The UK National Health Service’s 'innovation agenda': lessons on commercialization and trust

The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded

Assessing the morality of the commercial exploitation of inventions concerning uses of human embryos and the relevance of moral complicity

In late 2008, the Enlarged Board of Appeal of the European Patent Office (EPO) reached a decision supporting the rejection of a patent application on human embryonic stem cells filed by the Wisconsin Alumni Research Foundation (WARF). This article comments on some of the shortcomings of the decision. The key legal provisions at issue in this case were Rule 28(c) EPC, which forbids the granting of patents in respect of biotechnological inventions which concern uses of human embryos for industrial or commercial purposes, and Article 53(a) EPC, the morality provision of the European Patent Convention. The Board rightly found the Rule to exclude WARF’s claims (but, we argue, left a “deposit loophole”). However, one of the issues the Board had to address was whether the Rule might not apply because it extended the scope of prohibited subject matter beyond that prohibited by the Article. We argue that, unless the Article had been found to exclude patentability, the applicability of the Rule could not be determined. Even though at the oral hearing before the Board, both WARF and the EPO President identified the question whether the Article (the morality provision) constituted a barrier to patentability as the core issue in this case, the Board astonishingly decided that this question did not need answering (even though the Board did hint at the basis for the answer). We argue that this is a major shortcoming of the decision. Finally, we comment on the relevance of moral complicity to the question of patentability

Something more is necessary: are genes and genetic diagnostic tests statutory subject matter for US patents?

In a recent decision (AMP v. USPTO) from the US District Court, patent claims directed at DNA sequences corresponding to human genes and to diagnostic tests based on such genes have been found to be invalid, primarily on the basis that the DNA molecules claimed, which included cDNA, primers and probes, are 'products of nature' and are thus unpatentable. If upheld, this decision will have considerable impact on the ability of biotechnical companies and universities to patent the results of their research. In this article, we will explain the basis for this decision and discuss the appropriateness of patenting discoveries and their (obvious) uses in the light of this fascinating case. While our focus will primarily be on the product claims, diagnostic method claims were also revoked in AMP v. USPTO on the basis that they were for mental acts or did not involve any 'transformation of matter'. This will be discussed in the light of the recent US Supreme Court decision in Bilski v. Kappos, which focused on the patent-eligibility of process claims

Enclosing the academic commons : increasing knowledge transfer or eroding academic values?

cademic research is increasingly being commercialised. This ­commercialisation trend has different dimensions, among which the massive increase of patenting and licensing activities by universities, the significant growth of industry funding of academic research via so-called contract research, and the creation of ever more ‘spin-out’ companies. All this is strongly encouraged by governments throughout the Western world. The commercialisation trend has far-reaching consequences for access to the fruits of academic research and so the question arises whether the current policies are indeed promoting innovation or whether they are instead a symptom of a pro-commercialisation culture which is blind to adverse effects. This paper discusses the justifications that are given for the current policies and raises the question to what extent they threaten important academic values. Next, the question will be addressed as to why policymakers seem to ignore the adverse effects of the commercialisation of academic research. Finally, a number of proposals for improving university policies will be made

Moral disengagement and the motivational gap in climate change

Although climate change jeopardizes the fundamental human rights of current as well as future people, current actions and ambitions to tackle it are inadequate. There are two prominent explanations for this motivational gap in the climate ethics literature. The first maintains that our conventional moral judgement system is not well equipped to identify a complex problem such as climate change as an important moral problem. The second explanation refers to people’s reluctance to change their behaviour and the temptation to shirk responsibility. We argue that both factors are at play in the motivational gap and that they are complemented by crucial moral psychological insights regarding moral disengagement, which enables emitters to dissociate self-condemnation from harmful conduct. In this way, emitters are able to maintain their profligate, consumptive lifestyle, even though this conflicts with their moral standards with respect to climate change. We provide some illustrations of how strategies of moral disengagement are deployed in climate change and discuss the relationship between the explanations for the motivational gap and moral disengagement. On the basis of this explanatory framework, we submit that there are three pathways to tackle the motivational gap and moral disengagement in climate change: making climate change more salient to emitters and affirming their self-efficacy; reconsidering the self-interested motives that necessitate moral disengagement; and tackling moral disengagement directly

May the blessed Man win: a critique of the categorical preference for natural talent over doping as proper origins of athletic ability

Doping scandals can reveal unresolved tensions between the meritocratic values of equal opportunity + reward for effort and the "talentocratic" love of hereditary privilege. Whence this special reverence for talent? We analyze the following arguments: (1) talent is a unique indicator of greater potential, whereas doping enables only temporary boosts (the fluke critique); (2) developing a talent is an authentic endeavor of "becoming who you are,"whereas reforming the fundamentals of your birth suit via artifice is an act of alienation (the phony critique); (3) your (lack of) talent informs you of your proper place and purpose in life, whereas doping frustrates such an amor fati self-understanding (the fateless critique). We conclude that these arguments fail to justify a categorical preference for natural talent over integrated artifice. Instead, they illustrate the extent to which unsavory beliefs about "nature's aristocracy" may still be at play in the moral theatre of sports

Putting sustainability into sustainable human development

Abating the threat climate change poses to the lives of future people clearly challenges our development models. The 2011 Human Devel- opment Report rightly focuses on the integral links between sustainability and equity. However, the human development and capabilities approach emphasizes the expansion of people’s capabilities simpliciter, which is ques- tionable in view of environmental sustainability. We argue that capabilities should be defined as triadic relations between an agent, constraints and poss- ible functionings. This triadic syntax particularly applies to climate change: since people’s lives and capabilities are dependent on the environment, sus- tainable human development should also include constraining human activi- ties in order to prevent losses in future people’s well-being due to the adverse effects of exacerbated climate change. On this basis, we will advocate that the goals of sustainable human development should be informed by a fra- mework that consists of enhancing capabilities up to a threshold level, as well as constraining the functionings beyond this threshold in terms of their green- house gas emissions

Controversies surrounding continuous deep sedation at the end of life : the parliamentary and societal debates in France

Background: Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying. The practice is generally considered to be legal as a form of symptom control, although this is mostly only assumed. France has passed an amendment to the Public Health Act that would grant certain terminally ill patients an explicit right to continuous deep sedation until they pass away. Such a framework would be unique in the world. Discussion: In this paper we will highlight and reflect on four relevant aspects and shortcomings of the proposed bill. First, that the bill suggests that continuous deeps sedation should be considered as a sui generis practice. Second, that it requires that sedation should always be accompanied by the withholding of all artificial nutrition and hydration. In the most recently amended version of the legal proposal it is stated that life sustaining treatments are withheld unless the patient objects. Third, that the French bill would not require that the suffering for which continuous deep sedation is initiated is unbearable. Fourth, the question as to whether the proposal should be considered as a way to avoid having to decriminalise euthanasia and/or PAS or, on the contrary, as a veiled way to decriminalise these practices. Summary: The French proposal to amend the Public Health Act to include a right to continuous deep sedation for some patients is a unique opportunity to clarify the legality of continuous deep sedation as an end-of-life practice. Moreover, it would recognize that the practice of continuous deep sedation raises ethical and legal issues that are different from those raised by symptom control on the one hand and assisted dying on the other hand. Nevertheless, there are still various issues of significant ethical concern in the French legislative proposal