Tag: accountability

Bioethics News

Call for Papers: Health and Food Ethics

August 14, 2017

October 2018

Health and Food Ethics

Hippocrates once said, “Let food be thy medicine and medicine be thy food.” Physicians in some U.S. cities have followed this advice by writing prescriptions for patients to obtain fresh produce through healthy food outreach programs. Clinical encounters, however, cannot fully reverse the negative health effects of low quality diets. Further, millions remain hungry as the quantity of the global food supply is at risk. Providing safe, nutritious, and environmentally- sustainable food to all is a great challenge, and if the global community cannot find solutions to feed the world, economic and social costs will be high. “Ending hunger, achieving food security, improving nutrition, and promoting sustainable agriculture” is one of the Sustainable Development Goals set forth by the United Nations. As such, a central question worth exploring in the October 2018 issue of the AMA Journal of Ethics is: What should be the roles of health professionals in promoting accountability by governments, non-governmental and civil society organizations, and the food and beverage industry in promoting strategies that can meet the nutrition and health needs of our global population? Other issues include: reducing and redistributing food loss and waste; incentivizing responsible food production and labeling practices; communicating about food practices and food access during clinical encounters; and strategies to promote food security as a goal of health professions.

Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 12 February 2018.

Link for more information


Image: By Original: lyzadangerDerivative work: Diliff – http://www.flickr.com/photos/lyza/49545547,

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Refugees, Narratives, or How To Do Bad Things with Words

By Anna Gotlib

ABSTRACT. This paper addresses and critiques the anti-refugee rhetoric and policies, as well as their uncritical uptake, which developed around the candidacy of Donald Trump. My intent is to examine some of this election’s cruelest, most violent, and most racist rhetoric, reserved for Syrian (and other) refugees, and to consider some possible responses to such speech in the future. To that end, I problematize the representations and treatment of refugees within the United States from three distinct groups: European Jewish refugees of the Second World War; the Eastern Bloc refugees of the mid- and late twentieth century; and the current Syrian, largely Muslim refugees. I begin by defining the concepts of homelessness and moral luck. Second, I examine the three varying histories of refugee policies in the context of these two notions. Finally, I conclude with a combination of despair and hope: First, I offer a few observations about the role of language in the recent presidential election; second, I propose alternatives to the resulting linguistic and political violence by extending Hilde Lindemann’s notion of “holding” into sociopolitical contexts.

“How odd I can have all this inside me and to you it’s just words.”
― David Foster Wallace, The Pale King

I.  Introduction

The American election of 2016 was, in its vitriol, polarization, and outcome, unlike any in recent memory. This paper addresses and critiques the anti-refugee rhetoric and policies, as well as their uncritical uptake, which developed around the candidacy of Donald Trump. My intent is to examine and confront the fact that some of this election cycle’s cruelest, most violent, and most racist rhetoric was reserved for Syrian (and other) refugees, and to consider some possible responses to such speech in the future.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Fake News and Partisan Epistemology

by Regina Rini

ABSTRACT. This paper does four things: (1) It provides an analysis of the concept ‘fake news.’ (2) It identifies distinctive epistemic features of social media testimony. (3) It argues that partisanship-in-testimony-reception is not always epistemically vicious; in fact some forms of partisanship are consistent with individual epistemic virtue. (4) It argues that a solution to the problem of fake news will require changes to institutions, such as social media platforms, not just to individual epistemic practices.

Did you know that Hillary Clinton sold weapons to ISIS? Or that Mike Pence called Michelle Obama “the most vulgar First Lady we’ve ever had”? No, you didn’t know these things. You couldn’t know them, because these claims are false.[1] But many American voters believed them.

One of the most distinctive features of the 2016 campaign was the rise of “fake news,” factually false claims circulated on social media, usually via channels of partisan camaraderie. Media analysts and social scientists are still debating what role fake news played in Trump’s victory.[2] But whether or not it drove the outcome, fake news certainly affected the choices of some individual voters.

Why were people willing to believe easily dis-confirmable, often ridiculous, stories? In this paper I will suggest the following answer: people believe fake news because they acquire it through social media sharing, which is a peculiar sort of testimony. Social media sharing has features that reduce audience willingness to think critically or check facts. This effect is amplified when the testifier and audience share a partisan orientation.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Trust, Communities, and the Standing to Hold Accountable

by Thomas Wilk 

ABSTRACT. During the 2016 US Presidential campaign and in the aftermath of the election of Donald Trump, many of us have tried to hold friends, family, and acquaintances accountable for their support of a candidate and campaign that we judged to be racist, xenophobic, sexist, transphobic, ableist, and authoritarian. Even when our friends and family avowed, for example, anti-racist norms, our attempts to hold them to those norms were often met with rejections of our standing to do so: What gives you the right to call me out for my vote? In this paper, I argue for the regrettable conclusion that these challenges to our standing to hold are, in at least some cases, justified on the grounds that the targets of our holdings have little evidence that we would allow ourselves to be reciprocally held accountable. As such, recognizing our standing to hold them accountable would be a threat to their agency. I conclude by arguing that we now ought to engage in a project of rebuilding the kinds of communities in which the mutual trust that is foundational to our moral practices can be rebuilt.

 

INTRODUCTION

Who are you to tell me what I should do? What gives you the right to order me around? How dare you call me a racist!? Many of us have heard these refrains over the course of the 2016 US Presidential campaign and since the election of Donald Trump. We try talk to Trump supporters—family, former classmates, hometown friends, and online acquaintances—about the racism, xenophobia, sexism, transphobia, ableism, and authoritarianism that some of us have judged to be endemic to his campaign and nascent administration.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Tune Ups to Belmont & Common Rule Need to Consider Community-Engaged Research

Some bioethicists link the beginnings of our field to the Nazi Medical experiments and the Nuremberg Trial (Annas). Whether this is the beginning of bioethics is debatable, but without a doubt, research ethics has been a central topic in the field. In fact, the very first federal bioethics commission laid out the principles of research ethics in the Belmont Report. Later, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research recommended to the President and Congress that a uniform framework and set of regulations should govern human subjects research.  This effort reached fruition under The Federal Policy for the Protection of Human Subjects or the “Common Rule” that was issued in 1991.  Since then, there have been no major changes to the regulations – until now.  After a five-year process and thousands of comments, the new “final rule” was released on January 19th, 2017.  The July 2017 issue of the American Journal of Bioethics addresses these changes.  In addition to our usual open peer commentaries, we are posting a number of blog posts written in response to the AJOB target article.


by Eric Wat MA, Nancy Shore PhD, Sarena D Seifer MD, CCPH, Lola Sablan-Santos, Alice Park MPH, Mei-Ling Isaacs MPH, Ahahui Malama I Ka Lokahi, Kelly Edwards PhD, Elaine Drew PhD, John Cooks, Paige Castro-Reyes BS BA, CCPH

We concur with Friesen and colleagues’ (2017) assertion that the Belmont Report requires, at a minimum, a “tune-up” to better reflect the unique ethical values and demands of community-engaged research (CEnR).

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Trump Opioid Task Force Considers HIPAA Exception for Overdoses

by Craig Klugman, Ph.D.

Confidentiality is one of the sacrosanct principles of medicine. By keeping the secrets that patients share with health care providers, the patient trusts the provider and the provider has the information necessary to diagnose and treat. The Hippocratic Oath, American Medical Association commentaries, 1974 Federal Privacy Act and 1996 Health Insurance Portability and Accountability Act place confidentiality front and center in ethics and law.

Although we place confidentiality on a high pedestal, it does have many exceptions—some which are acceptable and some of which are required. For example, under the Tarasoff rule a provider in most states must report a specific and explicit threat to a third party. Reporting is required for concerns of public health such as abuse or infectious disease. Information must be shared if law enforcement shows a subpoena. A physician may consult colleagues about a case. Administrative assessment and quality improvement review can access patient information without specific patient consent.  In some states, a physician may inform a spouse of certain infectious diseases even when the partner does not want him/her to know. Exceptions are not made lightly since the lack of protecting secrets can decrease patient trust and thus the ability for health care providers to help patients. When exceptions are carved out they are generally because maintaining secrecy would substantially harm the patient or a third party.

A new required exception may be added to this list if New Jersey Governor Chris Christie has his way. He is asking the federal government to carve out a HIPAA exception to allow reporting to a family if a loved one has an opioid overdose.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

CIA Torture as Human-Subjects Research

In the piece linked below, the author (a professor of sociology at the University of California) argues that modern norms governing human-subjects research are actually stronger, or at least more clear, than those governing government-sanctioned torture. Some of us professionally involved in research ethics governance might not agree that norms of that discipline are beyond debate. Also, we might wonder whether ‘exporting’ the norms of research ethics for use in prosecuting torture is likely to be good for research ethics, or will it end with a reversal: Some will begin with the premise that the CIA’s torture/research program is justified by its public-interest objectives. And if the CIA can, er, ‘break new ground’ in the ethics of research, then why can’t others?

The CIA Didn’t Just Torture, It Experimented on Human Beings by Lisa Hajjar (for The Nation)

… No one has been held accountable for torture, beyond a handful of prosecutions of low-level troops and contractors. Indeed, impunity has been virtually guaranteed as a result of various Faustian bargains, which include “golden shield” legal memos written by government lawyers for the CIA; ex post facto immunity for war crimes that Congress inserted in the 2006 Military Commissions Act; classification and secrecy that still shrouds the torture program…

…Rather, because the concept of torture has been so muddled and disputed, I suggest that accountability would be more publicly palatable if we reframed the CIA’s program as one of human experimentation. If we did so, it would be more difficult to laud or excuse perpetrators as “patriots” who “acted in good faith….”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Attacks on Health Workers in War Zones Continue, Despite UN Resolution

A string of blatantly illegal attacks on clinics and ambulances in war zones around the world prompted the Security Council last year to demand protection for health workers and accountability for their attackers

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Recapping the recent plagiarism scandal

Parts of the paper that are nearly identical to my blog

A year ago, I received a message from Anna Powell-Smith about a research paper that was a mirror image of a post I wrote on my personal blog1 roughly two years prior. The structure of the document was the same, as was the rationale, the methods, and the conclusions drawn. There were entire sentences that were identical to my post. Some wording changes were introduced, but the words were unmistakably mine. The authors had also changed some of the details of the methods, and in doing so introduced technical errors, which confounded proper replication. The paper had been press-released by the journal,2 and even noted by Retraction Watch.3

I checked my site’s analytics and found a record of a user from the University of Cambridge computer network accessing the blog post in question three times on 2015 December 7 and again on 2016 February 16, ten days prior to the original publication of the paper in question on 2016 February 26.4

At first, I was amused by the absurdity of the situation. The blog post was, ironically, a method for preventing certain kinds of scientific fraud. I was flattered that anyone noticed my blog at all, and I believed that academic publishing would have a means for correcting itself when the wrong people are credited with an idea. But as time went on, I became more and more frustrated by the fact that none of the institutions that were meant to prevent this sort of thing were working.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

“I Never Considered That.” Medical Student Professionalism Peer- Evaluations and the Self-Identity of a Future Physician.

By Anna Lama

I recently presented a workshop on the assessment of professionalism at the Southern Group on Educational Affairs (SGEA) conference.  I planned to discuss the elements of assessment: developing a framework to define professionalism, discussing successful assessment practices and reviewing the various tools available to assess professionalism.1  Much to my surprise, the discussion quickly moved into deeper inquiry on student participation, perceptions, and self-identity through the use of peer evaluations on professionalism…

What do your students say about their feedback when they receive it?
Do you talk to students about overtly critical reviews?  Overtly glowing reviews?
How do you deal with initial reactions to those comments?
Are they anonymous?
How do you know they are reflecting and “getting real” with themselves?

Inquiring minds wanted to know! Thankfully, two of my medical students happened to be in the room with me.  “I really value the content of the peer evals, and the scale was not difficult to use.  This evaluation tool can help students with their teamwork skills which translate really well to working with patients.”  Gasp! My heart stopped beating for a moment as my student offered his unscripted reflection.  He was able to share a perspective in the most honest and intimate way.

As the assessment director for the West Virginia University School of Medicine, I read hundreds, if not thousands, of evaluation data pieces per year.  While all are important pieces, the most interesting is our student peer-to-peer evaluation and self-evaluation, which specifically addresses professionalism.  Both evaluations are similar in structure where the students are to identify strengths and weaknesses, through specific questions, within nine domains such as honesty and integrity, accountability, responsibility, etc.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.