Week 6:

To what extent might freedom increase if people turned off their

mobile phones and computer screen?
FREEDOM:

∙ Forced to find other leisure activities other than anything related to screen. They would go
outside in nature and visit their country or try sports and stay healthy or make new friends.
∙ Time to introspect and to practice mindfulness away from constant notifications from social
media
∙ Employers would not be able to disturb their employees during holidays or days-off. Hence
more family time and relaxation time. Not bound 24/7 by their work.
∙ Health benefits (reduces stress and anxiety, insomnia, inactivity and vision troubles)

NOT FREEDOM:

∙ Limited access to freedom of expression- to organize marches, using dark humour to highlight
social problems
∙ Educational purposes- inconvenience for the educational sector especially during the pandemic.
How would classes be organized? Access to educational material would have been limited. No
online courses as well.
∙ Restricted access to information both locally and worldwide. People won’t get updated
information about events happening in the world. In Mauritius only MBC- how far is the
information provided unbiased?
∙ Defies the concept of global village- no longer connected. Feeling of loneliness- no longer
instantly connected to family and relatives who are abroad
∙ No accessibility to e-commerce- online shopping or online grocery shopping

Week 7: Film adaptations of books are rarely as successful as the

writing. To what extent do you agree?
INTRODUCTION

∙ Adaptation of one form to another (called Remediation) requires changes to be made to the
original.
∙ Success may be measured in more than one way; financial, popularity, artistic as well as historic
influence, personal immersion.

BOOKS MORE SUCCESSFUL

 ∙ Books allow for more content, attracting attention to character thoughts and describing things
in a poetic way movies cannot.
∙ Books require many sittings, thus prolonging the experience of escape to weeks, rather than the
shorter escapes made possible by movies.
∙ Books is the original telling of the author, in the way the author intended to say it. Movies are
known to warp the vision of the author, in minor or major ways.
∙ Books appeal to the imagination of the reader, providing personal experiences for each reader,
being open to interpretation from person to person.

MOVIES MORE SUCCESSFUL

∙ Movies reach more audience in general, thus being more successful, financially. Also, film
adaptations tend to pick up already famous literary franchises, thus being even more successful.
∙ Movies are easier to digest, thus getting across the gist of the writing to people who would
otherwise note be interested in reading the book.
∙ Movies appeal to the audio-visual senses, enhancing immersion in the story, while also
remaining memorable for a longer amount of time.
∙ Movies are an easier escape since they give one set image to the story otherwise left to the
imagination in books.

EXAMPLES:

∙ Harry Potter franchise, Charlie and the Chocolate Factory, Dune, Hunger Game series, Anne with
an ‘E’, Lord of the Rings

Week 8: Evaluate the effectiveness of rehabilitation in the justice

system of your country.

EFFECTIVENESS OF REHABILITATION IN THE JUSTICE SYSTEM:

∙ Norway has consistently ranked number one on a number of lists entailing the best, most
comfortable prisons in the world. Norway has a recidivism rate of about 20% only.
∙ In an effort to offer better rehabilitative services to the inmates, many prisons have begun
providing psychiatrists to help deal with prisoners’ mental disorders and psychological issues.
Prisons also offer classroom settings in which inmates can learn to read and educate themselves.
These methods are proven to have a positive effect on the prisoners and have helped many to
overcome a background with little or no education. Upon their release, prisoners who have
stuck with these programs are given a better opportunity to succeed and to become law abiding
citizens.
∙ Rehabilitation takes place both inside prison, and in some cases, once an offender has been
released, on Resettlement Programmes. Help continues to be provided in these circumstances
 by the Probation Service and other agencies, either as a condition of their early release, or to
ease the transition into the community
∙ "Psychology as a discipline now has a tremendous amount of information about the origins of
criminal behavior,". Prisoners were encouraged to develop occupational skills and to resolve
psychological problems--such as substance abuse or aggression--that might interfere with their
reintegration into society.
∙ Juvenile rehabilitation is not designed to punish. It should be remembered that both mental and
substance rehabilitation often involve people staying in facilities. Juvenile rehabilitation
methods can greatly vary. Many methods are devised more to deter future delinquency and
provide strong guidance than to serve as outright punishment. Non-violent youth may, for
example, be housed in group homes. Those youth who have committed serious or violent crimes
may be sent to youth prisons. There are also boot camps which use military-style training
techniques to help rehabilitate youth. Those children who are more menacing than criminal may
be enrolled in after-school programs that are held in detention facilities.
∙ The children are often involved in skill-building programs. They may be given an opportunity to
earn educational diplomas. Also, they often receive personalized and intensive counseling.
Minors who have gone through boot-camp-style programs, for example, are believed to be less
likely to commit crimes in the future.

INEFFECTIVENESS OF REHABILITATION IN THE JUSTICE SYSTEM:

∙ The obstacles to successful re-integration are numerous, such as the challenge of finding stable
employment, stigma, prejudice. The stigma of imprisonment, and long absences from work on
CVs, has a tendency to put employers off hiring former prisoners – exacerbating social exclusion,
and increasing the risk of a return to crime.
∙ Rates of criminal recidivism around the world are reported to be as high as 50% and have not
declined in recent years. E.g Chile 50 % United States 55%
∙ According to Defimedia 69% of those offenders currently serving jail time in Mauritius have
been imprisoned in the past.
∙ Research has consistently shown that time spent in prison does not successfully rehabilitate
most inmates, and the majority of criminals return to a life of crime almost immediately. Many
argue that most prisoners will actually learn new and better ways to commit crimes while they
are locked up with their fellow convicts. They can also make connections and become more
deeply involved in the criminal world.
∙ The success that prisons achieve is hampered further by many prisoners lacking basic skills or
suffering from social and psychological problems. Thousands of prisoners are released every
year without anywhere to live, worsening problems of homelessness. Almost three-quarters of
those in prison have mental health problems and almost two-thirds have drug problems.
∙ It is also believed that putting minors who commit lower-scale offenses, such as truancy, with
those who have committed harsh crimes, such as rape, can have detrimental effects.
 ∙ A 2015 CSG Justice Center report investigated data from 39 states that track recidivism. It found
juveniles far more likely than adults to commit another offense after release from jail.
∙ The highest juvenile recidivism rates were 76% within three years and 84% within five years. A
study by Joseph Doyle, a researcher at the Massachusetts Institute for Technology, found that
40% of juvenile offenders ended up in adult prison for crimes committed by the time they
reached the age of 25. The study involved data from 30,000 juvenile offenders in Illinois.
∙ A study found that when kids went into juvenile detention, they were very unlikely to return to
high school at all. Basically, none of them are graduating high school

Week 9: Some developments in medicine appear to ignore ethical

issues. To what extent do you agree?

ETHICAL

∙ The four principles of Beauchamp and Childress – The four fundamental principles of ethics
which are being underscored are autonomy, non-maleficence, beneficence, and justice. Respect
for autonomy stands for acting intentionally after being given sufficient information and time to
understand the information. Beneficence is directed to promote the well-being of patients and
society. On the other hand, non-maleficence implies first do no harm which can be achieved by
careful decision making and having adequate training. Justice deals with the equitable
distribution of social benefits.
∙ Research involving human subjects includes: Studies of a physiological, biochemical, or
pathological process, or of the response to a specific intervention – whether physical, chemical,
or psychological – in healthy subjects or patients; Controlled trials of diagnostic, preventive, or
therapeutic measures in larger groups of persons, designed to demonstrate a specific
generalizable response to these measures against a background of individual biological
variation; Studies designed to determine the consequences for individuals and communities of
specific preventive or therapeutic measures; and Studies concerning human health-related
behaviour in a variety of circumstances and environments

PRINCIPLES OF ETHICS IN MEDICAL RESEARCH

∙ Principles of essentiality – Refers to whether the research is considered to be absolutely

essential after a due consideration of the existing scientific knowledge in the proposed area of
research. This should be scrutinized by an independent and responsible body of persons who,
after careful consideration, come to the conclusion that the research is likely to benefit the
humanity or environment.
∙ Principles of voluntariness, informed consent, and community agreement – Research
participants should be fully apprised of the research and the associated risks and benefits. The
participants should be informed of the right to abstain from the research or withdraw consent
at any time. Where research entails treating any community, the principles of voluntariness and
informed consent apply to the community as a whole and to each individual member. In case a
person is incapable of giving consent, a legally acceptable guardian should give the informed
consent.
∙ Principles of non-exploitation – The participants should be fully apprised of all the possible
dangers that may arise during the research so that they can appreciate all the physical and
psychological risks. Each research should include an in-built mechanism for compensation for
the human participants either through insurance cover or by any other appropriate means to
cover foreseeable and unforeseeable risks, and provide remedial action and comprehensive
aftercare.
∙ Principles of privacy and confidentiality – The identity and records of the participants are as far
as possible kept confidential (except when required for legal reasons). This is to avoid any form
of hardship, discrimination or stigmatization as a consequence of having participated in the
research.
∙ Principles of precaution and risk minimization – Due care and caution should be taken at all
stages of the research and experiment to ensure that the research participant and those
affected by it including the community are put to the minimum risk, suffer from no known
irreversible adverse effects, and generally, benefit from the research or experiment. There
should be a plan for interim reviews to detect whether any intervention arm (active or control)
is associated with increased risks, so that undue harms are avoided by stopping the research.
∙ Principles of professional competence – Research should be conducted by competent and
qualified persons who act with total integrity and impartiality and who have been made aware
of the ethical considerations to be borne in mind in respect of such research or experiment.
∙ Principles of accountability and transparency – The research or experiment should be conducted
in a fair, honest, impartial, and transparent manner after full disclosure is made by those
associated with the research or experiment of each aspect of their interest in the research, and
any conflict of interest that may exist. Full and complete records of the research should be
retained for such reasonable period as may be prescribed or considered necessary for the
purposes of post-research monitoring, evaluation of the research, conducting further research,
and scrutiny by the appropriate legal and administrative authority, if necessary.
∙ Principles of the maximization of the public interest and of distributive justice – The research or
experiment and its subsequent application should be conducted and used to benefit all human
kind (and not just those who are socially better off), in particular, the research participants
themselves and or the community from which they are drawn.
∙ Principles of public domain – The research findings should be brought into the public domain so
that its results are generally made known through scientific and other publications. This would
help in consolidating the scientific knowledge base of the field being studied and would prevent
the undue replication of studies which pose risks to some subjects.
∙ Principles of totality of responsibility – Professional and moral responsibility should be observed,
for the due observance of all the principles, guidelines, or prescriptions of those directly or
indirectly connected with the medical research. This extends to the institutes where this
research is carried out, as well as the sponsors of the research. The research should be duly
monitored and constantly subject to review and remedial action at all stages.
∙ The necessity for the teaching of clinical ethics rests in the fact that any serious decision making
involves 2 components—a technical decision requiring the application of knowledge of basic and
clinical sciences to the patient's present problems, and a moral component demanding that the
technically correct decision is also morally defensible. The technical component tells us what can
be done, the moral component, what ought to be done for the patient.
 ∙ Informed consent has 4 key components: disclosure, competency, comprehension, and
voluntaries. -Disclosure means the physician tells the patient about the diagnosis, prognosis,
risks, and benefits associated with possible treatment options. Patients are entitled to enough
information to enable them to ask reasonable questions about their options. Competency
means that the patient is able to understand relevant information, appreciate his or her needs
and values, use information rationally, and make treatment choices. Comprehension refers to
the requirement that patients understand the information that is given to them and that
physicians make a reasonable effort to enable them to do so. Voluntaries means that the patient
chooses freely without coercion.
∙ Taking Advantage of Big Data Without Dehumanizing Patients. Digital pills, also known as smart
pills, are pharmaceuticals that contain an ingestible sensor that transmits data after the pill is
consumed. The first digital pill to be approved in the United States was a form of the
antipsychotic medication aripiprazole (sold under the trade name Abilify) in 2017. A digital
sensor in the pills is activated by the patient’s stomach acid and generates an electrical signal
that’s picked up by a patch on the rib cage and then transmitted to a smartphone app. The
technology offers a promising benefit for treating patients who struggle with medication
adherence.
∙ Implementing Artificial Intelligence and Robotics Ethically.-The growing use of AI and robotics
also raises issues of healthcare technology ethics. AI refers to the ability of computers to mimic
human intelligence and learning. Potential medical applications include analysis of radiologic
images. AI used for health-related predictive analysis relies on large, diverse datasets, including
EHRs. The Genetic Information Nondiscrimination Act of 2008 prohibits employers and health
insurers from considering genetic information when making decisions such as hiring and firing or
health insurance eligibility. However, the law doesn’t apply to nongenetic predictive data.
Robotics are already heavily used in healthcare; robot-assisted surgeries are now commonplace,
and robotic prosthetics are advancing rapidly

UNETHICAL

∙ Conflicts of interest are inherent to the majority of relationships among individuals and of those
with companies and institutions and, certainly, research involving human beings is no exception.
In relation to clinical research, conflicts of interest occur at different levels and usually permeate
through various lines (e.g., in the pharmaceutical industry, about their decisions to invest and
develop new products, especially vaccines and drugs, and also in relation to marketing of these
products). Among the investigators, the conflicts may be related to the financial gains to
participate in pharmacy sponsored trials, or to the expected academic career boost attained
with the publication of the results of the trials and also to personal interests such as the financial
support for trips to international conferences.
∙ Issues in relation to confidentiality- Patients, health-care providers, and patient advocacy
organizations have expressed increasing concern about the confidentiality of clinical information
stored in large computerized databases. The accumulation of ever-larger stockpiles of sensitive
information raises reasonable concerns about inappropriate access and unauthorized disclosure.
Given the stigma often attached to psychiatric disorders and psychiatric treatment,
confidentiality of information on mental health and substance abuse treatment is especially
 critical. A few occurrences of inappropriate use or disclosure of clinical information have been
well publicized.
∙ Conflicts between Principles - Consider an example of a conflict that has an easy resolution: a
patient in shock treated with urgent fluid-resuscitation and the placement of an indwelling
intravenous catheter caused pain and swelling. Here the principle of beneficence overrides that
of nonmaleficence. Many of the conflicts that physicians face, however, are much more complex
and difficult. Consider a competent patient’s refusal of a potentially life-saving intervention (e.g.,
instituting mechanical ventilation) or request for a potentially life-ending action (e.g.,
withdrawing mechanical ventilation). Nowhere in the arena of ethical decision-making is conflict
as pronounced as when the principles of beneficence and autonomy collide.
∙ Example of conflicts between principles- Case 1. A 20-year old college student living in the
college hostel is brought by a friend to the Emergency Department (ED) because of unrelenting
headache and fever. He appeared drowsy but was responsive and had fever (40°C), and neck
rigidity on examination. Lumbar puncture was done, and spinal fluid appeared cloudy and
showed increased white cells; Gram stain showed Gram-positive diplococci. Based on the
diagnosis of bacterial meningitis, appropriate antibiotics were begun, and hospitalization was
instituted. Although initial consent for diagnosis was implicit, and consent for lumbar puncture
was explicit, at this point, the patient refuses treatment without giving any reason, and insists to
return to his hostel. Even after explanation by the physician as to the seriousness of his
diagnosis, and the absolute need for prompt treatment (i.e., danger to life without treatment),
the patient is adamant in his refusal.
∙ Comment. Because of this refusal, the medical indications and patient preferences (see Table 2)
are at odds. Is it ethically right to treat against his will a patient who is making a choice that has
dire consequences (disability, death) who gives no reason for this decision, and in whom a clear
determination of mental incapacity cannot be made (although altered mental status may be
presumed)? Here the principle of beneficence and principle of autonomy are in conflict. The
weighing of factors: (1) patient may not be making a reasoned decision in his best interest
because of temporary mental incapacity; and (2) the severity of life-threatening illness and the
urgency to treat to save his life supports the decision in favor of beneficence (i.e., to treat).
∙ Betancourt v. Trinitas Hospital is a New Jersey legal case concerning whether a hospital may
unilaterally refuse care to a patient on the grounds that it is futile to prolong the person's life
because there is little chance that the condition will improve. It has become the focal point of
the ongoing debate surrounding denial of care among professional bioethicists
∙ Greenberg v. Miami Children's Hospital Research Institute, 264 F. Supp. 2d 1064 (S.D. Fla. 2003),
was a decision by the United States District Court for the Southern District of Florida which ruled
that individuals do not own their tissue samples when researchers take them for testing.
∙ The Oncologist Who Injected Cancer Cells Into Patients and Prisoners.-During the 1950s and
1960s, Sloan-Kettering Institute oncologist Chester Southam conducted research to learn how
people’s immune systems would react when exposed to cancer cells. In order to find out, he
injected live HeLa cancer cells into patients, generally without their permission. When patient
consent was given, details around the true nature of the experiment were often kept secret.
Southam first experimented on terminally ill cancer patients, to whom he had easy access. The
result of the injection was the growth of cancerous nodules, which led to metastasis in one
person.
 ∙ Animal testing- Experimenting on animals is always unacceptable because:
1. it causes suffering to animals
2. the benefits to human beings are not proven
3. any benefits to human beings that animal testing does provide could be produced in
other ways
∙ Animals are subjected to tests that are often painful or cause permanent damage or death, and
they are never given the option of not participating in the experiment. Regan further says, for
example, that "animal [experimentation] is morally wrong no matter how much humans may
benefit because the animal's basic right has been infringed. The pain and suffering that
experimental animals are subject to is not worth any possible benefits to humans. "The
American Veterinary Medial Association defines animal pain as an unpleasant sensory and
emotional experience perceived as arising from a specific region of the body and associated with
actual or potential tissue damage" (Orlans 129). Animals feel pain in many of the same ways that
humans do; in fact, their reactions to pain are virtually identical (both humans and animals
scream, for example). When animals are used for product toxicity testing or laboratory research,
they are subjected to painful and frequently deadly experiments. Two of the most commonly
used toxicity tests are the Draize test and the LD50 test, both of which are infamous for the
intense pain and suffering they inflect upon experimental animals.

Week 10: The struggle for equal rights can never be won. Discuss.

INTRODUCTION

∙ Different classes- right to education and basic facilities becoming the norm (often impacted by
poverty);
∙ Gender- restriction to drive (using gender as a mode of oppression), pay gap, societal gender
roles, specific gender-based jobs, breadwinner vs homemaker category;
∙ Immigrants- access to basic amenities, facilities, education;
∙ People with power and commoners. Impunity, freedom of expression;
∙ Minorities such as LGBTQIA+ - Right to be recognized right to love and live freely, to get married,
adopt or have children, to get jobs irrespective of their gender;
∙ Equity vs equality. Giving each one what they need instead of giving everyone the same thing

CAN BE WON

∙ A change in mentalities is being ushered in – people are more and more in tune with the idea of
equality;
∙ Legislation around the world is being amended to give more representation to the minorities;
∙ Political correctness is valued more and more, while any form of discrimination is publicly
shamed on social platforms, if not punished in court;
CANNOT BE WON

∙ The term ‘equal’ is very subjective, from culture to culture

∙ Any form of hierarchical organization
∙ Generational Indoctrination of specific gender roles changes, but does not die out
∙ People and communities have different beliefs, opinions, and ideas of what is right and wrong –
xenophobia is ingrained in the human psyche
∙ Religious puritans use holy books to push forward their point
∙ Poverty makes it hard for people to make ends meet, or to buy stationeries for school or to pay
for education or basic facilities. Compensation or fiscal facilities given to them is insufficient as
well
∙ Economic divide has been increasing over the years.

WHAT CAN BE DONE

∙ Healthy Conversation and communication between generations;

∙ Enforce laws that provide equal opportunities to minorities, as well as legislation that punishes
any form of discrimination
∙ Promote peace and tolerance among people of different countries, tribes and communities
∙ Social media to address social taboos
∙ Sensibilisation campaign
∙ Amend the laws