Bioethics and Medical Ethics Commons^™

A Review Of “An Ethical Market In Human Organs,” By Charles A. Erin And John Harris, And A Proposed Solution To The Current Organ Shortage, Rachel Rattenni Fcrh '14

The Fordham Undergraduate Research Journal

In 2005, an Israeli man named Nick Rosen answered an ad in his local Tel Aviv newspaper searching for someone interested in selling a kidney. Through funding from the broker who placed the ad, Rosen was flown to New York and set up with a dialysis patient from Brooklyn. After Rosen and the dialysis patient passed a simple procedure for the screening of illegal organ sales by saying the two were old friends, the successful transplant surgery was performed at the esteemed Mount Sinai Medical Center in New York. The Brooklyn resident walked away never again needing to go on …

Genetic Sex Conditions And Redefining Sex, Jayce O'Shields

Student Scholarship

Western culture has a tendency to value binaries and discreet categories that separate its social structure and provide a sense of order and organization. The value placed on binaries and categories may be advantageous in some aspects, but when it starts to infringe upon the legal and medical rights of individuals not easily placed in either binary category, it can become less advantageous.

A baby is usually classified as either male or female shortly after birth, and all future legal, social, and economic actions and rights of that individual are more or less decided according to this classification. A problem …

Incorporating New Technologies Into Toxicity Testing And Risk Assessment: Moving From 21st Century Vision To A Data-Driven Framework, Russell S. Thomas, Martin A. Philbert, Scott Auerbach, Barbara A. Wetmore, Michael J. Devito, Ila Cote, J. Craig Rowlands, Maurice Whelan, Sean M. Hays, Melvin E. Andersen, M.E. (Bette) Meek, Lawrence W. Reiter, Jason C. Lambert, Harvey J. Clewell Iii, Martin L. Stephens, Q. Jay Zhao, Scott C. Wesselkamper, Lynn Flowers, Edward W. Carney, Tim P. Pastoor, Dan D. Petersen, Carole L. Yauk, Andy Nong

in Vitro Research Models Collection

Based on existing data and previous work, a series of studies is proposed as a basis toward a pragmatic early step in transforming toxicity testing. These studies were assembled into a data-driven framework that invokes successive tiers of testing with margin of exposure (MOE) as the primary metric. The first tier of the framework integrates data from high-throughput in vitro assays, in vitro-to-in vivo extrapolation (IVIVE) pharmacokinetic modeling, and exposure modeling. The in vitro assays are used to separate chemicals based on their relative selectivity in interacting with biological targets and identify the concentration at which these interactions …

Ethical Challenges And Solutions Involved In Reviewing A Protocol With Sex Offenders As Participants: The Concerns And Solutions Identified For Protecting A Highly Controversial Population, Hila Berger, Amy Krenzer, Nicole Bryan

Presentations and Proceedings

In reviewing research, the three basic tenets IRBs are expected to abide by are beneficence, justice and respect for persons. The IRB was challenged in meeting these tenets during the course of a recent review. Given the highly controversial participant population of sex offenders and the methodology initially proposed, there were a multitude of ethical challenges uncovered that required unique solutions. The protocol presented to the IRB was developed to investigate the use of networked technologies and communications for the purpose of human trafficking. To do so the researchers proposed recruiting “Johns” or individuals convicted of soliciting sex and interviewing …

Mid-Atlantic Ethics Committee Newsletter, Fall 2013

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Drug Firms, The Codification Of Diagnostic Categories, And Bias In Clinical Guidelines, Lisa Cosgrove, Emily E. Wheeler

Counseling, School Psychology & Sport Faculty Publication Series

The profession of medicine is predicated upon an ethical mandate: first do no harm. However, critics charge that the medical profession’s culture and its public health mission are being undermined by the pharmaceutical industry’s wide-ranging influence. In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests. Moving beyond a conflict-of-interest model, we use the conceptual and normative framework of institutional corruption to examine how organized psychiatry’s dependence on drug firms has distorted science. We suggest that academic-industry relationships have led to the corruption of …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

The Unseen And Untold Issues Of Clinical Trials And Research Ethics In Pakistan., Shahan Waheed, Emaduddin Siddiqui

Department of Emergency Medicine

No abstract provided.

Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

Can Acute Dermal Systemic Toxicity Tests Be Replaced With Oral Tests? A Comparison Of Route-Specific Systemic Toxicity And Hazard Classifications Under The Globally Harmonized System Of Classification And Labelling Of Chemicals (Ghs), Nigel P. Moore, David J. Andrew, Donald L. Bjerke, Stuart Creton, David Dreher, Thomas Holmes, Pilar Prieto, Troy Seidle, Tim G. Rowan

Experimentation Collection

Acute systemic toxicity data (LD50 values) and hazard classifications derived in the rat following oral administration and dermal application have been analysed to examine whether or not orally-derived hazard classification or LD50 values can be used to determine dermal hazard classification. Comparing the oral and dermal classifications for 335 substances derived from oral and dermal LD50 values respectively revealed 17% concordance, and indicated that 7% of substances would be classified less severely while 76% would be classified more severely if oral classifications were applied directly to the dermal route. In contrast, applying the oral LD50 values within the dermal classification …

Update - June 2013, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Will You Be a Provider or a Professional?
-- The Jack Provansha Bioethics Lecture Opens LLU School of Medicine Alumni Convention
-- From the Director - One Generation to the Next
-- Animal Rights: A Call to Commitment
-- Vegetarianism: The Interface of Science & Values
-- Bioethics at the Alumni Postgraduate Convention
-- Obamacare and the Future of Loma Linda
-- Center's Bioethics Grand Rounds: Poetry at the Bedside

Hannah Arendt And Pregnancy In The Public Sphere, Katy Fulfer

Future Directions in Feminist Phenomenology

No abstract provided.

Feminist Bio-Phenomenology, Christina Schües

Future Directions in Feminist Phenomenology

No abstract provided.

Diffusion Of Polst Education In Maine: Successes, Challenges, And Opportunities, Mary Lou Ciolfi

Muskie School Capstones and Dissertations

POLST, Physicians Orders for Life Sustaining Treatment originted in Oregon in the 1990's and is a vehicle for recording patient health care choices near the end of life as actionable physician orders so choices are honored with greater clarity and frequency at the point of care. This capstone is about educating and encouraging clinicians and the public to engage in conversations surrounding POLST.

The Pluripotency Proposition: A Biological And Ethical Case For The Utilization Of Hipscs In Place Of Hescs, Drew Dickson

Senior Honors Theses

Human embryonic stem cell (hESC) research has spurred ethical controversy ever since it became feasible in 1998. The reason for this is due to the fact that hESC research requires the destruction of a human embryo, thereby causing the cessation of life for that developing human. Despite this unavoidable consequence, many advocates of hESC research hold to the belief that the embryo is not actually a human person, and therefore deem the destruction of the embryo as justifiable. Many advocates of hESC research also have pointed to the unprecedented medical potential of hESCs to argue in favor of their case. …

When Evil Met Science: Nazi Medicine And Eugenics, Ashley Corey

Honors Theses

During World War II, millions of innocent people were murdered in Nazi Germany. For Hitler and his followers, having a pure race meant having a strong, unified country, and Germany took this idea to extreme and disturbing lengths. Corruption filled the government at all levels. As physicians were the only people authorized to run the gas chambers, traditional healers became death symbols. The Nazis and their physicians used their power to manipulate and murder for the collective goals of the country, as well as the personal gains that came with the high-end job titles. As I reveal the history and …

Malpractice Claims For Endoscopy, Lyndon V. Hernandez, Dominic Klyve, Scott E. Regenbogen

Mathematics Faculty Scholarship

AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure.

METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time.

RESULTS: There were 1901 endoscopy-related closed claims against …

Pill Thinkers: Ethical Implications Of Cosmetic Neurology, Donna Barbagallo

The Review: A Journal of Undergraduate Student Research

In lieu of an abstract, below is the first paragraph of the paper.

The desire for mind and body enhancement may be intrinsic to human nature. Individuals continually engage in behaviors like eating, exercising, or using chemicals such as caffeine or alcohol, in an effort to enhance mind and body for personal desire. The principle of autonomy and free will allows the individual the right to selfdetermination, freedom, and independence, although it is not an absolute right (Aiken, 2004). A healthy person can choose medical treatments like sildenafil citrate (Viagra) or more invasive treatments like cosmetic surgery to achieve personal …

Mid-Atlantic Ethics Committee Newsletter, Spring 2013

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Inflammatory Findings On Species Extrapolations: Humans Are Definitely No 70-Kg Mice, Marcel Leist, Thomas Hartung

Validation of Alternative Methods Collection

Modern toxicology has embraced in vitro methods, and major hopes are based on the Omics technologies and systems biology approaches they bring along (Hartung and McBride in ALTEX 28(2):83–93, 2011; Hartung et al. in ALTEX 29(2):119–28, 2012). A culture of stringent validation has been developed for such approaches (Leist et al. in ALTEX 27(4):309–317, 2010; ALTEX 29(4):373–88, 2012a; Toxicol Res 1:8–22, 2012b), while the quality and usefulness of animal experiments have been little scrutinized. A new study (Seok et al. 2013) now shows the low predictivity of animal responses in the field of inflammation. These findings corroborate earlier findings from …

Explaining The Supreme Court's Interest In Patent Law, Timothy R. Holbrook

IP Theory

No abstract provided.

Journey Of A Peace Journalist, Robert Koehler

Center for the Study of Ethics in Society Papers

Presented October 15, 2012. 2012 Winnie Veenstra Peace Lecture.

Warum Gesunde Menchen Immer Häufiger Fur Psychisch Krank Erklärt Werden, Lisa Cosgrove

Counseling, School Psychology & Sport Faculty Publication Series

zuerst einmal nicht schaden": Das ist der wohl wichtigste Grundsatz der Medizin. Aber diese Mission droht durch den Einfluss großer Pharmafirmen unterhöhlt zu werden. Der Vorwurf einer Verstrickung von Ärzten und Arzneimittelherstellern ist schon in fast allen medizinischen Fachrichtungen aufgekommen. Vor allem aber die Psychiatrie steckt in einer Glaubwürdigkeitskrise. Das zeigt sich in der aktuellen Debatte um die neue Auflage des "Diagnostischen und Statistischen Manual Psychischer Störungen" (DSM).

Dieses von der US-Psychiater-Vereinigung APA herausgegebene Handbuch definiert, was eine psychische Erkrankung ist. Die Bedeutung dieser Wertung geht weit über die USA hinaus - das Handbuch nimmt oft Definitionen der Weltgesundheitsorganisation vorweg. …

Rounding As An Ethicist: Challenges & Recommendations, Nicholas J. Kockler, John Tuohey

Articles, Abstracts, and Reports

No abstract provided.

Tobacco Endgame Strategies: Challenges In Ethics And Law, Bryan P. Thomas, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

There are complex legal and ethical tradeoffs involved in using intensified regulation to bring smoking prevalence to near-zero levels. The authors explore these tradeoffs through a lens of health justice, paying particular attention to the potential impact on vulnerable populations. The ethical tradeoffs explored include the charge that heavy regulation is paternalistic; the potentially regressive impact of heavily taxing a product consumed disproportionately by the poor; the simple loss of enjoyment to heavily addicted smokers; the health risks posed by, for example, regulating nicotine content in cigarettes—where doing so leads to increased consumption. Turning to legalistic concerns, the authors explore …

Ovaries, Testicles, And Uteruses, Oh My! Regulating Reproductive Tissue Transplants, Valarie K. Blake

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

This article will explore key regulatory and ethical challenges presented by reproductive tissue transplants (RTTs) as they are currently developing, recognizing that additional issues may reveal themselves as the technologies progress. Part I of this article will begin with a discussion of the current status of the technology, including the results and status of animal and human experiments for all three types of transplants. Part II will explore the demand for RTTs—who might consider such a transplant and why RTTS might be considered by some patients as more favorable than other reproductive options. Part III will explore the different regulatory …

The Rhetoric Of Choice: Restoring Healthcare To The Abortion Right, Yvonne F. Lindgren

Faculty Works

In 1973 the Supreme Court in Roe v. Wade both identified a constitutional right of abortion and asserted that, “the abortion decision in all its aspects is inherently, and primarily, a medical decision” to be made in consultation with a “responsible physician.” The Court thereby vested in doctors, instead of exclusively in women, the discretion to make the abortion decision. The Roe Court’s accommodation of the “medical model” of abortion reform was criticized for subordinating women’s constitutional rights to the judgment of their doctors. Since that time, the Court’s analysis has shifted to identify abortion exclusively as a right of …

Industry’S Colonization Of Psychiatry: Ethical And Practical Implications Of Financial Conflicts Of Interest In The Dsm-5, Lisa Cosgrove, Emily E. Wheeler

Counseling, School Psychology & Sport Faculty Publication Series

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and …

Carrots, Sticks And False Carrots: How High Should Weight Control Wellness Incentives Be? Findings From A Population-Level Experiment, Harald Schmidt

Frontiers in Public Health Services and Systems Research

Employers are increasingly using wellness incentives, including penalties for unhealthy behavior. Survey data suggests that people are willing to accept the principle of penalizing those perceived to take health risks, but the equally relevant question of the magnitude of acceptable penalties is unclear.

While the principle of penalizing overweight and obese people has some support, findings from a population-level experiment (n=1,000) suggest that the acceptable size of penalties is comparatively small, around $50: more than 10-fold below levels favored by advocates. Reward-based incentives are favored over penalty-based ones by a factor of 4. Of two different ways of framing penalty …

Mid-Atlantic Ethics Committee Newsletter, Winter 2013

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.