Publications : Book chapters

Is coercion ever beneficent? Public health ethics in early intervention and prevention for mental health

July 10, 2019. Posted in

Authors: Alex McKeown, Arianna Manzini, Ilina Singh

Early intervention in mental health seeks to improve the wellbeing of as many people as possible, by intervening at an early stage in the onset of illness, or by taking preventative action in ‘at risk’ populations. The paradigm is rhetorically powerful, and it is easy to talk in terms of it helping to deliver rights to health and realise social justice.

However, in spite – or perhaps because – of the apparently unarguable desirability of such goals, it is harder to discuss rights to dissent. In this respect the risk of coercion is an issue that should be discussed, especially because of the stigmatizing effect that the labelling associated with early intervention may have in mental health contexts. Here we explore this issue, with a particular focus on its practical and ethical implications in relation to UK policy for treating Attention Deficit Hyperactivity Disorder and mild Conduct Disorder in young people.

View Details

Neuro-enhancement at the Margins of Autonomy: In the Best Interest of Children and Elderly?

June 10, 2019. Posted in

Authors: David Lyreskog

The prospects of neuro-enhancement have generated a large range of philosophical and ethical debates. The possibility of pediatric neuro-enhancement—using technology and pharmaceuticals to enhance children’s cognitive or emotive capacities—is particularly complicated for a number of reasons. One of the main reasons is that children (at least young children) are not autonomous and can therefore not possibly consent to any interventions. Nonetheless, parents can potentially make decisions to enhance the capacities of their children.

In this chapter I investigate ethical issues of pediatric neuro-enhancement and neuro-enhancement in elderly with diminishing autonomy. I argue that the similarities and differences between the philosophical and ethical questions that arise in the respective cases show how complicated neuro-enhancement in non-autonomous persons is. In particular, I look at three issues: (1) What kinds of autonomy are diminished or underdeveloped, and how does that affect the moral permissibility of neuro-enhancement? (2) What role does the concept of “an open future” play? (3) What does it mean to look out for “the best interest” of a child or a non-autonomous elderly person, and how does it translate to the permissibility of neuro-enhancement? I argue that the difference in how we conceptualize the non-autonomy of children and that of elderly affects the permissibility of neuro-enhancement. I conclude that, as long as we make sure that a person becomes autonomous enough to pursue her own autonomy as a condition and as an ideal, her best interests have been looked after in terms of autonomy.

View Details

The moralization of the body: Protecting and expanding the boundaries of the self

June 10, 2018. Posted in

Authors: Gabriela Pavarini

How is morality revealed in the body? Protecting the body coincides with a desire to keep resources for the self, whereas breaking these boundaries (e.g., through physical touch) coincides with a desire to share with others. At its essence, morality can be viewed as concerning resource allocation. “Being moral” normally refers to the willingness to allocate personal resources to others. This includes helping others achieve their goals, comforting them, and sharing valuable goods such as food and information. Therefore, a substantial part of our everyday morality involves decisions on whether to keep our psychological, physical, and material resources to ourselves or, instead, give them away. For social life to be sustainable, human groups develop a shared understanding of who possesses what and the extent to which these resources are distributed and shared. In the present chapter we demonstrate how the negotiation of psychological and material resources with others is grounded in processes of the physical body, such as those that support disease avoidance. In what follows, we discuss the historical roots of our approach, its theoretical standpoint, and the accruing empirical evidence in support of it.

View Details

ADHD in the United Kingdom: Conduct, Class, and Stigma

June 10, 2017. Posted in

Authors: Ilina Singh

If attention deficit/hyperactivity disorder (ADHD) in the United Kingdom were a word cloud that attempted to capture its status as a social object, it would be characterized most prominently by a bold assemblage of biological and developmental research and researchers, intertwined with national guidelines and epidemiological reports. The pharmaceutical industry, health economics-related terms, and media reports would appear in smaller, lesser font caught up within this bold assemblage in a minor way. Smallest of all, elements related to ADHD as a lived experience would be (if we imagine this to be a three-dimensional word cloud) sucked into the vortex of the assemblage, a tiny object in the depths of a black hole. These elements and this configuration make up ADHD in the United Kingdom in the early 21st century.

View Details