On January 11, 2020 The New York Times (NYT) published an opinion piece by their Editorial Board: “The F.D.A. Is in Trouble. Here’s How to Fix It”. The F.D.A. is the US Food and Drug Administration, a regulatory body with gatekeeping powers over pharmaceutical markets. Since 1962, patients can access new medical treatments only after the F.D.A. has declared them safe and effective, on the basis of evidence gathered in clinical trials. This is a form of pharmaceutical paternalism: patients’ right to try whatever treatment they see fit is partially restricted – they will find in chemists only those drugs that the F.D.A. judge good for them. Yet, argues the NYT Editorial Board, “libertarian groups bent on deregulation at any cost” are exploiting the frustration of patients who don’t find any treatment option in the market to put pressure on the F.D.A., curtailing its “already diminished powers.” I think that the NYT is right to be concerned with this trend, and in a recent article, I provide an account of why exactly we should value pharmaceutical paternalism.
Category: Health (Page 2 of 3)
In this post, John Tillson discusses issues raised by the recent decision by ITV to pull the Jeremy Kyle Show from our television screens.
A guest of the Jeremy Kyle Show has (likely) taken his own life a week after failing the show’s lie detector test taken to prove his fidelity. His partner subsequently ended their relationship. In light of these events, the show was permanently cancelled by its network. The House of Commons Select Committee has announced an inquiry to “ask whether enough support is offered both during and after filming, and whether there is a need for further regulatory oversight.” One proposal the inquiry could consider is whether production companies ought to establish Ethics Review Boards (ERBs) whose approval shows would require in order to enter production, and whether networks ought to make such ethical approval a precondition of broadcasting.
In 2017, US-scientists succeeded in transferring lamb foetuses to what comes very close to an artificial womb: a “biobag”. All of the lambs emerged from the biobag healthy. The scientists believe that about two years from now it will be possible to transfer preterm human babies to an artificial womb, in which they have greater chances to survive and develop without a handicap than in current neonatal intensive care. At this point in time, developers of the technology, such as Guid Oei, gynaecologist and professor at Eindhoven University of Technology, see the technology as a possible solution to the problem of neonatal mortality and disability due to preterm birth. They do not envisage uses of it that go far beyond that. Philosophers and ethicists, however, have started thinking about the use of artificial womb technology for very different purposes, such as being able to terminate a risky pregnancy without having to kill the foetus, or strengthening the freedom of women. If we consider such further going uses, new ethical issues arise, including whether artificial womb technology could promote gender justice. Should we embrace this technology as a means towards greater equality between men and women?
In a world where “wellness” has become a cultural signal of the American elite (think yoga and spa treatments), employers have not been afraid to market wellness programs as a one-way ticket to greater health, wealth, and happiness. Watching this kind of rhetoric on display in the wellness movement, it’s hard not to think that wellness programs actually strengthen biases against what they’re intended to combat: disability, economic stagnancy, and mental illness. In this post, I articulate precisely this worry.
In recent months, both the central UK Government at Westminster, and the Scottish Government have released strategic plans for addressing obesity. In both cases, among the measures being considered is a ban on multi-buy discounts for unhealthy foods and drinks, such as confectionery, crisps, cakes and sugary sodas. This would outlaw price promotions that offer a discount for purchasing a larger quantity of the product – for example, ‘buy one, get one free’, or ‘2 for £3’. Promotions of this sort have been illegal for alcohol in Scotland (though not England) since 2011.
Critics of these plans see them as “draconian” government interference with private individuals’ freedom to make their own choices regarding what to eat and drink. Indeed, on the face of it, policies like the multi-buy discount ban look like a clear example of paternalism, infringing John Stuart Mill’s famous harm principle:
There is currently a lot of attention on the UK’s “housing crisis”. One issue here is the quantity of available housing. There are commitments to address the shortage of housing in the 2017 manifestos of both the Labour Party and the Conservative Party. Another issue is the quality of housing. On this issue, the Labour Party have restated the commitment they made in a 2015 Homes Bill to require that all homes meet the standard of being “fit for human habitation”. In this post, I explore the reasons in favour of this commitment.
Labour Market Injustice
Labour markets are rife with questions of justice. This series of blog posts; explore cases of injustice, highlight theoretical puzzles and point towards possible solutions. They emerged from debates at the ‘Labour Market Injustice’ Workshop co-hosted by Newcastle and Durham Universities and generously sponsored by the Society for Applied Philosophy. In this fourth post Sarah Goff discusses bearing the costs of maternity leave.
In a 2004 interview, Donald Trump described pregnancy as an “inconvenience” for business. Whether or not this remark reveals anything about President Trump’s intentions for his promised reforms to maternity leave in the U.S., it seems plausible as a statement of fact. For a business, it often will be an inconvenience for employees to have a legal right to take a leave of absence and return to their positions without penalty. Of course, the cost of providing paid leave is additional to any costs incurred from the inconvenience of the leave-taking itself.
Observing that there are costs to maternity leave does not imply new mothers lack a moral right to take it. The observation simply raises the question of who is responsible for bearing these costs. The case for employers to provide paid maternity leave is less strong than the case for employers to accommodate new mothers in taking a period of leave with a right to return to their jobs. While only employers can bear the cost of the inconvenience to business, there are many feasible arrangements for other actors to bear the costs of providing financial support during maternity leave. In fact, there is substantial variation across societies in: public provision for paid maternity leave, legal mandates on employers to provide paid leave, employers’ provision of paid leave in excess of legal requirements (particularly in high paying industries where there is a business interest in retaining skilled employees), and social and cultural practices of support for new parents from extended families and kinship networks.
[This post is co-authored by Julia Mosquera and Fay Niker]
A few days ago, the UK’s Department of Health approved the roll-out of new non-invasive prenatal testing (NIPT). The case in favour of NIPT is clear: it will provide diagnoses of Down’s syndrome with 99% accuracy and, as opposed to current tests like amniocentesis, will have no secondary effects on the mother or foetus.
But Sally Phillips’ BBC documentary ‘A World Without Down’s Syndrome?’, which aired earlier in the month, brought the issue to the attention of the general public in the hope of launching – or, more precisely, rekindling – the public debate concerning the ethics around technological developments in genetic screening. It asks us to think about the possible implications of NIPT for our society and, in particular, for people with Down’s syndrome – like her 11-year-old son, Olly.
One argument made against the proposal to legalise assisted dying in the UK is that making this change might result in older citizens feeling pressured to choose death, increased pressure on people to think about and defend their existence, and the inevitable acceptance of voluntary and, then, involuntary and non-voluntary euthanasia. This kind of argument can be called a slippery slope argument. A
slippery slope argument claims that if we make a proposed policy change, other changes or outcomes will occur, and because these other outcomes are objectionable, we should not make the policy change. I am generally sceptical of slippery slope arguments and in this post I wish to register some issues with their use.
On the outskirts of Amsterdam, there is a small village called Hogewey, notable because all of its 152 residents have severe or extreme dementia. Hogewey is a gated model village, complete with town square, post office, theatre, hair salon, café-restaurant and supermarket – as well as cameras monitoring residents around the clock, and well-trained staff working incognito, holding a myriad of occupations such as post-office clerks and supermarket cashiers. Every detail of this ‘fake reality’ has been meticulously designed to ensure that the residents can experience life as close to ‘normal’ as possible. Critics have drawn parallels with the deception depicted in the 1998 ‘social science fiction’ film The Truman Show; but many Alzheimer’s experts have praised the pioneering facility for being the first to adjust ‘our’ reality to allow those with dementia to be in a safe and comforting environment – one built around life rather than death.
|Taking inspiration from Hogewey, the Grove Care nursing home in Winterbourne, Bristol have developed ‘Memory Lane’; a recreation of a 1950s high street, including a Post Office, pub, bus stop, phone box and shop windows full of memorabilia.|
I’d like to briefly outline two sets of reasons for thinking we should move towards this model of care (all-day reminiscence therapy, or ‘Truman Care’ if you like), and to then briefly discuss what I assume to be the main problem facing this kind of move.