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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.

Should Junior Doctors Strike?

25 Jan, 16 | by Iain Brassington

Guest Post by Mark Toynbee, Adam Al-Diwani, Joe Clacey and Matthew Broome

[Editor’s note: Events in the real world have moved more quickly than David or I have; the facts of the junior doctors’ strike have moved on since the paper was published and this post submitted.  Still, the matters of principle remain. – IB]

A strike by junior doctors is planned for January 2016 following failure of the last-ditch ACAS (Advisory, Conciliation and Arbitration Service) mediated talks between the BMA and the Department of Health (via NHS Employers) – see media reports here, here, and here.  Industrial Action had previously been planned for December last year but was suspended at the last minute when both sides agreed to the now failed mediation.  The current regrettable position has resulted from over two years of formal negotiations between the BMA and NHS Employers regarding a new junior doctor contract.  The BMA went to its junior doctor members for a mandate for industrial action last autumn as the talks stalled and received an almost unprecedented mandate with 98% indicating they would be prepared to strike.

Subsequently, many well-known figures voiced their concerns about the ethical and practical implications of industrial action (here and here).  Strikes by doctors are not common, with only one example in the UK in the last generation, but far from unprecedented.  The overwhelming recent ballot result raises many interesting issues, foremost among them the ethical legitimacy of industrial action by doctors, specifically junior doctors.

The term ‘junior doctor’ is often misunderstood.  It applies to all doctors from graduation until completion of specialist training – over 50,000 individuals.  Their roles and responsibilities have evolved significantly over many years; their pay and hours have reduced whilst their debts, costs and responsibilities have increased.  The patient-doctor relationship has also changed with increased emphasis on patient involvement and the promotion of autonomy.

We have looked at arguments proposed during previous instances of doctor industrial action, often from this journal (see this, this, and this) and considered them in the current context.  Absolute ethical objections to doctor industrial action appear old-fashioned, especially when applied to junior doctors.  Concerns about harms caused by doctors withdrawing their labour also seem less sustainable in the light of recent evidence than perhaps would be expected.  Indeed, the ethical responsibilities of doctors may require them to take action if they believe patient care, or the well-being of their colleagues’, is being compromised.

So far there has been strong support for the junior doctors from the Consultant bodies of many Trusts, and the Royal Colleges.  The modern NHS asks more of its junior doctors than ever before, placing ever increasing responsibilities on their shoulders, with ever more challenging working conditions.  With industrial action by junior doctors now likely to go ahead, claims that it would be unethical appear to us to be increasingly hard to justify.

Read the paper here.


25 Jan, 16 | by Iain Brassington

It’s been a while, what with marking and supervising and writing new courses and general faff, but with luck the blog’ll be getting updated a bit more frequently; there’s a couple of guest posts in the queue, the first of which I’ll post later today.  And I’m hoping to restart semi-regular moans of my own ASAP, too.

In the meantime, I’m just going to draw your attention to this paper in the latest issue of the JME, in which Montgomery and Montgomery write about Montgomery.  If that doesn’t give you a deep sense that all is well with the world, you’re dead inside.

Research Ethics: You’re Doing it Wrong!

1 Jun, 15 | by Iain Brassington

With any luck, the marking tsunami will have receded by the end of the week, and so I should be able to get back to blogging a bit more frequently soon.

In the meantime, I’ll fill some space by ripping off something from the “Feedback” page of the latest New Scientist:

The TV industry has […] yet another new mantra: “Not just more pixels, but better pixels”.  The marketeers’ problem is that few people can actually see the extra details in their newest, flashiest sets unless they sit very close or the screen is very, very bright.

A colleague found a demonstration unpleasant, especially when the image flashed, and wondered about the possible risk of this triggering photo-epilepsy or migraines.  One company said, yes, this was being looked into- but no, they could not identify the university doing the work.

Then in the tea break at a tech conference a senior engineer from a UK TV station confided the reason: “We are very aware of the risks and would love to do some real research.  But nobody dares to do it because it would involve tests that deliberately push subjects into epileptic fits, and might very possibly kill them.”

In other words: here’s an intuitively plausible risk associated with product p; we could test whether p is safe; but doing that test itself would be unsafe.  Were this a pharmaceutical trial, one would expect that things would stop there – or, at the very least, that things would move very slowly and carefully indeed.  (Maybe if the drug is highly beneficial, and can be used in highly controlled circumstances, it might be worth it.)

But with TVs… well, it looks like journalists have been invited to the product launch already.  My guess is that if the TV is found to be risky, it’d be quietly withdrawn ex post facto – which seems rather late in the day.

It is a bit strange that trials on a product aren’t being done not so much because of what they might reveal, as because even doing the test might be iffy.  Stranger yet that this is unlikely to make much of a dent in the marketing strategy.  Or, given the requirements of consumer capitalism, not all that strange after all: take your pick.

Sometimes, Big Pharma can seem like a model of probity.

Guest Posts and Tumbleweed

12 May, 15 | by Iain Brassington

A quick editorial note: it’s been remarkably quiet here for a while.giphy

There’s no staggering reason for this: only that real life has got in the way of posting and also of getting guest posts published.  (I can’t speak for David, but I assume that the same goes for him.)

I think there’s about 4 or 5 guest spots waiting to come up; I’ll post them over the next few days.

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…

We’re Back!

14 Mar, 12 | by Iain Brassington

Just a quick housekeeping post: the servers fell over a couple of days ago, so noone has been able to moderate – or, as far as I can tell, submit – comments.  But hopefully things’re back on track now.

There has been a couple of changes, though: I have a feeling that the comments whitelist may have been wiped, so people may have to fill in all their details again to comment.  And there’s a couple of other alterations, too, so I’ve fiddled with some of the settings in the hope that the transition’ll be smooth – and hopefully the servers will stay standing.  I can’t see how to get the button that tweets posts back, nor the one that likes them on Facebook: I’ll keep looking for them.  Fingers crossed, eh?  Ah-ha!  Got ’em!

Update: One other change: there’s a hell of a lot of spam coming in, so I’m going to close comments on a post after a month to save having to mod and delete each post individually.


As you were.

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