Alex is a Postdoctoral Research Fellow with the Neuroscience, Ethics & Society team (NEUROSEC) and the Wellcome Centre for Ethics and the Humanities (WEH), most recently working on the MRC Pathfinder project which aims to harness health informatics and data science to improve mental health outcomes. Alex’s current research focuses primarily on ethical issues in mental health big data, and ethics of early intervention. Alex also established and co-Chairs the Mental Health Data Ethics Leadership group with Prof. Ilina Singh. Previously, Alex worked on the ROADMAP project, an EU-wide consortium project which aimed to improve outcomes for people with Alzheimer’s Disease.
Prior to Oxford, Alex held teaching and research positions at the University of Bristol Centre for Ethics in Medicine, as well as research positions at University College London Medical School Research Department for Medical Education, and the University of East London Institute for Health and Human Development. Alex has also been a visiting tutor at the Yale University Summer Institute in Bioethics.
Alex has a PhD in Bioethics from the University of Bristol. His thesis focused on the philosophical, ethical, and social implications of human enhancement technologies. His thesis focused on the philosophical, ethical, and social implications of human enhancement technologies. Subsequently, via a Wellcome Trust Ethics and Society Small Grant, he took forward the conclusions of his thesis, examining the relation between human enhancement and public health, which remains a significant research interest. Alongside this Alex’s interests include neuroethics and neurotechnologies, ethics in psychiatry and mental health, ethics in dementia, ethics in artificial intelligence, philosophy of mind, philosophy of medicine, epistemology – in particular debates in realism and anti-realism, and interdisciplinary methodology in applied and empirical ethics.
Before returning to academia to take his PhD Alex spent three years working in patient advocacy and policy research in genetics, and prior to this he took a BA in Philosophy and an MA in Healthcare Ethics at the University of Leeds.
Embodiment is typically given insufficient weight in debates concerning the moral status of Novel Synthetic Beings (NSBs) such as sentient or sapient Artificial Intelligences (AIs). Discussion usually turns on whether AIs are conscious or self-aware, but this does not exhaust what is morally relevant. Since moral agency encompasses what a being wants to do, the means by which it enacts choices in the world is a feature of such agency. In determining the moral status of NSBs and our obligations to them, therefore, we must consider how their corporeality shapes their options, preferences, values, and is constitutive of their moral universe. Analysing AI embodiment and the coupling between cognition and world, the paper shows why determination of moral status is only sensible in terms of the whole being, rather than mental sophistication alone, and why failure to do this leads to an impoverished account of our obligations to such NSBs.
Is coercion ever beneficent? Public health ethics in early intervention and prevention for mental health
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.
Ethical challenges of integration across primary and secondary care: a qualitative and normative analysis
BackgroundThis paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention.
MethodsWe evaluated an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners (GPs) in co-designing integrated clinical services.
ResultsThe key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based.
ConclusionsFrom our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making.
A response to open peer commentaries on "Just Policy? An Ethical Analysis of Early Intervention Policy Guidance?"
What outcomes are important to patients with mild cognitive impairment or Alzheimer’s disease, their caregivers, and health-care professionals? A systematic review
Clinical trials involving patients with Alzheimer's disease (AD) continue to try to identify disease-modifying treatments. Although trials are designed to meet regulatory and registration requirements, many do not measure outcomes of the disease most relevant to key stakeholders.
A systematic review sought research that elicited information from people with AD, their caregivers, and health-care professionals on which outcomes of the disease were important. Studies published in any language between 2008 and 2017 were included.
Participants in 34 studies described 32 outcomes of AD. These included clinical (memory, mental health), practical (ability to undertake activities of daily living, access to health information), and personal (desire for patient autonomy, maintenance of identity) outcomes of the disease.
Evidence elicited directly from the people most affected by AD reveals a range of disease outcomes that are relevant to them but are not commonly captured in clinical trials of new treatments.