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Public Health

Cigarettes and Plain Packs: The Ad Campaign

16 Apr, 13 | by Iain Brassington

Blogging here has been light for a little while, and probably will be for a little while longer because of Stuff and Things – but something caught my eye in Sunday’s Indy* that struck me as worth comment.  It was a full-page advert placed by JTI, which describes itself in the small print as “a leading international tobacco company” (and it is).

Anyhoo… the main bit of the ad is a copy of an email, obtained by an FoI request, apparently from the UK Department of Health to the Australian Department of Health and Ageing; it reads as follows (with the highlighting copied from the ad here as closely as I can manage):

Dear [redacted]

I work on the UK government’s tobacco policy team, with [redacted] and you will be aware that the UK government is considering the introduction of plain packaging of tobacco products.

As I’m sure you’re aware, one of the difficulties regarding this is that nobody has done this and therefore, there isn’t any hard evidence to show that it works.   Therefore, I am wondering whether the Australian government drafted any type of impact assessment or cost analysis in which the likely benefits and costs are measured, and if so, whether you would be willing to hare the information with us.

Many thanks,

And then in bold underneath, JTI’s copywriters have added:

WE COULDN’T HAVE PUT IT BETTER OURSELVES

Now, the email is dated the 10th of May 2011.  Australia’s plain-packaging law came into effect on the 1st December 2012; as far as I’m aware, Australia was the first country to pass such a law.  So, at the time of writing, there could not have been any hard data about its impact.  There could not possibly be any hard evidence to show that plain packaging works to reduce smoking rates.

The argument of the advert – actually, no: the subtext, since it’s not really an argument – is that the UK government should not introduce plain packaging because of the lack of hard data.  This seems to amount to a claim that governments should not introduce policies without hard data concerning their efficacy.  And there’s something correct about that for the most part.  But hard data are only available in the wake of the introduction of a policy.  If the policy is novel – as it is – then JTI would seem to be committed to the claim that no government should be the first to introduce a policy; which is as much as to say that no government should introduce it at all.

It’s understandable that that’s what they think.  But why not just say so?  Isn’t this ad just rather disingenuously dressing up opposition as something else?

Or have I missed something?

 

*Saturday’s Indy, with its column-inches devoted to Andrew Wakefield, is worth rather a lot of comment: more than I can offer at the moment.  I’ll point you in the direction of Martin Robbins in the Staggers instead.

Crime and the Less-Polluted City Solution

10 Jan, 13 | by Iain Brassington

People who listen to Today may have heard an article in the prime 8:10 slot on the 9th about the correlation between a drop in the use of leaded petrol, and a drop in violent crime rates.  (Mother Jones actually beat the BBC, having published a piece on the same research last week: I meant to post something then, but was buried by other stuff.)

The nub of the story is this: that violent crime has been falling in the past few years, and though this pattern seems to lag about 20 years behind a fall in the use of lead in petrol, the fit is pretty good: a decline in leaded petrol predicts a decline in violent crime by about two decades – which is just about the time that we might expect would elapse between the formation of the brain and the highest likelihood of violent behaviour in humans.  Neat.  The Mother Jones piece provides lots of links to the relevant research – links to this (from 1999), and this (from 2007), and this (from 2012).

If the lead hypothesis is sound, it seems to be ethically interesting in a couple of ways. For one thing, it opens the way to at least some antisocial behaviour to be seen as being symptomatic of a deeper public health problem.  That’s interesting enough as it is, but – admittedly – it might be little more than interesting, on the grounds that leaded petrol is pretty much a thing of the past anyway (Wikipedia says that, as of 2011, leaded petrol was widely available only in 7 countries).

But the other way in which it’s interesting has to do with arguments about so-called “moral enhancement”. more…

Junk food feeders are criminal child abusers? Really?

15 Oct, 12 | by David Hunter

Public Service Announcement: Sensitivity Advisory Sticker – Caution Post contains sarcasm.
In the interests of our more sensitive readers not taking offence I recommend they skip this post on the grounds that it will contain gentle sarcasm, disagreement and a certain amount of me asking “Is that really what they mean to say?”*

Blog Post:
The Oxford Practical Ethics Blog is typically very good, hence when there are posts that seem shall we say not quite as thought through as they might be it seems worth mentioning this and raising some debate. Presently Charles Foster has an interesting post: Should you be prosecuted for feeding junk food to your child?

more…

Mouse Eggs: A Cool Solution to a First-World Problem?

8 Oct, 12 | by Iain Brassington

The news that Japanese researchers have successfully induced skin cells to behave like viable eggs, which have then been fertilised to create a new generation of mice, may well come to be seen as a scientific milestone.  And if it’s not that, it’s definitely very, very cool.  (The original paper is here.)

Though the research does not necessarily translate into humans, it appears to demonstrate that the genetic material found in every cell in the body can be put to use in the creation of offspring. In principle, this offers infertile women the opportunity to have children that are genetically related, even if they do not have viable eggs of their own: cells from another part of the body could be used and “reprogrammed” to behave as eggs would.  (Putting the procedure to use in humans would be illegal under current UK law, since the synthesised eggs would not be what the Human Fertilisation and Embryology Act calls “permitted”.  But the law is, after all, just the law.)

There will probably be concerns raised; but they aren’t obviously any more serious in relation to this technology than they would be in relation to others.

The most obvious concern – and, prima facie, the most powerful – would be about the safety of the procedure were it to be used in humans. more…

CFP: Wellbeing and Public Policy

20 Apr, 12 | by Iain Brassington

This may be of interest to readers…

MANCEPT Workshops in Political Theory – Ninth Annual Conference
Manchester Centre for Political Theory (MANCEPT), University of Manchester
5th – 7th September 2012

Workshop on Well-being and Public Policy: Call for Abstracts

David Cameron, in a recent speech on introducing national measures of well-being to inform public policy, claimed that the UK government is aiming to measure the progress of the nation, “not just by how our economy is growing, but by how our lives are improving; not just by our standard of living, but by our quality of life.” In short, the UK government is looking to measure the nation’s well-being in order to “help make a better life for people.” Other governments and international organizations are also increasingly focusing upon well-being as a policy goal.

This workshop will focus on whether, and how, public policy can and should be informed, in some way, by considerations of the public’s well-being. There will be up to 12 speakers in total, who will be invited to give a 30 minute presentation, followed by a discussion. Potential areas of interest include (but are not limited to):

  • The role of well-being in public policy
  • The limits of political utilitarianism
  • Paternalism and well-being
  • The implications of different theories of well-being for public policy
  • The interaction between different measures of well-being and public policy

If you are interested to present during this workshop, please send to one or both of us an abstract of no more than 500 words with your full name and institutional affiliation before May 15th.

Convenors:
Sam Wren-Lewis (University of Leeds): samwrenlewis@gmail.com
Tim Taylor (visiting research fellow, University of Leeds): phltet@leeds.ac.uk

Further details about the conference available at
http://manceptworkshops2012.wordpress.com/.

Vaccination, and Policies for Enforcement

5 Apr, 12 | by Iain Brassington

Rob Crilly reported in the Telegraph a couple of days ago that Pakistan is to pursue a policy of fining people who do not have their children vaccinated against polio.  Now, at the time I write this, I can’t find this story or anything like it replicated elsewhere – Dawn, which is Pakistan’s biggest English-language newspaper and has carried 15 stories on polio so far this year (and which is supportive of mass vaccination), doesn’t mention it; nor does al-Jazeera – but let’s allow for the sake of the argument that the story is true, and that fines are to be imposed on parents who fail to get their children vaccinated (or that they’re being at least considered).  I’m in two minds about such a policy.

Obviously, the prevailing attitude in anglophone bioethics is to be suspicious of mandatory interventions into health decisions: it’s hard to get away from the Georgetown Mantra.

On the other hand, polio is very nasty indeed, and Pakistan is one of the three remaining countries in the world where it exists.  (The others are Afghanistan and Nigeria; in all three cases, there have been active campaigns against vaccination on the grounds that it’s “un-Islamic” – which I suppose is true, but only inasmuch as that it has nothing whatsoever to do with Islam – and suspicion of vaccination workers has grown in Pakistan over the last year because they’re seen as potential CIA operatives.)  Vaccination is much less nasty than polio, and Pakistan is already implementing a number of policies (such as offering it free at toll-booths) to increase vaccination.

There seem to be two questions that need to be addressed.  First, is a policy of mandatory vaccination permissible?  Second, is a fine the right way to enforce it? more…

Cancer drugs and magic money fountains of youth

26 Mar, 12 | by David Hunter

The McMillian Cancer trust has published a report described on the radio as I drove to Manchester this morning as a damming and shameful report about the NHS and discrimination. The report alleges that more than 14 thousand elderly cancer sufferers are allowed to die in the UK because of age based discrimination.
more…

Raised Glasses to Raised Prices?

26 Mar, 12 | by Iain Brassington

The proposal that there should be a minimum 40p/ unit price for alcohol, announced last week, has been broadly welcomed.  Not universally, but broadly.  There has been some dissent – but, by and large, it doesn’t seem to have been particularly vocal.

From a ethicist’s perspective, the objection that we might expect to hear articulated most has to do with paternalism: if the move is designed to coerce people into a certain kind of behaviour, and the motivation for this is a concern with people’s own good, then that might be presented as undue interference.  However, the response to this is simply to deny that paternalism of this sort is always a bad thing.  ”Respect for autonomy” has become something of a dogma among many people working in bioethicists, but it’s not beyond question – and it’s certainly not enough simply to stamp your foot and say, “Yes, but AUTONOMY” to defeat a proposal.  At the very least, the idea that governments should not intervene to prevent self-harming behaviour needs argumentative backing.  (I know that this is a particular bugbear of Angus Dawson and a number of other people working in public health ethics.  I don’t agree with the suggestion in some quarters that the “rules” of PHE are different from the “rules” of the rest of bioethics, such that autonomy is not as important in PHE as it is in those other areas – I think that ethics is ethics is ethics; but this simply means that unquestioning deference to autonomy and liberty is philosophically bogus right across the board.)

But, actually, the minimum-pricing policy doesn’t have to be defended on public health grounds.   more…

CfP: Criminalizing Contagion: Ethical, legal and clinical challenges of prosecuting the spread of disease and sexually transmitted infections

3 Feb, 12 | by Iain Brassington

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…

Is Bird Flu Research a Security Risk?

21 Dec, 11 | by Iain Brassington

A story that has had a little airtime on the news over the last 24 hours or so concerns requests by US officials that details of research into a bird flu variant be held back from publication on the grounds that it might be of use to terrorists:

The National Science Advisory Board for Biosecurity recommended that the “general conclusions” be published but that final manuscripts not include details that “could enable replication of the experiments by those who would seek to do harm”.

The BBC’s health news blog reports that

Professor John Oxford from Barts and the London School of Medicine [says], “They should definitely publish. The biggest risk with bird flu is from the virus itself. We should forget about bio terrorism and concentrate on Mother Nature.”  [He and Prof Wendy Barclay from Imperial College London] agree that the influenza virus would make a pretty poor bioterrorist weapon, unless your aim was to spread the infection across the world. Influenza has no respect for borders, so introducing a virus in one country would inevitably spread it globally.

But Michael Parker, Professor of Bioethics and Director of the Ethox Centre at the University of Oxford, disagrees.  ”The position that everything should be published is not tenable. There must be some scientific information which contains an immediate threat to public safety if it fell into the wrong hands.”

Parker’s worries reflect those articulated by Tom Douglas and Julian Savulescu in the JME a little while ago; they argued that synthetic biology raises significant new ethical problems, not least because of the potential for “dual use”.

I have to admit that I have yet to be convinced by the biosecurity worries.   more…

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