Dr Alexis Paton is a medical ethicist and sociologist. Her work examines areas of ethical concern in medicine, with a focus on health inequality, patient safety, decision-making in medicine, and healthcare improvement. She is an expert in medical ethics, medical sociology and social epidemiology. She does practical research designed to improve health policy and practice.
She has expertise in and can speak to several topics within these disciplines including:
• COVID-19 ethics
• Pandemic public health
• The impact of COVID-19 on BAME groups
• Health inequalities
• The social determinants of health and illness
• Patient autonomy
• Maternity safety
• Neonatal care
• Fertility preservation
• Medical ethics education.
She is currently the Chair of the Committee on Ethical Issues in Medicine for the Royal College of Physicians and a Trustee of the Institute of Medical Ethics. She writes a regular column for the Independent, and all her pieces can be viewed at: https://www.independent.co.uk/author/alexis-paton
Areas of Expertise (8)
Sociology of Health
Newcastle University: PhD, Sociology 2015
University of British Columbia: MA, Philosophy 2010
University of King’s College: BSc, Biology 2007
- Royal College of Physicians : Chair of the Committee on Ethical Issues in Medicine
- Institute of Medical Ethics : Trustee
Media Appearances (5)
After Matt Hancock’s snap decision to axe Public Health England, this is everything we could lose
The Independent online
In the UK, we have had a tradition of public health that has almost nothing to do with pandemics and everything to do with improving the wellbeing of the whole nation for the long term. We can’t afford to lose that now.
I’m worried about Boris Johnson’s plan to tackle obesity – the government cannot abandon its responsibility to the public
The Independent online
If you get sick from coronavirus in Britain, it is your fault. Or that is at least the message the government is giving. To add insult to injury, if you’re obese, that is also your fault. So a double whammy that will leave you with an increased likelihood of a poor Covid-19 outcome too.
The government can’t just follow the science – we need ethics to guide us out of lockdown
The Independent online
Signage has been of particular importance throughout the pandemic. Like exit signs on the motorway, the mantra “stay home – protect the NHS – save lives” was a clear and consistent message that by following this path, the UK would find itself more or less in one piece after lockdown.
Coronavirus: exposing class divides
The Week online
Writing in The Independent, Alexis Paton and Agomoni Ganguli-Mitra say “many of the measures being taken to stymie the pandemic will intensify existing health inequalities”.
We’ve just witnessed the last avoidable NHS scandal – the ones that will follow are now simply inevitable
The Independent online
In the last three months the NHS has seen a number of safety scandals break – and more are certainly in the wings, waiting to be uncovered. It is easy to think, and who can blame the British public if they do, that the NHS has stopped caring. That these new and historical cases of neglect, poor care, indifferent attitudes and lapses in patient safety are due to an incompetent system, employing uncaring staff.
Research Focus (1)
Sociological theory and Qualitative research methods
Improving healthcare services
Dr Alexis Paton's research focuses on how sociological theory and qualitative research methods can be combined with bioethical frameworks to improve healthcare services. She is particularly interested in how decision-making occurs in practice in the NHS. Using this sociological bioethics lens, her research identifies where existing policies and guidelines on decision-making require re-evaluating to facilitate improved support for patients and staff making healthcare decisions. By examining decision-making empirically, using qualitative methods, Alexis' research also explores the important role of the social sciences in the development of bioethical theories that are used in everyday medical practice.
Ethical road map through the covid-19 pandemicBMJ
Zoe Fritz, Richard Huxtable, Jonathan Ives, Alexis Paton, Anne Marie Slowther, Dominic Wilkinson
The covid-19 pandemic has created profound ethical challenges in health and social care, not only for current decisions about individuals but also for longer term and population level policy decisions. Already covid-19 has generated ethical questions about the prioritisation of treatment, protective equipment, and testing; the impact of covid-19 strategies on patients with other health conditions; the approaches taken to advance care planning and resuscitation decisions1; and the crisis in care homes.
The fundamental role of storytelling and practical wisdom in facilitating the ethics education of junior doctorsHealth
Alexis Paton, Ben Kotzee
Practical wisdom is a key concept in the field of virtue ethics, and it has played a significant role in the thinking of those who make use of virtue when theorising medical practice and ethics. In this article, we examine how storytelling and practical wisdom play integral roles in the medical ethics education of junior doctors. Using a qualitative approach, we conducted 46 interviews with a cohort of junior doctors to explore the role doctors feel phronesis has in their medical ethics practice and how they acquire practical wisdom through storytelling as an essential part of their medical ethics education. Through thematic analysis of the interviews, we discuss the key role storytelling about moral exemplars and role models plays in developing medical ethics education, and how telling stories about role models is considered to be one of the most useful ways to learn medical ethics. We finish by developing an argument for why practical wisdom should be an important part of medical ethics training, focusing on the important role that phronesis narratives should have in teaching medical ethics.
Optimising neonatal service provision for preterm babies born between 27 and 31 weeks gestation in England (OPTI-PREM), using national data, qualitative research and economic analysisBMJ open
Thillagavathie Pillay, Neena Modi, Oliver Rivero-Arias, Brad Manktelow, Sarah E Seaton, Natalie Armstrong, Elizabeth S Draper, Kelvin Dawson, Alexis Paton, Abdul Qader Tahir Ismail, Miaoqing Yang, Elaine M Boyle
Introduction In England, for babies born at 23–26 weeks gestation, care in a neonatal intensive care unit (NICU) as opposed to a local neonatal unit (LNU) improves survival to discharge. This evidence is shaping neonatal health services. In contrast, there is no evidence to guide location of care for the next most vulnerable group (born at 27–31 weeks gestation) whose care is currently spread between 45 NICU and 84 LNU in England. This group represents 12% of preterm births in England and over onr-third of all neonatal unit care days. Compared with those born at 23–26 weeks gestation, they account for four times more admissions and twice as many National Health Service bed days/year.
“Being Guided”: What Oncofertility Patients’ Decisions Can Teach Us about the Efficacy of Autonomy, Agency, and Decision- Making Theory in the Contemporary Clinical EncounterIJFAB: International Journal of Feminist Approaches to Bioethics
Recent research on patient decision-making reveals a disconnect between theories of autonomy, agency, and decision-making and their practice in contemporary clinical encounters. This study examines these concepts in the context of female patients making oncofertility decisions in the United Kingdom in light of the phenomenon of “being guided.” Patients experience being guided as a way to cope with, understand, and defer difficult treatment decisions. Previous discussions condemn guided decision-making, but this research suggests that patients make an informed, autonomous decision to be guided by doctors. Thus, bioethicists must consider the multifaceted ways that patients enact their autonomy in medical encounters.
About time: how time infuences and facilitates patient autonomy in the clinical encounterMonash Bioethics Review
In this article I discuss the little examined relationship between time and patient autonomy. Using the fndings from a study on the experience of premenopausal cancer patients making fertility preservation decisions during their treatment, I focus on how the patients in the study understood time, and how this understanding interacted with and infuenced their decision-making. I then analyse in more depth the importance of time in patient decision-making, and the relationship of time to concepts of patient autonomy and decision-making in the feld of bioethics more generally. Focusing on the relational conception of autonomy, I conclude that time is an integral part of patient autonomy which warrants further research, such that it can be better integrated into concepts of patient autonomy, and the policy and guidelines that they inform and infuence