Bioethics and Medical Ethics Commons^™

Eight Is Enough?: The Ethics Of The California Octuplets Case, Scott Paeth

Scott R. Paeth

The recent California octuplets case raises a number of important issues that need to be addressed in the context of the increasingly widespread practice of in vitro fertilization. This paper explores some of those issues as looked at from the perspective of protestant theological ethics and public theology, examining the moral responsibilities of the various participants in the process, both before and after the octuplets’ birth, including the mother, her doctors, the health care bureaucracy, the wider society, and the media. Each of these participants failed in significant respects to consider the ethical implications of the births in this complicated …

The Ethics Of Abortion: Women's Rights, Human Life, And The Question Of Justice, Christopher Kaczor

Faculty Pub Night

No abstract provided.

What’S Right About The Medical Model In Human Subjects Research Regulation, Heidi Li Feldman

Georgetown Law Faculty Publications and Other Works

Critics of Institutional Review Board (IRB) practices often base their charges on the claim that IRB review began with and is premised upon a "medical model" of research, and hence a "medical model" of risk. Based on this claim, they charge that IRB review, especially in the social and behavioral sciences, has experienced "mission creep". This paper argues that this line of critique is fundamentally misguided. While it remains unclear what critics mean by "medical model", the point of contemporary human research subjects regulation remains the same across all domains of research. That point is to protect the autonomy of …

Antenatal Risk Factors, Cytokines And The Development Of Atopic Disease In Early Childhood, Esther Chung, Rachel Miller, Michael Wilson, Stephen Mcgeady, Jennifer Culhane

Esther K. Chung

Atopic diseases are complex entities influenced by an array of risk factors including genetic predisposition, environmental allergens, antenatal exposures, infections and psychosocial factors. One proposed mechanism by which these risk factors contribute to the development of atopic disease is through alterations in the production of T helper type 1 (Th1) and type 2 (Th2) cytokines. The objectives of this review are to discuss antenatal exposures that are associated with pediatric atopic diseases, to discuss the influence of the intrauterine environment on neonatal immune responses, to provide an overview of the Th1 and Th2 pathways and how they relate to atopic …

Kantian Ethics: A Support For Euthanasia With Extreme Dementia, Joshua Beckler

CedarEthics Online

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Fall 2012

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Marriage Without Procreation?: A Biblical Analysis, Mindy Vasser

CedarEthics Online

No abstract provided.

Why Most Biomedical Findings Echoed By Newspapers Turn Out To Be False: The Case Of Attention Deficit Hyperactivity Disorder, Francois Gonon, Jan-Pieter Konsman, David Cohen, Thomas Boraud

School of Social Work

Context: Because positive biomedical observations are more often published than those reporting no effect, initial observations are often refuted or attenuated by subsequent studies. Objective: To determine whether newspapers preferentially report on initial findings and whether they also report on subsequent studies. Methods: We focused on attention deficit hyperactivity disorder (ADHD). Using Factiva and PubMed databases, we identified 47 scientific publications on ADHD published in the 1990s and soon echoed by 347 newspapers articles. We selected the ten most echoed publications and collected all their relevant subsequent studies until 2011. We checked whether findings reported in each ‘‘top 10’’ publication …

Screening Mammograms In Alzheimer’S Disease Patients, George M. Yousef, Piyush Sovani, Sirisha Devabhaktuni, Lynne J. Goebel

Lynne J. Goebel

Very little guidance exists to help clinicians and families decide whether mammograms are useful in elderly women with Alzheimer’s Disease (AD). We present a case of a patient with moderate AD who had a positive mammogram and discuss the dilemma faced by the family and clinician in deciding what was best to do for the patient. In this case, the family opted for breast conserving surgery (BCS) followed by palliative care which brought up the question of whether screening was appropriate with this treatment goal in mind. We reviewed the literature on AD and breast cancer screening and summarize these …

Opinion: Bias Is Unavoidable, Lisa Cosgrove

Counseling and School Psychology Faculty Publication Series

It is part of the human condition to have implicit biases—and remain blissfully ignorant of them. Academic researchers, scientists, and clinicians are no exception; they are as marvelously flawed as everyone else. But it is not the cognitive bias that’s the problem. Rather, the denial that there is a problem is where the issues arise. Indeed, our capacity for self-deception was beautifully captured in the title of a recent book addressing researchers’ self-justificatory strategies, Mistakes Were Made (But Not by Me).

Exploring Pregnant Women’S Perceptions And Decision Making Of Household Chemicals: Phthalates As A Model, Justin M. Ashley

Electronic Thesis and Dissertation Repository

Recent research has identified a group of plasticizers known as phthalates as potential anti-androgens and a risk to developing male fetuses. A constructivist grounded theory study was used to understand pregnant women and obstetrical care providers’ perceptions of phthalates. Twenty-three pregnant women and twelve obstetrical care providers (Obstetricians, Family Physicians, and Midwives) from Southwestern Ontario participated in semi-structured interviews. Pregnant women and clinicians had little knowledge regarding phthalates and the potential associated risks. Women felt that knowledge of these risks would be important to prenatal counselling while clinicians required more evidence. Two separate but related models emerged from the data …

Ethical Challenges Of Preexposure Prophylaxis For Hiv, Jonathan S. Jay, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

On July 16, 2012, emtricitabine/tenofovir (Truvada) became the first drug approved by the US Food and Drug Administration for preexposure prophylaxis (PrEP) of human immunodeficiency virus (HIV) for adults at high risk. While PrEP appears highly effective with consistent adherence, effective implementation poses ethical challenges for the medical and public health community. For PrEP users, it is necessary to maintain adherence, safe sex practices, and routine HIV testing and medical monitoring, to maximize benefits and reduce risks. On a population level, comparative cost-effectiveness should guide priority-setting, while safety measures must address drug resistance concerns without burdening patients' access. Equitable distribution …

What Is The Role And Authority Of Gatekeepers In Cluster Randomized Trials In Health Research?, Antonio Gallo, Charles Weijer, Angela White, Jeremy Grimshaw, Robert Boruch, Jamie Brehaut, Allan Donner, Martin Eccles, Andrew Mcrae, Raphael Saginur, Merrick Zwarenstein, Monica Taljaard

Charles Weijer

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the CRT is to be set on a firm ethical foundation. This paper addresses the sixth of the questions posed, namely, what is the role and authority of gatekeepers in CRTs in health research? ‘Gatekeepers’ are individuals or bodies that represent the interests of cluster members, clusters, or organizations. The need for gatekeepers arose in response to the difficulties in obtaining …

The Ethics Of Vaginal Birth After Cesarean, Sonya Charles

Philosophy and Religious Studies Department Faculty Publications

The decline in providers and facilities that will allow a trial of labor after cesarean forces many women to choose a repeat cesarean. The choice is frequently not much of a choice, however, since the full range of options are often not on the table. This limited 'choice' violates obstetricians' obligations both to respect patients' autonomy and to offer them good care. There has been a vigorous but so far not very fruitful debate in the last few years about the lack of access to a trial of labor after cesarean. Some recently released documents express concern about the limited …

Book Review: Pathological Altruism, Katrina Bramstedt

Katrina A. Bramstedt

In my work as a transplant ethicist I have always been interested in the topic of altruism. Thus, when a book appeared with the title, Pathological Altruism, I was very intrigued to read it. An exceedingly heavy book, however, arrived in my mailbox, and I admit I was taken aback. But upon reading Pathological Altruism, edited by Barbara Oakley, Ariel Knafo, GuruprasadMadhavan, and David SloanWilson, I was not disappointed. In fact, chapter 1 baited me with the line, “Altruism can be the back door to hell.”

Art Review: Edo-Kingyo's Coolness And The Night Aquarium Museum Lounge, Katrina Bramstedt

Katrina A. Bramstedt

Extract:As with circuses, aquariums have been the subject of concern for animal welfare experts (Tilikum, Katina, Corky, Kasatka, and Ulises v. SeaWorld 2011): Is captivity the best place for these animals? Are these settings merely entertainment venues? If they provide an educational experience for viewers, does the learning experience outweigh the risks to the animals? Could the education be gained by other modes? What are the elements of animal welfare in the setting of an aquarium? After viewing the Edo—Kingyo’s Coolness Tokyo art exhibit online using the creator’s YouTube video (Kimura 2011), the importance of all of these questions becomes …

Under The Gun: Ongoing Assaults On Bahrain’S Health System, Richard Sollom, Holly G. Atkinson

Publications and Research

In February 2011, the Government of Bahrain began targeting health professionals who treated protesters. In April 2012, PHR's Richard Sollom, Deputy Director, and Holly Atkinson, MD, FACP, past President of PHR's Board and volunteer expert, authored a report showing the devastation on Bahrain's health system that have resulted from the Government of Bahrain’s continued assault on doctors, patients, and the healthcare system.

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

University of New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

Medical Oxymoron Or Necessary Prevention Of Repeat Sex Offenses: An Examination Of The Appropriateness Of Existing Chemical Castration Statutes, Robert Watters

Robert Watters

The current chemical castration statutes in six states are full of logical constitutional, medical and ethical questions and concerns. The basis for the criticism can be traced to how the schemes were developed compared to the those used in Europe. The castration statutes enacted after long trial and error periods are, therefore, easily discernible from those signed into law quickly as a reaction to some outside event.

Book Review: Dream Of Ding Village By Yan Lianke, Mike Frick

China Beat Blog: Archive 2008-2012

Unsurprisingly, the Chinese government levied a “three nos” ban—no sales, no distribution, and no promotion—against Dream of Ding Village after its publication in 2005. Though the storytelling relies heavily on dream sequences, Yan takes little poetic license when exposing the depth of the state’s culpability in spreading HIV among poor, medically-naïve farmers. He is just as uncompromising when detailing how officials denied responsibility for the ensuing AIDS epidemic, even as they profited from its human tragedy. No one in Ding Village receives medical care, mental health counseling, food assistance, or a chance to hold the blood heads legally accountable. Cast …