Past Projects

Informing ethical deliberation around ventilator allocation in the pandemic

Investigators: Professor Dominic Wilkinson (Director of Medical Ethics, Oxford Uehiro Centre for Practical Ethics); Professor Julian Savulescu (Director, Oxford Uehiro Centre for Practical Ethics)

Aim: to provide rapid, timely, relevant input into policies for ventilator allocation in the UK and overseas.

• Funded by Oxford's Covid 19 Research Response Fund 

• Duration: 8 months (April - Dec 2020)

The burning ethical question raised by the COVID-19 pandemic is how to care for large numbers of patients simultaneously becoming critically unwell. In Italy, intensive care services were overwhelmed, and clinicians were forced to make extremely difficult choices in the absence of clear guidance. Modelling suggests that other health systems, including the NHS, will be similarly affected.  There is a need for ethical guidelines on how to allocate treatment, but such guidelines are highly controversial and depend crucially on which values to incorporate (Savulescu et al). There is no existing information about views of the UK general public on these questions. It will constitute the first part of an international collaborative study and will be used to provide rapid, timely, relevant input into policies for ventilator allocation in the UK and overseas.

Neurointerventions in Crime Prevention

PI: Dr Thomas Douglas

Wellcome Trust 100705/Z/12/Z

See grant outputs on Europe PMC.

Interventions that act directly on the brain, or ‘neurointerventions’, are increasingly being used or advocated for crime prevention. For instance, drugs that attenuate sexual desire are sometimes used to prevent recidivism in sex offenders, while drug-based treatments for substance abuse have been used to reduce addiction-related offending. Recent scientific developments suggest that the range of neurointerventions capable of preventing criminal offending may eventually expand to include, for example, drugs capable of reducing aggression or enhancing empathy.

In this Wellcome Trust-funded project, we are investigating ethical questions raised by the use of such interventions to prevent criminal offending, focusing particularly on cases where they are imposed on convicted offenders as part of a criminal sentence or as a condition of parole. On the one hand, there seems to be at least some reason to support the use of neurointerventions in this way, since there is a clear need for new means of preventing crime. Traditional means of crime prevention, such as incarceration, are frequently ineffective and can have serious negative side-effects; neurointervention may increasingly seem, and sometimes be, a more effective and humane alternative. On the other hand, neurointerventions can be highly intrusive and may threaten fundamental human values, such as bodily integrity and freedom of thought. In addition, humanity has a track record of misguided and unwarrantedly coercive use of psychosurgery and other neurotechnological 'solutions' to criminality.  

We are deploying philosophical methods and recent thinking on autonomy, coercion, mental integrity and moral liability to answer two over-arching questions:

• When, if ever, may the state force neurointerventions on criminal offenders?
• When, if ever, may the state offer neurointerventions to criminal offenders?

We plan also to examine how our answers to these questions bear on the use of neurointerventions to prevent offending in individuals who have not previously offended, but are thought to be at high risk of doing so. This project is led by Dr Thomas Douglas, and is assisted by Postdoctoral Research Fellow Dr Jonathan Pugh.

Project website: https://ebip-oxford.org/

The Ethics of Novel Therapeutic Applications of Deep Brain Stimulation

PI:  Dr Jonathan Pugh

Wellcome Trust 203195/Z/16/Z

See grant outputs on EuropePMC.

Deep brain stimulation (DBS) is a neurosurgical procedure that has been used to ameliorate motor symptoms associated with neurological conditions such as Parkinson’s disease. Following its success in this regard, DBS has been increasingly considered as a treatment for psychiatric disorders including obsessive-compulsive-disorder,depression, anorexia nervosa, schizophrenia, and addiction. As well as promising beneficial treatment outcomes, the use of DBS in psychiatry might also provide researchers with insights into the neurological mechanisms underlying psychiatric disorders. Although this is an important development, the use of DBS in psychiatry raises ethical issues that are distinct from those raised by its use in the treatment of non-psychiatric neurological conditions, due to the diminished decision-making competence amongst many psychiatric patients, and the effects that psychiatric disorders often have on the patient’s self-conception and values, effects that DBS may exacerbate. The disturbing historical abuses of neurosurgery in psychiatry also suggest that it is imperative to develop adequate ethical guidelines for the use of DBS in this context.

In this Wellcome Trust funded project, I aim to provide a comprehensive study of the ethics of novel therapeutic applications of DBS, and to develop policy recommendations and ethical guidelines for its use. I seek to address the ethical issues alluded to above by focusing on questions pertaining to the following interrelated four core themes:

Authenticity and Personal Identity
The Significance Of Consent and Weighing Risks
The Research Ethics Paradigm
Distributive Justice and Resource Allocation

Rational Decisions: the Ethics of Rationing in Newborn Intensive Care

PI:  Professor Dominic Wilkinson

Wellcome Trust 106587/Z/14/Z

See grant outputs in Europe PMC.

I will examine the controversial questions that arise in the care of seriously ill infants whose lives might be saved, but only at great expense. Public health systems can’t provide every treatment that parents might want for their child and I will ask if there is a way to fairly decide which infants should be treated. 

I will draw on both medical ethics and medical science and address questions that doctors in newborn intensive care units (NICU) face regularly, such as how expensive is too expensive, how effective does a treatment need to be to justify the cost of treatment, should intensive care treatment be assessed on the same basis as new medicines, and how society should deal with conflicts between parents and doctors about providing treatment. 

The project will aim to help NICU doctors think clearly about the ethical questions involved in rationing treatment, both in wealthy countries and low-income countries. It will provide guidelines for policies relating to costly treatment and for people who have to make these decisions.

Moral Decision Making

The interdisciplinary research project Intuition and Emotion in Moral Decision Making: Empirical Research and Normative Implications, funded by the Volkswagen Foundation, aimed to elucidate the role of emotion and intuition in moral decision-making from an empirical, historical, and philosophical perspective.  The project funded an international conference 'Normative Significance of Cognitive Science' (further details and audio files below).

St Hugh's College, University of Oxford | 17-18 July, 2012

Speakers:
Kwame Anthony Appiah (Princeton University)
Stephen Darwall (Yale University)
Antti Kauppinen (Trinity College Dublin)
Regina Rini (University of Oxford)
Maureen Sie (Erasmus University)
Alex Voorhoeve (London School of Economics)
Liane Young (Boston College)

What is the relationship between normative ethics and scientific research on moral judgment and decision-making? What potential is there for drawing ethical implications from such empirical investigations? While questions in this area have received considerable attention lately, the discussion so far has been largely dominated by two opposing scepticisms: scepticism about the relevance of empirical research to ethics, and scepticism about the value of ‘traditional’ moral theory. This workshop aims to go beyond such outright scepticism by investigating different ways in which empirical research might impact on normative ethics. The focus will be on philosophical reflection, whether critical or constructive, rather than on simply showcasing the latest scientific research.

Hosted by the Oxford Uehiro Centre for Practical Ethics and the Oxford Centre for Neuroethics, Faculty of Philosophy, Oxford University.

Recordings:

• Maureen Sie (Erasmus Universiteit Rotterdam) “Science, Responsibility & The Traffic Participation View on Human Agency”
• Alex Voorhoeve (London School of Economics) “When Can('t) We Trust Our Moral Intuitions in Distributive Cases?”
• Kwame Anthony Appiah (Princeton University) “Accepting our natures. When should we accept the ways people tend to behave; when should we aim to change them?”
• Liane Young (Boston College) “When the mind matters for morality”
• Stephen Darwall (Yale University) “Experimental Evidence for Morality As Accountability”

Practical Ethics and the Neuroscience of Altruism

Principal Investigators: Julian Savulescu, Guy Kahane, Nadira Faber, Andreas Kappes

A Uehiro Centre research project, in collaboration with the Department of Experimental Psychology, and funded by the Wellcome Trust (ISSF).

Our lives are fraught with uncertainty. How people learn about uncertainty in their decision-making has become a central part of research in neuroscience. Yet, a substantial number of people’s decisions not only affects them, but also others. And little is known about how people learn about the effects of their actions on others. For research on altruism in psychology, neuroscience and philosophy, understanding how people learn about the outcomes of their actions for others is crucial. The results of this social learning process provide the foundations for people’s social decisions. For psychologists and neuroscientists, a better understanding of these foundations is essential if we want to know what motivates people to act altruistically and the underlying biology of prosocial decisions. For philosophers, normative theories of ethical behaviour need to integrate how outcome uncertainty should be integrated into people’s decision-making.

The Ethical Significance of Consciousness for Bioethics

Investigator:  Dr Josh Shepherd, Society & Ethics Postdoctoral Research Fellowship

Wellcome Grant 104347/Z/14/Z

Dr Shepherd's research goals were:

1. Develop an account of the value of consciousness that is sensitive to important distinctions between forms and levels of consciousness, as well as important philosophical and scientific work on the nature of consciousness.

2. Offer systematic analyses of the place of consciousness in our understanding of three ethical concepts: moral status, well-being, and morally responsible agency.

3. Apply understanding of the ethical significance of consciousness to emerging issues in biomedical research and ethics. 

Open access publications:

Chapters and Journal Articles: See list on Europe PMC.

Book: Shepherd, J., (2018), 'Consciousness and Moral Status', (Routledge) [NBK540410]