Dr Voo Teck Chuan is an assistant professor at the Centre for Biomedical Ethics, National University of Singapore Yong Loo Lin School of Medicine. He was a Caroline Miles Visiting Scholar at the Ethox Centre in March-April 2019.
Recently, the treatment of a guest worker with a life-threatening disease was highlighted in international news. Baby Jane Allas, a foreign domestic worker based in Hong Kong was fired by her employer after she was diagnosed with aggressive stage 3 cervical cancer, with her illness cited as the reason. In losing her employment visa, she lost her right to stay in Hong Kong and her right to access its heavily subsidized public healthcare. Her work termination was, in her words, akin to a death sentence because she would not be able to pay for her treatment if she were to return to her country. Even if she could pay, the urgent treatment that she needed would, according to her, be delayed as she would be placed on a wait-list. Going for treatment would also not be easy as the hospital is far from her home. Continue reading “Ethical treatment of guest workers with non-work related catastrophic medical conditions”
How often do we, as starting doctoral students, get the chance to practice defending our proposed research projects in front of a panel of scholars, each a respective expert in their field? Well, that’s exactly what happened in Amsterdam on April 11 and 12, 2019. Continue reading “First Edition of the Oxford-Amsterdam Spring School!”
Dr. phil. Joschka Haltaufderheide, M.A., is a researcher at the Institute for Medical Ethics and History of Medicine, Ruhr-University Bochum. His fields of interest include concepts of ethical expertise and ethics consultation in healthcare. He was a Caroline Miles Visiting Scholar at the Ethox Centre in July/August 2018.
Ethical expertise, which mostly comes as part of clinical ethics support services (CESS) in mental healthcare, is a valuable tool in psychiatric practice. In Germany, since the mid-nineties, it has often been advocated as being useful for professionals in this field to analyze, clarify or resolve ethical issues in everyday practice. In a recently published study, two of my colleagues conducted the first psychiatry-specific survey to shed some light on the recent situation of CESS in psychiatry. In their survey, Gather et al. asked for 32 items regarding already established or planned structures of ethics consultation in psychiatric hospitals in Germany.[i] To our surprise, more than 90% of German psychiatric hospitals have already implemented ethical support structures of different types. However, despite this very high implementation rate, the number of actual cases dealt with in these services is low. Continue reading “The Art of Being Directive without Being Directive? Roles of Ethical Experts in Psychiatry”
Ethan Cowan, MD, MS, is an Associate Professor of Clinical Emergency Medicine and the Director of Research and Community Engagement in the Department of Emergency Medicine at Mount Sinai Beth Israel Hospital, Icahn Mount Sinai School of Medicine, New York, NY and our 2018 Andrew Markus visiting scholar.
Recently, I was a co-investigator on a National Institutes of Health (NIH) funded project studying the initiation of buprenorphine/naloxone in the Emergency Department for patients with moderate to severe opioid use disorder. This medication assisted treatment is instrumental in the fight against the raging opioid epidemic in the United States. To help encourage patients to participate in the study we provided them with a monetary incentive for enrollment and follow-up. This incentive was not particularly large but for the Institutional Review Board (IRB) it raised concerns about undue inducement. In this study, and others like it, the concern of IRBs seems to hinge on the belief that money somehow impairs the ability of a potential research subject to provide valid informed consent for study participation. But, is this problem real or imagined? Continue reading “Time to Bury Concerns about Monetary Undue Inducements in Research”
Ariella Binik, Ethox Centre, University of Oxford
Vulnerability has long been recognized as a central concept in research ethics. It aims to identify populations in need of special protections and to clarify the protections that should be provided. Despite a long history in research ethics guidelines and considerable attention in bioethics scholarship, offering a clear and persuasive account of what it means to be vulnerable, who is vulnerable, and why they are vulnerable remains controversial. Continue reading “Vulnerability and Health Research: The REACH Project”
Tobias Haeusermann is an affiliated researcher and student supervisor at the Department of Sociology at the University of Cambridge, where he received his PhD in 2016. At Cambridge he teaches and instructs undergraduate students for the HSPS Tripos “Introduction to Sociology: Modern Societies I” and the paper “Social Context of Health and Illness” within the Medical and Veterinary Sciences Tripos. He previously was a post-doctoral fellow at the Epidemiology, Biostatistics and Prevention Institute (EBPI) at the University of Zurich, Switzerland. He was also our Caroline Miles visiting scholar in February 2018.
In the wake of ever decreasing costs for analysing genetic information, companies such as 23andMe, FamilyTreeDNA, and Ancestry.com now provide customers easy and affordable access to their genetic data. In particular, tracing one’s ancestry is steadily gaining popularity, above all in nations with a rich history of immigration. When used to find lost family members and ties or to seek connection to other people and places, such tests can be of great value. Yet even then, one runs the risk of altering their self-perception, which, as a result, can lead to profound psychological distress for individuals and their families alike. We should therefore tread carefully when digging up family roots, as we may unearth some uncomfortable truths about the present.
Continue reading “In 2018, Let’s Root Out Genetic Racism For Good”
Suzanne Metselaar, Dept. of Medical Humanities, VU University Medical Center, Amsterdam and Gerben Meynen, Humanities, Dept. of Philosophy, VU University, Amsterdam, and Ruth Horn and Michael Dunn from the Ethox Center, Wellcome Centre for Ethics and Humanities, University of Oxford
Making the transition from being a student to becoming part of an international community of bioethicists can be a challenge. What to expect when participating in conferences? How to critically engage in current bioethical debates? How to bring your point across as convincingly as possible, but to do this in a respectful way, acknowledging the work done by others?
In order to support students in making this transition, we have been organizing an annual Winter School for students of the MA-program Philosophy, Bioethics, and Health (PBH), a two-year MA-program of Philosophy and Medical Humanities, VU University (Medical Center) in Amsterdam. The Winterschool January 2018 was its 5th edition. Continue reading “Oxford-Amsterdam Winter School – 5th edition!”
Karin Jongsma is an assistant professor of medical ethics at the Julius Center of Utrecht University Medical Center, the Netherlands and a Post-doctoral fellow at the department of Medical Ethics and History of Medicine in Göttingen, Germany. She was also our Caroline Miles visiting scholar in November 2017.
She works with Prof. Dr. Annelien Bredenoord (Utrecht) and Prof. Dr. Silke Schicktanz (Göttingen). Her research focuses on who should have a say in decision-making and representative practices, and she is particularly interested in digital health.
Apps and big data are increasingly used to track, analyse and predict health and health behaviour via smartphones, wearables and via online behaviour. Health care has a history of failed IT investments, and health research has a reputation of being expensive to innovate in, but commercial tech-companies such as Google, Facebook and Apple have succeeded in creating momentum towards a digital change. These companies have developed and implemented technologies that offer innovative ways for collecting, storing and analysing complex and rich health-related data. This data driven research and care may be referred to as digital health. The rising attention for big data and digital health has come with high expectations and is supposedly paradigm-changing. It is hoped that the possibilities of doing research and monitoring patients and not yet patients will create new ways of predicting, treating and preventing illnesses (eg Topol 2015), but digital health will simultaneously create new risks and harm and will shift the dynamics of health research and health care.
Continue reading “Do traditional bioethical solutions suffice in times of digital health?”
We had a great talk here at Ethox a few weeks ago by Dr Steve Clarke, on sacred values and the sanctity of life. Steve is a Senior Research Associate in the Oxford Uehiro Centre for Practical Ethics and a Senior Research Fellow in the Centre for Applied Philosophy and Public Ethics, Charles Stuart University.
If you missed this talk, you can listen again here…
Listen to Dr Steve Clarke’s talk here
Continue reading “Sacred Values and the Sanctity of Life”
Morten Fibieger Byskov is a postdoctoral researcher with the department of Communication, Philosophy, and Technology at Wageningen University & Research, the Netherlands, and our current Caroline Miles visiting scholar.
Multi-drug resistant organisms (MDROs), or antimicrobial resistance (AMR), pose a dire threat to individual and public health. Not only is AMR a danger to vulnerable individuals who require antibiotic treatment, but the over- and misuse of antibiotics also threatens the effectiveness of antibiotics for future generations. As such, AMR presents a unique problem for public health ethics and healthcare ethics that should ideally address ethical issues at both the public and individual level.
Continue reading “The Ethics of AMR Carriership”