosophical thinking about distributive justice in health care? Unfortunately I don’t have much positive to say, it is a matter I think of trying to be sensitive to the complexities of the actuality of health care decision making and muddling through.

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