The Thin End

If health care resources and staff are stretched to the limit, difficult life or death choices must be made.  Who to treat? That will be the question. At ordinary times decisions might be made based on whether treatment will do more harm than good.  It might even be the patient who decides.  End of life decisions are more often like that.  Will further treatment help? But these are not regular times. The British Medical Association guidance on pandemics says "In dangerous pandemics the ethical balance of all doctors and health care workers must shift towards the utilitarian objective of equitable concern for all – while maintaining respect for all as ‘ends in themselves’." If resources are spent on saving the life of one person at the expense of many others, how then is that balance to be made? One thing is sure.  Our actions are also part of this ethical mix.  Our efforts will determine whether or not the anticipated surge in those requiri...

The creation of genetically-modified babies is not only ethically justifiable but “highly desirable”, according to new academic research from a leading UK bioethicist. Dr Kevin Smith from Abertay University in Dundee, Scotland, has published ethical analysis concluding that the risks of gene editing are now low enough to justify its use with human embryos, with a view to producing genetically-modified (GM) people. In the paper, published in medical ethics journal Bioethics , Dr Smith argues that an ethically sound attempt could be less than two years away, and predicts such research could kick-start a revolution in human genetic modification. It is difficult to see what the nature of this research would be.  The problem does not lie in the ethics of 'designer babies', but in the possible complications of such research.  This is the point I and my colleagues made in a paper we published a few years ago.  Genes are rarely specific for a given characteristic.  ...

Bad trade and bad products are killing our planet. We have said this before on The Thin End . There is no better example than that of palm oil. It is used ubiquitously in so many products, and its production is a major factor destroying rainforests and threatening precious species. Demand for palm oil is 'skyrocketing worldwide' . It is used in packaging and in so much of our snack foods, cookies, crackers, chocolate products, instant noodles, cereals, and doughnuts, and the list goes on. Bad for the planet So, why is this so bad for the planet? The oil is extracted from the fruit of the oil palms native to Africa. It is now grown primarily in Indonesia and Malaysia, but is also expanding across Central and West Africa and Latin America. Palm oil production is now one of the world's leading causes of rainforest destruction, and this is impacting adversely some of the world's most culturally and biologically diverse ecosystems. Irreplaceable wildlife spec...

Latest Podcast. A weekly round up of news and views on topical issues. This week: Invasive Rabbits and Hares, pesticides and hummingbirds, Invasive mosquitos, abortion law reform in the UK, and controversl new blood pressure guidelines.

In an editorial in The BMJ , published today, editor in chief of BMJ Sexual & Reproductive Health, Sandy Goldbeck-Wood, on behalf of her editorial board colleagues, calls on British premier, Theresa May, to decriminalise abortion in the UK.   This follows the recent decisions to liberalise abortion laws in the Republic of Ireland and the Isle of Man. Abortion law in UK The UK 1967 Abortion Act was introduced to provide a legal defence against the criminal law passed in 1861,  but the Offences Against the Person Act remains on the statute book. The women of Northern Ireland are the most vulnerable to this 150 years old, anachronistic piece of Victorian criminal law,  because under the law in the Province allows for no defence,  even in cases of rape or fatal fetal abnormalities. As a result, women who have an abortion in Northern Ireland still  face a maximum sentence of life imprisonment. The UK government has argued that this is a matter for the d...

Women in England should be allowed to take both the pills required for an early medical abortion at home, just like their peers in Scotland and now Wales, argue healthcare leaders, in an editorial published online in BMJ Sexual & Reproductive Health. Currently in England, women who have an early medical abortion take one drug, mifepristone, in the clinic then need to return to take a second drug, misoprostol, 36-48 hours later. In Scotland, and soon in Wales, misoprostol can be taken by the woman at home, but in England it must be administered within a licensed hospital or clinic. Developed in 1973,  misoprostal is commonly used in labour induction and is regarded by the WHO as safe and effective. Leading clinicians call for change in regulations The heads of the Royal College of Obstetricians and Gynaecologists, the Faculty of Sexual and Reproductive Healthcare, and the British Society of Abortion Care Providers now call on health and social care secretary, Jer...