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The Professional is Political
Yesterday it was reported that [more] that Prof John Ashton, a county medical officer for Cumbria, had been called by his Primary Care Trust (PCT) to attend a hearing. This had, apparently, been arranged to consider if he had broken the NHS code of conduct by appending his signature to an letter criticising Lansley's proposed NHS reforms. It seems that someone thinks that having a political opinion is not a privilege NHS employees enjoy and it started off another round of #iamspartacus on the twitters.
However, in the News and Star, a local Cumbrian newspaper, Prof Ashton is quoted as saying:
[Prof Ashton] stressed it was his professional – not personal or political opinion – that the reforms will cause irreversible long-term damage to the health service.
I am not sure what it is that makes Prof Ashton's opinion on these matters in some way a 'professional' one, as distinct from a personal or a political one. Indeed I don't think a professional opinion on these reform either needs or can be differentiated from a personal opinion and it certainly cannot be said to be apolitical. However I do not think there is any need for Prof Ashton to deny his professional opinion on NHS reform is in no way related to his personal or political opinion. They cannot and should not be separated. Certainly when he is speaking in a professional-political capacity then his 'mode of expression' might be somewhat different to when he is speaking in a purely personal-political capacity but professionals cannot, in some way, be deemed or demanded to be apolitical.
Death: Metaphysical and Epistemological
A little while ago I attended a workshop held by the Philosophy of Medicine research group at King’s College London. The focus of the day was on ‘Death’ and as one point I made a comment about how our discussion was, in my view rightly, beginning to range across what John Searle might call ‘brute’ and ‘social’ facts. In this particular case the ‘brute facts’ could have been understood to be some of the philosophical arguments we had discussed as well as the largely implicit or assumed biological facts, or biological metaphysics, of death. In contrast the ‘social facts’ would be related to our cultural acceptance of death as a part of life; our ability to discuss death and plan for our own and that of others; the way in which we handle death in hospitals and elsewhere; the way in which death is written into law, professional guidelines and in actual (clinical) practices. In the break another of the days attendees asked me how death could be a social construct and I am afraid I did a rather bad job of answering. I think this is because it wasn’t exactly what I was trying to say with my comment and because the concept of death isn’t really something I focus on in my research, although it was a minor topic of concern when I undertook the MA in Health Care Ethics at Leeds.
Elective Ventilation and Opting-In or Opting-Out
The biggest UK bioethics story of this past week (apart from the on going attempt to ruin the NHS by the Tory led coalition) has been the BMA's report 'Building on Progress: Where Next for Organ Donation Policy in the UK' which proposes and considers a number of ways in which the supply of organs suitable for transplantation might be increased. Public discussion has been particularly focused on the idea of 'elective ventilation' which involves extending life support to patients who will derive no benefit from the treatment (although since they will derive no benefit it is questionable if it can be called treatment). Dominic Wilkinson, an Australian Consultant Neonatologist and Assistant Professor of Medical Ethics at the University of Adelaide, discusses the ethics of elective ventilation here, on Oxford's Practical Ethics blog and here, cross posted on the JME blog. Broadly speaking elective ventilation is where the sole reason for commencing or extending 'life support,' i.e. artificial ventilation, is to allow for the harvesting of organs in the best possible condition for transplantation.
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