This conference has chosen the theme of “voices of communities” as its running conference narrative. Interestingly, on this first day of the conference we were hearing a diversity of voices from the bioethics community. In a given session, there might be a philosopher, a health care administrator, and an entrepreneur presenting one after another. And those in the audience responding to their “performances” (thanks Alistair Browne), may include physicians, academics, allied health professionals, and lawyers. Each discipline tends to have their own way of presenting their findings, which requires a certain flexibility on the part of the conference attendees to adjust their gaze towards the particular disciplinary styles.
Plenary Lecture: Voice of the Voiceless – Andrew Robinson, BC Representative for Children and Youth.
The Plenary on Day 2 of the Canadian Bioethics Society meeting was given by Andrew Robinson, the Associate Deputy Representative Advocacy, Community and Aboriginal Relations with the BC Representative for Children and Youth (RCY). The mandate of the RCY is to support “children, youth and families who need help in dealing with the child welfare system and advocate for changes to the system itself”. Robinson started his talk with the appalling statistic that BC leads Canada in child poverty rates and that his organization is involved in 4500 children’s lives – children whose lives are significantly affected by decisions made by the state for their care. Aboriginal children are disproportionately affected – they make up 3% of the populuation but 50% of the children in care. Robinson cited the UN Convention on the Rights of Children on which Canada is a signatory. He asserted that it is a right for children to know “what’s going on in their life”. Drawing from his work with children, he shared stories of what happens when children are listened to. He spoke of one 7 year old girl who phoned their office and demanded to speak with the top person to ask “Can someone tell me why I can’t see my Mom?” Her mother had been removed from her because of mental health issues that put the daughter at risk. No one had explained to the little girl what was going on in her life. In another case, an abused child kept telling social workers that it wasn’t his father abusing him, but his mother. Based on the mother’s account the father was removed from the home. Only when Robinson’s organization got involved was the child heard, and made safe. Robinson feels that it is our obligation to listen to the voice of children and make sure it is heard. “Ethics”, Robinson says, “is humanizing each other.” Continue reading
“Holding space for possibilities in a time of uncertainty” – Carole Robinson, on her definition of hope.
Carole Robinson, from UBC Okanagan, gave the plenary talk last night to open the conference. She approached end-of-life issues from a relational ethics perspective. In particular, she concentrated on emphasizing the need conversations with families around advanced care planning. Robinson’s take on relational ethics was inclusive of both individualistic perspectives on autonomy and decision-making, in addition to relational views which emphasize human relationships as being crucial. For example, Robinson advised shifting the question from “what do you want” to “if you can’t speak for yourself, how would you guide your family to speak for you”? This question would thus open up the ethical space for a larger conversation that enables dialogue around options for care. This may include, for example, what would a do not resuscitate order (DNR) look like, and how successful a DNR would likely be. Robinson reported that most conceptions of interventions such as DNR come from popular medical television dramas which sensationalize high success rates. Although much of Robinson’s presentation has been an important topic of discussion for many years, her plenary was a call to action for medical professionals to begin the advanced care planning conversation with their patients and families.
Today, Thursday June 10, we look forward to the plenary session on child and youth welfare, and concurrent sessions on clinical equipoise, the ‘hidden curriculum’ in post-graduate ethics training for psychiatry residents, end-of-life issues, and autonomy and decision-making in plastic surgery.
The 21st Annual Canadian Bioethics Society Conference will be taking place this year in Kelowna, British Columbia from June 9th – 12th. The theme of this year’s conference is “Voices of Communities”.
Like last year, I will be blogging live from the conference. However this year I won’t go at it alone, as I’ve managed to coerce a few other UBC Neuroethics folk to contribute to conference blog posts. These include Joanne Reimer and Elana Brief, who both will be presenting papers. Joanne will be discussing her study, Spinal Cord Injury and the Clinical Translation of Stem Cells: Stakeholder Perspectives, June 11 at 10:30 am. Elana will be presenting Protecting or Silencing: The Benefits and Harms of Community Anonymity, the same afternoon at 2:00 pm. Check the official program for room designations. Research Coordinator Emily Borgelt will also post her reflections on sessions during the conference.
For those interested, the Canadian Neuroethics Interest Group will be held Friday, June 12th at 7:30 am in the Selkirk room. Yes. That is a.m. as in ante meridiem as in morning. Early morning. See you there!
Conference Webpage: http://en.cbskelowna2010.ca/
Image source: CBS Kelowna
It seems that everywhere I look nowadays, I’m seeing images of, or reading descriptions of, the brain in some shape or form. Sometimes the brain itself is the main focus of a book, movie, advertisement, public health campaign, blog, or news headline. For example, I’ve noticed the brain – or related terms such as ‘neuro’ or ‘mind’ – as the subject of interest in places such as Marco Roth’s piece on The Rise of the Neuronovel, films such as Minority Report and Eternal Sunshine of the Spotless Mind, covers of popular public interest magazines, the purpose of computer games (‘train your brain!’), and the emergence and convergence of disciplines such as neuro-economics, neuro-ethics, neuro-anthropology, neuro-aesthetics, neuro-law, neuro-philosophy, and those which do not even start with ‘neuro’ (but nonetheless contain the word) such as socio-cognitive-neuroscience and psycho-neuro-endocrinology. Indeed, the field of neuroscience itself could be thought of as a set of disciplines devoted to the study of the mind/brain for years, which converged approximately mid-way through the 20th century. Continue reading
Toronto’s Centre for Addiction and Mental Health (CAMH) – Canada’s largest addiction and mental health research and treatment facility – recently announced that come July 2010, three of its principle sites will be entirely smoke free. This announcement appears to be the next step from CAMH’s 2005 non-smoking policy, in which smoking was prohibited in all buildings and in the designated smoking rooms on inpatient units. Clients, staff and visitors were still able to smoke in designated areas on the grounds.
Justification for the new policy is based on the following argument:
“This is first and foremost part of CAMH’s commitment to transform care for our clients…we should not accept a lower quality of life for people with mental vs physical illness. This decision is equally motivated by health and safety – CAMH has a legal and ethical obligation to provide a safe, hazard-free treatment setting and workplace for our clients, staff, volunteers and visitors. In 2009 the primary cause of death in mental health and addictions populations was tobacco-related medical illness…”
Over at The New Republic, Sally Satel, psychiatrist and resident scholar at the American Enterprise Institute, recently reviewed the controversial book Addiction: A Disorder of Choice by psychologist Gene Heyman. Heyman’s thesis is that conventional wisdom about addiction being a ‘disease’, or perhaps a ‘brain disease’, is incorrect. Satel quotes Heyman by saying, “that the idea [of] addiction [as] a disease has been based on a limited view of voluntary behavior.” Accordingly, addiction is not an “irresistible act”, as he claims the term ‘addiction’ implies, and is in fact a “disorder of choice”. [Note: I have not read Heyman's book, so I will not comment on the book directly]. Indeed, Satel conveys Heyman’s position as one that is in opposition to perspectives from powerful public figures that support the view that “Addiction is a Brain Disease, and it Matters.” Satel agrees with Heyman’s position, namely that if addiction is a disease, it is a disease the person chose for herself.
Satel’s review of Addiction prompted a response from writer Sascha Z. Scolbic and Peter Scolbic (TNR’s executive editor), who argued that Satel was puting up a “straw man” argument. [See Satel's reply to the Scolbic's here].
I’ll admit that it may seem odd, or perhaps even unnecessary, to begin a post on a neuroethics blog to query the meaning of neuroethics. Although barely into its 8th year as an academicized field of study, the area of inquiry called “neuroethics” has developed a professional society, an academic journal devoted to issues that fall within the bioethics-neuroscience scope, another bearing its namesake, books (e.g., here, here, here, and here), and a few blogs (e.g., here & here) — including this one. Although the Dana Foundation’s “Neuroethics: Mapping the Field” conference is often credited as jump-starting neuroethics, it appears others have being ‘doing neuro-ethics’ well before the conference took shape (see, for instance, Gillett and also Churchland).
In an influential paper, Adina Roskies attempted to define neuroethics by demarcating the “ethics of neuroscience” from the “neuroscience of ethics”(Roskies does note, however, that these two aims can be pursued independently but also tend to affect one another). Roskies original account described the ethics of neuroscience as being somewhat akin to what has been a traditional focus of bioethics research, namely, the ethics of something, e.g., conducting neuroscience research with humans, the ethics of neurotechnology (e.g. deep-brain stimulation) and guidelines for research and clinical practice. The neuroscience of ethics focuses on how philosophical notions of free will, identity and other aspects of moral cognition can be explored through understanding how the brain works. Perhaps a simplistic explanation, since the paper was published in 2002 Roskies’ conception has had an impact on how neuroethics has taken shape. Continue reading