Bioethics and Medical Ethics Commons^™

Tuskegee Redux: Evolution Of Legal Mandates For Human Experimentation, Robert S. Levine, Jamila C. Williams, Barbara A. Kilbourne, Paul D. Juarez

Sociology Faculty Research

Human health experiments systematically expose people to conditions beyond the boundaries of medical evidence. Such experiments have included legal-medical collaboration, exemplified in the U.S. by the Public Health Service (PHS) Syphilis Study (Tuskegee). That medical experiment was legal, conforming to segregationist protocols and specific legislative authorization which excluded a selected group of African Americans from any medical protection from syphilis. Subsequent corrective action outlawed unethical medical experiments but did not address other forms of collaboration, including PHS submission to laws which may have placed African American women at increased risk from AIDS and breast cancer. Today, anti-lobbying law makes it …

The Moral Status Of Invasive Animal Research, Bernard E. Rollin

Experimentation Collection

No abstract provided.

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 …

Mid-Atlantic Ethics Committee Newsletter, Fall 2012

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Opinion: Bias Is Unavoidable, Lisa Cosgrove

Counseling, School Psychology & Sport 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).

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 …

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 …

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

LSU 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, …

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 …

The End Of Nowhere: The History Of Tuberculosis In Ri, Emma G. Sconyers

Senior Honors Projects

The World Health Organization estimates that approximately one third of the word's current population had been infected with tuberculosis. Prior to the 1940's TB was considered an incurable, chronic affliction. Historically, many people were forcibly detained in tuberculosis sanatoria to lessen the spread of the disease; my great granfather being one of them. In 1939, without warning, he was taken from his pregnant, jobless wife and one-year-old daughter, who were left to fend for themselves for two years without government planning or assistance. He spent those two years at Wallum Lake Sanitorium in northern Rhode Island, a place my great-grandmother's …

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

Internal Medicine

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 …

Hormonal Birth Control And Abortifacient Mechanisms, Catherine M. Powell

Senior Honors Theses

Recently, there has been a growing controversy, especially among evangelicals, over whether the birth control pill might have an abortifacient mechanism that sometimes causes early chemical abortions. An understanding of this controversy necessitates a clear definition of abortion, abortifacient, pregnancy, implantation, and especially personhood. If a zygote (fertilized egg) is not a person, then it has no fundamental rights and there is essentially no debate concerning the possible link between birth control pills and abortion. There is strong indirect evidence of post-fertilization, or abortive, effects of hormonal birth control. If zygotes are people, and birth …

Mid-Atlantic Ethics Committee Newsletter, Spring 2012

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The Use Of Biomarkers Of Toxicity For Integrating In Vitro Hazard Estimates Into Risk Assessment For Humans, Bas Blaauboer, Kim Boekelheide, Harvey Clewell, Mardas Daneshian, Milou M.L. Dingemans, Alan M. Goldberg, Marjoke Heneweer, Joanna Jaworska, Nynke I. Kramer, Marcel Leist, Hasso Seibert, Emanuela Testai, Rob J. Vandebriel, James D. Yager, Joanne Zurlo

in Vitro Research Models Collection

The role that in vitro systems can play in toxicological risk assessment is determined by the appropriateness of the chosen methods, with respect to the way in which in vitro data can be extrapolated to the in vivo situation. This report presents the results of a workshop aimed at better defining the use of in vitro-derived biomarkers of toxicity (BoT) and determining the place these data can have in human risk assessment. As a result, a conceptual framework is presented for the incorporation of in vitro-derived toxicity data into the risk assessment process. The selection of BoT takes into account …

A Mother's Worst Nightmare, What's Left Unsaid: The Lack Of Informed Consent In Obstetrical Practices, Andrew Iverson Almand

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.

Ada Code Of Ethics (April 2012), American Dental Association

Code of Ethics

The ADA Code of Ethics has three main components: The Principles of Ethics, the Code of Professional Conduct and the Advisory Opinions. Contents may also include: Amendment to ADA Principles of Ethics and Code of Professional Conduct and Insert for the ADA Principles of Ethics and Code of Professional Conduct. The most current issue is available on the ADA’s website.

Cosmetic Neurology: Enhancement Of The Mind And Attention Deficit Hyperactive Disorder Medication Abuse Among College Students, Mary M. Huff

Senior Honors Theses

Cosmetic neurology is becoming increasingly popular, and it is not just sleep deprived, over worked college students who are interested. People are beginning to seek off-label prescriptions for medications that are typically used to treat disorders such as attention deficit hyperactive disorder (ADHD) or narcolepsy, while researchers are trying to create drugs used solely for mind enhancement purposes. Along with these drugs come many legal and ethical quandaries relating to the regulation of current use as well as the what ifs of future possibilities. A survey was conducted among college students regarding the diagnosis of ADHD, the abuse of ADHD …

Sorry Buddy, But Your Name Isn't On The List: Fear And The Ethics Of Organ Donation In Film, Ted Callis

Annual Undergraduate Conference on Health and Society

The fear of death and illness is a powerful motivator. When taking into account the ethical reasoning that drives organ transplantation and procurement practices, it is persuasive enough to sway minds and corrupt pure reason. And so this paper will uncover how fear of illness and death shape answers to the ethical questions that arise in transplant debates and how these debates are in turn raised in the ethical dilemmas portrayed by popular American films. This paper will examine recent films such as The Island, and Never Let Me Go to illustrate how the ethical dilemmas associated with organ …

Sacrée Et Inviolable: The Hiv+ Mother In Ivoirian Health Policy, Amber Alaniz

Annual Undergraduate Conference on Health and Society

« La personne humaine est sacrée (2)… Le domicile est inviolable. Les atteintes ou restrictions ne peuvent y être apportées que par la loi. (4) La famille constitue la cellule de base de la société. L'État assure sa protection. (5)» Constitution of La Côte d’Ivoire, Articles 2,4,5[1]

The Ivoirian national constitution, authored and enacted in July of 2000, while expressing a devotion to democratic thought (Preamble) and to the sovereignty of the individual (Article 2), also acknowledges the primacy of the Ivoirian family and collective identity as the basis of society and advances a moral duty on the part …

Dialogues, Dilemmas, And Disclosures: Genomic Research And Incidental Findings, Lynn W. Bush, Karen H. Rothenberg

Faculty Scholarship

No abstract provided.

Alternative Approaches For Medical Countermeasures To Biological And Chemical Terrorism And Warfare, Thomas Hartung, Joanne Zurlo

Biomedical Research and Alternative Methods Collection

The desire to develop and evaluate drugs as potential countermeasures for biological and chemical threats requires test systems that can also substitute for the clinical trials normally crucial for drug development. Animal models have limited predictivity for drug efficacy, as is well known from many disappointments in clinical trials. Traditional in vitro and in silico approaches are not really game changers here, but the substantial investment into novel tools now underway might bring about a second generation of alternative approaches. The avenue pursued focuses primarily on the development of a Human on a Chip, i.e., the combination of different three-dimensional …

Knowledge, Wisdom, And Service: The Meaning And Teaching Of Professionalism In Medicine, Matthew K. Wynia

Center for the Study of Ethics in Society Papers

Papers presented for the Center for the Study of Ethics in Society Western Michigan University. Presented September 29, 2011.

Bias During The Evaluation Of Animal Studies, Andrew Knight

Morality and Ethics of Animal Experimentation Collection

My recent book entitled The Costs and Benefits of Animal Experiments seeks to answer a key question within animal ethics, namely: is animal experimentation ethically justifiable? Or, more precisely, is it justifiable within the utilitarian cost:benefit framework that fundamentally underpins most regulations governing animal experimentation? To answer this question I reviewed more than 500 scientific publications describing animal studies, animal welfare impacts, and alternative research, toxicity testing and educational methodologies. To minimise bias I focused primarily on large-scale systematic reviews that had examined the human clinical and toxicological utility of animal studies. Despite this, Dr. Susanne Prankel recently reviewed my …

Animal Models For Human Disease – Reflections From An Animal Researcher’S Perspective, Imke Tammen

Between the Species

Neuronal ceroid lipofuscinoses (NCL) are a group of lethal inherited neurodegenerative disorders in humans and many animal species. Critical reflections on a range of ethical issues concerning NCL have been instigated by my research on sheep and cattle affected with NCL, the claim that these sheep and cattle are useful models for the disease in humans, and engagement with families and support groups. My reflections on moral status of animals and validity of animal models are outlined in this paper.

Genes And Plays: Bringing Elsi Issues To Life, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Ethical complexities surround the promise of genomic technology and the power of genetic information as they alter conceptions of identity and dynamics within personal and professional relationships. Creative approaches such as dramatic vignettes offer a unique analytical stage for imagining the bioethical past and future. Dramatic narratives can bring to life images of differing perspectives and values when experiencing innovations in medicine. Although the scientific landscape shifts, concerns expressed in theatre from 50 years ago parallel many contemporary ELSI (ethical, legal and social implications) issues, highlighting the ongoing struggle to appreciate the impact of emerging genetic technologies on relationships. To …

Accelerating The Development Of 21st-Century Toxicology: Outcome Of A Human Toxicology Project Consortium Workshop, Martin L. Stephens, Craig Barrow, Melvin E. Andersen, Kim Boekelheide, Paul L. Carmichael, Michael P. Holsapple, Mark Lafranconi

in Vitro Research Models Collection

The U.S. National Research Council (NRC) report on “Toxicity Testing in the 21st century” calls for a fundamental shift in the way that chemicals are tested for human health effects and evaluated in risk assessments. The new approach would move toward in vitro methods, typically using human cells in a high-throughput context. The in vitro methods would be designed to detect significant perturbations to “toxicity pathways,” i.e., key biological pathways that, when sufficiently perturbed, lead to adverse health outcomes. To explore progress on the report’s implementation, the Human Toxicology Project Consortium hosted a workshop on 9–10 November 2010 in Washington, …

Update - February 2012, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Cancer Stories: An Argument for Narrative Ethics
-- Dual-Degree Masters of Arts in Bioethics
-- From the Director
-- Finding a Voice for Seventh-day Adventist Ethics in the Radical Reformation?

Legal Does Not Mean Rational: The Practicality Of Treating First-Trimester Abortion Clinics The Same As Hospitals, Ania O. Wlodek

William & Mary Journal of Race, Gender, and Social Justice

No abstract provided.