All 34 entries tagged Ethics
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December 05, 2006
In response to Trev’s heartfelt pleadings and the fact that I haven’t blogged for a VERY long time…
An article decribing some of the comments of Warwick sociology professor Steve Fuller was printed on the front page of the Boar on 7th November (a long time ago, I know). In it, Fuller is said to advocate the use of fraudulent data in scientific research in order to tweak results and make conclusions more convincing. He has even defended the actions of South Korean professor Woo Suk Hwang, who pretended that he had managed to clone a human embryo. He decribes the approach he suggests as ‘idealising’ results rather than ‘fraud’.
The article also details a survey take by Nature in the US which suggests that a third of postgraduate researchers did not follow ethical guidelines in their research. Currently, when articles come to publication, the journal editors have to essentially take them on face value. Fuller argues that we shouldn’t put so much trust in our scientists.
Should we take the scientists’ word for it? Should there be some kind of vetting system aiming to identify fraudulent research? Would measures of this kind ‘slow the pace of science down prohibitively’, as Fuller puts it? How easy would it be possible to maintain some kind of uniform standard in this vetting system? Does the fact that some kind of scientific fraud takes place already, and that eradicating it would be very difficult, justify its existence to the extent that we shouldn’t do anything about it? If you allow some kind of fraud (the ‘tweaking’ of results, for instance) how do you then stop it from going beyond just ‘tweaking’? Can we then trust the scientists to ‘tweak’ their results in the direction of the actual truth (inaccuracies can happen either through intentional bias or just because the data subtly suggests something that on further investigation actually turns out to be fictitious)?
October 20, 2006
The other day I sat down (a relatively rare occurrance at the moment) and watched the Horizon programme about Isabelle Dinoire, the first person to receive a face transplant. Isabelle was mauled by her pet dog, an horrific incident which left her without her lips, part of the flesh on her chin and the bottom half of her nose. Nearly a year ago she underwent the first ever face transplant operation, which was a success.
Whilst Isabelle was, herself, incredibly positive about the operation and its results, a huge amount of contraversy and argument has surrounded the proceedure.
- Whilst the majority of transplant operations that are currently carried out routinely are life-saving, face transplants are not essential to survival in any way. It the proceedure a luxury that we don’t need?
- On the other hand, as a result of the way she looked, Isabelle’s life changed dramatically. For example, she had to wear a mask over her face when she went out. Is this deterioration in quality of life enough of a justification?
- A vastly important consideration in any transplantation proceedure is the risk of rejection. The immune system of the recipient will attack the transplanted tissue unless strong immunosuppressant drugs are taken by the for the rest of their lives. These drugs make the patient more susceptible to infection and increase the risk of cancer. Despite these drugs, there is still a 5% risk of rejection.
- Along similar lines, a disfigured person (for example a burn victim) will often have large amount of skin and facial tissue left, and may have already undergone many operations to improve their appearance, facial function and comfort. To carry out a face transplant on that patient will mean removing all of their skin and a large amount of the soft tissue order for them to receive the new face. If their immune system then rejects it they would be in a far worse situation than they were before the operation.
- The other, less tangible, issue is a psychological one. The face is associated far more with identity than any other part of the body. Although the transplanted tissue moulds to the bone structure of the recipient, the face will still be considerably different from their own. Is this too much of a hurdle to jump for some patients? In contrast, some might say that the patient might have already undergone so much adjustment to become accustomed to their disfigured state that making the jump to transplantation is not so great.
August 14, 2006
I'm currently listening to an interesting programme on Radio 4 about the current 'crisis' in sperm donation. Recent law changes have given the children of sperm donors the right to trace their fathers once they reach adulthood. Unsurprisingly, this has significantly decreased the numbers of sperm donors to a critical point.
- Should a child have the automatic right to find out who their parents are, even in the formerly anonymous and random act of sperm donation?
- Are the recent changes morally important as they encourage potential donors to really consider the consequences their contribution rather than being principally swayed by the monetary advantages? Is it necessary for a potential donor to consider these issues so seriously?
- What are the motivating factors for sperm donation and have they now changed?
- If we accept that the change in the law is morally right how can we overcome the current crisis in sperm availability?
May 24, 2006
With the current murmerings about the rights of criminals being overplayed and victims being put at extra risk a story in this morning's Metro seemed particularly apt.
Jonathan Wright was assaulted by Michael Donohoe and hit over the dead with a nail–studded post, leaving him with a three–inch gash over his ear. However, when he applied to the Criminal Injuries Compensation Authority for compensation he was turned down because he swore at his assailant. Quoting from the letter of refusal…
Your conduct, in being verbally abusive towards the assailant, was an important factor in the incident.
May 19, 2006
I was attempting to avoid the H5N1 bandwagon but it looks like I failed…
Many have complained recently about the coverage of the bird flu story in the media, saying that it has been sensationalist and potentially panic–inducing. This is clearly a difficult subject because whilst the chances of the virus mutating and becoming a transmissible human virus are relatively low, if this does actually happen the resultant pandemic could be terrifying. It depends on how you classify a potential crisis. The BBC has on its forum, as many have highlighted, a series of alarmist comments from members of the public (as well as, presumably, a swathe of others asking everyone to calm down). The BBC and newspapers have been criticised for their own coverage of the situation.
The opening paragraph from a recent New Scientist article read:
I have nothing against miracles, but whenever there's a big buzz about a new drug, it's a fair bet it'll be down to the usual suspects: vested interests, early research, and uncritical journalists.
I'm sure everyone will be aware of the hype surrounding the release, and subsequent variable availability, of the new breast cancer drug Herceptin. The media pronounced it a 'wonder drug', but how many people know the real truth about its successes? The tests carried out showed that Herceptin benefits only a small number of women – shrinking tumours in only 15% of cases – yet the early reports did not make this clear. The trial was carried out on women who had cancers that had been treated early. Emphasising a figure of a 52% reduction in recurrence in a group who already have a small chance of re–contracting the disease is misleading (even those who have no treatment after surgery have a recurrence maximum of 10% per year, dropping to 3% after 10 years). The test groups were also very small – only in the 10s – so the perceived advantages could have been down to pure chance. Yet this drug was described as a potential ‘cure’ by the 2006 President of the American Society of Clinical Oncology: a man who is also a paid consultant to Genentech, Herceptin’s US distributor.
Another important recent medical story was about the drugs trial that left six men critically ill. Many criticisms were voiced at the time criticising and even blaming the manufacturer of the drug. Yet when a follow–up story came out declaring that the manufacturer had followed all the required protocols and was thus not guilty of any negligence it didn't make the BBC News website front page, nor the Science and Nature front page. In fact, I had to do a search to find it.
Now, I don’t begrudge anyone access to a treatment that may save or help to sustain their lives: far from it. However, bearing in mind the huge variation between the hype and the reality in the case of Herceptin I can’t help but think that the injustice has been blown slightly out of proportion. Again with H5N1, there is a balance to be had between the potential risks. But is it the duty of the media to reflect these issues realistically and in a balanced manner? The newspapers need to sell and the TV companies need to maximise viewer ratings, and sensational stories will help with this. However, whereas newspapers are private companies, the BBC is publicly funded and has a Board of Governors who purport to act as ‘trustees of the public interest’. Is it in the public interest for these stories to be reported in a totally balanced manner or should we be expected to draw our own conclusions based on the true facts? How do you ensure a balanced coverage when many important stories may be reported many times, each time with a potentially different slant? Surely the purpose of a forum is to air the views of the public: should the BBC or any other company censor its fora to prevent potential hysteria or is this unfair?
May 06, 2006
I have become very aware that many recent posts have delved into the consideration of human rights, and there are a great many different viewpoints expressed by all the contributors.
Is the advocation of human rights always a good thing or is there a point at which the rights of the individual become detrimental to society as a whole? Are people, particularly in the social climate we have now, willing to surrender their rights for the sake of society? Should they? Do all members of society have equal rights, and if not, should they?
May 04, 2006
Writing about web page http://news.bbc.co.uk/1/hi/health/4971930.stm
The top headline on today's BBC News homepage is the story of Patricia Rashbrook, 63, who is now seven months pregnant with her fourth baby after undergoing IVF treatment abroad by controversial fertility doctor Severino Antinori.
- Should someone have the right to have a child irrespective of their circumstances, be that age or anything else?
- Why should the state or a doctor have the right to deny a women the chance of having a baby when she has the means and is in reasonable health?
- Should the increased health risks of pregnancy and birthing for older women be taken into account even if the mother is determined to go ahead despite these risks? Should we also consider the increased risk of genetic disease?
- Are the Rashbrooks putting the welfare of their child first? Or are they being selfish?
- Is there a difference between a women who is reproductively challenged but of a childbearing age undergoing IVF and one who is post–menopausal? Is one more unnatural than the other? This concept of what is natural is difficult. Is it unnatural for us to undergo any other surgical treatment? Or take drugs?
- Antinori defends his actions by arguing that Rashbrook has a life expectancy of at least another 20 years so she should live to see her child into adulthood. Is this a reasonable argument? Is it fair to expect the child to potentially take on the role of carer for their parents before they are an adult?
- Antinori also argues that older people make better parents. Is this generally–held assumption true? Is it valid to say that beyond a certain point parental skills may well deteriorate, as mobility and agility decrease. If women were meant to raise children into their old age why would the menopause exist? Is there something to be said about problems of a gap of two generations rather than just one?
- Is there more of a stigma attached to older mothers than older fathers? Why is this?
May 02, 2006
The BBC is currently running a survey which presents four hypothetical philosophical dilemmas representative of potential real–life situations.
What if (and here I paraphrase)...
- You are in hospital and are providing life support for someone else. If you stay there for the next nine months the other person will be cured and you will leave unharmed. Do you have an obligation to stay?
- You are watching a train run down a track towards a group of five people who are unable to move and will certainly be killed. You have the chance to divert the train down another track which has only one person stuck in its path. Should you change the direction of the train?
- The same train is running down the same track towards the same five people. You are standing on a bridge over the track, next to a fat man. You want to jump down onto the track to stop the train from running over the five people, but you are not heavy enough to stop it. The fat man is. Should you push him over the edge? Is your answer the same as that for the previous example? If not, why not?
- You and five people are stuck in a cave and there is a small hole in the wall you could get out of. The largest of the group is chosen to go first but he gets stuck. The tide is rising and you need to get out quickly. You find some dynamite, which will not blow a hole in the wall but will move the man who is stuck. He pleads with you for his life. Do you blast the man out, allowing you and the remaining four to escape? If you were in the place of the man would you say the same?
Is there a difference between killing someone and letting them die? Are consequences all that matter, or are there some things we should never do, whatever the outcome?
April 27, 2006
Writing about web page http://news.bbc.co.uk/1/hi/health/4947046.stm
A breaking story today announces that hospital heart surgery survival rates are being published for the first time. However, they have stopped short of making the publishing of success rates compulsory for individual surgeons: only those who have volunteered have had their results published. Perhaps unsurprisingly the ones who have come forward have success rates above the expected average. However, there is much pressure to make the publishing of these results mandatory and for other medical specialisms to follow suit.
- If I was a patient going in for major surgery I would want to know that my surgeon was competent and was not likely to make mistakes. Do we have a right to know this information and possibly make changes to our treatment on the basis of it?
- It may encourage some with lower standards to make more effort to improve their techniques. On the other hand, it may cause extra counterproductive stress.
- Surgeons may refuse to operate on high-risk patients in case they bring down their averages.
- Will the results be truly reflective of a surgeon's ability? A doctor could just have a string of bad luck and as a result be blacklisted because the sample size isn't large enough to reflect a true average.
Is this an irreconcilable situation?
April 24, 2006
A New Scientist article from early last month discussed the ethics behind the US method of execution: lethal injection. At the end of February Californian officials delayed the execution of Michael Morales, sentenced to death for a murder he committed in 1981:
His lawyers argued that a lethal injection would constitute cruel and unusual punishment, prohibited under the US constitution. Their case was based on a study published last year in The Lancet (vol 365, p 1412) that suggested some inmates were given too little anaesthetic before receiving fatal doses of other drugs, and might therefore experience unnecessary pain. At a hearing set for May, the state of California must show that it has a lethal injection that does not kill in a cruel and unusual way. Several other states, including Florida, Maryland, Missouri and Texas, have similar cases pending. Medical opinion is not on their side.
I have blogged before about the possible objections to the treatment of inmates in prisons in this country. Many have expressed the view that prisoners should be punished for their crimes and that the current prison system is far too comfortable to be a proper deterrent or to reform anyone. Often inmates gain access to far more readily available medical treatment, health and exercise facilities than they would when free. Far more is spent on a meal for a prisoner than on one for a child in a state school.
A recent survey, I forget where I read it, considered the sensitive subject of the care of people dying naturally in the UK. I think the respondants indicated that approximately a third of deaths were not satisfactory: they didn't think that homes, hospitals or other organisations provided sufficient care to make the death of their loved ones as peaceful as possible. A recent survey of health workers (from a BBC news article) indicated that '69% admitted that many conditions suffered by the elderly, such as dementia, arthritis and sensory impairment, were overlooked… some 57% said they lacked training and support, and a quarter said they struggled to cope with dying patients.'
I know that these examples come from different countries controlled by different systems of law, but are we getting the balance right by worrying too much about some, who have indeed subverted our laws, when we're neglecting other law-abiding citizens?