Tag: government policy

Bioethics Blogs

In The Journals – November by Christine Sargent

Hello trusty readers. Check out November’s haul for “In The Journals,” and be sure to check out the special issue of Science, Technology, and Human Values: Feminist Postcolonial Technosciences.

 

American Ethnologist:

Memory, body, and the online researcher: Following Russian street demonstrations via social media (open access)

Patty A. Gray

The Moscow street demonstrations of 2011–12 were the largest public gatherings in Russia since the collapse of the Soviet Union. They were also the largest-ever gathering of Russians on social media. While using the Internet to follow such large-scale social movements remotely, researchers experience social media as a context in which anthropology happens. They may think about “being there” in new ways that shift their focus to their own processes of memory making and sense of bodily presence. Experiencing and remembering social media in the body challenges the distinctions we might otherwise make between virtual and physical encounters.

Royal pharmaceuticals: Bioprospecting, rights, and traditional authority in South Africa

Christopher Morris

The translation of international biogenetic resource rights to a former apartheid homeland is fostering business partnerships between South African traditional leaders and multinational pharmaceutical companies. In the case of one contentious resource, these partnerships are entrenching, and in some instances expanding, apartheid-associated boundaries and configurations of power. The state and corporate task of producing communities amenable to biodiversity commercialization and conservation is entangled with segregationist laws and spatial planning. Rather than exclusion and the closure of ethnic boundaries, resource rights in this context foreground forced enrollment and the expansion of indigenous group-membership as modes of capitalist accumulation in an extractive economy.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Invited Guest Post: Healthcare professionals need empathy too!

Written by Angeliki Kerasidou & Ruth Horn, The Ethox Centre, Nuffield Department of Population Health, University of Oxford

 

Recently, a number of media reports and personal testimonies have drawn attention to the intense physical and emotional stress to which doctors and nurses working in the NHS are exposed on a daily basis. Medical professionals are increasingly reporting feelings of exhaustion, depression, and even suicidal thoughts. Long working hours, decreasing numbers of staff, budget cuts and the lack of time to address patients’ needs are mentioned as some of the contributing factors (Campbell, 2015; The Guardian, 2016). Such factors have been linked with loss of empathy towards patients and, in some cases, with gross failures in their care (Francis, 2013).

We recently argued for the importance of professionals’ emotional wellbeing in the development and exercising of empathy (Kerasidou, Horn, 2016). Empathy is the ability to comprehend another person’s experience, and the capacity to understand the world from their perspective. Feeling empathy towards someone is also what motivates positive action and the desire to help. The beneficial effects of empathy on patient care are well researched. It has been shown to improve adherence to therapy, increase patient satisfaction, decrease medical errors, and lead to fewer malpractice claims (Hickson et al. 2002). However, very little attention has been given to the moral and emotional labour empathy requires from physicians. In order for medical professionals to be able to develop and exercise empathy, they themselves need access to support and the right work conditions to be in place (Eichbaum, 2014).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Politics of HIV

Harry Critchley argues that laws and policies can contribute to the spread or reduction of HIV infections.

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The International AIDS Conference has returned to Durban, South Africa for the first time in nearly two decades. When the conference was last held there in 2000, President Thabo Mbeki shocked attendees by publicly questioning the causal link between HIV and AIDS and walking out during an impassioned keynote address by a young boy born with HIV. In a recent op-ed, South Africa’s health minister, Aaron Motsoaledi, noted that the conference in 2000 marked a low point in the country’s official attitude towards HIV/AIDS—a failure on the government’s part that is estimated to have led to nearly 330,000 premature deaths between 2000 and 2005.

In the intervening years, however, South Africa has experienced a sea change in its approach to HIV, in large part because of greater synergy between government policy makers and the scientific community. The country now operates the world’s largest drug treatment initiative and has seen significant improvements in its life expectancy and newborn infection rates. South Africa is also at the forefront of new prevention, testing, and treatment programs for HIV. The country still faces steep challenges, however. It has the largest population with HIV in the world and struggles with high rates of infection amongst young women aged 15 to 24. Nonetheless, the ambitious ’90-90-90’ UNAIDS global targets for 2020—90% of persons with HIV diagnosed, 90% of those diagnosed receiving treatment, and 90% of those receiving treatment virally suppressed—appear for the first time to be within reach.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals July 2016 – Pt. I by Christine Sargent

Check out the first instalment of this month’s In the Journals!

 

Critical public health 

Global mental health and its critics: moving beyond the impasse (open access)

Sara Cooper

The field of Global Mental Health has very quickly engendered a new institutional and research landscape, having recently established a number of its own research centres and training programmes. Under the banner of this field, there has also been an explosion of international research programmes and interventions which have received significant financial backing from a range of international donors, development agencies, and governments.1 In sum, Global Mental Health has increasingly captured the imagination of a wide range of stakeholders and has made major strides in establishing mental health as a priority within the global health arena. Indeed, a recent Google search for ‘Global Mental Health’ on 1 November 2009 identified approximately 62,300 related sites, of which over 85% of them were registered since 2008 (Patel & Prince,2010). This increasingly powerful field has, however, also elicited a range of critical responses, with growing controversy over its conceptualisations, goals and imagined outcomes (Campbell & Burgess, 2012; Kirmayer & Pedersen, 2014; Mills & Fernando, 2014).

Stigmatizing surveillance: blood-borne pathogen protocol and the dangerous doctor

Valerie Webber, Janet Bartlett & Fern Brunger

HIV and hepatitis B and C are viruses that have been unduly set apart from other infectious diseases in terms of the symbolic pull they exert and the anxiety they produce. This is reflected in health care policy and protocol. Hospitals, health care regions and colleges of physicians and surgeons create guidelines and procedures that single out HIV or hepatitis B and C as requiring special attention.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Abortions: Coming soon to PEI

Nasha Nijhawan and Kelly McMillan explain why the PEI government has finally elected to provide abortion services on the Island.

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On March 31, 2016, the Premier of Prince Edward Island, Wade MacLauchlan, announced that by the end of 2016, PEI will develop a plan to open a reproductive health clinic offering medical and surgical abortions in an Island hospital. This announcement represents a sudden reversal in the Province’s 28-year-old policy not to provide abortions on the Island.

Following last week’s reversal, the question on every reporter’s lips was: “why now?” As Premier MacLauchlan candidly admitted, his decision was a concession to threatened Charter litigation served on January 5, 2016 by a group of veteran advocates called Abortion Access Now PEI Inc.

As social movements rarely score their victories by merely threatening Charter litigation, the question of why this worked in this case bears comment. In our view (as counsel for Abortion Access Now PEI), this success can be attributed partly to the recent surge in creative activism by abortion access advocates on PEI, and partly to the way the litigation fundamentally reframed the discussion about what the Province was doing and why.

Image by “Shirley Karats” (artist pseudonym)

Before this litigation, the question of what exactly was PEI’s abortion policy had stumped activists and health providers alike. In 2011, the CEO of Health PEI stated publicly that there were no regulatory barriers to abortion, and that any doctor who wished to perform the procedure on PEI could do so freely. However, when a working group at the Queen Elizabeth Hospital in Charlottetown tried to develop a plan in 2014 to bring in a Nova Scotia physician to provide abortion services, the Province instructed Health PEI to stop them because it was “against government policy,” much to the CEO’s apparent surprise.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Beware ‘Innovation-Speak’

Matthew Herder wrote a Master’s thesis on Canadian science policy some ten years ago and by the time he was done, he had sworn off the word ‘innovation.’

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In Canada, since the 1980s, the term ‘innovation’ has appeared in every significant federal science policy document, save for that of the Conservative government under Brian Mulroney. Deciding ‘innovation’ wasn’t innovative enough, in 1987 the Mulroney government invented its own term—the awkward ‘InnovAction.’ I called my Master’s thesis “The Rhetoric of Innovation” and when I was finished I hoped never to type the word again.

So when ‘innovation’ appeared again and again in the #Budget2016 speech in the House of Commons and in the budget itself, the hairs on the back of my neck stood up.

I know why the current Liberal federal government under Justin Trudeau, like every other federal government in recent decades, used the term ‘innovation.’ I’ve probably used it in every paper I’ve written since I swore off using the term. If you work on science or technology policy, intellectual property law, or engage in practically any field of research, it’s inescapable. How can anyone be against innovation? The word serves as a powerful marker of human achievement. It signals our capacity to improve our condition through creativity, perseverance, and insight. It means something to nearly everyone and its scope to do good is as limitless as human potential.

Pictured from left to right are the Canadian Prime Ministers who, since the 1980s, have introduced a federal science policy: Brian Mulroney, Jean Chrétien, Paul Martin, Stephen Harper, and Justin Trudeau

Herein lies innovation’s magic, but also its trick—a trick that governments and other actors have long traded on.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Interview: David S. Oderberg

Interview: David S. Oderberg

David S. Oderberg is Professor of Philosophy at the University of Reading, UK, and has written extensively on bioethical issues such as abortion, euthanasia, genetic engineering, animal rights, and capital punishment from a natural law, anti-consequentialist viewpoint. He is also the editor of Ratio, an international journal of analytic philosophy. Xavier Symonds, Deputy Editor of BioEdge, asked him to comment on the state of contemporary bioethics.

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Xavier Symons: In your opinion, what are the main philosophical concepts that bioethicists tend to misunderstand?

David S. Oderberg: There’s a lot of misunderstanding in the bioethics industry (because it is something of an industry), although I’d prefer to put it in terms of simple mistakes or confusions. I don’t think most bioethicists misunderstand what they believe or recommend at policy level, since most have a clear agenda, which is to pull apart as many “taboos”, i.e., commonsense traditional prohibitions, as possible.

A lot of the time, the ends justify the means inasmuch as bioethicists will use whatever argument they have to hand, whether good, bad, or indifferent, to advance a prior agenda. In that sense, I suppose you could say they misunderstand the function of argument, which is to get to the truth, not to advance a previously-adopted policy.

I recall reading, a number of years ago, a report by the UK’s Human Fertilisation and Embryo Authority, produced by a handful of bioethicists and devoted to defending human embryo experimentation. It was abundantly clear from the report that the authors (most of whom I had barely heard of as far as the philosophy profession is concerned) were intent on recommending embryo experimentation to the government as morally permissible, and they used whatever argument or “theory” they could to defend it.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Don’t write evil algorithms

Google is said to have dropped the famous “Don’t be evil” slogan. Actually, it is the holding company Alphabet that merely wants employees to “do the right thing”. Regardless of what one thinks about the actual behaviour and ethics of Google, it seems that it got one thing right early on: a recognition that it was moving in a morally charged space.

Google is in many ways an algorithm company: it was founded on PageRank, a clever algorithm for finding relevant web pages, scaled up thanks to MapReduce algorithms, use algorithms for choosing adverts, driving cars and selecting nuances of blue. These algorithms have large real world effects, and the way they function and are used matters morally.

Can we make and use algorithms more ethically?

The algorithmic world

The basic insight is that the geosphere, ecosphere, anthroposphere and technosphere are getting deeply entwined, and algorithms are becoming a key force in regulating this global system.

The word “algorithm” (loosely defined here as a set of rules that precisely defines a sequence of operations to reach a certain goal) may be the fashionable way of saying “software” right now, but it applies just as well to mathematical methods and formal institutions and social praxis. There is an algorithm for becoming a UK citizen. However, it is the algorithms in our technology that leverage our power at an accelerating pace. When technology can do something better than humans it usually does it far better, and it can also be copied endlessly or scaled up.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Incentives, Penalties, and Vaccination.

This popped up on my FB feed yesterday: a proposal from the Australian government that certain child welfare payments should be withheld from parents who refuse to vaccinate their kids based on “conscientious objection”.

Parents who do not vaccinate their children will lose welfare payments of up to $2100 per child under a federal government policy set to be announced before the May budget.

Under changes that could save more than $50 million a year, Social Services Minister Scott Morrison is preparing to scrap a “conscientious objection” provision which allows anti-vaccination parents to still claim welfare benefits including childcare assistance and Family Tax Benefit A.

Fairfax Media understands the Family Tax Benefit A is worth up to $2100 per child.

What to make of the idea?

Well, I think that certain things can be taken more or less as read.  The first is that vaccination is a good thing, and is quite possibly a prima facie duty.  The second is that governments may, and perhaps must, encourage vaccination.  So it looks as though an argument in defence of the idea could be valid.  Measures to increase levels of vaccination are desirable; this is a measure that (if it works) would increase levels of vaccination; therefore this is desirable.  We’d have to do a bit of work to see whether the argument actually does work – formal validity won’t guarantee that – but in the meantime, the policy may be justified on the basis that it’s reasonable to believe that it would work.

But that is not, of course, the whole story.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Vaccinate or be turned back

In the fight to end polio, the Pakistani government has for the past year made safe-haven for internally displaced persons (IDPs) conditional on receiving polio vaccinations.

The country’s ruling party, the Pakistan Muslim League, has made polio drops mandatory for anyone leaving the country’s tribal areas – the regions in which the worst polio outbreaks have occurred. 

Previous voluntary vaccination programs in these regions have failed to eradicate the polio threat.

As the stakes grow higher, the authorities have chosen to prioritize public health over individual consent.

A significant number of refugees refuse the vaccine, and for this reason are turned back at regional checkpoints.

In June last year, for example, nearly 40 trucks carrying internally displaced persons (IDPs) from North Waziristan en route to Afghanistan were turned back by the Pakistan army at the Pakistan-Afghan border. The refugees demanded that they be first provided with food and shelter before the administration of the vaccine.

Refugees often believe Taliban authorities, who claim that vaccination is a ‘Western conspiracy’ and will ‘spoil’ (i.e. render infertile) their children.

This is not an entirely unfounded claim. In 2011, the CIA used a hepatitis vaccination program as a front to gather intelligence on the whereabouts of Al Qaeda leader Osama bin Laden.

The new government policy has attracted the attention Western bioethicists. In an article in this month’s edition of the Journal of Medical Ethics, Art Caplan and David L Curry of the NYU School of Medicine argue that states have a right and a responsibility to require vaccination in instances where serious vaccine-preventable diseases threaten local populations.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.