Responsibility and Healthcare
Collective Responsibility for Infectious Disease
The Oxford Martin Programme on Collective Responsibility for Infectious Disease: Bringing together zoology, history, philosophy, psychology and medicine, our four-year project addresses the central research question: What is the role of collective responsibility in the genesis of and appropriate response to the threat of infectious disease? Our principal aim is to generate disease-specific policy recommendations for collective action on influenza, malaria, antibiotic resistance and vaccine-preventable childhood infections. Further information and a selection of resources can be found on the project's webpage.
Individual Responsibility and Healthcare
Julian Savulescu’s Wellcome Trust Senior Investigator Award: Responsibility and Healthcare. This project addresses questions such as: What is moral responsibility and does it matter in healthcare? Should treatment decisions and the allocation of resources take into account whether patients are responsible for their condition? Is it the physician’s role to encourage patients to take responsibility for their health? Does addiction undermine responsibility? We are conducting a number of research projects on this topic. For example, right now we working with Wilmington Healthcare to understand how medical doctors think about healthcare and responsibility, looking at whether and how trained medical professionals think that patient responsibility should be incorporated into healthcare decisions. Further information and a selection of resources can be found below and on the project's webpage.
Ethics, Conflict and Medical Treatment for Children: From Disagreement to Dissensus
Wilkinson, D. and Savulescu, J., (2018), 'Ethics, Conflict and Medical Treatment for Children: From disagreement to dissensus', (Elsevier)
FIRST PRIZE IN THE 2019 BMA BRITISH MEDICAL BOOK AWARDS, PRESIDENT'S AWARD CATEGORY
We are grateful to the Wellcome Trust and Elsevier for making Professors Savulescu and Wilkinson's 2018 book 'Ethics, Conflict and Medical Treatment for Children: From disagreement to dissensus' freely available.
What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents’ wishes?
The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world.
In this open access book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict.
From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new ‘dissensus’ framework for future cases of disagreement.
Free download: https://www.ncbi.nlm.nih.gov/books/NBK537987/pdf/Bookshelf_NBK537987.pdf
Bad Beliefs: Why They Happen to Good People
Levy, N., (2021), 'Bad Beliefs: Why They Happen to Good People', (OUP) (Open Access, free to download)
With thanks to the Wellcome Trust and Oxford University Press for facilitating Open Access for this title.
Bad beliefs - beliefs that blatantly conflict with easily available evidence - are common. Large minorities of people hold that vaccines are dangerous or accept bizarre conspiracy theories, for instance. The prevalence of bad beliefs may be politically and socially important, for instance blocking effective action on climate change. Explaining why people accept bad beliefs and what can be done to make them more responsive to evidence is therefore an important project.
A common view is that bad beliefs are largely explained by widespread irrationality. This book argues that ordinary people are rational agents, and their beliefs are the result of their rational response to the evidence they're presented with. We thought they were responding badly to evidence, because we focused on the first-order evidence alone: the evidence that directly bears on the truth of claims. We neglected the higher-order evidence, in particular evidence about who can be trusted and what sources are reliable. Once we recognize how ubiquitous higher-order evidence is, we can see that belief formation is by and large rational.
The book argues that we should tackle bad belief by focusing as much on the higher-order evidence as the first-order evidence. The epistemic environment gives us higher-order evidence for beliefs, and we need to carefully manage that environment. The book argues that such management need not be paternalistic: once we recognize that managing the epistemic environment consists in management of evidence, we should recognize that such management is respectful of epistemic autonomy.
Free download: https://fdslive.oup.com/www.oup.com/academic/pdf/openaccess/9780192895325.pdf
Davies, B., (2022), 'Responsibility and the recursion problem', Ratio, Vol: 35(2): 112-122 [PMC9361470]
Davies, B. and Parker, J., (2022), 'Doctors as appointed fiduciaries: A supplemental model for medical decision-making', Cambridge Quarterly of Healthcare Ethics, Vol: 31(1): 23-33 [PMC9019555]
Davies, B. and Savulescu, J., (forthcoming 2022), 'Institutional responsibility is prior to personal responsibility in a pandemic', Journal of Value Inquiry, Vol: online first 03 January 2022 [PMC8721471]
Levy, N., (2022), 'In Trust We Trust: Epistemic Vigilance and Responsibility', Social Epistemology, Vol: 36(3): 283-298 [PMC9595099]
Alonso, M. and Savulescu, J., (2021), 'He Jiankui’s gene editing experiment and the non-identity problem', Bioethics, Vol: 35(6): 563-573 [PMC8524470]
Brown, R., Mahtani, K., Turk, A. and Tierney, S., (2021), 'Social Prescribing in National Health Service Primary Care: What Are the Ethical Considerations?', Milbank Quarterly, Vol: 99(3): 610-628 [PMC8452361]
Cameron, J., Savulescu, J. and Wilkinson, D., (2021), 'Is Withdrawing Treatment Really More Problematic than Withholding Treatment?', Journal of Medical Ethics, Vol: Vol: 47(11): 722-726 [PMC7295851]
Davies, B., (2021), ''Personal health surveillance': The use of mHealth in healthcare responsibilisation', Public Health Ethics, Vol: 14(3): 268–280 [PMC8661076]
Davies, B. and Savulescu, J., (2021), 'The Right Not to Know: Some steps towards a compromise', Ethical Theory and Moral Practice, Vol: 24: 137–150 [PMC7611423]
Feng-Gu, E., Everett, J. A. C., Brown, R., Maslen, H., Oakley, J. and Savulescu, J., (2021), 'Prospective intention-based lifestyle contracts: mHealth technology and responsibility in healthcare', Health Care Analysis, Vol: 29(3): 189-212 [PMC8321967]
Giubilini, A., Minerva, F., Schuklenk, U. and Savulescu, J., (2021), 'The "Ethical" COVID-19 vaccine is the one that reserves lives: religious and moral beliefs on the COVID-19 vaccine', Public Health Ethics, Vol: 14(3): 242-255 [PMC8344725]
Giubilini, A., Savulescu, J. and Wilkinson, D., (2021 forthcoming), 'Queue questions: Ethics of COVID-19 vaccine prioritization', Bioethics, Vol: 35(4): 348-355 [PMC8013927]
Giubilini, A., Savulescu, J. and Wilkinson, D., (2021), 'Which Vaccine? The Cost of Religious Freedom in Vaccination Policy', Journal of Bioethical Inquiry, Vol: 18(4): 609-619 [PMC8696246]
Gross, J., Faber, N., Am, N., Cowen, P., Browning, M., Kahane, G., Savulescu, J., Crockett, M. J. and De Dreu, C., (2021), 'When Helping is Risky: The Behavioral and Neurobiological Tradeoff of Social and Risk Preferences', Psychological Science, Vol: 32(11): 1842-1855 [PMC7614101]
Gyngell, C. and Savulescu, J., (2021), 'The ethics of genomic passports: Should the genetically resistant be exempted from lockdowns and quarantines?', Journal of Medical Ethics, Vol: 48(10): 689-694 [PMC9554064]
Levy, N. and Savulescu, J., (2021), 'After the Pandemic: New Responsibilities', Public Health Ethics, Vol: 14(2): Pages 120–133 [PMC7989173]
McConnell, D., (2021), 'Compensation and hazard pay for key workers during an epidemic: An argument from analogy', Journal of Medical Ethics, Vol: 47(12): 784-787 [PMC8639952]
Notini, L., Gaff, C. L., Savulescu, J. and Vears, D. F., (2021), 'Clinicians' Views and Experiences with Offering and Returning Results from Exome Sequencing to Parents of Infants with Hearing Loss', Journal of Clinical Medicine, Vol: 11(1): 35 [PMC8745321]
Palacios‐González, C., Pugh, J., Wilkinson, D. and Savulescu, J., (forthcoming 2021), 'Ethical heuristics for pandemic allocation of ventilators across hospitals', Developing World Bioethics, (online first)
Savulescu, J., Everett, J. A. C., Maslen, H., Bringedal, B., Nussberger, A. M. and Wilkinson, D., (2021), 'An empirical bioethical examination of Norwegian and British doctor’s views of responsibility and (de)prioritization in healthcare', Bioethics, Vol: 35(9 (Special Issue: Truthfulness and deception in dementia care)): 932-946 [PMC8581988]
Savulescu, J., Giubilini, A. and Danchin, M., (2021), 'Global Ethical Considerations Regarding Mandatory Vaccination in Children', The Journal of Pediatrics, Vol: 231(April): 10-16 [PMC7817402]; and
Authors' reply: Reply to Sprengholz and Betsch, The Journal of Pediatrics, online (17 August 2021)
Savulescu, J., Kahane, G. and Gyngell, C., (2021), 'Collective Reflective Equilibrium in Practice (CREP) and Controversial Novel Technologies', Bioethics, Vol: 35(7): 652-663 [PMC8581760]
Takla, A., Savulescu, J., Kappes, A. and Wilkinson, D., (2021), 'British laypeople’s attitudes towards gradual sedation, sedation to unconsciousness and euthanasia at the end of life', PLoS ONE, Vol: 16(3):e0247193, [PMC7997648]
Vears, D. F., Borry, P., Savulescu, J. and Koplin, J., (2021), 'Old challenges or new issues? Genetic health professionals’ experiences obtaining informed consent in diagnostic genomic sequencing', AJOB Empirical Bioethics, Vol: 12(1) [PMC8120994]
Williams, B., Cameron, J., Trauer, J., Marais, B., Ragonnet, R. and Savulescu, J., (2021), 'The Ethics of Selective Restriction of Liberty in a Pandemic', Journal of Medical Ethics, Vol: 47(8): 553-562 [PMC8327318]
Brick, C., Kahane, G., Wilkinson, D., Caviola, L. and Savulescu, J., (2020), 'Worth living or worth dying? The views of the general public about allowing disabled children to die', Journal of Medical Ethics, Vol: 46(1) [PMC6984061]
Brown, R., Savulescu, J., Williams, B. and Wilkinson, D., (2020), 'A Passport to Freedom? Immunity Passports for COVID-19', Journal of Medical Ethics, Vol: 46(10) [PMC7525773]
Davies, B. and Savulescu, J., (2020), 'From Sufficient Health to Sufficient Responsibility', Journal of Bioethical Inquiry, Vol: 17(3): 423-433 [PMC7557480]
Davies, B., (2020), 'Responsibility and the limits of patient choice', Bioethics, Vol: 34(5): 459– 466 [PMC7318668]
Davies, B., (2020), 'The right not to know and the obligation to know', Journal of Medical Ethics, Vol: 46(5): 300-303 [PMC7250654] and response to commentaries at [PMC7279182]
Giubilini, A. and Savulescu, J., (2020), 'Moral responsibility and the justification of policies to preserve antimicrobial effectiveness'. in M. Selgelid and E. Jamrozik, (Eds.) Ethics and Drug Resistance: Collective Responsibility for Global Public Health (Part of the Public Health Ethics Analysis book series (PHES, volume 5). (Springer) [NBK566842]
Giubilini, A. and Savulescu, J., (2021), 'Stopping exploitation: properly remunerating healthcare workers for risk in COVID-19 pandemic', Bioethics, Vol: 35(4): 372-379 [PMC8014134]
Giubilini, A. and Savulescu, J., (2020), 'Beyond money: conscientious objection in medicine as a conflict of interest', Journal of Bioethical Inquiry, Vol: 17(2): 229–243 [PMC7367904]
Giubilini, A., Savulescu, J. and Wilkinson, D., (2020), 'COVID-19 vaccine: vaccinate the young to protect the old?', Journal of Law and the Biosciences, Vol: 7(1) [PMC7337759]
Grimwade, O., Savulescu, J., Giubilini, A., Oakley, J., Osowicki, J., Pollard, A. and Nussberger, A., (2020). 'Payment in Challenge Studies: Ethics, Attitudes and a New Payment for Risk Model', Journal of Medical Ethics, Vol: 46(12): 815–826 [PMC7719900]
Levy, N. and Savulescu, J., (2020), 'Epistemic Responsibility in the Face of a Pandemic', Journal of Law and the Biosciences, Vol: 7(1) [PMC7381967]
Maslen, H. and Rainey, S., (2020), 'Control and Ownership of Neuroprosthetic Speech', Philosophy and Technology, Vol: 34(3): 425–445
Parker, J. and Davies, B., (2020), 'No blame no gain? From a No Blame culture to a responsibility culture', Journal of Applied Philosophy, Vol: 37(4): 646-660 [PMC7750815]
Rainey, S., Maslen, H. and Savulescu, J., (2020), 'When Thinking is Doing: Responsibility for BCI-Mediated Action', AJOB Neuroscience, Vol: 11(1): 46-58 [PMC7034530]
Maslen, H., Savulescu, J. and Hunt, C., (2020), 'Praiseworthiness and Motivational Enhancement: “No Pain, no Praise?”', Australasian Journal of Philosophy, Vol: 98(2): 304-318 [PMC7254567]
McConnell, D., (2021), 'Conscientious Objection in Health Care: Pinning down the Reasonability View', The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, Vol: 46(1): 37-57 [PMC7829616]
McConnell, D., (2020), 'Balancing the duty to treat with the duty to family in the context of the COVID-19 pandemic', Journal of Medical Ethics, Vol: 46(6): 360-363 [PMC7211094]
Savulescu, J. and Cameron, J., (2020), 'Why Lock Down of the Elderly Is Not Ageist and Why Levelling Down Equality Is Wrong', Journal of Medical Ethics, Vol: 46(11): 717–721 [PMC7335694]
Véliz, C., (2020), 'Not the doctor’s business: Privacy, personal responsibility, and data rights in medical settings', Bioethics, Vol: 34(7): 712-718 [PMC7587002]
Brown, R., Maslen, H. and Savulescu, J., (2019), 'Responsibility, Prudence and Health Promotion', Journal of Public Health, Vol: 41(3): 561–565
Brown, R., (2019), ''Irresponsibly' Infertile? Obesity, Efficiency, and Exclusion from Treatment', Health Care Analysis, Vol: 27(2): 61–76 [PMC6548064]
Brown, R. and Savulescu, J., (2019 ), 'Responsibility in Healthcare Across Time and Agents', Journal of Medical Ethics, Vol: 45(10): 636-644 [PMC6855791]
Crone, D., and Levy, N., (2019), 'Are free will believers nicer people? (Four studies suggest not)', Social Psychological and Personality Science, Vol: 10(5): 612–619 [PMC6542011]
Dao, B., Faber, N., Giubilini, A., Douglas, T., Selgelid, M. and Savulescu, J., (2019), 'Impartiality and infectious disease: prioritising individuals versus the collective in antibiotic prescription', AJOB Empirical Bioethics, Vol: 10(1): 63-69 [PMC6446247]
Davies, B. and Savulescu, J., (2019), 'Solidarity and Responsibility in Health Care', Public Health Ethics, Vol: 12(2): 133-144 [PMC6655468]
Doolabh, K., Caviola, L., Savulescu, J., Selgelid, M. and Wilkinson, D., (2019), 'Is the non-identity problem relevant to public health and policy? An online survey', BMC Medical Ethics, Vol: 20(1): 46 [PMC6612186]
Earp, B. D., Skorburg, J., Everett, J. a. C. and Savulescu, J., (2019), 'Addiction, identity, morality', AJOB Empirical Bioethics, Vol: 10(2): 136-153 [PMC6506907]
Giubilini, A. and Savulescu, J., (2019), 'Vaccination, risks, and freedom: the seat belt analogy', Public Health Ethics, Vol: 12(3): 237-249 [PMC7020768]
Giubilini, A. and Savulescu, J., (2019), 'Demandingness and public health', Moral Philosophy and Politics, Vol: 6(1): 65-87 [PMC7802634]
Giubilini A, Caviola L, Maslen H, Douglas T, Nussberger Am, Faber N, Vanderslott S, Loving S, Harrison M and J, S., ( 2019 ), 'Nudging Immunity: The Case for Opt Out Vaccination of Children in School and Day Care by Default', HEC Forum, Vol: 31(4): 325-344 [PMC6841646]
Giubilini. A., (2019), 'The Ethics of Vaccination', (Palgrave Macmillan)
Koplin, J., Gyngell, C. and Savulescu, J., (2019), 'Germline Gene Editing and the Precautionary Principle', Bioethics, Vol: 34(1): 49-59 [PMC6972592]
Levy, N., (2019), 'Due Deference to Denialism: Explaining Ordinary People's Rejection of Established Scientific Findings', Synthese, Vol: 196(1): 313–327 [PMC6338713]
Levy, N., (2019), 'Nudge, nudge, wink, wink: Nudging is giving reasons', Ergo, Vol: 6(10) [PMC6774767]
Levy, N., (2019), 'Taking responsibility for responsibility', Public Health Ethics, Vol: 12(2): 103–113 [PMC6655467]
Levy, N., (2019), 'Applying Brown and Savulescu: The Diachronic Condition as Excuse.', Journal of Medical Ethics, Vol: 45(10): 646-647 [PMC6855789]
Milnes, S., Corke, C., Orford, N. R., Bailey, M., Savulescu, J. and Wilkinson, D., (2019 ), 'Patient values informing medical treatment: a pilot community and advance care planning survey', BMJ Supportive & Palliative Care, Vol: 9(3) [ PMC6817704]
Savulescu, J., Kahane, G. and Gyngell, C., (2019), 'From public preferences to ethical policy', Nature Human Behaviour, Vol: 3(12): 1241-1243 [comment]
Savulescu, J. and Persson, I., (2019), 'The duty to be morally enhanced', Topoi: An International Review of Philosophy, Vol: 28(1): 7-14 [PMC6887531]
Savulescu, J. and Wilkinson, D., (2019), 'Consequentialism and the Law in Medicine'. in in T. C. de Campos, J. Herring and A. M. Phillips., (Eds.) Philosophical Foundations of Medical Law, (OUP) [NBK550265]
Véliz, C., (2019), 'Medical privacy and big data: A further reason in favour of public universal healthcare coverage'. in T. C. d. Campos, J. Herring and A. M. Phillips, (Eds.) Philosophical Foundations of Medical Law, (OUP) [NBK550265]
Véliz, C., Maslen, H., Essman, M., Smith Taillie, L. and Savulescu, J., (2019), 'Sugar, Taxes, and Choice', Hastings Center Report, Vol: 49(6): 22-31 [PMC6916313]
Wilkinson, D. and Savulescu, J., (2019), 'Current controversies and irresolvable disagreement: the case of Vincent Lambert and the role of ‘dissensus’', Journal of Medical Ethics, Vol: 45(10): 631-635 [PMC6855788]
Wilkinson, D., Butcherine, E. and Savulescu, J., (2019), 'Withdrawal Aversion and the Equivalence Test', American Journal of Bioethics, Vol: 19(3): 21-28 [PMC6436546]
Everett, J. A. C., Savulescu, J., Faber, N. and Crockett, M. J., (2018), 'The costs of being consequentialist: Social inference from instrumental harm and impartial beneficence', Journal of Experimental Social Psychology, Vol: 79 (November): 200-216 [PMC6185873]
Giubilini, A., Douglas, T. and Savulescu, J., (2018), 'The Moral Obligation to be Vaccinated: Utilitarianism, Contractualism, and Collective Easy Rescue', Medicine, Health Care and Philosophy, Vol: 21(4): 547-560 [PMC6267229]
Giubilini, A., Douglas, N., Maslen, H. and Savulescu, J., (2018), 'Quarantine, isolation and the duty of easy rescue in public health', Bioethics, Vol:18(2): 182-189 [PMC6001516]
Giubilini, A. and Levy, N., (2018), 'What in the world is collective responsibility?', Dialectica, Vol: 72(2): 191-217 [PMC6380084]
Kappes, A., Faber, N. S., Kahane, G., Savulescu, J. and Crockett, M. J., (2018), 'Concern for Others Leads to Vicarious Optimism', Psychological Science, Vol: 29(3): 379-389 [PMC5858641]
Levy, N., (2018), 'Addiction: The Belief Oscillation Hypothesis'. in H. Pickard and S. Ahmed, (Eds.) The Routledge Handbook of Philosophy and Science of Addiction, (Routledge) [NBK540394]
Levy, N., (2018), 'Socializing Responsibility'. in K. Hutchison, C. Mackenzie and M. Oshana, (Eds.), Social Dimensions of Moral Responsibility. (Oxford University Press) NBK513458
Levy, N., (2018), 'Taking responsibility for health in an epistemically polluted environment', Theoretical Medicine and Bioethics, Vol: 39(2): 123-141 PMC6105200
Levy, N., (2018), 'Responsibility as an Obstacle to Good Policy: The Case of Lifestyle Related Disease', Journal of Bioethical Inquiry, Vol: 15(3): 459-468 PMC620903
Maslen, H., Cheeran, B., Pugh, J., Pycroft, L., Boccard, S., Prangnell, S., Green, A. L., Fitzgerald, J., Savulescu, J. and Aziz, T., (2018), 'Unexpected Complications of Novel Deep Brain Stimulation Treatments: Ethical Issues and Clinical Recommendations', Neuromodulation, Vol: 21(2): 135-143 [PMC5811790]
Pillutla, V., Savulescu, J. and Maslen, H., (2018), 'Rationing Elective Surgery for Smokers and Obese Patients: Responsibility or Prognosis?', BMC Medical Ethics, Vol: 19(28) [PMC5921973]
Pugh, J., Pycroft, L., Sandberg, A., Aziz, T. and Savulescu, J., (2018), 'Brainjacking in Deep Brain Stimulation, and Autonomy', Ethics and Information Technology, Vol: 20(3): 219-232 [PMC6290799]
Savulescu, J. and Persson, I., (2018), 'The Moral Importance of Reflective Empathy', Neuroethics, Vol: 11(2): 186-193 [PMC5978797]
Savulescu, J., Bambery, B., Douglas, T., Selgelid, M., Maslen, H., Giubilini, A. and Pollard, A., (2018), 'Influenza vaccination strategies should target children', Public Health Ethics, Vol: 11(12): 221-234 [PMC6093440]
Shepherd, J., (2018), 'Consciousness and Moral Status', (Routledge) [NBK540410]
Wagner, K., Maslen, H., Oakley, J. and Savulescu, J., (2018), 'Would you be willing to zap your child's brain? Public perspectives on parental responsibilities and the ethics of enhancing children with transcranial direct current stimulation', AJOB Empirical Bioethics, Vol: 9(1): 29-38 [PMC6068541]
Wilkinson, D. and Savulescu, J., (2018), 'Ethics, Conflict and Medical Treatment for Children: From disagreement to dissensus' (Elsevier) [NBK537987]
Wilkinson, D. Petrou, S. and Savulescu, J., (2018), 'Expensive care? Resource-based thresholds for potentially inappropriate treatment in intensive care', Monash Bioethics Review, Vol: 35(1-4), pp 2-23 [PMC6096869]
Wilkinson, D. and Savulescu, J., (2018), 'Cost equivalence and pluralism in publicly funded health care systems', Health Care Analysis, Vol: 26(4): 287–309 [PMC6208988]
Doolabh, K., Caviola, L., Savulescu, J., Selgelid, M. and Wilkinson, D., (2017), 'Zika, contraception and the non-identity problem.', Developing World Bioethics, Vol:17(3): 173-204 [PMC5698776]
Douglas, T., Pugh, J., Singh, I., Savulescu, J. and Fazel, S., (2017), 'Risk Assessment Tools in Criminal Justice and Forensic Psychiatry: The Need for Better Data', European Psychiatry, Vol: 42(May): 134–137.
Douglas, T., Earp, B. D. and Savulescu, J., (2017), 'Moral Neuroenhancement'. in K. Rommelfanger and L. Johnson, (Eds.) Routledge Handbook of Neuroethics, (Routledge) [NBK493126]
Giubilini, A., Savulescu, J., Douglas, T., Birkl, P. and Maslen, H., (2017), 'Taxing Meat: Taking Responsibility for One’s Contribution to Antibiotic Resistance', Journal of Agricultural and Environmental Ethics, Vol: 30(2): 179-198 [PMC5837014]
Gyngell, C., Savulescu, J. and Douglas, T., (2017), 'The ethics of germline gene editing', Journal of Applied Philosophy, Vol: 34(4): 498–513 [PMC5573992]
Levy, N., (2017), 'Nudges in a post-truth world', Journal of Medical Ethics, Vol: 43(8): 495-500.
Lowe, G., J. Pugh, G. Kahane, L. Corben, S. Lewis, M. Delatycki and J. Savulescu, (2017). 'How should we deal with misattributed paternity? A survey of lay public attitudes', AJOB Empirical Bioethics Vol:8(4): 234-242 [PMC5849225]
Persson, I. and Savulescu, J., (2017), 'Moral Hard-Wiring and Moral Enhancement', Bioethics, Vol: 31(4): 286-295.
Pugh, J., Maslen, H. and Savulescu, J., (2017), 'Deep Brain Stimulation, Authenticity and Value', Cambridge Quarterly of Healthcare Ethics, Vol: 26(4): 640-657.
Savulescu, J. and Schaefer, G. O., (2017), 'Better Minds, Better Morals: A Procedural Guide to Better Judgment', Journal of Posthuman Studies, Vol: 1(1): 26-43.
Savulescu, J. and Schuklenk, U., (2017), 'Doctors Have No Right to Refuse Medical Assistance in Dying, Abortion or Contraception', Bioethics, Vol: 31(3): 162–170
Wilkinson, D. and Nair, T., (2017), 'Settling for second best: when should doctors agree to parental demands for suboptimal medical treatment?', Journal of Medical Ethics, Vol: 43(12): 831-840 [PMC5827708]
Arora, C., Savulescu, J., Maslen, H., Selgelid, M. and Wilkinson, D., (2016), 'The Intensive Care Lifeboat: a survey of lay attitudes to rationing dilemmas in neonatal intensive care', BMC Medical Ethics, Vol: 17(1): 69.
Persson, I. and Savulescu, J., (2016), 'Moral Bioenhancement, Freedom and Reason', Neuroethics, Vol: 9(3): 263-268.
Porsdam- Mann, S., J, S. B. and Savulescu, J., (2016), 'Facilitating the ethical use of health data for the benefit of society: Electronic health records, consent and the duty of easy rescue', Philosophical Transactions A, Vol: 374(2083)(2083).
Pugh, J., Kahane, G. and Savulescu, J., (2016), 'Partiality for Humanity and Enhancement'. in S. Clarke, J. Savulescu, C. A. J. Coady, A. Giubilini and S. Sanyal, (Eds.) The Ethics of Human Enhancement: Understanding the Debate. (Oxford: Oxford University Press)
Roache, R. and Savulescu, J., (2016), 'Enhancing Conservatism'. in S. Clarke, J. Savulescu, C. A. J. Coady, A. Giubilini and S. Sanyal, (Eds.) The Ethics of Human Enhancement: Understanding the Debate (Oxford: Oxford University Press)
Savulescu, J., (2016), 'Concise argument—wellbeing, collective responsibility and ethical capitalism', Journal of Medical Ethics, Vol: 42(6): 331-333. [freely available]
Snoek, A., Levy, N. and Kennett, J., (2016), 'Strong-willed but not successful: The importance of strategies in recovery from addiction', Addictive Behaviors Reports, Vol: 4: 102-107.
Wilkinson, D., De Crespigny, L., Skene, L. and Savulescu, J., (2016), 'Protecting Future Children from In-Utero Harm', Bioethics, Vol: 30(6): 425-432.
Disease caused by lifestyle is a pressing public health issue. Rising costs from health conditions that seem to be partly due to individual behaviour make issues of resource allocation a priority. Some people think that the right response is to direct resources to those who are not responsible for their disease, at the cost of those who are. Such proposals raise many issues. While resources are limited, the NHS is based on a principle of equal treatment for equal need. Is it right to disrupt this principle in the name of cost-saving?
Philosophers, psychologists and neuroscientists have also raised questions about the idea of freedom that underpins claims of responsibility, and of our ability to tell when people are responsible for their health. When our choices are shaped by our genes, upbringing and the broader social environment, does it even make sense to hold people responsible for their health? Or will we simply end up focusing on already stigmatised groups who need our support rather than our condemnation? Some have suggested that an inability to take responsibility is itself a health issue. In the future, we might try to enhance patients’ ability to take responsibility, strengthening their capacity for sticking to commitments and exercising willpower.
Issues of responsibility also apply beyond the question of resource rationing. Holding patients responsible might be seen as a natural partner to respecting patient autonomy. But some people think that there are limits to how far autonomy should be respected in a health care service. Patients sometimes want treatments that are harmful or unnecessary, or refuse treatments that generate considerable public good at little personal cost. Must society really respect such choices in all cases?
Medical professionals also have responsibilities and rights. How should doctors, nurses and other caregivers behave when they object to providing a treatment on moral grounds?How should society and the healthcare system treat them?
These pressing issues, among others, are the subject of this series of podcasts. The series is part of a broader project, funded by the Wellcome Trust and led by Professor Julian Savulescu, on Responsibility and Health Care.
Should obese people be held responsible for being overweight? (Released 10 June 2019)
Suppose an obese person requires a hospital procedure for a condition that is in part linked to their obesity. Many people might believe that a patient must bear responsibility for being overweight. And, other things being equal, that's a reason to prioritize the needs of another patient first. So is the concept of responsibility a useful one in determining how to distribute health resources. Becky Brown is not convinced.
Becky Brown is a philosopher at Oxford's Uehiro Centre for Practical Ethics, University of Oxford. Becky's work focuses on the ethics of health promotion, particularly questions about responsibility for unhealthy behaviour. This research involves considering how philosophical theories can be informed by evidence from the social and medical sciences and vice versa. Ultimately, the aim of this work is to better understand what kinds of approaches to encouraging healthy behaviour are justified.
Should patient autonomy always be respected? (Released 24 June 2019)
A fundamental value of modern medicine is patient autonomy. Doctors should not insist upon a medical procedure or impose a procedure on a patient. The patient's consent - or the consent of a parent or guardian - needs to be obtained. But are there any exceptions to this basic principle. Alberto Giubilini argues that there are....
Alberto Giubilini is a Research Fellow at the University of Oxford, working on the Oxford Martin Programme on Collective Responsibility for Infectious Disease. He is based at the Uehiro Centre for Practical Ethics and at the Wellcome Centre for Ethics and Humanities. He has a PhD in Philosophy from the University of Milan, and prior to joining Oxford he worked in Australia at Monash University, University of Melbourne and Charles Sturt University. He has published on different topics in bioethics and philosophy, including a recent on The Ethics of Vaccination (Palgrave MacMillan 2019).
Responsibility and Addiction (Released 8 July 2019)
Normally, when we say that somebody is addicted to a substance, like a drug, we believe it is because they have lost control - they don't have the ability to resist their desire for it - even if they at some level still believe it is harmful to them. And to some extent, we are inclined to say, they are no longer responsible for surrendering to this desire. But Neil Levy says science should force us to reconsider the link between control, responsibility and belief.
Neil Levy is Professor of Philosophy at Macquarie University, Sydney, Australia, and a Senior Research Fellow at Oxford's Uehiro Centre for Practical Ethics, University of Oxford.
What is the link between responsibility and effort? (Released 22 July 2019)
Compare the athlete who finds training really tough but does it anyway, with the athlete who takes a substance that makes training easier. We tend to think that people who strain hard to achieve their goals are more deserving of praise than those for whom it is effortless, or who take advantage of shortcuts. Hannah Maslen believes this intuition is mistaken.
Hannah Maslen is the Deputy Director of the Oxford Uehiro Centre for Practical Ethics, University of Oxford. Hannah works on a wide range of topics in applied philosophy, from neuroethics, to moral emotions and criminal justice. Hannah is currently the Editor-in-Chief for the journal Neuroethics.
Doctors and their conscience! (Release date 5 August 2019)
Should doctors be allowed to deny a medical procedure to patients on grounds of conscience? Some doctors believe abortion to be wrong. Should they be permitted to turn away a woman who wants a legal abortion? Dominic Wilkinson is both a philosopher and a physician.
Dominic Wilkinson is Director of Medical Ethics and Professor of Medical Ethics at Oxford's Uehiro Centre for Practical Ethics, University of Oxford, UK. He is a consultant in newborn intensive care at the John Radcliffe Hospital, Oxford, holds a health practitioner research fellowship with the Wellcome Trust, and is a senior research fellow at Jesus College Oxford.
Responsibility and Justice (Release date 19 August 2019)
If two people have a medical condition that requires treatment and John is responsible for having the condition, but Janet is not, then some people believe that Janet should take priority. Janet should be treated first. But benefiting Janet in this way only really makes sense if we are first clear what we mean by John being ‘responsible’ for his condition.
Ben Davies is a postdoctoral research fellow on Professor Julian Savulescu's Wellcome Trust project on the relevance of personal responsibility to healthcare policy. His primary research focus is on issues in medical resource allocation. He completed his PhD at King's College London in 2015, working on ethical issues related to enhancements targeting human ageing.
Interviews by David Edmonds (OUC Distinguished Research Fellow & Consultant Researcher).
The podcast series is a collaboration between Philosophy 24/7 and the Oxford Uehiro Centre for Practical Ethics.
Philosophy 24/7 brings you concise interviews with leading philosophers about pressing moral, political and social questions and is hosted by David Edmonds, a multi-awarding winning BBC journalist, and one half of the duo behind the Philosophy Bites podcast.
We are grateful to the Wellcome Trust for funding the project.
The Practical Ethics Video Series makes the most important and complex debates in practical ethics accessible to a wide audience through brief interviews with high profile philosophers in Oxford. Video interviews on this and other topics can be found on our YouTube channel.
Featured YouTube interview with Dr Rebecca Brown
Giubilini, A., (2019), Health vs Choice? The Vaccination Debate, Battle of Ideas Festival, Barbican Centre, London (3 November). YouTube
Governments in some countries, like Italy and France, have introduced new measures to compel vaccination against specified diseases, linking proof of vaccination to children’s access to state-provided schooling. These measures are presented as a necessary expression of the public good, of the right of children to be protected from serious and sometimes life-threatening diseases, and of the need to uphold truth against lies. However, the turn to compulsion has led some commentators, even some who support vaccination, to raise questions about these measures. Over 200 years since Edward Jenner’s use of cowpox to provide immunity from smallpox, what should we make of the situation now? Is there a legitimate right for individuals or parents to refuse vaccination? Or are claims for the public good and for the right of children to good health, expressed if necessary through compulsion, more ethically persuasive?
Giubilini, A., (2019), 'The World Vaccination Report: The Evidence', BBC World Service (22 June).
Brown, R., (2019), 'Obese people unfairly denied IVF by cost-cutting NHS, says Oxford academic', The Independent (14 April 2019). [This article is based on Dr Brown's open access paper available on EuropePMC PMC6548064]
Giubilini, A., (2019), 'Italy's attitude towards vaccine is a 'cultural and social problem'', Sputnik Radio (13 March).
Giubilini, A., (2019), 'The Ethics of Vaccination', book launch, Oxford Martin School (5 March). Livestreamed and available to view on YouTube.
Brown, R., (2018), 'Subfertility deserves attention, but not because it is a disease', BioNews comment piece. Philosophers have debated how best to define health and disease for some time. The main two approaches focus on biological nature and social construction. The first identifies disease as biological deviations from the norm. The second argues that societies construct diseases by responding to certain conditions in particular ways, for instance by treating them with medicine. Neither of these definitions is universally accepted. Subfertility provides an example of why it can be so difficult to determine exactly what makes something a disease. (16 July).
Welcome to the Uehiro Centre’s Practical Ethics and Responsibility competition!
"How am I responsible for the environment? Should there be limits on how we can punish people who do wrong? If very ill patients want to die, should doctors be held responsible if they help them? Who is responsible for the global spread of infectious diseases?"
If these and other questions about our responsibilities towards each other, our planet and our future make you think, then this competition is for you!
At the Oxford Uehiro Centre for Practical Ethics we think a lot about responsibility and how we can all do more to tackle some of the biggest ethical problems facing us today.
We're inviting people in school years 11, 12 and 13 in small teams (between three and five members) to send us a video about an ethical problem and how you think responsibility is involved.
The best entries will be invited to the University of Oxford for our Ethics and Responsibility Day, where you can take part in a debate, lots of opportunities to discuss ethics with our researchers, and a taste of University life. There’s a cash prize for the winning schools too!
The Oxford Uehiro Centre for Practical Ethics is grateful to Schools Outreach Co-ordinator Wedad Rattab, and to an advisory group of teachers for supporting this event.
See competition webpage for further details.