Monday, April 30, 2007

Quoting Steve Miles on Mr Wolfowitz

Steve H Miles, medical professor at the University of Minnesota at Minneapolis and author of Oath Betrayed in a quote unquote on Mr Wolfowitz: 'The medical ethics lesson from Wolfowitz is that it OK to hang a medical ethicist who steals a large cache of palliative care meds from the narcotics cabinet of an underfunded public hospital to give to his addicted girlfriend.'

Tuesday, April 24, 2007

Pretty scary things - comfort food among them

I went with a colleague to a place called Dallas BBQ in Brooklyn. I can recommend it to you as a true local experience. It's usually jam packed with mostly substantially obese folks of all ages - I take that back, not all ages, there are only few elderly people, because obesity leads to the premature death of far too many people. Anyway, Dallas BBQ is a steak, ribs, fried onion rings, fries, margarita type place that serves gigantically oversized portions of essentially junk 'food' at fairly low/reasonable prices. I got to be honest, I greatly enjoyed the atmosphere in this place. The staff were friendly and the folks feasting themselves to death were remarkably cheerful. I particularly 'enjoyed' parents ensuring that their newborns get addicted to the same type of food so that they can also die premature deaths. I mean, if the idea of 'child abuse' makes any sense at all, it needs to incorporate such stuff, too.

being quiet

i am currently away attending a conference and various meetings. realistically i will only be able to update the blog in a couple of day's time.
udo schuklenk

Wednesday, April 18, 2007

Is our species strongly motivated by egalitarian thinking/instincts?

There's an interesting piece in an April 2007 issue of NATURE (doi:10.1038/nature05651). I excerpt the gist of it. The researchers conducted an experiment designed to test whether humans follow egalitarian strategies even when they are not forced to do so (ie they could, anonymously, be completely selfish and aim for the maximisation of their own benefits). Interestingly, in the experiment, those well-off transferred anonymously some of their wealth to the least well-off while those least well-off also aimed to reduce inequality. There was some concern about free-riders, but the basic principle driving the research participants (independent of each other, anonymously, and without any coercion) was egalitarian in nature. Anyway, here's some content from the paper:

'The results show that subjects reduce and augment others’ incomes, at a personal cost, even when there is no cooperative behaviour to be reinforced. Furthermore, the size and frequency of income alterations are strongly influenced by inequality. Emotions towards top earners become increasingly negative as inequality increases, and those who express these emotions spend more to reduce above-average earners’ incomes and to increase below-average earners’ incomes. The results suggest that egalitarian motives affect income-altering behaviours, and may therefore be an important factor underlying the evolution of strong reciprocity and, hence, cooperation in humans.
To elicit emotional reactions, we presented subjects hypothetical scenarios in which they encountered group members who obtained higher payoffs than they did (see Methods). Subjects were then asked to indicate on a seven-point scale whether they felt annoyed or angry (1, ‘not at all’; 7, ‘very’) by the other individual. In the high inequality’ scenario, subjects were told they encountered an individual whose payoff was considerably greater than their own. This scenario generated much annoyance: 75% of the subjects claimed to be at least somewhat annoyed, whereas 41% indicated a high level (4 or more) of annoyance. Many subjects (52%) also indicated that they felt at least some anger towards the top earner. In the ‘low-inequality’ scenario, differences between subjects’ incomes was smaller, and there was significantly less anger (Wilcoxon signed rank test, P, 0.0001) and annoyance (P,0.0001). Only 46% indicated they were annoyed and 27% indicated they were angry. Individuals apparently feel negative emotions towards high earners and the intensity of these emotions increases with income inequality
These emotions seem to influence behaviour. Subjects who said they were at least somewhat annoyed or angry at the top earner in the high-inequality scenario spent 26% more to reduce above-average earners’ incomes than subjects who said they were not annoyed or angry. These subjects also spent 70% more to increase below-average earners’ incomes. Mann–Whitney tests of both differences indicate that they are significant (one-tailed, P50.05 and P50.001, respectively).
Emotional reactions towards high earners—even when the source of income is known to be purely random—cause individuals to engage in costly acts that promote equitable resource distributions. The evidence here indicates that social inequality arouses negative emotions that motivate both the reduction and augmentation of others’ incomes. This finding supports research that indicates humans are strongly influenced by egalitarian preferences.

Finally, the results are also consistent with the punishment of noncontributors and the reward of contributors in public good games. Although concerns for equality are clearly not the only motive for human behaviour in these contexts, our results suggest that egalitarian motives may underlie strong reciprocity and, thus, play an important role in the maintenance of ooperation.

Part of the problem I have with this experiment is that it cannot control for ownership in the sense that the redistribution that took place in this experiment took place among people who didn't know each other, and where those that provided some of their wealth voluntarily to support those less well-off did not actually really spent any of their own wealth, but merely hypothetical wealth in an experimental situation.

Tuesday, April 17, 2007

You can do something against violent gun crime in the USA

Yet another gun crime related carnage in the land of the free.32 innocent members of the university community at Virginia Tech University were gunned down by a shooter who seems to have subsequently turned his gun on himself and committed suicide. True to form born-again Christian George W Bush, President of that country and a true fanatic as far as the 'right' of US Americans is concerned to bear arms, goes on national TV. He goes on waffling about a good God (you might recall, the omniscient, good, all-powerful entity that somehow failed to stop this carnage), and grieving heavily with the families who lost their loved ones, yet failing to make any noise whatsoever about the need to control the all-too-easy access to guns in his country. In Virginia effectively everyone above the age of 18 can legally purchase handguns without any background checks whatsoever. Big surprise that in this society there's about one or two such slaughter events per year, yet nothing happens re gun control.
You can do your bit to change that situation by supporting organisations such as stop the nra (the nra is the national rifle association of america). Incredibly as it may sound, but some 30,000 US American die each year in that country from injuries inflicted by gun shot wounds.

Sunday, April 15, 2007

What's wrong with selling your story to the media?

It is quite amazing. A few weeks ago a number of British Navy crew were taken 'hostage' by Iranian forces in Iraqi/Iranian (depending on who you choose to give credence to) territorial waters. After a short propaganda war the Iranians released their trophy. I guess most readers will have watched this soap on TV and will have made up their own mind about the story.
However, there was an aftermath to it all. The UK defence minister permitted the troopers to sell their story to the news media. The main reasons that were given, initially at least, suggested that the military believed the story would come out one way or another anyway and that by allowing the Navy personnel to speak themselves they could control the message to some extent.
This all seemed eminently sensible until all hypocritical hell broke lose. There was a lot of waffling about professional standards being breached by those soldiers. The Conservatives did what opposition parties probably always do, they demanded that the Defence minister resign. The same newspapers that fell over each other in attempts at securing the rights for the sailors' stories began condemning their alleged greed. Well, for starters, these papers began offering cash in the first place. What puzzles me much more, however, is the question of which professional standards these sailors could have possibly broken. They did not divulge any military secrets during their interviews, and there was a great deal of public interest in knowing the details of their ordeal. So, if anything, they performed a public service, did not harm anyone, and managed to get their message across (ie they refuted the Iranian version of events).
What puzzles me about this saga is that families who lost family members serving in the Iraq or Afghanistan adventures of Mr Blair attacked the defence secretary for permitting those sailors to sell their stories. What is so deeply offensive about receiving a payment for the story. Would these same people have not complained if they had volunteered the information? Why should they have volunteered the information free of charge? I think there was no good reason for this at all. These soldiers serve in a war that arguably is pointless at best, it certainly is illegal and likely to destabilise the Middle East even further. If those folks supplement their meagre salaries (meagre in relation to the daily risk to their lives) by selling their story, I think only a hypocrite would complain!
I say: leave them alone.

Saturday, April 14, 2007

Time to go Mr Wolfowitz

Very sensible commentary in today's FINANCIAL TIMES. The paper describes how Paul Wolfowitz, current President of the World Bank and one of the Bush administration's leading neocons, has breached a whole range of ethics rules at the Bank when he helped his girlfriend (who also worked at the Bank) to a cushy job in the US government. Now, while she is on secondment there the Bank picks up the tab. More remarkable even, his girlfriend draws a gigantic salary during her secondment, larger even than that of Condoleeza Rice, the US Secretary of State. Wolfowitz made much of his commmitment to fight corruption, another good reason for why he ought to resign. The FINANCIAL TIMES comments on the White House's continuing support for Wolfowitz: 'To place loyalty above all other virtues is the ethics of a mafia boss not of the leader of a great country. The US president also needs to consider what is both right and in the interests of his own country.' This point is well-made. US President Bush is famously loyal to staff who show loyalty to him. As the FT point out, to do this without regard for your underlings failures is more the behaviour of a mafia boss than that of the leaders of the world's remaining superpower.

Friday, April 13, 2007

Aberdeen University promises to reduce animal experiments

It is quite remarkable - scientists at Aberdeen University decided to undertake experiments which reportedly 'involved injecting the rats with cannabis and dropping them into a vat of milk.Scientists then watched to see if the rodents could remember where a submerged platform was.' I can't help but think that this seems a somewhat pointless exercise with little likely future benefit for either humans or rodents. So, quite possibly it would have been better if that research had never been undertaken. Animal rights folks have been up in arms about this kind of research, pointing out that in other studies rodents were injected with lethal doses of all sorts of illicit drugs. Now, surely if these drugs are illegal in the sense that you may not sell, purchase and use them, why would we want to subject animals (who tend not usually to be in the market for such chemicals) to pain and death by injecting them with such substances? Anyone taking such drugs is responsible for the consequences of such an action. There's no need to torture animals to death in order to find out what the effect of such drugs is on rodents - who, this is worth repeating, don't normally sell, purchase and take such drugs.
Well, in response to the public outcry the University of Aberdeen promises to reduce animal experiments. That's a start.

Wednesday, April 11, 2007

Frozen embryos and such things

Natallie Evans and her that time partner Howard Johnston decided to conceive a child by means of IVF. As the BBC reports, 'Ms Evans was diagnosed with ovarian cancer in 2001, but six of the couple's fertilised embryos were frozen and stored prior to her treatment.'Well, as so often in the real world, there's no happy ending to this story. Ms Evans and Mr Johnston split up and each went their own way. Mr Johnston, however, wanted the frozen embryos destroyed, while Ms Evans wanted them implanted in order to conceive a child. She is infertile due to the effects of her cancer episode and pointed out that this was her last chance to conceive a child. She took the case through the legal instances in the UK as well as in the EU and saw her appeals rejected by every single court. Her arguments were that she wanted her own children and that the embryos had a right to life. The former argument is a classic case of question begging, because even if we agreed that she had such a right, it's unclear why it is Mr Johnston's responsibility to supply the genetic material for this purpose. And the embryos supposed 'right to life', well, while I don't agree with the very idea that embryos have any rights at all, let's suppose they do (ie for the sake of the argument). Surely Mr Johnston could always maintain that the embryos should then not be destroyed but kept in the freezer in perpetuity. That way they wouldn't have their supposed 'right to life' denied, yet Ms Evans would also not be able to conceive of the children she desires so badly. In case you wonder why one could possibly think that embryos (see photo to the left) don't have a right to life ... well, I wonder why any one could think that something has a right to life that has no central nervous system, no brain, no capacity to suffer, no sense of his/her past/future, and indeed no wish to be alive.

On a more serious note, however, I wonder what drives Ms Evans' somewhat fanatical approach to this all. Why does she insist on carrying a baby to term that she began producing with her ex-partner (who wants to have nothing to do with her any longer). I mean, if she so badly wants a baby, why not adopt one? Similarly, Mr Johnston... I'm tempted to say 'get a life mate' or 'get real', and 'why don't you let her have her way'. All that he contributed was a tiny bit of genetic material. What would be the big deal about letting her have her way provided a deal is signed that establishes that he won't incur any costs and responsibilities (and rights) in terms of the kid(s) up-bringing. End of story. It all seems rather petty.

Tuesday, April 10, 2007

WHO in favour of fair innings based resource allocation justice

WHO, in a recently published report, has come out in favour of an approach to resource allocation justice based on the fair innings argument. That is quite interesting. US authorities, more or less, came out in favour of maximising lives saved instead of maximising life years saved (ie no discrimination in favour of the young). The UK has come up with a draft ethics guideline leaving open the question how scarce life-preserving treatments should be allocated in case of pandemic influenza. So, it's not insignificant that the WHO's experts support an approach aiming to save the maximum number of life years that can be preserved.

Monday, April 09, 2007

(Hopefully) the UK's last homeopathic 'hospital' to close its doors soon

The Observer newspaper reports that the UK's last homeopathic 'hospital' might be about to be closed because the NHS's Primary Care Trusts will refuse to reimburse patients 'treated' there. That's pretty good news. I doubt anyone other than avowed homeopathy fans such as the Queen (yep, HRM etc etc) and her son Prince Charles will miss the outfit. Surely, as a matter of public policy it cannot be that tax monies are being spend on 'treatments' of truly unknown benefit. There is no (I am not exaggerating here) independent scientific evidence supporting the idea that homeopathy works. So, if patients are keen on placebos, we should be able to find a slightly cheaper way than a costly 'hospital' requiring millions of tax monies every year for its up-keep. It is surely unethical to waste health resources that could be poured into buying and distributing medicine proven to work.

Sunday, April 08, 2007

More up-coming events

With reference to the below, there's a second event in April that I will also attend. It's the Fourth International Conference on Ethical Issues in Biomedical Engineering in Brooklyn, New York. In case you're going there and you read this blog, give us a shout (preferably a friendly one :).

Catching up in Person? Up-coming Events

Here's information about a conference the topic of which is genuinely close to my heart. I'm going to give a talk there, so please do let me know in case you read this blog on the odd occasion and you will be around. Always good to catch up in person when there's a chance.

Theoretical Perspectives on Global Health and Human Rights
19th April 2007 Institute of Law Medicine and Bioethics University of Liverpool Lecture theatre 3, Liverpool Law School

Convenors: Dr Maria Stuttaford and Professor Gillian Lewando Hundt, University of Warwick Professor John Harrington, University of Liverpool

13.30 - 13.40 Welcome Professor Alan Irwin (Dean of SES Liverpool)

13.40 – 14.00 Opening remarks Professor John Harrington (University of Liverpool), Dr Maria Stuttaford (University of Warwick), Professor Gillian Hundt (University of Warwick)

14.00 – 15.30 Professor Paul Hunt (UN Special Rapporteur on the Right to Health) ‘Reflections on Implementing the Right to Health’ Professor Upendra Baxi (University of Warwick) 'The Place of the Human Right to Health. Contemporary Approaches to Global Justice; Some Impertinent Interrogations'

16.00 – 17.30 Dr Lisa Forman (Canadian Institutes of Health Research) 'What Future for the Minimum Core? From the Margins to the Centre: The International Right to Health and the South African Experience'
Professor Udo Schüklenk (Glasgow Caledonian University) 'The 10/90 Gap in International Health Research - Drug R&D: Whose Moral Responsibility is it?' 17.30 End of Session 19.30 Dinner (details will be provided on a separate sheet)

20th April 2007 Institute of Law Medicine and Bioethics
University of Liverpool Lecture theatre 3, Liverpool Law School
9.30 – 11.00
Professor John Harris and Muireann Quigley (University of Manchester) on the ethical limits of global organ markets
Professor Simon Caney (University of Oxford) 'Global Justice, Health and Climate Change'

11.30 – 13.00 Professor Robyn Martin (University of Hertfordshire) 'Comparative National Population Health Laws And Comparative Approaches To Human Rights: Seeking Global Health In A Disparate World'
Dr Brigit Toebes (University of Aberdeen) 'Taking a Human Rights Approach to Health Care Commercialisation'

13.00 – 14.00 Lunch 14.00 – 14.45 Professor Roger Brownsword (King's College London) 'The Ancillary-Care Responsibilities of Researchers: Reasonable But Not Great Expectations'

14.45 -15.15 Concluding remarks Dr Maria Stuttaford and Professor Gillian Lewando Hundt, University of Warwick, Professor John Harrington, University of Liverpool

Saturday, April 07, 2007

Hotels ... gone are the good old days

Umm, not by way of bragging, but I stayed in London during the last few days, in this hotel. There is something mildly disconcerting about the ever growing greed of hotel proprietors. In the good old days if one had forgotten toothpaste, the hotel receptionist would hand over toothpaste to the hotel guest, and the same would be true for other basic amenities. Well, not any longer. The Thistle Hotel that I stayed in had a vending machine in the lobby dispensing even things like headache pills at exorbitant prices (something close to 5 GBP for a couple of aspirin pills). Similarly, I stayed in a Park Inn (the 'budget' version of the SAS Radisson hotel group) in Bochum in Germany a few weeks back and discovered that they aim to rip off their guests by charging the living hell out of them for internet access (a thing you'd get free of charge in virtually every hotel in the USA, no matter how down market). Mind you, even use of the sauna (much advertised as a hotel facility on the internet) requires that one tells the receptionist 30 minutes ahead that one wants to use it so that they'd get it started...

I made the mistake to grab a take-way coffee in the lobby of the Thistle hotel. I realised immediately why they didn't display any prices at all for their paper-cup coffees. They charged 'only' 3.50 GBP for the cup.

So, again, let the buyer beware. I have to say, as far as hotel chains go, my best experiences were made in Holiday Inn's and their upmarket relatives Crown Plaza hotels. No hidden charges, internet access rip-off's and the endless nonsense practised by so many other hotel chains.

Friday, April 06, 2007

Moving on to Canada

I got myself a new job. Here's how Canada News Wire reports the move:

Queen's University attracts first Ontario Research Chair

OTTAWA, April 4 /CNW Telbec/ - Queen's University has appointed the first of eight new Ontario Research Chairs in Public Policy - part of a $25-million provincial government initiative to address key policy issues.
A world leader in the study of health care ethics related to policy, Dr. Udo Schuklenk will be the Ontario Research Chair in Bioethics. Dr. Schuklenk was successfully recruited from Glasgow Caledonian University in Scotland, where he was professor and head of the Centre for Ethics in Public Policy and Corporate Governance.
"We are extremely pleased to welcome to Queen's such a highly accomplished scholar with significant research experience," says Principal Karen Hitchcock. "His outstanding publication record, international experience gained at universities in Australia, South Africa, Germany and Britain, and reputation for public service make Dr. Schuklenk an excellent choice for this new position. We look forward to his contributions to this important and highly complex area of public policy."
"We are delighted to welcome a scholar of Dr. Schuklenk's calibre and international reputation to Queen's University," said John Gerretsen, MPP Kingston and the Islands, on behalf of Chris Bentley, Minister of Training, Colleges and Universities. "Along with the remaining seven Ontario Research Chairs, we look forward to the benefits of an increased number of leading edge researchers at our universities who will help ensure that the next generation of graduate students is prepared to address issues and find novel solutions to problems of central relevance to all Ontarians."
Co-editor-in-chief of Bioethics, the official journal of the International Association of Bioethics, Dr. Schuklenk's publications in this area have been critically acclaimed. As Chair, he plans to examine the degree to which market forces should be allowed to dictate the direction of pharmaceutical research; how communities whose "local knowledge" is commercially exploited by pharmaceutical companies should be compensated; and how to define appropriate measures of infectious disease control in conditions of pandemic.

Tuesday, April 03, 2007

The US and Global Warming

I thought, by way of celebrating yesterday's US Supreme Court Judgement which declared that the US Presidency was seriously deficient in its policy response on global warming and environmental protection issues, a spoof video featuring George W Bush on global warming and other issues- enjoy (or don't).

Sunday, April 01, 2007

Made in England - Bought in Scotland...

I know, I know, to some this might sound like a Fool's Day posting, but... I bought myself a pair of new sneakers today. Not that I needed them, those that I use are still in perfectly good shape. However, I wanted to start into spring with a new set of sports wear, so don't castigate me too loudly, if you could. Even so, I bought a pair of terrible looking sneakers from a company called New Balance. I bought them for no reason other than the label saying that they were made in England, and that they're vegan friendly (ie no animal was killed producing them). I preferred them to shoes made in Vietnam, China or any of these places, because I know that a product produced in the UK by local workers means: 1] the sneakers didn't have to be transported half-way around the world to get to me (less energy wasted); 2] the company had to abide by pretty strict EU/UK rules and regulations on the environment (they were produced in a manner less harmful to the environment than a pair of sneakers produced in China where standards are substantially lower and environmental protection is by and large unknown); 3] the company had to abide by EU/UK labour regulations, which means staff receive a pension, paid leave, don't work more than 35-40 hours per week, things like that; 4] last but not least, no animal was subjected to suffering or was killed during the production of the sneakers.

So, in short, by supporting New Balance I supported a better deal for the environment, and a better deal for the factory workers producing the sneakers. Seems eminently sensible to me.

What's the downside? Well, for starters, the sneakers were more expensive then comparable sneakers produced in Asia. I don't mind, but I do understand that many people do not have the luxury of being able to afford more expensive products. The other downside, and I got to be honest here, these sneakers look about as terrible as the cars Rover produced (yes, the defunct last British owned car maker). I truly wonder what prevents the company from producing seriously better looking sneakers, given the premium it charges for its England made products.

COVID19 and the ethics of hospital triage decision-making

There is a lot of talk these days about the predicted coming wave of COVID19 patients needing ICU beds and ventilators in particular, and th...