On acts, omissions and responsibility

Centre for Social Ethics and Policy and Institute for Science, Ethics and Innovation, School of Law, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
Journal of medical ethics (Impact Factor: 1.69). 09/2008; 34(8):576-9. DOI: 10.1136/jme.2008.024729
Source: PubMed
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    ABSTRACT: Understanding what sorts of things one might be responsible for is an important component of understanding what one should do in situations where the administration of artificial hydration and nutrition are required to sustain the life of a patient. Relying on work done in the philosophy of action and on moral responsibility, I consider the implications of omitting the administration of artificial hydration and nutrition and instances in which the omitting agent would and would not be responsible for the death of the patient. I am primarily interested in arguing against those who wish to seat responsibility for the death of a patient in an underlying pathology, even when the underlying pathology is not the cause of the patient's death.
    Journal of Medicine and Philosophy 06/2014; 39(4). DOI:10.1093/jmp/jhu022 · 0.79 Impact Factor
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    ABSTRACT: Some issues in medical ethics have been present throughout the history of medicine, and thus provide us with an opportunity to ascertain: (1) whether there is progress in medical ethics; and (2) what it means to do good medical ethics. One such perennial issue is physician assistance in dying (PAD). This paper provides an account of the PAD debate in this journal over the last 40 years. It concludes that there is some (but limited) progress in the debate. The distinctions, analogies and hypothetical examples have proliferated, as have empirical studies, but very little has changed in terms of the basic arguments. The paper further argues that many of the contributions to the debate fail to engage fully with the concerns people have about the legal introduction of PAD in the healthcare system, perhaps because many of the contributions sit on the borderline between academic analysis and social activism. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Journal of Medical Ethics 01/2015; 41(1):40-3. DOI:10.1136/medethics-2014-102288 · 1.69 Impact Factor
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    ABSTRACT: There is increasing recourse to quantitative approaches in healthcare allocation and prioritisation, frequently using methods from operational research and health economics. Such approaches can prove very attractive and influential, employing what are viewed as scientific, rational, methods. But can high-tech quantitative analysis, taken to its apparently logical conclusion, cause the ethical ‘human’ dimension in health care to be overridden. This paper develops some of the ethics arguments posed in an earlier paper by Mullen and Mullen (2006), questioning whether it is ever permissible to kill someone. It then suggests why numbers might kill and discusses what might prevent this. Some recent developments are then reviewed to address the question of whether “Killing by Numbers” has become more or less likely. It is concluded that, despite recent developments, the attraction of apparently logical quantitative approaches means that numbers probably are still killing people.
    01/2013; DOI:10.1016/j.orhc.2013.10.003