A selection of seminars and special lectures on wide-ranging topics relating to practical ethics. The Oxford Uehiro Centre for Practical Ethics was established in 2002 with the support of the Uehiro Foundation on Ethics and Education of Japan. It is an integral part of the philosophy faculty of Oxford University, one of the great centres of academic excellence in philosophical ethics.
Hope in Healthcare
In this St Cross Special Ethics Seminar, Professor Stephen Clarke the role of hope in patients undergoing major healthcare procedures, and how it relates to decision-making in situations of risk and uncertainty. It is widely supposed that it is important to imbue patients undergoing medical procedures with a sense of hope. But why is hope so important in healthcare, if indeed it is? We examine the answers that are currently on offer and show that none do enough to properly explain the importance that is often attributed to hope in healthcare. We then identify a hitherto unrecognised reason for supposing that it is important to imbue patients undergoing significant medical procedures with hope, which draws on prospect theory, Kahneman and Tversky’s hugely influential descriptive theory about decision making in situations of risk and uncertainty. We also consider some concerns about patient consent and the potential manipulation of patients, that are raised by our account. We then consider some complications for the account raised by religious sources of hope, which are commonly drawn on by patients undergoing major healthcare procedures.
Against Legalizing Female 'Circumcision' of Minors
In this St Cross Special Ethics Seminar, Dr Brian Earp argues that all medically unnecessary genital cutting of non-consenting persons should be opposed on moral and legal grounds. Defenders of male circumcision increasingly argue that female ‘circumcision’ (ritual cutting of the clitoral hood or labia) should be legally allowed in Western liberal democracies even when non-consensual. In a recent article, Richard Shweder (2021) gives perhaps the most persuasive articulation of this argument to have so far appeared in the literature. In my own work, I argue that no person should be subjected to medically unnecessary genital cutting of any kind without their own informed consent, regardless of the sex characteristics with which they were born or the religious or cultural background of their parents. Professor Shweder and I agree that Western law and policy on child genital cutting is currently beset with cultural, religious, and sex-based double-standards. We disagree about what should be done about this. In this talk, I argue that ‘legalizing’ childhood female genital cutting so as to bring it into line with current treatment of childhood male genital cutting is not an acceptable solution to these problems. Instead, all medically unnecessary genital cutting of non-consenting persons should be opposed equally on moral and legal grounds and discouraged by all appropriate means. Creative Commons Attribution-Non-Commercial-Share Alike 2.0 UK: England & Wales; http://creativecommons.org/licenses/by-nc-sa/2.0/uk/
Vaccine policies and challenge trials: the ethics of relative risk in public health
In this St Cross Special Ethics Seminar, Dr Sarah Chan outlines some risks arising from the deliberate infection of human participants to infectious agents for research purposes In this St Cross Special Ethics Seminar, Dr Sarah Chan explores three key areas of risk in ‘challenge trials’ – the deliberate infection of human participants to infectious agents as a tool for vaccine development and improving our knowledge of disease biology. Dr Chan explores a) whether some forms of challenge trials cannot be ethically justified; b) why stratifying populations for vaccine allocation by risk profile can result in unjust risk distribution; and c) how comparing these cases and the evaluation of relative risk reveals flaws in approach to pandemic public health.
Do We Need Mental Privacy? The Ethics of Mind Reading Reloaded
Marcello Ienca discusses moral and legal issues surrounding the decoding – ‘mind reading’ - of brain activity In the 1990s, following rapid advances in the use of technologies such as functional magnetic resonance imaging (fMRI), an ethical debate arose around the concept of 'mind reading': the possibility of decoding a person's mental states (including their conscious experience) based on quantitative measurements of their brain activity. This debate concerned the moral and legal status of information about mental states (mental information) and the definition of normative principles to justify the collection and processing of such information. However, the poor replicability of fMRI-based studies combined with conceptual clarifications within the philosophy of mind (such as Dennett's vehicle-content distinction) showed that this debate rested on weak empirical and conceptual grounds. As a result, the interest of the bioethics/neuroethics community waned. A couple of decades later, however, the wide availability of brain data outside the clinical setting combined with the use of artificial intelligence models to process and decode such data (through a process known as 'reverse inference') make the ethical debate on mind-reading topical again, albeit on a different conceptual ground. In addition, AI approaches such as affective computing and natural language processing have shown the possibility of inferring a person's mental states also from non-neural data (e.g., social media). This presentation will discuss the moral and legal status of mental information and the conditions for legitimate access to and alteration of such information. In particular, it will examine the concepts of ‘mental privacy’ and ‘cognitive liberty’ and defend the thesis that every person should enjoy a right to mental self-determination. This includes both the negative freedom from coercive or otherwise non-voluntary access to one's mental sphere and the positive freedom of the individual to modify their mental states and processes (e.g. through cognitive or affective enhancement).
Waiver or understanding? A dilemma for autonomists about informed consent
Professor Gopal Sreenivasan delivers a New St Cross Special Ethics Seminar on the topic of Informed Consent. This talk develops a novel argument to show that prospective research subjects can validly consent to participate in a study without understanding (most of) the content of the required disclosure. Its point of departure is the right subjects standardly have to waive (most of) the investigator’s duty to disclose. Things get worse for autonomy based defences of informed consent because this right to waive is very well grounded in an individual’s autonomy.
Fighting diseases of poverty through research: Deadly dilemmas, moral distress and misplaced responsibilities
A New St Cross Special Ethics Seminar, with Professor Maureen Kelley. Much of global health research occurs against the backdrop of severe, intersectional and structural vulnerabilities, where susceptibility to disease and early death are driven by poverty, and related factors such as political conflict and climate change. Global health research priorities over the last two decades have been shaped by a small number of high income country institutions, with political commitments informed largely by the ‘global burden of disease’ model. On this model, international research has primarily targeted infectious diseases and other causes of high morbidity and premature, preventable mortality, but has ignored the structural determinants of those diseases. An unintended consequence is that researchers at the frontlines of data collection and interaction with participants and communities come face-to-face with the daily suffering of participants and family members. They often face heart-rending dilemmas in responding to complex health, social, and economic needs that far outstrip the resources and expertise of most research projects or clinical trials. In this presentation, I will share findings from a longitudinal research ethics study, where local ethics teams were embedded within ongoing clinical and social science research studies in contexts of severe poverty, food shortages, droughts and flooding, gender-based violence and political conflict—typical of many global health research sites. Based on our empirical ethics findings, including experiences of research participants, community members and researchers, I will offer critical reflections on the limitations of current accounts of researcher responsibility (ancillary care or duty of care), and suggest we rethink the ways that current global health research institutions and funders engage the underlying structural drivers of disease and suffering.