Bioethics and Medical Ethics Commons^™

Attitudes Of Parents At Risk Of Inheriting Li-Fraumeni Syndrome To Wards Predictive Genetic Testing In Their Minor-Aged Children., Leslie A. Newman

Dissertations and Theses (Open Access)

Li-Fraumeni Syndrome (LFS) is a hereditary cancer syndrome which predisposes individuals to cancer beginning in childhood. These risks are spread across a lifetime, from early childhood to adulthood. Mutations in the p53 tumor suppressor gene are known to cause the majority of cases of LFS. The risk for early onset cancer in individuals with Li-Fraumeni Syndrome is high. Studies have shown that individuals with LFS have a 90% lifetime cancer risk. Children under 18 have up to a 15% chance of cancer development. Effectiveness of cancer screening and management in individuals with Li-Fraumeni Syndrome is unclear. Screening for LFS-associated cancers …

An Updated History Of The Teratology Society., Thomas H Shepard, Mason Barr, Robert L Brent, Andrew Hendrickx, Devendra Kochhar, Godfrey Oakley, William J Scott, John M Rogers

Department of Pediatrics Faculty Papers

BACKGROUND: The 49-year history of the Teratology Society is reviewed. An abbreviated history is outlined in table form, with listings of the Warkany Lectures, the Continuing Education Courses, and officers of the society. The original article was updated to include the years 2000 to 2010.

METHODS: A year-by-year description of the events is given, including the scientific and social content of the annual meetings and changes in the business of the society, in many cases using comments from the past presidents. The valuable and unique diversity of the members is discussed and illustrated, presenting the disciplines and main research areas …

Reproductive Toxicology, Robert L. Brent

Department of Pediatrics Faculty Papers

Summary

1. WEC has many useful scientific purposes.

2. You cannot utilize WEC to label a drug or chemical as a teratogen if the exposures utilized will result in embryonic or fetal death in vivo.

3. WEC can indicate that a drug or chemical is embryotoxic.

4. If the exposure level for clinical use of a drug or environmental exposure of a chemical is known, it should be used in WEC studies along with higher exposures as well.

5. You cannot predict that a drug is a cardiac teratogen from WEC when no cardiac malformations are observed, as in this …

Researchers’ Views On Ethical Challenges In Healthcare Cluster-Randomized Trials, Andrew Mcrae

Research Day (Arts & Humanities, FIMS, and Education)

• Cluster-randomized trials (CRTs) commonly used in education, public health, healthcare and social sciences
• Groups of individuals randomly assigned to receive one of 2 (or more) comparator interventions
• Effect of interventions evaluated after collecting data from individual group members
• Ethics guidelines developed for oversight of research enrolling individual subjects
• Little specific guidance for ethical conduct of CRTs
• Lack of guidance may lead to variability in ethics reviews between jurisdictions and over time

Conceptual Problems In Research Ethics, Charles Weijer

Research Day (Arts & Humanities, FIMS, and Education)

This poster addresses these issues:
• What good is medical research?
• What is owed to the study subject?
• When is research risk acceptable?
• How should we conduct research in developing countries?
• How should we conduct research involving communities?

Pharmaceutical Philanthropic Shell Games, Lisa Cosgrove, Harold J. Bursztajn

Counseling, School Psychology & Sport Faculty Publication Series

In response to increasing public distrust and congressional concerns regarding pharmaceutical company influence on medical research and education, professional organizations have taken steps to phase out or regulate industry-sponsored educational support. A related problem is industry funding of philanthropic organizations, such as patient advocacy groups. Thus, when the office of Sen Charles Grassley (R-Iowa) recently reported that the National Alliance for the Mentally Ill received substantial pharmaceutical funding, there was concern among the membership’s psychiatric patients and their families.

Update - March 2010, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Glorifying God in Our Body: A Seventh-day Adventist Theological Foundation for Nursing
-- Editorial
-- New Beginning at the Center for Christian Bioethics

Toxicity Testing In The 21st Century: A Vision And A Strategy, Daniel Krewski, Daniel Acosta Jr, Melvin Anderson, Henry Anderson, John C. Bailar Iii, Kim Boekelheide, Robert Brent, Gail Charnley, Vivian G. Cheung, Sidney Green Jr, Karl T. Kelsey, Nancy I. Kerkvliet, Abby A. Li, Lawrence Mccray, Otto Meyer, Reid D. Patterson, William Pennie, Robert A. Scala, Gina M. Solomon, Martin Stephens, James Yager, Lauren Zeise

Experimentation Collection

With the release of the landmark report Toxicity Testing in the 21st Century: A Vision and a Strategy, the U.S. National Academy of Sciences, in 2007, precipitated a major change in the way toxicity testing is conducted. It envisions increased efficiency in toxicity testing and decreased animal usage by transitioning from current expensive and lengthy in vivo testing with qualitative endpoints to in vitro toxicity pathway assays on human cells or cell lines using robotic high-throughput screening with mechanistic quantitative parameters. Risk assessment in the exposed human population would focus on avoiding significant perturbations in these toxicity pathways. Computational systems …

Medical Conscience And The Policing Of Parenthood, Richard F. Storrow

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

As state and local anti-discrimination provisions become more and more comprehensive, physicians who refuse to treat patients for reasons of sexual orientation or marital status are beginning to face legal liability. Increasingly, physicians are invoking codes of medical ethics alongside more familiar constitutional law claims in support of their claim to insulation from legal liability. This Article explores what medical ethics has to say about physicians who, for sincerely held religious reasons, refuse to treat patients for reasons of sexual orientation or marital status. The issue is explored through the lens of a case recently decided by the California Supreme …

Familial Hypercholesterolemia: A Decade Of Progress, Samuel S. Gidding, Md

Department of Pediatrics Faculty Papers

Natural history studies of familial hypercholesterolemia (FH), a genetic disorder associated with elevated cholesterol and premature coronary artery disease, and with a frequency of about 1:500 in the general population, were first conducted in the 1970s. 1 Homozygotes, with cholesterol levels in excess of 500 mg/dl experience coronary events as early as adolescence and heterozygotes (with one normal and one abnormal gene) are affected prematurely in middle age. The first major breakthrough in understanding the disease came with the discovery of the low density lipoprotein (LDL) receptor by Brown and Goldstein, work that won the Nobel prize.

On The Appropriateness Of A Christian Bioethics, Thomas A. Cavanaugh

Philosophy

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Winter 2010

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Ada Constitution & Bylaws (2010), American Dental Association

Constitution & Bylaws

The ADA Commons Constitution & Bylaws archival collection comprises printed issues of the American Dental Association's Constitution and Bylaws. The collection also includes the ADA Charter and the ADA Code of Ethics issued 1924-1946.

Ada Code Of Ethics (January 2010), 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.

What About The Children? Benjamin And Arendt: On Education, Work, And The Political, Jules Simon

Selected Works Temporary Series

This article is a rough draft of an article that I contributed to an edited volume of articles dealing with progressive education theory. I reflect on articles that Hannah Arendt and Walter Benjamin wrote that deal with educational reform and innovation, both political in nature.

Toward Genuine Rodent Welfare: Response To Reviewer Comments, Jonathan P. Balcombe

Laboratory Experiments Collection

I’m grateful to the editors for soliciting critiques of my commentary and for the opportunity to respond. Because one of the respondents (Patterson-Kane, 2010/this issue) does not take issue with the main points of my article, whereas the other (Blanchard, 2010/this issue) does, I focus my remarks here mostly on Blanchard’s critique.

The Current Scientific And Legal Status Of Alternative Methods To The Ld50 Test For Botulinum Neurotoxin Potency Testing, Sarah Adler, Gerd Bicker, Hans Bigalke, Christopher Bishop, Jörg Blümel, Dirk Dressler, Joan Fitzgerald, Frank Gessler, Heide Heuschen, Birgit Kegel, Andreas Luch, Catherine Milne, Andrew Pickett, Heidemarie Ratsch, Irmela Ruhdel, Dorothea Sesardic, Martin Stephens, Gerhard Stiens, Peter D. Thornton, René Thürmer, Martin Vey, Horst Spielmann, Barbara Grune, Manfred Liebsch

Experimentation Collection

No abstract provided.

Non-Invasive Methods Of Identifying And Tracking Wild Squid, Ruth A. Byrne, James B. Wood, Roland C. Anderson, Ulrike Griebel, Jennifer A. Mather

Morality and Ethics of Animal Experimentation Collection

The ability to identify individual free-living animals in the field is an important method for studying their behavior. Apart from invasive external or internal tags, which may cause injury or abnormal behavior, most cephalopods cannot be tagged, as their skin is too soft and delicate for tag retention. Additionally, cephalopods remove many types of tags. However, body markings have been successfully used as a non invasive method to identify individuals of many different species of animals, including whale sharks, grey whales, seals, and zebras. We developed methods to sex and individually identify Caribbean reef squid, Sepiotheuthis sepioidea. Males showed distinct …

Harm Or Mere Inconvenience? Denying Women Emergency Contraception, Carolyn Mcleod

Philosophy Publications

This paper addresses the likely impact on women of being denied emergency contraception (EC) by pharmacists who conscientiously refuse to provide it. A common view—defended by Elizabeth Fenton and Loren Lomasky, among others—is that these refusals inconvenience rather than harm women so long as the women can easily get EC somewhere else nearby. I argue from a feminist perspective that the refusals harm women even when they can easily get EC somewhere else nearby.

What About The Children? Benjamin And Arendt: On Education, Work, And The Political, Jules Simon

Departmental Papers (Philosophy)

This article is a rough draft of an article that I contributed to an edited volume of articles dealing with progressive education theory. I reflect on articles that Hannah Arendt and Walter Benjamin wrote that deal with educational reform and innovation, both political in nature.

Price And Pretense In The Baby Market, Kimberly D. Krawiec

Faculty Scholarship

Throughout the world, baby selling is formally prohibited. And throughout the world babies are bought and sold each day. As demonstrated in this Essay, the legal baby trade is a global market in which prospective parents pay, scores of intermediaries profit, and the demand for children is clearly differentiated by age, race, special needs, and other consumer preferences, with prices ranging from zero to over one hundred thousand dollars. Yet legal regimes and policymakers around the world pretend that the baby market does not exist, most notably through prohibitions against “baby selling” – typically defined as a prohibition against the …

Bioethics And Biosecurity Education In China: Rise Of A Scientific Superpower., Barr S. Michael, Joy Yueyue Zhang

Book Chapters

This chapter explores ethics, education and the life sciences in China. It is based on work conducted by the authors in two separate but complimentary projects. Barr’s observations derive from interviews and discussions in Beijing, Shanghai and Guangzhou with life scientists and policymakers in infectious-disease hospitals, university-research labs, the Chinese Academy of Sciences, and the Ministry of Health. Zhang’s study focused on China’s governance of stem-cell research and involved interviews with scientists, ethicists and policymakers at more than 25 sites across China. Below, we set the context by describing the role of science in China’s quest to become a leading …

Can There Be A Progressive Bioethics?, Richard O. Lempert

Book Chapters

Progressive bioethics-the words are not an oxymoron. Far from it; they are more redundant than oppositional. Yet they leave me almost as uneasy, as if they were contradictory. My unease exists because bioethics should be neither progressive nor regressive, neither right wing nor left wing, neither liberal nor conservative. It should be just good, sound ethics applied to the often difficult moral problems posed by present-day medicine and the genomic revolution.

I do not mean to suggest by this that all bioethicists need agree. Respectable ethicists using established modes of ethical analysis have long disagreed on and argued for different …

From A Constitutional Right To A Policy Of Exceptions: Abigail Alliance And The Future Of Access To Experimental Therapy, Patricia J. Zettler, Seema K. Shah

Faculty Publications By Year

Although there has been considerable attention to the plight of terminally ill patients with highly sympathetic constitutional and contractual claims that they should be permitted access to unapproved drugs, courts have been appropriately reluctant to grant such claims. Congress and administrative agencies have the requisite institutional competence to decide complex policy issues related to science and health care such as those involved in establishing an expanded access program. Congress and FDA should allow only limited access to unapproved therapies because there are significant concerns about the safety and efficacy of unapproved drugs. Moreover, many of the proposals to widen access …

Dr. Cezanne And The Art Of Re(Peat)Search: Competing Interests And Obligations In Clinical Research, Robyn L. Bluhm, Jocelyn Downie, Jeff Nisker

Philosophy Faculty Publications

Clinician researchers have a number of roles, each of which carries specific obligations. There are times when these obligations may be in competition (up to and including conflict) with each other. Using a narrative case study that describes a group of colleagues discussing their clinical department's participation in an industry-sponsored research protocol, we illustrate a number of the obligations faced by clinician researchers, and discuss how competing interests and obligations can lead to ethical problems. The case study is followed by a discussion of the effect of university-industry relations on competing interests and obligations in both clinical research and the …

Effect Of Visual Media Use On School Performance: A Prospective Study, Iman Sharif, Md, Mph, Thomas A. Wills, Phd, James D. Sargent, Md

Department of Pediatrics Faculty Papers

Purpose: To identify mechanisms for the impact of visual media use on adolescents' school performance.

Methods: We conducted a 24-month, four-wave longitudinal telephone study of a national sample of 6,486 youth aged 10 to 14 years. Exposure measures: latent construct for screen exposure time (weekday time spent viewing television/playing videogames, presence of television in bedroom) and variables for movie content (proportion of PG-13 and R movies viewed).

Outcome measure: self- and parent reports of grades in school. Effects of media exposures on change in school performance between baseline and 24 months were assessed using structural equation modeling. Information about hypothesized …

Access To Prescription Drugs: A Normative Economic Approach To Pharmacist Conscience Clause Legislation, Joanna K. Sax

Faculty Scholarship

The goals of this Article are two-fold: (1) to explain that pharmacist conscience clause legislation may be expanded to areas concerning controversial biomedical research; and (2) to demonstrate that welfare economics can be applied to analyze pharmacist conscience clause legislation. Regarding the first goal, the broad language of existing and proposed conscience clause legislation creates an umbrella that allows a pharmacist to escape liability for refusing to fill a prescription for almost any type of medication. With respect to the second goal, this Article applies welfare economics to demonstrate that pharmacist conscience clauses are a part of tort law and …

Reduced Mortality And Increased Bpd With Histological Chorioamnionitis And Leukocytosis In Very-Low-Birth-Weight Infants., David A. Paul, Md, Kelly Zook, Md, Amy Mackley, Rnc, Robert G. Locke, Do

Department of Pediatrics Faculty Papers

OBJECTIVE: To investigate the association between leukocytosis, mortality and bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBW) born to mothers with histological chorioamnionitis.

STUDY DESIGN: A retrospective cohort study from a single level 3 neonatal intensive care unit. The study sample included infants born to mothers with histological chorioamnionitis (n=252). Total white blood cells (WBCs) after birth were measured. Leukocytosis was defined as a total WBC count >30 000 per mm(3) in the first 2 days of life. Outcomes investigated included BPD and death. Both unadjusted and multivariable analyses were carried out.

RESULT: After controlling for potential confounding variables, infants who …

Bringing Toxicology Into The 21st Century: A Global Call To Action, Troy Seidle, Martin Stephens

Experimentation Collection

Conventional toxicological testing methods are often decades old, costly and low-throughput, with questionable relevance to the human condition. Several of these factors have contributed to a backlog of chemicals that have been inadequately assessed for toxicity. Some authorities have responded to this challenge by implementing large-scale testing programmes. Others have concluded that a paradigm shift in toxicology is warranted. One such call came in 2007 from the United States National Research Council (NRC), which articulated a vision of ‘‘21st century toxicology” based predominantly on non-animal techniques. Potential advantages of such an approach include the capacity to examine a far greater …

Scientific Autonomy And The 3rs, Bernard E. Rollin

Experimentation Collection

No abstract provided.