Tag: common good

Bioethics Blogs

Access to Physicians’ Prescription Habits

Jean-Christophe Bélisle-Pipon calls attention to issues of accessibility and transparency related to the collection and sale of physician prescribing data by data solution companies.

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QuintilesIMS is a data solution company that provides services to the pharmaceutical industry. In 2002, the company was authorized by the Commission d’accès à l’information du Québec to receive and make use of personal information held by Québec pharmacies about physician prescribing practices, provided that: 1) specific professional acts were not linked to specific professionals; 2) physicians could refuse to have their information used; and 3) use of the information was restricted to reaching out, informing and training physicians. Data related to physician prescribing practices is sold by Québec pharmacies to QuintilesIMS. In turn, QuintilesIMS collects, collates this data and sells it to pharmaceutical companies for marketing purposes.

Recently, information related to QuintilesIMS business practices were leaked to the media.

Allegations have been made suggesting that data detailing the prescribing practices of 7,000 Québec physicians (including identifying information) have been disclosed to pharmaceutical companies. If proven true, this would represent an unauthorized practice, that contravenes the Act respecting the protection of personal information in the private sector. The issue at stake in the allegations is not the disclosure to companies, but rather, the disclosure of identifying information.

Physician prescribing data must be clustered in groups of 30 that have similar prescribing profiles. Thus, it is impossible in Canada (contrary to the US) to have access to individual physician prescribing profiles. In Québec, physicians can opt out of this data collection, and those who allow their information to be used, freely have access to their own prescribing profile.

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

The Value of Oversight in a Century of Promise & ‘Cures’

This post, by CEC member Paul McLean, originally appeared on WBUR’s CommonHealth blog.
The blood-thinner heparin is not a 21st-century cure. It was discovered 100 years ago by a scientist looking for something else entirely, and is one of the oldest drugs still in regular use.
After my daughter was diagnosed with a potentially fatal blood disorder, heparin played a key daily role in her treatment. We’d wash our hands meticulously, lay out gloves and antiseptic wipes, saline flushes for the access lines to her fragile immune system, and finally the sealed heparin syringe.
For many months, we went through boxes of heparin and never questioned its safety. Never had reason to.
But in 2008, after my daughter was officially declared cured and we’d used heparin for the last time, contamination in the supply from China killed 19 Americans and harmed many others. Writing that sentence still gives me the chills. My daughter survived thanks to medicine, but it also could have killed her.
So you can understand why, as the 21st Century Cures Act sailed to passage, I experienced both excitement and dread.
That heparin contamination was in part due to lax oversight of the drug supply chain. It reminds me why I do not want to see the work of the Food and Drug Administration compromised by overeager drug companies taking advantage of the hopes of desperate patients, and taking shortcuts on safety.
The “giant piñata” of a bill, as science blogger Derek Lowe aptly described the 21st Century Cures Act, is destined to explode in unexpected ways.

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

Stoking the Flames of Competitiveness on an Overheating Planet

Image via

STUDENT VOICES

By: Michael Aprea

This essay is in response to the Carnegie Council for Ethics in International Affairs video “Climate Protectionism and Competitiveness.”  

Steam put the world in motion. It lit up the night, and tightened humanity’s grasp on the forces of nature. Nature, however, has eluded the human race and has forced civilization to reconsider its power in the most fundamental sense. Scientist, politicians, and citizens now face the heat as they scramble to address a cycle of global warming spawned by the progress of the industrial revolution that threatens to unhinge the fragile balance of Earth’s ecosystems. Reducing carbon emissions has been the answer to the problem. This standard that has taken hold in developed nations has morphed into a global economic crusade against carbon emissions through regulation, taxation and sanctions seeking to curb the emissions of the developing world. Although consumer responsibility and global collaboration in an endeavor to reverse global warming trends are laudable, it is important to recognize the risks these steps pose on global trade, the citizens of developing countries, and the debt developed nations have as beneficiaries of the first fruits of fossil fuels.

The United States owes its status as an economic superpower to the progress of the industrial revolution; a revolution fueled by carbon emitting fossil fuels. The rapid growth of nations such as Unites States reliant on fossil fuels came at price–rising global temperatures. Carbon doesn’t only heat up cold economies, it also has the ability to raise average global temperatures as it gets trapped in the atmosphere and captures solar radiation.

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

Party politics, people’s lives

As health care financing rises yet again to the top of our national legislative agenda, some fundamental questions ought to be strongly considered. First, and most fundamental: Is some level of healthcare a right, that the government is therefore obligated to protect? Is it better viewed as a common good, like roads and fire protection services, that everybody pays for through taxes and everybody benefits from? Should it be treated as a luxury item, like large-screen TVs and designer clothing, that only those who can afford it get to enjoy?

Other important questions: What are the strengths and weaknesses of the current system of financing health care? Who does it benefit? Who does it harm? What will be the effects on patients, intended and unintended, of changing the current system? Who will benefit, and who will be harmed by those changes? What will be the effects on physicians and health insurance companies? How will any changes affect the patient-physician relationship, for good or for ill?

Is the free market the best way to finance health care? Or is it best publicly financed? Or some mixture of both? Why?

A most important question is, How does the system treat the most disadvantaged, the poorest, the most helpless or down on their luck, and the ones who need it the most? How should it treat them?

What should the ideal health care system for patients look like? Can we start moving towards that ideal? How?

Other fundamental questions will no doubt present themselves to the reader.

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

Xenobiology and environment

PDF-logoSynthetic biology and xenobiology could be great tools for improving the environment, but there must be a balance in which the pursuit of benefits for humans is combined with respect for nature and its laws.

On 15th May 2015, Pope Francis published his encyclical Laudato si, in which he gave his views on the problem of environmental pollution that is devastating our planet, and how it affects not only nature, but ourselves, especially the most disadvantaged.

The problem of pollution, over-exploitation of resources and the global warming caused by these is being studied from different perspectives. One of these is the drive for research into new methods that can help us to obtain clean energy that will allow us to continue our development, obtain more resources for food and industry without depleting the planet, and methods for decontamination and repair of damaged ecosystems. Xenobiology could have a huge impact on all these projects in the future.

Xenobiology is a young discipline within synthetic biology that is at the forefront of some of the proposed projects. Xenobiology aims to add letters to the natural genetic alphabet to be able to obtain new words, and to write a story different the one told to us by nature. In the words of Floyd E. Romesberg, one of the principal investigators in the expansion of the genetic alphabet: “If you’re given more letters, you can invent new words, you can find new ways to use those words and you can probably tell more interesting stories” (Callaway, 2014).

A transformation of biology such as that envisaged by xenobiology still presents risks and certain ethical questions, but at the same time, it represents a new way to overcome our environmental problems.

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

The Ethics of Climate Change Activism: Fear vs. Reality

Image via NASA

STUDENT VOICES

By: Chelsea Zantay

This essay is in response to the Carnegie Council for Ethics in International Affairs video clip “Global Ethics Forum: Ethics Matter: A Conversation with Bill McKibben.”  

Often when a problem is too big or too scary we throw up our hands and announce that “there is nothing we can do” to solve it.  Admittedly, climate change feels like one of those problems.  It seems like a quagmire of depressing facts and statistics.  It is now scientific fact that the polar ice caps are melting, our oceans are rising and becoming more acidic, and if we do not curb our consumption of fossil fuels, our planet will be rendered unlivable.  The plethora of disturbing information on climate change is enough to cause anyone to have a sleepless night or make them wish they had never heard the truth about our warming planet.  However, ostriches with their heads buried in the sand do not get much done, and once you know some truth, you cannot un-know it.  And so the question at hand is not “is climate change happening?” for that question has been answered in the affirmative (although climate change deniers would like to see this issue removed from our national political discourse).  The question right now is “what are we going to do about it, if anything?”

Bill McKibben, environmental scientist and founder of 350.org, has spent his career writing about climate change and mobilizing communities as an activist for the cause. 

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

Guest Post: Epigenetics: Barriers to the translation of scientific knowledge into public policies

Written by Charles Dupras and Vardit Ravitsky

Bioethics Programs, School of Public Health, University of Montreal

 

Environmental epigenetics is a rising field of scientific research that has been receiving much attention. It explores how exposure to various physical and social environments (e.g. pollution or social adversity) affects gene expression and, eventually, our health. Environmental epigenetics can sometimes explain why some of us carry increased risks of developing specific diseases. It provides activists a powerful vocabulary to promote environmental awareness and social justice. This new vocabulary, which allows us to discuss the consequences of disparities at the molecular level, has been enthusiastically mobilized as an effective way of stimulating political will for promoting public health preventive strategies.

However, this perspective – that we call the ‘policy translation’ of epigenetics – can be contrasted with a ‘clinical translation’ that targets the development of novel biomedical tools to assess epigenetic risks and reverse a detrimental epigenome. In a recent paper published in The Hastings Center Report, we argue that these two approaches are competing for public resources. We suggest that in Western contexts, the clinical translation of epigenetics may end up being prioritized over the policy translation of epigenetics, to the detriment of efforts to promote policy and public health. We highlight four potential barriers or biases that may impede the ‘policy translation’ of epigenetics, with the aim of cautioning against this scenario.

First, our societies operate under the ‘technological imperative’, a culturally engrained preference for technological solutions. In the context of epigenetics, this means that research findings are likely to be translated into biotechnological innovation that targets individual health.

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

Welcome Fall 2016 Master’s Students!

The Ethics and Society blog is delighted to welcome the following candidates to Fordham University’s Master of Arts in Ethics and Society:

Kelly Collins

Kelly Collins graduated in 2011 with a BS in Philosophy and Political Science from Florida State University.  After moving to New York City shortly after graduation, she began working as a legal assistant in a well-known international law firm.  While pursuing her MA in Ethics and Society, Kelly hopes to utilize real-world skills to analyze and reflect upon today’s moral dilemmas.

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Tim Colvin

Tim Colvin is currently a senior at Fordham University from Kings Park, New York. He is a dual major in Political Science and Classical Civilization with a minor in Philosophy. Tim is interested in attending law school and hopes to apply a background in ethics in practice after completing the MA in Ethics and Society.

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Margaret Desmond

Margaret Desmond completed her BA in Anthropology and Philosophy at Fordham University. She has worked at Catholic Charities Refugee Resettlement Office, the Museum of Jewish Heritage, and the Bronx Oncology Living Daily Program during her time in New York. Margaret joined the Center for Ethics Education as a graduate assistant this fall and will also be completing her MA in Ethics and Society. With her interest in medicine and background in archaeology, Margaret hopes to explore the ethical issues of these different disciplines while in the program.

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Yohan Garcia

Yohan Garcia is a Fordham University student from Puebla, Mexico. He earned an Associate’s Degree from the Borough of Manhattan Community College in Business Management, and a BA in Political Science from Hunter College.

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

Bioethics and its better self

Renee Fox is one of the most, if not the most, distinguished American sociologists alive. If anything, this makes the attention that she has devoted to bioethics and bioethics workers all the more surprising, because after all, how interesting or important ARE we as subjects? She clearly would not agree with my assessment. She has written a whole book on it (Observing Bioethics, with Judith Swazey), and recently published a talk entitled “Moving bioethics toward its better self: a sociologist’s perspective”, where she clearly and unapologetically has gone from observing bioethics to prescriptively stating what bioethicists ought to be doing. Of course, people telling bioethicists what to do is nothing new. Some make a career out of lumping all bioethicists together and lambasting them as a band of heartless utilitarians promoting a culture of death. Fox is a more astute and gentler critic. For one thing, she apparently thinks bioethics has a ‘better self’, and that it can be nudged in that direction.

So where does Fox think bioethics is now, such that it needs a good nudge? First, its focus is narrow, concentrating on a relatively limited set of phenomena in biology, medicine and medical technology, particularly as they relate to the beginning and end of life. In understanding the ethical issues related to these phenomenon, bioethics goes back to the well of one particular value (autonomy) over and over again, to the neglect of other values like the common good, solidarity and social justice. The comfort zone of bioethics is the individual or interpersonal level of analysis: it appeals strongly to moral imagination (because you can imagine ‘what you would do’ in a certain case) as well as resonating with traditional American individualism.

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

Should Your Driverless Car Hit a Pedestrian to Save Your Life?

June 24, 2016

(New York Times) – People say that one day, perhaps in the not-so-distant future, they’d like to be passengers in self-driving cars that are mindful machines doing their best for the common good. Merge politely. Watch for pedestrians in the crosswalk. Keep a safe space. A new research study, however, indicates that what people really want to ride in is an autonomous vehicle that puts its passengers first. If its machine brain has to choose between slamming into a wall or running someone over, well, sorry, pedestrian.

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.