MBBS Curriculum 2020

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    Placebo-Controlled Surgical Trials
    1 October 2015 - 18:30-20:00

    Lecture: David Beard, Professor of Musculoskeletal Sciences, University of Oxford
    Comment: David Papineau, Professor of Philosophy, King’s College London

    K2.31, King’s Building, Strand, King’s College London

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    Lies, Damn’d Lies, and Statistics: Is it possible to communicate cancer risk accurately?
    15 October 2015 - 18:30-20:00

    Lecture: Steve John, Lecturer, History and Philosophy of Science, University of Cambridge
    Comment: Deborah Ruddy, Consultant in Clinical Genetics, Guy’s and St. Thomas’ Hospital

    Henriette Raphael House, Function Room, Guy’s Campus

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    Abstract:

     

    The fact that different ways of presenting the same risk information can have very different effects on patients’ choices raises an ethical challenge: how, if at all, should medical professionals use such “perlocutionary knowledge”? In this paper, I suggest that reflection on the nature of risk estimates poses an even harder problem: which reference classes should physicians use to calculate patients’ risks in the first place? I then sketch one answer to this challenge, based on an account of rational gambling. Unfortunately, this answer seems to conflict with much current medical practice. In the final part of the paper, I try to justify current practice. I conclude with some remarks on the implications of my argument both for clinical ethics and for the philosophy of science.

    Abstract
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    Surviving the Sirens: Should there be advance directives for people with Bipolar? -- CANCELLED
    29 October 2015 - 18:30-20:00

    Lecture: Tania Gergel, Visiting Research Fellow in Ancient Philosophy (Dept. of Classics) and Philosophy of Psychiatry (IoPPN)
    Comment: Alexander Ruck Keene, Barrister and Honorary Research Lecturer at the University of Manchester

    This event has been cancelled due to illness. It will be rescheduled for a later date.


    ”Just because I’m paranoid doesn’t mean they’re not out to get me”: The Problem of Defining Delusion
    12 November 2015 - 18:30-20:00

    Lecture: Dr. Abdi Sanati, Consultant Inpatient Psychiatrist, North East London NHS Foundation Trust
    Comment: Dr. Luis Flores, MD, MA, MPhil

    King’s Building, K2.31, Strand

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    Abstract:

     

    Delusions have long been seen as a hallmark of madness, but what makes something a delusion? People have mistaken beliefs without being called deluded, and the beliefs of deluded people can be true. In this talk, these and other difficulties with defining delusion will be explored from the points of view of both theory and clinical practice.

    Abstract Video Recording


    Cause or Correlation? Causal Evidence in Medicine and Law
    28 January 2016 - 18:30-20:00

    Lecture: Brendan Clarke, Department of Science and Technology Studies, UCL
    Comment: Nicki Cohen, Neuropathologist, GKT Department of Medical Education, KCL

    Anatomy Lecture Theatre, Hodgkin Building, Guy’s Campus

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    Abstract:

     

    How can medical researchers generate reliable knowledge about treatment outcomes? The usual answer to this question is that randomised clinical trials are the best way of doing this. But there are many cases where doing a trial is not possible. In such cases, researchers must rely on other kinds of evidence. However, as is well-known, these kinds of evidence have many shortcomings, such as suffering from confounding and various species of bias. This talk uses methods drawn from the law to explore improved ways of working with imperfect evidence in medicine.

    Abstract Video Recording


    In Defense of the Social Value Requirement for Clinical Research
    11 February 2016 - 18:30-20:00

    Lecture: Annette Rid, Department of Social Science, Health, and Medicine, KCL
    Comment: Benedict Rumbold, Department of Philosophy, UCL

    Anatomy Lecture Theatre, Hodgkin Building, Guy’s Campus

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    Abstract:

     

    Many commentators and guidelines endorse the view that clinical research should be permitted only when it is socially valuable, meaning that it collects data which can be used to improve health. Despite this widespread endorsement and codification, there has been no systematic analysis of why social value is a necessary condition on acceptable clinical research, and a recent article even suggests it is not necessary. I evaluate the relevant ethical arguments and policy considerations and provide justification for the view that social value is an ethical requirement for the vast majority of clinical research trials, and should be mandated by guidelines and policies for clinical research.

    Abstract


    Configuring the Participants in Clinical Research
    25 February 2016 - 18:30-20:00

    Lecture: Norma Morris, Department of Science and Technology Studies, UCL
    Comment: John Craven, Philosophy, KCL

    K2.31, King’s Building, Strand, King’s College London

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    Abstract:

     

    Empirical work on participation in clinical research (using qualitative methods) has highlighted some of the configuration work being carried out by and on those taking part. Lay contributors try out different identities and behaviours, and develop conceptions of their role in response to circumstances. Clinical staff have to reconcile the professional demands of research and of care, and adjust as necessary their pre-formed expectations of participants’ needs. They must additionally comply with professional, legal, ethical and governance frameworks and rules. The presentation discusses tensions emerging for the actors, meeting at the confluence of these three streams, in the performance of clinical research.

    Abstract


    Pain: survival, science and suffering
    10 March 2016 - 18:30-20:00

    Lecture: Emma Briggs, Florence Nightingale Faculty of Nursing and Midwifery, KCL
    Comment: Shawn Vigil, Philosophy, KCL

    K2.31, King’s Building, Strand, King’s College London

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    Abstract:

     

    Our understanding of the nature, mechanisms and meaning of pain has evolved significantly over the last century but its complexity still presents many clinical, ethical and philosophical challenges. Pain is widespread; a universal human experience and the most frequent reason people seek healthcare. Pain has a demonstrable impact on the individual, the family and health and social care systems. This presentation sets the scene for the discussion by exploring the impact and role of pain and the unpredictable relationship between the science and suffering.

    Abstract


    Mortality
    29 September 2016 - 16:30-18:00

    LectureDavid Galloway, KCL Philosophy

    Anatomy Lecture Theatre, Hodgkin Building, Guy’s Campus

    Abstract:

    Would it be a good thing for us if we were able to lengthen our lives indefinitely, in excellent physical health? Or would we all, even in the most favourable circumstances, choose eventually to die? If we would so choose, then our mortality is not in itself a bad thing, and immortality is not to be desired. I will discuss factors we might consider in making this choice.

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    Essay Contest
    Reading Group Video Recording


    Were you a part of your mother? The Metaphysics of Pregnancy
    13 October 2016 - 16:30-18:00

    LectureElselijn Kingma, Department of Philosophy, University of Southampton
    Comment: Dr. Shree Datta, Consultant Obstetrician and Gynecologist, King’s College Hospital

    New Hunt’s House, G.12, Guy’s Campus

    Abstract:

    What is the metaphysical relationship between the gestating organism and its embryo/fetus? I compare two views: (1) the fetal container model: the fetus is not part of but merely contained within or surrounded by the gestating organism; (2) the part-whole model: the fetus is part of its gestator. The fetal container model appears to be the received view. It is widely assumed but, I argue, without good argument; this model needs substantial support if it is to be taken seriously. The part-whole model is not presently defended, but I argue that it derives considerable support from a range of biological and physiological considerations. I conclude that the part-whole model has the upper hand and that, if true, this has important consequences for the metaphysics of persons and organisms and, perhaps, ethics and law.

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    Video Recording


    Delusional Reasoning
    27 October 2016 - 16:30-18:00

    LectureMatthew Parrott, KCL Philosophy

    King’s Building, K-1.56, Strand Campus

    Abstract:

    In psychiatric textbooks and diagnostic manuals delusions are typically characterized in terms of impaired reasoning or as manifestations of irrationality. Yet it remains unclear what precisely is irrational about delusional patterns of thinking. In this presentation, we will examine several styles of reasoning exhibited in cases of delusion, some of which, as we shall see, appear surprisingly rational. This suggests, I shall claim, that delusional cognition is far more nuanced than standard textbooks and manuals might lead us to believe.

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    Video Recording


    Surviving the Sirens: Should there be advance directives for people with bipolar?
    10 November 2016 - 17:00-18:30

    LectureTania Gergel, IoPPN
    Comment: Alex Ruck Keene, Barrister

    New Hunt’s House, Lecture Theatre 2, Guy’s Campus

    Abstract:

    Bipolar Affective Disorder is a cyclical condition, with periods of remission and periods of illness, which often involve loss of decision-making capacity and damaging behaviour. For people with Bipolar, a self-binding (advance) directive (SBD), which commits them to treatment during future episodes, even if unwilling, can seem the most rational solution for an imperfect predicament. Nevertheless, efforts to establish a provision for SBDs are hampered by valid, but also paralysing, ethical, clinical and legal concerns. Paradoxically, the rights of people with Bipolar are being ‘protected’ through being denied an opportunity to protect themselves. We will present and discuss a model of an SBD which could represent a legitimate and ethically coherent form of self-determination.

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    Video Recording


    What's wrong with pragmatic trials?
    26 January 2017 - 17:00-18:30

    LectureNancy Cartwright, University of Durham and University of California, San Diego (Work with Sarah Wieten)

    Video Recording

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    Abstract:

    In principle nothing is wrong with pragmatic trials: trials that ‘seek to determine the effectiveness of an intervention in a real-world setting to inform clinical decision making’ (Roland and Torgerson, 1998). In aid of this, pragmatic trials eliminate some of the exclusion conditions that are usual in what are labelled ‘ideal’ or ‘explanatory’ trials. The trouble comes with the concepts of ‘effectiveness’ and ‘external validity’. Positive results in well-conducted trials, whether ideal or pragmatic, show only that the treatment has worked for some members of the population enrolled in the trial. They cannot establish that it works in general nor what other factors help or hinder. Similarly, a pragmatic trial can establish that the treatment worked in the particular ‘real world’ setting – the one in which it was conducted, not that it works in ‘real world clinical practice’. Nor can they tell us what, if anything, is causally relevant in those settings. What can they do then? We shall argue that pragmatic trial results can be used in just the same way as ‘explanatory’ trial results: in tandem with a great deal of other evidence and theory, especial ‘midrange’ theory, to build credible local claims about how specific populations – or possibly even a specific individual – in specific places and circumstances may respond.
     


    Manic Temporality and Decision-Making: A Phenomenological Approach
    2 March 2017 - 17:00-18:30

    LectureWayne Martin, Department of Philosophy, University of Essex.

    Anatomy Lecture Theatre, Hodgkin Building, Guy’s Campus

    Abstract:

    The symptom scales and diagnostic criteria for mania are peppered with temporally inflected language: increased rate of speech, racing thoughts, flight of ideas, hyperactivity. But what is the underlying phenomenological structure of temporal experience in manic episodes? We identify a set of hypotheses about manic temporality formulated by two pioneers in 20th century clinical phenomenology: Eugène Minkowski (1885-1972) and Ludwig Binswanger (1881-1966). We then test, critique, and refine these hypothesis using methods of “second-person phenomenology” in an interview-based study of persons with a history of bipolar disorder and a current diagnosis of mania. We show that Minkowski and Binswanger were wrong to claim that persons experiencing acute mania are somehow trapped in the present moment. But we provide evidence that supports their hypothesis that disturbance in the formal structure of temporal experience is a core feature of mania. Developing a suggestion from Binswanger, we propose an interpretation of manic temporality as involving a distinctive form of protention. We identify consequences of this temporal disturbance for the assessment of decision-making capacity under conditions of mania.

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    Privacy, consent and health data: using identifiable health data for secondary purposes ethically, but without consent
    16 March 2017 - 17:00-18:30

    LectureJames Wilson, Department of Philosophy, UCL

    Anatomy Lecture Theatre, Hodgkin Building, Guy’s Campus

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    Abstract:

    A number legal regimes (e.g. England’s section 251 of the NHS Act 2006), have a mechanism that allows research involving identifiable health information to proceed without consent for a large population on grounds of the impracticability of gaining consent, even though the same research project would require the consent of all participants were the number of participants significantly smaller. This paper examines the cogency of the reasoning involved in such decisions, arguing that it seems difficult to justify on the assumption that in usual circumstances individuals have a right that their identifiable health information not be used without their consent. If using someone’s identifiable information without their consent would violate their rights if they were a member of a small group, why should it stop being a violation of that person’s rights if the group they are in becomes sufficiently large? I propose instead a new ethical justification for such use of health data, which I call the reasonable trespass account.