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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…

Call for Participants: Concepts of Mental Health

8 Jan, 13 | by Iain Brassington

British Postgraduate Philosophy Association Masterclass 2013
April 12th-13th, University College London

This year’s BPPA masterclass will be on concepts of mental health, and applications are invited from graduate researchers within the field of philosophy and mental health.

A masterclass involves a mixture of seminars, group workshops, presentations by students and experts and critical discussion.  The small number of participants (8-10) means that all will have a chance to speak and discuss their research as well as getting to know others working in similar areas.  It is an excellent way of deepening and broadening understanding of a given area and further developing one’s own research.

This year’s masterclass will be led by experts committed to furthering interdisciplinary research into mental health issues, combining philosophical training with clinical experience.  Professor Bill Fulford is Emeritus Professor of Philosophy and Mental Health at the University of Warwick and is a Member of the Philosophy Faculty at the University of Oxford.  His previous posts include Honorary Consultant Psychiatrist at the University of Oxford and Special Adviser for Values-Based Practice in the Department of Health.  Dr Hanna Pickard is a fellow of All Souls College at the University of Oxford and a Wellcome Trust Biomedical Clinical Ethics Research Fellow in the Department of Philosophy at the University of Oxford.  She also holds a clinical post as a therapist at the Complex Needs Service with the Oxford Health NHS Foundation Trust.  The experts will be leading group-workshops and seminars and will present on their own research over the course of the masterclass.

The broad focus of the masterclass will be on exploring the varying conceptions of mental health and illness and the assumptions accompanying and lying behind these conceptions.  The aim is to explore the assumptions and often false dichotomies which shape perceptions of mental health, from the perceptions of those in the field of psychiatry to those found amongst other medical professionals and the non-medical public.  Topics we expect to be discussed include, but are not restricted to

  • free will, responsibility and related notions and their applications and misapplications within understanding of mental health problems, in particular in relation to addiction;
  • the effect of neurological research on conceptions of mental health;
  • the distinction between cognitive disorders and personality disorders;
  • the extent to which mental illness can and ought to be understood within the framework of physical illness.

The precise content of the masterclass will be in part determined by the research interests of the participants and there will be opportunities for 6 participants to present their own research.

To apply, send an academic CV (including any relevant clinical or practical experience) with a cover letter stating your area of research, the relevance of your research to the masterclass and what you could contribute to the masterclass (500 words max).  Please also state whether you would like to present on your research (presentations will be brief - about 20 minutes each). Please also attach a reference from your supervisor (if applicable), confirming your interest and that you would make a valuable contribution to the masterclass.

The masterclass will be held at University College London.  Breakfast and lunch will be provided on both days and accommodation for those coming from outside of London.  There may also be some small travel bursaries available.

Deadline for applications: February 15th

Please send applications and any queries to: bppamasterclass2013@gmail.com

Website: https://sites.google.com/site/bppamasterclass2013/
Twitter: @BPPAmasterclass

 

[IB adds: This looks excellent, and anyone working in this field should definitely consider going.  And the rest of us should just pray that it's videotaped and uploaded to YouTube...]

Cochlear Implant: On!

14 Dec, 12 | by Iain Brassington

A few weeks ago, I linked to a post on William Mager’s blog in which he said (a) that he was about to have a cochlear implant fitted, and (b) that he’d write about the experience as it progressed.

I don’t know how many readers of this blog followed the link or subscribed; for those who didn’t, I thought I’d just point you in the direction of the latest update.  In short: the implant was fitted; it was turned on; it was… unexpected.  Not completely pleasant from the word go, and a little odd.  But also… well:

I spent an hour yesterday walking round the house tapping different surfaces with a wooden drumstick. Before, with a hearing aid, I’d have heard these taps simply as a ‘tap’ sound. But I had a eureka moment when I realised that tapping a wooden stick on a wooden surface sounded different in pitch and tone to tapping on a glass surface, or a metal surface. Of course, I knew that was the case – but this was the first time ever, EVER… that I’d actually heard that and been able to distinguish so clearly between the different sounds.

That has to be a little bit magical, doesn’t it?

On the other hand, what he can hear is limited.  And so

[n]ow I’m sitting in a world of silence, punctuated by random, violent bursts of sounds that I’ve never heard or experienced quite in the same way before.

What I’m experiencing now isn’t hearing as I imagined it, or as I’ve known it for the last 30 years. It’s completely different, and it’s making me feel really tired and disconnected from everything. I’m finding it really hard to concentrate, to hold on to a specific thought for a long time. [...]

Most disconcerting of all is the dawning realisation that what I thought I was hearing for the last 30 years of my life wasn’t actually hearing. It was just compressed, distorted garbage noise through a hearing aid. What I’m feeling in my head now is much, much closer to actual sound, but it isn’t sound.

I’m fairly confident in my hunch that being able to hear is on the whole preferable to not being able to hear; though there might be times when not hearing is preferable, being able to do so at least gives you the choice – which raises the intriguing possibility that someone with a device that he could used to switch his own hearing on or off might be, in that sense at least, very well off indeed: better off than someone with no ability to hear and someone with no ability not to.  (In just the same way, having a car is good all else being equal, even if there’re times when walking is preferable, because you have the option of using it.)

But still: it’s worth keeping in mind that the process of restoring – or instilling – hearing isn’t a straightforward leap from position A to more desirable position B.  There’s an ambiguity about it.  Even granted confidence that B is more desirable, we can’t take it for granted.

 

Savita Halappanavar: A Woman who Died Needlessly, not a Political Wedge’

17 Nov, 12 | by BMJ

Guest post by Sorcha Uí Chonnachtaigh

I am going to, rather controversially, agree with one aspect of the statements of pro-life activists commenting on this case. That is not something I thought I’d ever say. Like, ever ever.

A statement issued by Youth Defence (one of Ireland’s most radical pro-life organisations) made the valid point that “Irish doctors are always obliged to intervene to save the life of a mother, even if that risks the life of her baby”. Because of some misconceptions about the reasons for Savita’s maltreatment, it is assumed that Ireland needs to reform its abortion law so that this never happens again.  While I would strongly support abortion law reform in Ireland, it is not necessary to ensure this never happens again.  Mere legal regulation of the status quo on abortion would prevent this.  As the (limited) law stands, this should never have happened at all. While some believe that legislation to regulate access to already lawful abortions constitutes law reform, any such legislation would not alter the current legal position – it would merely give meaningful access to abortions.

I don’t agree with anything else that has been included in pro-life posts/articles (stop throwing things at your computer screens), but more on that later.  First, I want to elaborate on this to clear up some of the misconceptions about Irish law that have been expressed in condemnations of the case around the web.

If you have clicked through to this post, it is very likely that you’ve already read about the facts of Savita’s case, first reported in the  Irish Times on 14 November, and at least some of the estensive commentary pieces available on the issues arising from this case (like this, and this, and this).  (These links here are to pieces by Irish people with more informed knowledge of the legal situation.)

For the sake of comprehensiveness, I’ll provide an edited summary of the facts of the case (as reported to the Irish Times by Savita’s husband Praveen): more…

Kelly Hills, Data Miner

7 Nov, 12 | by Iain Brassington

Kelly Hills has been data-mining – collecting and collating information about the frequency with which certain terms appear in paper titles in three journals: the JME, Bioethics, and the AJoB.

I was going to say that the charts are not much use, but that they are pretty and quite cool; and I was going to add that their lack of utility doesn’t matter at all because prettiness and coolness is sufficient to make them worth looking at.  Not everything worthwhile is worthwhile because it’s useful, after all.  Being a philosopher, I have to believe that.

But then it occurred to me that there probably is some utility to them.  Taken with some care, they help us to see what is held to be important by people publishing work – and, I suppose, they might also help decide which journals are more receptive to certain topics (or, conversely, which journals are saturated with them).

Here’s what the JME‘s chart looks like:

The image isn’t perfect, of course: because size is a mark of brute numbers and the algorithm that generates the image isn’t sensitive to context, “ethics”, and “ethical” get separated, when the reality might not indicate that they merit separate consideration.  “Euthanasia” gets only a small amount of attention – which tells us something about the heat-to-light ratios in debates on the topic.  It also gives some support to John Coggon’s idea that it’s getting hard to find anything new worth saying in that particular field – though I’d’ve thought the same, and more, would apply in respect of consent, and that seems to generate a heck of a lot of attention.

Neonatal Withdrawal of Treatment: A Doctor Writes…

6 Nov, 12 | by Iain Brassington

There’s a great little article recently published in the BMJ about what it’s like to be the medic considering withdrawal of feeding from a neonate.

Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was 10 days.

I had no idea it’d be that long.  I had no idea it’d be that long even for healthy adults who stopped drinking, let alone already-ill neonates.  (My scientifically-naïve intuition would have been that an adult body could stand up to more than an infant one.)

The fact is ethically neutral; and we need to be careful about skipping over the fact/ value boundary too easily.  But value claims bounce off, and are informed by, factual claims, and this is the sort of thing that might well be important when considering questions about withholding and withdrawing treatment, and about killing and letting die, and all the rest of it.

And, of course, the infant isn’t the only morally relevant actor in all this:

It is draining to be the most responsible physician. Everyone is looking to me to preside over and support this process. I am honest with the nurse when I say that it is getting more and more difficult to make my legs walk me on to this unit as the days elapse, that examining the baby is an indescribable mixture of compassion, revulsion, and pain.

I can see how that’d be.

William Mager is having a Cochlear Implant.

9 Oct, 12 | by Iain Brassington

And he’s going to blog about the experience.

On Tuesday 6th November at around 7.30am I’ll be in a hospital room while a surgeon uses a marker pen to draw a line behind my ear. Soon after that, I’ll be wheeled into an operating theatre where they’ll make a small incision behind my ear, following the line of marker pen ink.

Once they’ve opened a flap of skin behind my ear, they’re going to drill into my skull, until they reach my inner ear. They’ll then hollow out a small cavity in the flesh beneath the ear flap, where they will insert a piece of technology worth about £10,000. Into the hole in my skull goes a tiny electrode extending all the way into my inner ear, with around 20 or more individual contacts stimulating my cochlear. Hopefully the general anaesthetic will do its job and I won’t feel any of this while it’s happening, because I’ve seen pictures of this procedure and it looks pretty painful.

[...]

When I’m switched on six weeks after the operation, I have no idea what will happen. Either I’ll feel a faint buzzing in my skull, or hear consonants for the first time. Either way, the hard work starts after that.

Subscribe!

He’s a film-maker in real life: so while you’re waiting for the next post, have a look at some of his films.  This one takes only a couple of minutes to show how there’s really very little that deaf people can’t do… er… so long as the… um… support is… as long as…  Yeah.  Watch it, anyway.

Passive Euthanasia: A Cri de Cœur

5 Oct, 12 | by Iain Brassington

Don’t worry: this isn’t another instance of me yammering on about the right to die or the right to induce death.

I’ve recently received a parcel; it contained a copy of this book by Leanne Bell, which happened to fall open at p 204.  On that page, you’ll find this passage:

Active euthanasia involves a deliberate act intended to kill [...].  This is illegal in England and Wales because it satisfies the definition of ‘unlawful killing’ and will therefore either be murder or manslaughter depending on the mens rea (that is, the state of mind) of the doctor at the time.  He is likely to face criminal prosecution, regardless of whether the patient and/or the family requested or consented to it.  By contrast, passive euthanasia involves the withholding or withdrawing of treatment from the patient, i.e. an omission rather than an act, and, in certain circumstances, can be legal. [emphasis mine - IB]

No.  Wrong.  Wrong on two fronts.  Withholding treatment may be an omission, but withdrawing it isn’t.  More importantly, while the active/ passive distinction boils down to one between administration and non-administration, it is simply not true that non-administration is the same as passive euthanasia.

Euthanasia requires the intention to end life based on a motive of beneficence directed at the person who will die.  Neither withdrawing nor withholding treatment indicates the intention to end life.  Only if you’re withdrawing or withholding treatment with the intention that this should end life have you committed passive euthanasia.

There’s a simple test you can run here: When withdrawing or withholding treatment, would it be coherent to hope for the patient’s survival – however miraculous - without further intervention?  It would not be coherent in cases of euthanasia, because you can’t intend that life should end and yet hope that it doesn’t.  It could be coherent otherwise.

Or another version of the same test: If you are considering withholding or withdrawing treatment and the patient does not die, would you see this as contrary to your intention?  If yes, you’re considering passive euthanasia; if no, you aren’t.

Bell is by no means alone in getting PE wrong.  The mistake is all over the place – both in the clinical ethics literature, and in the wider public domain.  I’m not wholly sure where it’s come from, but I suspect it may derive from Rachels having made it in”Active and Passive Euthanasia“, and then a little more explicitly in “Killing and Letting Die“:

Many people believe that “passive euthanasia” – allowing terminal patients to die, rather than pointlessly prolonging their lives – is sometimes permissible; but they also believe that killing patients is always wrong.

I’ve got a lot of time for Rachels, and much of what he says on killing and letting die in these essays is good.  But this is wrong.  Even good essays can have wrinkles in them; and this is a big one.  And if it’s the source of the same mistake being made elsewhere, that’s quite serious. more…

Jon Cogburn’s Plea to Grad Students (and Others)

24 Sep, 12 | by Iain Brassington

[IB: I'm taking the liberty of copying in its entirety Jon Cogburn's post on NewAPPS about submitting papers to journals, because it's worth reading.  He directs it to graduate students - but I think that the same point applies to anyone, especially if they're new to the field in which they're writing.  Since a lot of people writing for journals like the JME - especially on topics in clinical ethics - are medics before they're ethicists, or are coming at ethics from a non-standard direction, I think that the advice is particularly pertinent.]

A Plea to Graduate Students Submitting Papers

Three times this year a bad thing has happened after I’ve encouraged editors to give a paper “revise and resubmit.”

Note that whenever I review a paper and don’t recommend immediate acceptance I work really hard trying to help the writer so that their rewrite will to be up to the quality of the journal.  Even when I counsel “rejection” I still try to give detailed constructive advice about how the paper could be recast, even suggesting places the author should send the rewritten paper.

So three times this year instead of making the changes I recommended the author resubmitted substantially the same paper and argued with some vehemence that they should not have to change their paper in the ways I suggested.  In all three cases the journal editor had given the paper “revise and resubmit,” but then rejected the insufficiently rewritten paper.  In two of these cases I googled the paper title after this was over and found out that the submitters were graduate students.  This is so bad on so many levels.

First, it’s clear to me that some graduate students have no idea that “revise and resubmit” is a very, very good thing, that if you just rewrite the paper up to the reviewer and editor’s standards that at most journals it is almost certain to get accepted.  All three of the people viewed “revise and resubmit” as if it were a kind of rejection, and not a kind of conditional acceptance, as it usually amounts to (de facto if not de jure).  Second, it’s clear to me that some graduate students have no idea what “idiot-proofing” a paper amounts to.  Let me explain.  Suppose that your reviewer is an uncharitable idiot.  Suppose I was when reviewing the papers.  It doesn’t matter!  My comments are still invaluable because you still need to rewrite the thing so that the next uncharitable idiot reviewing it doesn’t make the same mistakes.  Third, it’s clear to me that some graduate students have no idea how high the burden of proof is if you want to convince an editor that the reviewer who has published extensively in the topic in question is making elementary mistakes about the paper.So please communicate this to all and sundry: (1) Revise and resubmit is something to be celebrated, (2) always take into account criticism and suggestions, even if only to idiot-proof for the next reviewer, (3) have some humility.I”m not trying to be censorious here.  If I was I wouldn’t spend so much time giving detailed advice about how to get papers up to publishable standards.  In addition, I know first-hand how stressful this process is for writers and first-hand how stress can produce weird and suboptimal behavior.  I’m trying to help.

I’d very be interested to hear if other reviewers have faced this kind of self-destructive behavior, and if so if there’s anything more we should be doing to stop it.  But if I’m being a jerk here, I trust that someone will point that out too.

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

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