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The Academy

Stop What You’re Doing: This is Important.

14 Oct, 15 | by Iain Brassington

I’d not realised it, but the latest iteration of the erstwhile Medical Innovation Bill – colloquially known as the Saatchi Bill – is up for debate in the Commons on Friday.  This is it in its latest form: to all intents and purposes, though, it’s the same thing about which I’ve blogged before.

In a nutshell, the Bill does nothing except remove protections from patients who would (under the current law) be able to sue for negligence in the event that their doctor’s “innovative” treatment is ill-founded.

Much more articulate summaries of what’s wrong with the Bill can be found here and here, with academic commentary here (mirrored here on SSRN for those without insitutional access).  There have been amendments to the Bill that make the version to be discussed on Friday slightly different from that analysed – but they are only cosmetic; the important parts remain.

Ranged against the Bill are the Medical professional bodies, the personal injuries profession, patient bodies, and research charities.  In favour of the Bill are the Daily Telegraph, a few people in the Lords who should know better (Lord Woolf, Lady Butler-Sloss: this means you), and Commons MPs who – understandably – don’t want to be seen as the one who voted against the cure for cancer.

Gloriously, Christ Heaton-Harris, who introduced the Bill, did so only after winning the ballot for Private Members’ Bills.  In a nutshell, he was allotted Parliamentary time, and then began the process of wondering what to do with it – which suggests that even the Bill’s sponsor doesn’t have a burning commitment to the cause – or, at least, didn’t when he took it on.

Still, the Bill has the support of Government; as it stands, there’s a good chance that it’ll pass.

SO: Take a few minutes to look up your MP’s email address – you can do that by following this link – and drop him/ her a line to encourage them to vote against the Bill.

Do it.

How do Medical Students Learn Ethics?

3 Aug, 15 | by Iain Brassington

Guest Post by Carolyn Johnston

How interested are medical students in learning ethics and law? I have met students who have a genuine interest in the issues, who are engaged in teaching sessions and may go on to intercalate in ethics and law. On the other hand some consider that ethics is “just common sense”. They want to know only the legal parameters within which they will go on to practice and do not want to be troubled with a discussion of ethical issues for which there may not be a “correct” answer.

Ethics and law is a core part of the undergraduate medical curriculum and so in order to engage students successfully I need to know whether my teaching materials are relevant, useful and interesting. In 2010 I ran a student selected component in which MBBS Year 2 students created materials for medical ethics and law topics for pre-clinical students which they considered were engaging and relevant, so that students might go further than learning merely to pass exams. One student, Marcus Sorensen, who had managed a design consultancy focusing on web design and development before starting his medical studies, came up with the idea of a website as a platform for ethics materials for King’s students and he created the website

It was through our ongoing discussions that we identified a lack of information about students’ experiences of learning medical ethics and law, especially outside the classroom environment. more…

Making the Jump to a Medico-Legal Career

15 Jul, 15 | by BMJ

Guest Post by Daniel Sokol

On a number of occasions, I have been asked by early career ethicists about the move from ethics to law, or the wisdom of seeking a legal qualification to supplement their ethical knowledge. In the UK, this can be achieved remarkably quickly. This blog post is an answer to those questions, based only on my own experiences.

In 2008, I was a lecturer in medical ethics and law at St George’s, University of London. I had no legal training, and felt uncomfortable teaching law to medical students. Some of the graduate students were former lawyers and it must have been obvious to them that the limits of my legal knowledge extended no further than the PowerPoint slide.

That year, an old school friend, a solicitor, encouraged me to become a lawyer. “I can imagine calling you ‘My learned friend‘ in court”, he said. And so the seed was planted, and with each soul-sapping marking session, and each article published and quite unread, the seed grew until, in 2009, I resigned from my lectureship to study on the law conversion course, now called the Graduate Diploma in Law (GDL). more…

On Being a Hypocrite

1 Jul, 15 | by Iain Brassington

A piece appeared in The Atlantic a few days ago that aims to prick the perceived bubble of professional ethicists.  In fact, the headline is pretty hostile: THE HYPOCRISY OF PROFESSIONAL ETHICISTS.  Blimey.  The sub-headline doesn’t pull its punches either: “Even people who decide what’s right and wrong for a living don’t always behave well.”

I know that headlines are frequently not written by the person whose article they head, and so these won’t tell us much about the article – but, even so, I’m beginning to twitch.  Do I decide what’s right and wrong for a living?  I don’t think I do.  I possibly thought that that’s what an ethicist does when I was a fresher, or at school – but I’m not certain I did even then.  And even if I did, I discovered pretty quickly that it’s quite a bit more complicated than that.  For sure, I think about what’s right and wrong, and about what “right” and “wrong” mean; and I might even aspire to make the occasional discovery about right and wrong (or at least about how best to think about right and wrong).*  But as for deciding what is right and wrong?  Naaaah.

Anyway: to the substance of the piece, which – to be fair – is more moderate in tone, pointing out that “those who ponder big questions for a living don’t necessarily behave better, or think more clearly, than regular people do”.  That’s probably accurate enough, at least a good amount of the time.  I’d like to think that I’m thinking better about a particular problem than most people when I’m working on it; but I’m also thinking better about in that context than I would be at other times.  (Ask me about – say –  genetic privacy while I’m drafting a section of a paper on genetic privacy, and I’m your man.  Ask me while I’m making pastry… not so much.)  If we allow that I’m better at dealing with (a) specific moral question(s) while “on duty”, that won’t mean I’m not susceptible to the same intellectual shortcuts and fallacies as everyone else at least most of the rest of the time.  I’m probably almost as susceptible to them even when I am on duty.  I’d assume that the same applies to others in the profession, too.

The article does make great play of the apparent inconsistencies between what ethicists say and what they/ we do.  So there’s the finding about how many more say that eating meat is morally problematic than actually avoid it, and the chestnut about how ethics books are the ones most frequently stolen from libraries.**  At least there are decent sources cited – peer-reviewed papers like this one that are philosophically informed, to boot.

So: ethicists aren’t reliably better behaved than others.  I don’t think that should surprise us, though.  But, there’s a couple of questions into which we might still want to dig more deeply. more…

Questions to which the Answer is Yes

28 Nov, 14 | by Iain Brassington

Over at Practical Ethics, Charles Camosy asks a question: Can bioethics be done without theology?

Yep.  It can.

Well, that was quick and simple.

But – oh, all right: I probably ought to say a bit more.  Now, Camosy’s post is quite long, and that means that if I want to scrutinise it in any detail, I’d have to generate something at least as long.  I’m not sure if I – or any reader – has the patience for that, so what follows is probably not going to be without the odd gap.  All the same, this post has turned out to be something of a monster in its own right – so it might be worth going to make a cup of tea first if you intend to read it.

The tl;dr version is that I think that Camosy’s argument is fallacious in several places.  And though I’m arguing from a position of godlessness, I think that the problems ought to be apparent to those who do have faith as well.  With that caveat issued, here we go… more…

Consigned to the Index

28 May, 14 | by Iain Brassington

There’re probably times when all of us have had a solution, and just had to find a problem for it.  It’s an easy trap; and it’s one into which I suspect Gretchen Goldman may have fallen in an article in Index on Censorship about scientific freedom and how it’s under threat from disputes about Federal funding in the US.  No: I’m not going to be arguing against scientific freedom here.  Only against a certain use of the appeal to scientific freedom in response to a particular problem. First up, let’s note the points on which Goldman may well be correct.  She notes that the disputes in the US about federal funding that have led to big cuts and a short-but-total government shutdown are very bad for science.  She points out that political machinations even meant that researchers working in government-funded areas couldn’t access their emails.  This had direct and indirect consequences, all of which were pretty undesirable.  For example,

[m]any government scientists were not allowed to access email, much less their laboratories. One scientist noted that his “direct supervisor … confiscated all laptop computers on the day of the shutdown”.

Without access to work email accounts, federal scientists were also prevented from carrying out professional activities that went beyond their government job duties. Several scientists pointed out that their inability to access emails significantly slowed down the peer-review process and, therefore, journal publication.

In the wider sense, to have science and funding bodies that are vulnerable to political shenanigans isn’t good for science, and is probably not good for humanity.  You don’t have to think that research is obligatory to think that it’s often quite a good thing for science to happen all the same.  And shutdowns are particularly bad for students and junior researchers, whose future career might depend on the one project they’re doing at the moment; if a vital field trip or bit of analysis or experiment is liable to get pulled at almost any moment, they don’t have a reputation yet to tide them over.

So far, so good.  However, things are iffier elsewhere. more…

Resurrectionism at Easter

23 Apr, 14 | by Iain Brassington

There’s a provocative piece in a recent New Scientist about what happens to unclaimed bodies after death – about, specifically, the practice of coopting them for research purposes.

Gareth Jones, who wrote it, points out that the practice has been going on for centuries – but that a consequence of the way it’s done is that it tends to be the poor and disenfranchised whose corpses are used:

[T]he probably unintended and unforeseen result [of most policies] was to make poverty the sole criterion for dissection. [… U]nclaimed bodies are still used in countries including South Africa, Nigeria, Bangladesh, Brazil and India. While their use is far less in North America, they continue to constitute the source of cadavers in around 20 per cent of medical schools in the US and Canada. In some states in the US, unclaimed bodies are passed to state anatomy boards.

For Jones, the practice of cooption ought to be stopped.  His main bone of contention is the lack of consent – it’s a problem that’s made more acute by the fact that the bodies of the disenfranchised are more likely to be unclaimed, but I take it that the basic concern would be there for all.

One question that we might want to ask right from the off is why informed consent is important. more…

How Magic can help Teach Students about Medical Ethics

24 Aug, 13 | by Iain Brassington

Guest post by Daniel Sokol, KCL

For some time, I have been interested in the relationship between magic and medical ethics.  Five years ago, I gave a talk in Prague on how to use magic in medical ethics education.  More recently, I held a workshop on Magic for Anaesthetists, which touched on ethical issues in anaesthesia.  My latest ‘guest’ lecture is entitled Magic, Medicine and Medical Ethics and examines the ways in which the work of professional magicians can shed light on the art and ethics of medicine.

This blog is for those who teach medical ethics.  It explains how a magical effect can help convey ideas in a memorable and thought-provoking way.  I am grateful to Gerry Griffin, a fantastic card magician from the United States, for permission to use one of his effects.  I respectfully ask readers to keep the secret to themselves.


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:

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…]


23 Oct, 12 | by Iain Brassington

Seriously!  Theoretical Medicine and Bioethics has published a paper with a hundred and ninety-eight listed authors!

I’ve always been slightly puzzled by multi-authored papers – by just how many people get to add their names to a piece of work.  A friend of mine who is a proper scientist once tried to explain how it works in the sciences to me – about how you need to give credit to the people who ran the experiment, but also to those who did the titration and general donkey-work.  That seems fair enough.  Having said that, I suspect that there’s often a bunch of people who get credits that shouldn’t be there.  (I remember once seeing a CV from a guy that had 45 pages’ worth of publications listed.  Granted, it was double-spaced… but, still: there must have been the thick end of a thousand papers listed; there’s no way on God’s good Earth that he could have played a significant role in all of them.  So why was he entitled to claim them?  Why did he take the credit?  Apparently, it was because, although not all of the papers referred to work he’d done, they did all refer to work done by other people in a lab he ran.)  Anyway… the Steinhauser et al ad infinitum paper, with its 198 authors, isn’t lab-based, so the credit-where-it’s-due argument wouldn’t work.

(Jozsef Kovacs, writing in a paper currently available as a pre-pub in the JME, is also concerned about authorial inflation, and who should get the credit for a given paper, and how to improve things.  It’s definitely worth a look.)

The author list for the Steinhauser paper seems to have been generated at least in part via the membership of a Facebook group (and one that no longer exists, or at least one that is so private that it doesn’t show up on a search).  That’s just silly, and there’s no way that anyone can successfully marshall so many contributors.  That turns a paper into an open letter.  Indeed: the “authors” seem to think that their paper could be treated as such without loss: more…

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