Colin Koopman
Originally posted March 15, 2017
Here is an excerpt:
Foucault’s work shows that disciplinary power was just one of many forms that power has come to take over the past few hundred years. Disciplinary anatomo-politics persists alongside sovereign power as well as the power of bio-politics. In his next book, The History of Sexuality, Foucault argued that bio-politics helps us to understand how garish sexual exuberance persists in a culture that regularly tells itself that its true sexuality is being repressed. Bio-power does not forbid sexuality, but rather regulates it in the maximal interests of very particular conceptions of reproduction, family and health. It was a bio-power wielded by psychiatrists and doctors that, in the 19th century, turned homosexuality into a ‘perversion’ because of its failure to focus sexual activity around the healthy reproductive family. It would have been unlikely, if not impossible, to achieve this by sovereign acts of direct physical coercion. Much more effective were the armies of medical men who helped to straighten out their patients for their own supposed self-interest.
Other forms of power also persist in our midst. Some regard the power of data – that is the info-power of social media, data analytics and ceaseless algorithmic assessment – as the most significant kind of power that has emerged since Foucault’s death in 1984.
The article is here.
Sunday, May 14, 2017
Saturday, May 13, 2017
Justices Blast One-Stop-Shop Experts in Alabama
Tim Ryan
Courthouse News
Originally posted April 24, 2017
The Supreme Court’s liberal justices shredded an argument by Alabama’s solicitor general Monday that criminal defendants are not entitled to a mental health expert separate from the ones tapped by prosecutors.
McWilliams v. Dunn, the case the Supreme Court heard this morning, is nested inside the court’s 1984 decision in Ake v. Oklahoma, which held that poor criminal defendants using a defense of insanity are entitled to an expert to help support their claim.
A split has emerged in the 30 years since the decision, with some states deciding one expert helping both the prosecution and defense satisfies the requirement, and others choosing to assign an expert for the defendant to use exclusively.
The article is here.
Courthouse News
Originally posted April 24, 2017
The Supreme Court’s liberal justices shredded an argument by Alabama’s solicitor general Monday that criminal defendants are not entitled to a mental health expert separate from the ones tapped by prosecutors.
McWilliams v. Dunn, the case the Supreme Court heard this morning, is nested inside the court’s 1984 decision in Ake v. Oklahoma, which held that poor criminal defendants using a defense of insanity are entitled to an expert to help support their claim.
A split has emerged in the 30 years since the decision, with some states deciding one expert helping both the prosecution and defense satisfies the requirement, and others choosing to assign an expert for the defendant to use exclusively.
The article is here.
Friday, May 12, 2017
US Suicide Rates Display Growing Geographic Disparity.
JAMA.
2017;317(16):1616. doi:10.1001/jama.2017.4076
As the overall US suicide rate increases, a CDC study showed that the trend toward higher rates in less populated parts of the country and lower rates in large urban areas has become more pronounced.
Using data from the National Vital Statistics System and the US Census Bureau, the researchers reported that from 1999 to 2015, the annual suicide rate increased by 14%, from 12.6 to 14.4 per 100, 000 US residents aged 10 years or older.
(cut)
Higher suicide rates in less urban areas could be linked with limited access to mental health care, the opioid overdose epidemic, and social isolation, the investigators suggested. The 2007-2009 economic recession may have caused the sharp upswing, they added, because rural areas and small towns were hardest hit.
The article is here
2017;317(16):1616. doi:10.1001/jama.2017.4076
As the overall US suicide rate increases, a CDC study showed that the trend toward higher rates in less populated parts of the country and lower rates in large urban areas has become more pronounced.
Using data from the National Vital Statistics System and the US Census Bureau, the researchers reported that from 1999 to 2015, the annual suicide rate increased by 14%, from 12.6 to 14.4 per 100, 000 US residents aged 10 years or older.
(cut)
Higher suicide rates in less urban areas could be linked with limited access to mental health care, the opioid overdose epidemic, and social isolation, the investigators suggested. The 2007-2009 economic recession may have caused the sharp upswing, they added, because rural areas and small towns were hardest hit.
The article is here
Physicians, Not Conscripts — Conscientious Objection in Health Care
Ronit Y. Stahl and Ezekiel J. Emanuel
N Engl J Med 2017; 376:1380-1385
“Conscience clause” legislation has proliferated in recent years, extending the legal rights of health care professionals to cite their personal religious or moral beliefs as a reason to opt out of performing specific procedures or caring for particular patients. Physicians can refuse to perform abortions or in vitro fertilization. Nurses can refuse to aid in end-of-life care. Pharmacists can refuse to fill prescriptions for contraception. More recently, state legislation has enabled counselors and therapists to refuse to treat lesbian, gay, bisexual, and transgender (LGBT) patients, and in December, a federal judge issued a nationwide injunction against Section 1557 of the Affordable Care Act, which forbids discrimination on the basis of gender identity or termination of a pregnancy.
The article is here, and you need a subscription.
Here is an excerpt:
Objection to providing patients interventions that are at the core of medical practice – interventions that the profession deems to be effective, ethical, and standard treatments – is unjustifiable (AMA Code of Medical Ethics [Opinion 11.2.2]10).
Making the patient paramount means offering and providing accepted medical interventions in accordance with patients’ reasoned decisions. Thus, a health care professional cannot deny patients access to medications for mental health conditions, sexual dysfunction, or contraception on the basis of their conscience, since these drugs are professionally accepted as appropriate medical interventions.
N Engl J Med 2017; 376:1380-1385
“Conscience clause” legislation has proliferated in recent years, extending the legal rights of health care professionals to cite their personal religious or moral beliefs as a reason to opt out of performing specific procedures or caring for particular patients. Physicians can refuse to perform abortions or in vitro fertilization. Nurses can refuse to aid in end-of-life care. Pharmacists can refuse to fill prescriptions for contraception. More recently, state legislation has enabled counselors and therapists to refuse to treat lesbian, gay, bisexual, and transgender (LGBT) patients, and in December, a federal judge issued a nationwide injunction against Section 1557 of the Affordable Care Act, which forbids discrimination on the basis of gender identity or termination of a pregnancy.
The article is here, and you need a subscription.
Here is an excerpt:
Objection to providing patients interventions that are at the core of medical practice – interventions that the profession deems to be effective, ethical, and standard treatments – is unjustifiable (AMA Code of Medical Ethics [Opinion 11.2.2]10).
Making the patient paramount means offering and providing accepted medical interventions in accordance with patients’ reasoned decisions. Thus, a health care professional cannot deny patients access to medications for mental health conditions, sexual dysfunction, or contraception on the basis of their conscience, since these drugs are professionally accepted as appropriate medical interventions.
Thursday, May 11, 2017
The Implications of Libertarianism for Compulsory Vaccination
Justin Bernstein
BMJ Blogs
Originally posted April 24, 2017
Here is an excerpt:
Some libertarians, however, attempt to avoid the controversial conclusion that libertarianism is incompatible with compulsory vaccination. In my recent paper, “The Case Against Libertarian Arguments for Compulsory Vaccination,” I argue that such attempts are unsuccessful, and so libertarians must either develop new arguments, or join Senator Paul in opposing compulsory vaccination.
How might a libertarian try to defend compulsory vaccination? One argument is that going unvaccinated exposes others to risk, and this violates their rights. Since the state is permitted to use coercive measures to protect rights, the state may require parents to vaccinate their children. But for libertarians, this argument has two shortcomings. First, there are other, far riskier activities that the libertarian prohibits the government from regulating. For instance, owning and using automobiles or firearms imposes far more significant risk than going unvaccinated, but libertarians defend our rights to own and use automobiles and firearms. Second, one individual going unvaccinated poses very little risk; the risk eventuates only if many collectively go unvaccinated, thereby endangering herd immunity. Imposing such an independently small risk hardly seems to be a rights violation.
The entire blog post is here.
BMJ Blogs
Originally posted April 24, 2017
Here is an excerpt:
Some libertarians, however, attempt to avoid the controversial conclusion that libertarianism is incompatible with compulsory vaccination. In my recent paper, “The Case Against Libertarian Arguments for Compulsory Vaccination,” I argue that such attempts are unsuccessful, and so libertarians must either develop new arguments, or join Senator Paul in opposing compulsory vaccination.
How might a libertarian try to defend compulsory vaccination? One argument is that going unvaccinated exposes others to risk, and this violates their rights. Since the state is permitted to use coercive measures to protect rights, the state may require parents to vaccinate their children. But for libertarians, this argument has two shortcomings. First, there are other, far riskier activities that the libertarian prohibits the government from regulating. For instance, owning and using automobiles or firearms imposes far more significant risk than going unvaccinated, but libertarians defend our rights to own and use automobiles and firearms. Second, one individual going unvaccinated poses very little risk; the risk eventuates only if many collectively go unvaccinated, thereby endangering herd immunity. Imposing such an independently small risk hardly seems to be a rights violation.
The entire blog post is here.
Is There a Duty to Use Moral Neurointerventions?
Michelle Ciurria
Topoi (2017).
doi:10.1007/s11245-017-9486-4
Abstract
Do we have a duty to use moral neurointerventions to correct deficits in our moral psychology? On their surface, these technologies appear to pose worrisome risks to valuable dimensions of the self, and these risks could conceivably weigh against any prima facie moral duty we have to use these technologies. Focquaert and Schermer (Neuroethics 8(2):139–151, 2015) argue that neurointerventions pose special risks to the self because they operate passively on the subject’s brain, without her active participation, unlike ‘active’ interventions. Some neurointerventions, however, appear to be relatively unproblematic, and some appear to preserve the agent’s sense of self precisely because they operate passively. In this paper, I propose three conditions that need to be met for a medical intervention to be considered low-risk, and I say that these conditions cut across the active/passive divide. A low-risk intervention must: (i) pass pre-clinical and clinical trials, (ii) fare well in post-clinical studies, and (iii) be subject to regulations protecting informed consent. If an intervention passes these tests, its risks do not provide strong countervailing reasons against our prima facie duty to undergo the intervention.
The article is here.
Topoi (2017).
doi:10.1007/s11245-017-9486-4
Abstract
Do we have a duty to use moral neurointerventions to correct deficits in our moral psychology? On their surface, these technologies appear to pose worrisome risks to valuable dimensions of the self, and these risks could conceivably weigh against any prima facie moral duty we have to use these technologies. Focquaert and Schermer (Neuroethics 8(2):139–151, 2015) argue that neurointerventions pose special risks to the self because they operate passively on the subject’s brain, without her active participation, unlike ‘active’ interventions. Some neurointerventions, however, appear to be relatively unproblematic, and some appear to preserve the agent’s sense of self precisely because they operate passively. In this paper, I propose three conditions that need to be met for a medical intervention to be considered low-risk, and I say that these conditions cut across the active/passive divide. A low-risk intervention must: (i) pass pre-clinical and clinical trials, (ii) fare well in post-clinical studies, and (iii) be subject to regulations protecting informed consent. If an intervention passes these tests, its risks do not provide strong countervailing reasons against our prima facie duty to undergo the intervention.
The article is here.
Wednesday, May 10, 2017
How do you punish a criminal robot?
Christopher Markou
The Independent
Originally posted on April 20, 2017
Here is an excerpt:
Among the many things that must now be considered is what role and function the law will play. Expert opinions differ wildly on the likelihood and imminence of a future where sufficiently advanced robots walk among us, but we must confront the fact that autonomous technology with the capacity to cause harm is already around. Whether it’s a military drone with a full payload, a law enforcement robot exploding to kill a dangerous suspect or something altogether more innocent that causes harm through accident, error, oversight, or good ol’ fashioned stupidity.
There’s a cynical saying in law that “wheres there’s blame, there’s a claim”. But who do we blame when a robot does wrong? This proposition can easily be dismissed as something too abstract to worry about. But let’s not forget that a robot was arrested (and released without charge) for buying drugs; and Tesla Motors was absolved of responsibility by the American National Highway Traffic Safety Administration when a driver was killed in a crash after his Tesla was in autopilot.
While problems like this are certainly peculiar, history has a lot to teach us. For instance, little thought was given to who owned the sky before the Wright Brothers took the Kitty Hawk for a joyride. Time and time again, the law is presented with these novel challenges. And despite initial overreaction, it got there in the end. Simply put: law evolves.
The article is here.
The Independent
Originally posted on April 20, 2017
Here is an excerpt:
Among the many things that must now be considered is what role and function the law will play. Expert opinions differ wildly on the likelihood and imminence of a future where sufficiently advanced robots walk among us, but we must confront the fact that autonomous technology with the capacity to cause harm is already around. Whether it’s a military drone with a full payload, a law enforcement robot exploding to kill a dangerous suspect or something altogether more innocent that causes harm through accident, error, oversight, or good ol’ fashioned stupidity.
There’s a cynical saying in law that “wheres there’s blame, there’s a claim”. But who do we blame when a robot does wrong? This proposition can easily be dismissed as something too abstract to worry about. But let’s not forget that a robot was arrested (and released without charge) for buying drugs; and Tesla Motors was absolved of responsibility by the American National Highway Traffic Safety Administration when a driver was killed in a crash after his Tesla was in autopilot.
While problems like this are certainly peculiar, history has a lot to teach us. For instance, little thought was given to who owned the sky before the Wright Brothers took the Kitty Hawk for a joyride. Time and time again, the law is presented with these novel challenges. And despite initial overreaction, it got there in the end. Simply put: law evolves.
The article is here.
Who Decides When a Patient Can’t? Statutes on Alternate Decision Makers
Erin S. DeMartino and others
The New England Journal of Medicine
DOI: 10.1056/NEJMms1611497
Many patients cannot make their own medical decisions, having lost what is called decisional capacity. The estimated prevalence of decisional incapacity approaches 40% among adult medical
inpatients and residential hospice patients and exceeds 90% among adults in some intensive care
units.3,4 Patients who lack capacity may guide decisions regarding their own care through an
advance directive, a legal document that records treatment preferences or designates a durable
power of attorney for health care, or both. Unfortunately,the rate of completion of advance directives
in the general U.S. population hovers around 20 to 29%, creating uncertainty about who will
fill the alternate decision-maker role for many patients.
There is broad ethical consensus that other persons may make life-and-death decisions on
behalf of patients who lack decisional capacity. Over the past few decades, many states have enacted
legislation designed to delineate decisionmaking authority for patients who lack advance directives. Yet the 50 U.S. states and the District of Columbia vary in their procedures for appointing and challenging default surrogates, the attributes they require of such persons, their priority ranking of possible decision makers, and dispute resolution. These differences have important implications for clinicians, patients, and public health.
The article is here.
The New England Journal of Medicine
DOI: 10.1056/NEJMms1611497
Many patients cannot make their own medical decisions, having lost what is called decisional capacity. The estimated prevalence of decisional incapacity approaches 40% among adult medical
inpatients and residential hospice patients and exceeds 90% among adults in some intensive care
units.3,4 Patients who lack capacity may guide decisions regarding their own care through an
advance directive, a legal document that records treatment preferences or designates a durable
power of attorney for health care, or both. Unfortunately,the rate of completion of advance directives
in the general U.S. population hovers around 20 to 29%, creating uncertainty about who will
fill the alternate decision-maker role for many patients.
There is broad ethical consensus that other persons may make life-and-death decisions on
behalf of patients who lack decisional capacity. Over the past few decades, many states have enacted
legislation designed to delineate decisionmaking authority for patients who lack advance directives. Yet the 50 U.S. states and the District of Columbia vary in their procedures for appointing and challenging default surrogates, the attributes they require of such persons, their priority ranking of possible decision makers, and dispute resolution. These differences have important implications for clinicians, patients, and public health.
The article is here.
Tuesday, May 9, 2017
Ethics experts question Kushner relatives pushing White House connections in China
Allan Smith
Business Insider
Originally published May 8, 2017
Ethics experts criticized White House senior adviser Jared Kushner's relatives for using White House connections to enhance a presentation to Chinese investors last weekend.
Members of Kushner's family gave multiple presentations in China detailing an opportunity to "invest $500,000 and immigrate to the United States" through a controversial visa program and promoting ties to Kushner and President Donald Trump, according to media reports.
Richard Painter, who was President George W. Bush's top ethics lawyer from 2005 to 2007 and is now a professor at the University of Minnesota, told Business Insider the presentation was "obviously completely inappropriate."
He added that the Kushner family "ought to be disqualified" from the EB-5 visa program they were promoting. The visa is awarded to foreign investors who invest at least $500,000 in US projects that create at least 10 full-time jobs.
The article is here.
Business Insider
Originally published May 8, 2017
Ethics experts criticized White House senior adviser Jared Kushner's relatives for using White House connections to enhance a presentation to Chinese investors last weekend.
Members of Kushner's family gave multiple presentations in China detailing an opportunity to "invest $500,000 and immigrate to the United States" through a controversial visa program and promoting ties to Kushner and President Donald Trump, according to media reports.
Richard Painter, who was President George W. Bush's top ethics lawyer from 2005 to 2007 and is now a professor at the University of Minnesota, told Business Insider the presentation was "obviously completely inappropriate."
He added that the Kushner family "ought to be disqualified" from the EB-5 visa program they were promoting. The visa is awarded to foreign investors who invest at least $500,000 in US projects that create at least 10 full-time jobs.
The article is here.
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