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.


Assisted Suicide and the Courts: Lather, Rinse, Repeat.

22 Aug, 11 | by Iain Brassington

“Martin”‘s story has been generating a reasonable amount of media and blog attention over the lat few days.  (Udo Schuklenk considers some of the Telegraph‘s coverage, for example, and finds it severely wanting.)  Paralysed after a stroke, “Martin” wants help to end his life; but his wife doesn’t want to be the one to help him.  The next best person would be one of his medical attendants.  According to the DPP’s guidance on assisted suicide, though (which I examined here), prosecution is more likely  if

[t]he suspect was acting in his or her capacity as a medical doctor, nurse, other healthcare professional, a professional carer (whether for payment or not), or as a person in authority, such as a prison officer, and the victim was in his or her care.

“Martin” claims that this is unfair discrimination, and has launched a legal bid to ensure that medics wouldn’t face prosecution for assisting his suicide.  You’d have to have a heart of stone not to sympathise with his plight.  Cast in a certain light, I think he’s got a moral case (though perhaps on slightly more slender grounds than might appear at first: as far as I can tell, he’s got noone lined up who would be willing to help; and absent a willing assistant, the bid looks empty, since it’s one thing for Smith to be entitled to assist Jones’ suicide, but another entirely for Jones to be entitled to Smith’s help).  Whether he’s got a legal one… I’m really not so sure.  And so I think I know how this is going to go.

The judges will hear his case.  They’ll look at the law.  They might acknowledge that they can see “Martin”‘s legal point.  They’ll express heartfelt sympathy.  Then they’ll tell him that there’s nevertheless nothing they can do without a change in the law.  And they’ll tell him to go home.

There’ll be a bit of a media flurry; but the law on assisted suicide won’t change, and the ethical arguments won’t change, and the minds of the people making the arguments won’t change, and “Martin” will still be in his bed.  And in a couple of years, someone whose case is similar but different enough will emerge asking the same sort of thing, and we’ll go through it all again.

Lather, rinse, repeat.

Is it OK to Laugh?

15 Dec, 10 | by Iain Brassington

Guy Francis has a website and a YouTube channel.  Some of the stuff on his YouTube channel is him singing along to pop songs.  What’s noteworthy is that Francis also has quite severe Tourette’s syndrome.  This makes his karaoke somewhat unique.  (For a sample, take a look at this.  It’s almost certainly Not Safe for Work.)

Now, Francis’ attitude to his Tourette’s is pretty plain: you don’t name your website if you think that there’s no levity to be had from it.  From the short communication I’ve had with him, he seems to see his situation as simply being at one point in a big picture of general human oddness – which I think is absolutely right.  (“My point is no one escapes, everyone is ‘comedy gold’ within their group. It’s not cruelty, it’s life.”  Damn straight.)

But there’s something slightly disconcerting about watching the vids. more…

On Nailing one’s Colours to the Mast

13 Sep, 10 | by Iain Brassington

“You’re a Kantian,” people in my department tell me.  At least, I think that’s what they say – I’m assuming that there’s no comma before the final syllable, and that I’ve got all the vowels right.  I don’t think I am, actually (a Kantian, that is – I couldn’t comment on the other option).  I’m fascinated by Kant, and think his moral system is magnificent, but I’m not sure it’s correct: I don’t buy the stuff about the nature of the will, I think he occludes the difference between reason and reasonability, and so on.  Rather, my hunch is that it’s like a magnificently-crafted carriage clock in which some of the more important cogs have the wrong number of teeth.  The mechanism may work smoothly and be a wonder of engineering, but the piece itself is deeply unreliable.

I’m not sure what my theoretical starting point is – I suspect it’s a kind of weirdly mutated Aristotelianism, laced with a bit of Kant (whom I think has more in common with Aristotle than he’d ever have admitted anyway).  Having said this, I’m reasonably sure that I’m a non-consequentialist, and quite possibly an anti-consequentialist to boot.

At least, that’s what I’d say if you asked me.  In practice, though? more…

Concord in Ethics and Bioethics

24 Mar, 10 | by Iain Brassington

Over at Pea Soup, Ralph Wedgwood makes an interesting claim:

I suspect that on several issues that are the focus of fierce moral controversies today – such as homosexuality and the death penalty – there is significantly less disagreement among contemporary philosophers than in the population as a whole. Indeed, I tentatively suggest, the historical record indicates that philosophers have been pushed towards the liberal view on these issues by some fundamental features of philosophy itself.

To what extent is this true?  more…

Questions, questions…

25 Jan, 10 | by Iain Brassington

In response to the post below about circumcision, “IntactByDefault” asked a number of questions.  I think that they merit a thread of their own, although I’ve touched on some of the issues before.

Is it not the case that, short of legislation, the role of bioethicists is to put a check on the potentially unethical behaviors of those who practice medicine on humans?

Why have the rights of male children been subordinated to such issues as cultural habit and medically superfluous parental preference or belief?

Why aren’t bioethicists, including yourself, relentlessly shaming and using any other tool at your disposal to correct the behavior of medical practitioners who modify the genitals of children without meeting the ethical standards developed to protect the rights of minors?


When the Witch Asks a Question, I Can’t Resist

4 Nov, 09 | by Iain Brassington

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.

In Memory of Kerry Anne Stapleton Hunter

11 Sep, 09 | by David Hunter

This year marks the tenth anniversary of my first wife’s death. Kerry Anne (KAS to her friends) had cystic fibrosis and passed away after a good hard fight on the 12th of September , 1999 a year and a half after we married.

Kerry taught me many things and was really my main impetus for becoming interested in medical ethics. It was a natural extension of the many discussions we had had.


Swine Flu: A Titanic Struggle

10 Sep, 09 | by Iain Brassington

The Department of Health today launced Exercise Prometheus, an

exercise for the social care sector to assess and develop its resilience planning in readiness for a second wave of the pandemic swine flu. Designed as an ‘off the shelf’ package primarily for use by local authorities in partnership with their local  providers of social care, the exercise has been developed by the Health Protection Agency from experience gained in previous pandemic influenza exercises.

I like this a lot – although I have to admit that the main attraction for me is the choice of “Prometheus” as the title.  It’s nice to see that someone in the DoH has a classical education and a nerdy obsession with etymology.

A rose by any other name would smell as sweet…

30 Aug, 09 | by David Hunter

One thing I’ve been pondering lately is what we might use to refer to a gathering of bioethicists?


Knowing You, Knowing Us

25 Aug, 09 | by Iain Brassington

It’s all very well to vanish off to a conference and put faces to names… but that can’t help with the important questions, like What does the internet think of you?.  Fortunately, this little app can tell you.  Type in your name, and it’ll do the Google version of a genetic fingerprint.

In the interests of openness, here’s what the internet thinks of your humble editors:

Possibly by virtue of having a more frequently-occuring name than either of the other two, David seems to have the most interesting “genome”, and I’m really rather dull compared to both – although I’m about as illegal as social, which must be because of all those parties.

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