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 Group site.

Gratuitous Misuse of the Blog

Testing, testing…

24 Mar, 14 | by Iain Brassington

So, yeah.

It’s been a bit quiet here, hasn’t it?

There’s been a range of reasons.  Mainly, it’s had to do with David and I both having to do (whisper it) real w*rk, and that’s got in the way.

And then WordPress went a bit odd, which made it impossible to post anything.  (Part of the reason for this post is to confirm that I can publish something.)

And something else, too, from my personal perspective: I’ve been blogging here since 2008, and it’s hard to stay grumpy for that long.  Even for me.  So think of recent quietness as a sabbatical.  I think my grumpiness is recharged now, though.  So there’ll be a guest post going up soon, and then – I hope – back to something like normal from me.

Hello, hello; it’s good to be back.  I’d post a link to a vid for that, too, except for the unfortunate associations with Gary Gli…  Wait: what?  The Glitter Band is still touring?  Good grief.  Well, if they can keep going, I have no excuse, do I?

Still can’t embed videos, though…

How to write a crap essay/paper in bioethics – or how to write bioethics to be published in medical journals…

7 Oct, 13 | by David Hunter

I’ve been considering writing a reflective piece about the general quality of bioethics papers in medical journals, focusing on how the medium (the audience and the severe word limits) impacts on the message and its quality – possibly as a bit of a moan since I’ve not yet managed to get a medical journal to accept one of my papers (my favourite rejection from an editor yet being “nice try, but too philosophical – maybe try the journal of medical ethics?”). Furthermore publication pressures tend to select for particular styles of pieces – I’ve remarked to people in the past that the way to get published in the BMJ is to write a piece critical of research ethics review - preferably with an anecdote  Then this morning on twitter I saw this lovely funny piece by James Lenman of the University of Sheffield on how to write a crap essay in philosophy which contains gems such as:

 “Whenever in any doubt as to what to say about X, say, apropos of nothing in particular and without explanation, that X is extremely subjective.

When that gets boring, try saying that X is all very relative. Never say what it is relative to.”

And I decided to just borrow and extend the idea in this piece. So take James’ rules as given and add these rules to enable the reader to write a crap piece of work in bioethics:

1. Unreflectively copy a piece of work by a philosopher. If they wasted time qualifying their view or noting it only applies in a limited situation make sure you strip that out.

2. Remember if you are a doctor you don’t need good arguments – you have authority… Remember if you are a philosopher you don’t need to know the context to write authoritatively about it.

3. Never use an argument where an anecdote will do. A homily is worth a thousand arguments.

4. Instead of making an argument, say “I will argue”. Then don’t, an assertion will do. No one will notice.

5. Don’t ever make a modest claim when you can make a bold assertion. Only extremes can be correct.

6. According to the OED it is important to define your terms using the dictionary not how they have been defined in the relevant literature.

7. Please do begin your paper with a vaguely relevant quote from “Literature” this shows that you are well read and thus quite clearly correct. As D’Israeli said: “The wisdom of the wise, and the experience of ages, may be preserved by quotation.”

8. If empirical evidence is relevant to your paper make sure you either don’t find any or you just run a google search and then cherry pick the evidence to support your case without considering its quality.

9. Remember the is/ought problem is a philosophical problem not a bioethical problem so you don’t need to worry about it when making grand assertions from tiny bits of empirical evidence.

10. Ad hominem is a valid argument structure.

11. All slopes are slippery. If its bad and it is remotely possible let us assume that it will happen.

12. There are no principles/theories but the four principles.

13. Obviously the four principles approach is the only one worth considering. Make sure you refer to all four principles (but nothing other than them) especially if several of the principles are irrelevant to the situation you are discussing – before concluding that autonomy trumps the others.

14. Remember the more arguments/assertions you can give the better – why waste time on critical reflection and depth when you can squeeze in more arguments/assertions. Especially ensure that there is no methodological or theoretical consistency about the position you advance.

15. If your argument gets into trouble you can save it by referring to Nazi Germany and implying that your opponents view would have been looked on kindly there.

Please suggest more rules in the comments…  

PhD funding in ethics and/ or law at Manchester School of Law

28 Jan, 13 | by Iain Brassington

Details here; bioethics PhDs are available in the conventional form, or as a structured PhD in Bioethics and Medical Jurisprudence.

NB: the first deadlines are next week, so get your skates on.

 

A Little Something for the Holiday…

22 Dec, 11 | by Iain Brassington

Here’s a little holiday challenge for you: come up with a bioethical controversy that some dark part of your soul wants to be real, if only because (a) you can get a paper out of it, and (b) it’ll cause heart attacks among the sort of people who make a point of listening to The Moral Maze.  The only real constraint that I’m placing is that your scenario has to be at least on nodding terms with plausibility.

Put the title of the paper, and the abstract, in the replies.  Since the scenarios you’ll describe will almost certainly never arise, there’s no need to worry about having your thunder stolen.  Although, thinking about it, it’d be interesting to see if any real papers did materialise.

Here’s mine to get you going.

How Reproductive Cloning can Solve the Organ Shortage.

Saviour siblings have enjoyed a reasonable amount of attention in the bioethical literature over recent years, with a significant number of voices arguing in favour of the permissibility of deliberately choosing embryos that are tissue-matches for older siblings – though perhaps with the proviso that the parents should have been intending to reproduce anyway.  But what about adults who develop serious health problems requiring a transplant?  One potential solution to the problem is therapeutic cloning.  However, this is potentially problematic, on the grounds that it involves creating a human life just to harvest component parts.  A better solution would be to create a saviour sibling by means of reproductive cloning; this would mean patients benefit from new bone-marrow, and a nice new baby brother or sister.

Sheelagh McGuinness tells me that she and Margot Brazier cooked up something to beat this a while ago, and described the outline.  It was impressively weird: I hope she posts it.

Symposium on Public Health and Political Philosophy

28 May, 11 | by David Hunter

We are happy to announce a symposium on Public Health and Political Philosophy hosted by the Centre for Professional Ethics at Keele and funded by the Wellcome Trust.

The symposium will run from 10 – 5 on the 17th of June and is at Keele University. (Directions to Keele can be found here:
http://www.keele-conference.com/21/directions )

Public health raises issues that are familiar in political philosophy,
such as when is it permissible for the state to force people to do
something either for their or others good, how we ought to distribute
scarce resources, decision making in situations of fundamental
uncertainty and the limits of common moral concepts such as
responsibilities in the face of disasters.

The focus of the symposium will be on topics in public health where
ideas from political philosophy are relevant. We are particularly
interested in the interplay between public health ethics and political
philosophy, and what these two areas can learn from each other.

Speakers include:
Dr James Wilson, UCL
Dr Martin O’Neill, York
Dr Simon Clark, Nottingham
Dr Stephen John, Cambridge
Mr Adrian Viens, Queen Mary

Attendance is free however places are strictly limited so please contact David Hunter at d.hunter@peak.keele.ac.uk to book a place.

There will be a limited number of travel subsidies up to the value of
£50 available for students who wish to attend the workshop available on a first come, first served basis please indicate if you would like to be considered for such a bursary when you book your place.

In ur videoz, appreciatin ur formz

27 May, 11 | by Iain Brassington

After yesterday’s maundering on about Kant, here’s an example of how to keep philosophy in its rightful place.   I like to think that the cat was thinking, “Holy tables?  Really?  I’m going to have to save you from yourself here, matey”.

(props to HappyToast for the link.)

Musing about Kant (2)

26 May, 11 | by Iain Brassington

It’s very easy, having encountered Kant for the first time, to think that his account of morality is much too cold and impersonal to be plausible – the sort of thing you might expect from a computer rather than a human.  And though this criticism is rather simplistic – I think that Kant does have a deep humanity to him: it’s just that he doesn’t think that that should inform morality – I wonder whether there’s something to it after all.  I wonder whether there’s a reading of Kant that could only make sense to intelligent computers, and – more importantly – computers in a network; and whether such an account of morality would come naturally to them.

The starting point for this little essai (and I make no claims that the thoughts expressed here are particularly well-developed: all I’m doing is taking the opportunity afforded by the blog to publicise some stuff that’s been knocking around my brain for a while) is fairly straightforward: Kant’s separation of the sensible and intelligible parts of human life.  As far as he’s concerned, morality has to do with the latter rather than the former (because sensibility implies determinism; morality implies freedom; freedom implies autonomy; autonomy implies the will; and the will is practical reason); he claims that

a rational being must regard himself qua intelligence as belonging not to the world of sense but to the world of understanding.  Therefore he has two standpoints from which he can regard himself and know laws of the use of his powers and hence of all his actions: first, insofar as he belongs to the world of sense subject to laws of nature (heteronomy); secondly, insofar as he belongs to the intelligible world subject to laws which, independent of nature, are not empirical but founded on reason.

As a rational being and hence belonging to the intelligible world, can man never think of the causality of his own will except under the idea of freedom.  […]  Now the idea of freedom is inseparably connected with the idea concept of autonomy, and this in turn with the universal principle of morality, which ideally is the ground of all actions of rational beings, just as natural law is the ground of all appearances. (4:452-3; emphasis mine)

and makes similar claims elsewhere.

Right: so the moral law is ideal rather than real; but, more importantly, Kant contrasts the “universal principle of morality” with the natural law that is the ground of all appearances – and so, implicitly, the universal principle of morality is to be distinguished from appearances.  I don’t think that any of this is particularly radical.  By which I mean, of course, that it is radical – but it’s standard undergrad philosophy stuff.

However, things get a bit weirder once you begin to prise that apart. more…

Musing about Kant

11 May, 11 | by Iain Brassington

So… I’ve been writing a paper on Kant, the basic thrust of which is to assert the importance of respect for autonomy over and above respect for persons.  (That is, I think that Kant thinks that we ought to respect persons because they’re autonomous; this is in contrast to the modern idea that we ought to respect autonomy because it’s a property of persons.)  But the journal’s word limit has meant that I can’t fit some bits in – so I’ll shove ‘em here instead.

One line I’ve had to drop has to do with what seems like a blind-spot in the Categorical Imperative (or “another blind spot”, if you’re that way inclined).  If there is only one CI (and Kant claims that there is), and if the CI mandates respect for autonomy (and he claims that it does), there ought to be a way to say that any wrong action is a violation of respect for autonomy, either in oneself or others.  (If we couldn’t tie all wrongful actions to that, there’d have to be more than one principle of morality.)  Correspondingly, any claim that an action violates respect for persons, on the reading of Kant that I favour, would have to be translatable into a claim about it failing to respect autonomy.  But there are some times when Kantian respect for autonomy looks quite weak in comparison to a “respect for persons” claim.  Take, for example, recent* controversy about Christian doctors demanding the right to ask patients if they can pray for them.  I think that such an offer ought not to be made.  Part of my objection has to do with respecting the integrity of the patient, and I guess that this has some kind of relationship with a claim about respect for persons.  However, I’m really struggling to see how this could be substantiated by means of an appeal to autonomy.  So if respect for autonomy is fundamental to morality – as I think it is for Kant – the offer would not violate the duty.  Since I think it does, I must think that, at least, there is something missing from Kant’s account.

*Blimey.  It’s not as recent as I thought.

Hyperexpensive royal weddings – the opportunity costs in terms of health

29 Apr, 11 | by David Hunter

James Wilson (UCL) and I recently wrote a briefing paper for the Nuffield Council on Bioethics on the ethical issues surrounding hyper-expensive treatments – that is treatments which exceed NICEs usual cut off point of £30000 per quality adjusted life year (qualy). One factor that we kept coming back to was the need to consider the opportunity cost of funding relatively inefficient medicines (which has implications for example for Cameron’s Cancer Drug Fund).

I thought it was apt today to reflect on the opportunity costs involved in the tax payer footing the bill for part of the royal wedding – namely the security costs. These have been estimated now at twenty million pounds.

Hence if this public expenditure was instead used on health care, using NICEs cut off point we could at least save 666 quality adjusted life years – and of course it could be much more since many treatments cost less than £30000 per qualy.

Now of course things aren’t this clear cut, we have to factor in the probable tourist income due to the wedding, the tax income from people buying bunting and flags from the pound store and so on as well as the impact of all the good will and cheer the papers are nattering on about. And to counter balance this we need to consider any further tax earnings from the 666 Qualys generated, the economic costs of an additional public holiday and so on.

Nonetheless it is at least a sobering thought – there may well have been a public good based argument for the royal couple eloping…

Medical Ethics at Keele to be Axed?

17 Mar, 11 | by Iain Brassington

This was supposed to be embargoed, but there’ve been enough leaks to make me think I can go public with it: news has emerged today that the Centre for Professional Ethics at Keele (PEAK) is facing the axe, as is the Keele Philosophy programme.

A Senate Paper detailing the proposed cuts is widely available, and people outside Keele can view it here.  The general gist of it is that most of PEAK’s activity is to go, with a small amount absorbed into the Law School.  The Philosophy programme is to go as well.  It also looks as though the problems faced by PEAK and the Philosophy department are attributable to a combination of the recession and bad management by the University; hardly unique, hardly incurable, and hardly grounds to close the academic department.

As far as I know, the decision hasn’t been finalised yet – I believe that the relevant meeting will be in April – so there’s still time to do something about it.

Any decision to shut PEAK would be senseless.  I’m informed that, not so long ago, the department provided Keele with 2% of its overall income.  But even if you put that aside, PEAK is an academic gem, and any half-sane university would do everything it could to keep it going.  PEAK boasts an absurdly high concentration of talent, with world-standard researchers in reproductive ethics, public health ethics, and research ethics (to name just three fields).  Its web of alumni and former staff demonstrates just how successful it has been over the years at attracting and honing talent, and sending it back out in to the world.

I have personal reasons to be very attached to PEAK.  At the start of my career, the Centre went out of its way to provide me with an office, library access, and enough teaching to keep me solvent, and did so for long enough that I could cobble together enough publications to stand a chance of getting my current gig in Manchester.  The three years I spent there were a joy.

And, of course, my co-blogger David Hunter is based at Keele.

This is a very bad day for Keele University, and a very bad day for bioethics in the UK, if not the world.

Facebook groups for both have been set up here (for PEAK) and here (for Philosophy).  If you would like to express your opinion of the proposal (politely please) the VC can be contacted here:
Prof. Nick Foskett, VC: n.h.foskett@vco.keele.ac.uk ; you could cc: Prof. Rama Thirunamachandran, Deputy Vice-Chancellor and Provost: r.thirunamachandran@vco.keele.ac.uk, and Prof. David Shepherd, Dean of Humanities and Social Sciences d.g.shepherd@humss.keele.ac.uk – both of whom are signatories to the proposed restructuring.  Please, though, do keep things polite.

(Thanks to Andrew Willetts for the Senate Paper link)

JME blog homepage

Journal of Medical Ethics

Analysis and discussion of developments in the medical ethics field. Visit site

Latest from JME

Latest from JME

Blogs linking here

Blogs linking here