Tag: ethics

Bioethics Blogs

Happy 15th Birthday, Neuroethics!

[This post first appeared in the Neuroethics Blog on May 13, 2017: http://www.theneuroethicsblog.com/2017/05/happy-15th-birthday-neuroethics.html]

Fifteen years ago, on May 13, 2002, a two-day conference called “Neuroethics: Mapping the Field” began at the Presidio in San Francisco. And modern neuroethics was born. That conference was the first meeting to bring together a wide range of people who were, or would soon be, writing in “neuroethics;” it gave the new field substantial publicity; and, perhaps most importantly, it gave it a catchy name.


That birthdate could, of course, be debated. In his introduction to the proceedings of that conference, William Safire, a long-time columnist for the NEW YORK TIMES (among other things), gave neuroethics a longer history:

The first conference or meeting on this general subject was held back in the summer of 1816 in a cottage on Lake Geneva. Present were a couple of world-class poets, their mistresses, and their doctor. (Marcus)

Safire referred to the summer holiday of Lord Byron and Percy Bysshe Shelley; Byron’s sometime mistress, Claire Clairmont; and Shelley’s then-mistress, later wife, known at the time as Mary Godwin and now remembered as Mary Wollstonecraft Shelley. The historically cold and wet summer of 1816 (“the year without a summer”) led them to try writing ghost stories. Godwin succeeded brilliantly; her story eventually was published in 1818 as FRANKENSTEIN: OR, THE NEW PROMETHEUS.

Camillo Golgi, image courtesy of
Wikipedia.
Safire’s arresting opening gives neuroethics either too little history or too much. If, like Safire, one allows neuroethics to predate an understanding of the importance of the brain, early human literature – both religious and secular – show a keen interest in human desires and motivations.

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

Interview with Arthur Caplan

by Kaitlynd Hiller and Rachel F. Bloom

It is a difficult task to succinctly describe the professional accomplishments of Arthur Caplan, PhD. For the uninitiated, Dr. Caplan is perhaps the most prominent voice in the conversation between bioethicists and the general public, as well as being a prolific writer and academic. He is currently the Drs. William F. and Virginia Connolly Mitty Professor of Bioethics at NYU Langone Medical Center and NYU School of Medicine, having founded the Division of Bioethics there in 2012. Additionally, he co-founded the NYU Sports and Society Program, where he currently serves as Dean, and heads the ethics program for NYU’s Global Institute for Public Health. Prior to joining NYU, he created the Center for Bioethics and Department of Medical Ethics at the University of Pennsylvania Perelman School of Medicine, serving as the Sidney D. Caplan Professor of Bioethics. Dr. Caplan is a Hastings Center fellow, also holding fellowships at The New York Academy of Medicine, the College of Physicians of Philadelphia, the American Association for the Advancement of Science, and the American College of Legal Medicine. He received the lifetime achievement award of the American Society of Bioethics and Humanities in 2016.

Dr. Caplan’s experience is not at all limited to the academic realm: he has served on numerous advisory counsels at the national and international level, and is an ethics advisor for organizations tackling issues from synthetic biology to world health to compassionate care. Dr. Caplan has been awarded the McGovern Medal of the American Medical Writers Association, the Franklin Award from the City of Philadelphia, the Patricia Price Browne Prize in Biomedical Ethics, the Public Service Award from the National Science Foundation, and the Rare Impact Award from the National Organization for Rare Disorders; he also holds seven honorary degrees.

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

Decades on from Henrietta Lacks, we’re still struggling to find an adequate consent model

The ‘immortal’ HeLa cells. Heiti Paves/Shutterstock

When 30-year-old Henrietta Lacks walked through the doors of a Baltimore hospital in 1951 to get a “knot in the stomach” checked, she couldn’t have known she was about to change the face of medical research.

After undergoing a biopsy on her “knot”, Lacks was diagnosed with cervical cancer; it was so aggressive that she died only a few months later.

Henrietta Lacks.
Oregon State University/Flickr., CC BY-SA

But that was not the end of Lacks’s “life”. A small part of the cervical biopsy was retained and conveyed to the hospital’s tissue culture laboratory. There Dr George Gey, head of the laboratory, had been working for a few years on a system whereby human cells would continuously divide and grow in culture dishes. Gey had had no success thus far, but when he placed Lacks’s cells in culture, they behaved very differently.

Lacks’s cells survived, multiplied, grew robustly, and continued to do so for weeks and months afterwards – subsequently generating the first immortalised human cell line.

Gey never made a profit from these “HeLa” cells – named after Henrietta Lacks – but did distribute them to other scientists. Since then, the HeLa cells have been grown in countless laboratories across the globe and have now lived for twice as long outside Lacks’s body as they did inside it.

HeLa cells have revolutionised medical research, made countless contributions to medicine – from vaccine production to fertility treatment – and have been the foundation of a multi-billion dollar industry.

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

Dear Mr. President: It’s Time for Your Bioethics Commission

by Craig Klugman, Ph.D.

Last week, seven Democratic members of the U.S. House Representatives sent a letter to the White House asking President Trump to appoint a director to the Office of Science and Technology Policy (OSTP), position that normally serves as the presidential science advisor. The impetus for writing the letter was a communication from the Deputy National Science Advisor that two hoax reports, that tried to undermine climate change, were circulating through the West Wing as “science.” The Congresspersons state “Where scientific policy is concerned, the White House should make use of the latest, most broadly-supported science…Relying on factual technical and scientific data has helped make America the greatest nation in the world.” Among the signers are a PhD in math and a PhD in physics. They hold that the U.S. faces strong questions that revolve around science, both opportunities and threats, and the need for a scientist who can understand and explain the importance of objective fact to the chief executive is essential.

This article led me to think that the U.S. also faces a lot of issues regarding health and medicine and their impact on society. Consider the task of creating a new health plan, CRISPR/CAS-9, in vitro gametogenesis, the threat of Zika, extra uterine gestational systems, legalized marijuana, digital medicine—pharmaceutical computing for treating disease, head transplants, and DYI science are among the bioethical issues that will effect policy in the coming few years. Thus, it is time for President Trump to call for his Presidential Bioethics Commission.

The last bioethics advisory body ended in January 2017, although many of the staff are still winding down the office and archiving the many reports and papers produced.

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

How you’ll grow up, and how you’ll grow old

By Nathan Ahlgrim
Nathan Ahlgrim is a third year Ph.D. candidate in the Neuroscience Program at Emory. In his research, he studies how different brain regions interact to make certain memories stronger than others. In his own life, he strengthens his own brain power by hiking through the north Georgia mountains and reading highly technical science…fiction.

An ounce of prevention can only be worth a pound of cure if you know what to prevent in the first place. The solution to modifying disease onset can be fairly straightforward if the prevention techniques are rooted in lifestyle, such as maintaining a healthy diet and weight to prevent hypertension and type-II diabetes. However, disorders of the brain are more complicated – both to treat and to predict. The emerging science of preclinical detection of brain disorders was on display at Emory University during the April 28th symposium entitled, “The Use of Preclinical Biomarkers for Brain Diseases: A Neuroethical Dilemma.” Perspectives from ethicists, researchers conducting preclinical research, and participants or family members of those involved in clinical research were brought together over the course of the symposium. The diversity of panelists provided a holistic view of where preclinical research stands, and what must be considered as the field progresses.
Throughout the day, panelists discussed different ethical challenges of preclinical detection in the lens of three diseases: preclinical research and communicating risk in the context of Autism Spectrum Disorder (ASD), interventions and treatment of preclinical patients in the context of schizophrenia, and the delivery of a preclinical diagnosis and stigma in the context of Alzheimer’s disease.

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

Medical Students Can Handle the Truth; Their Mentors Should be More Open About It

By Shannon Tapia

Medical School is rough.  Fortunately there is a recent movement to make medical education more humane.  The movement to bring humanity, ethics, and love back into the molding of our future physicians is crucial. Personally, I felt my medical school was on the forefront of this push.  Perhaps it was because we had Jesuit priests for attendings and the hospital’s motto of “We also treat the human spirit” filtered into the treatment of students.  Whether it was something about myself or my medical school, I was fortunate to never experience the depression, competitive urges, burnout and isolation that is so prevalent during American medical school years…

But there is an underlying and hidden truth that is never spoken about, or at least wasn’t to me, in medical school.  As students we are warned how tough medical school is and furthermore how absolutely draining residency is.  When we’re in the thick of either in even the most uplifting programs and schools, we are monitored for burnout, offered services to prevent it, and given support in ways students and residents of the 20th century never were. More frequently now, we are prepared for these harsh realities.  But what we’re not told, ever, is that even if and when we make it through medical school and residency/fellowship to attending physicians we may well find it’s not greener on the other side.  We may still first experience burnout when we’re supposed to be summiting our Everest Mountain of medical training. As many mountain climbers will tell you, often the way down from the peak is just as hard if not harder than the climb up.

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

Agreement and disagreement about experimental treatment. The Charlie Gard Appeal

by Dominic Wilkinson and Julian Savulescu

@Neonatalethics

@juliansavulescu

Tomorrow, the UK Court of Appeal will review the controversial case of a British infant, Charlie Gard. Charlie’s parents are appealing a recent High Court decision that gave doctors permission to withdraw his life support. They have raised money for Charlie to travel to the US for an experimental medical treatment.

 

Best Interests

The legal decision for Charlie will be based upon an assessment of his best interests. He has a rare genetic disorder affecting his muscles and his brain. He has been on life support since last October and has been progressively deteriorating. A neurologist in the USA has suggested that experimental nucleoside treatment might, in theory, offer some benefit, though it has never previously been tried in this situation.

The central ethical question is whether it would be best to provide the experimental treatment and continue intensive care for Charlie for several months more, or to withdraw treatment and allow him to die. How should we weigh up the risks and benefits of those two alternatives?

We have previously written about this difficult question. In a pair of editorials in the Lancet medical journal, we expressed different points of view. Dominic Wilkinson argued that the proposed course of treatment would do more harm than good. In his view, it is likely that Charlie would experience pain and discomfort from continued treatment; it is also unlikely, given what is known about it, that Charlie would benefit from nucleoside treatment. In contrast, Julian Savulescu argued that it is not clear that continued mechanical ventilation in intensive care is so terrible a life that it would not be worth living.

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

Nudges in a post-truth world.

Guest Post: Neil Levy

Full Article: Nudges in  a Post-Truth World

Human beings are motivated reasoners. We find ways to believe what we want to believe, sometimes even in the face of strong evidence to the contrary. This fact helps to explain why so many political issues are intractable, and why so many of us reject the scientific consensus on urgent issues like GMOs, vaccination and climate change. Given the importance of these issues, any means of increasing our responsiveness to evidence deserves exploration.

Nudges – proposals, stemming from the behavioural sciences, for changing the way people act by changing their environments – may be one way of increasing responsiveness to evidence. In my paper, I briefly review evidence that suggests that people resist messages for (apparently) irrelevant reasons, and that by focusing on these reasons, we can make them more responsive to these messages. For instance, people tend to dismiss testimony that comes from those who do not share their political ideology, even when the issue is an empirical one (like climate change). There is evidence that ensuring that the ideology of the source matches the ideology of the audience makes the audience more receptive to the message.

But nudges are ethically controversial. There are a number of reasons why they are controversial, but the central reason is that many people see them as threatening the autonomy of the nudged. It is one thing to address people are reasoning beings, by giving them arguments. It is another to address them as mechanisms, bypassing their reasoning.

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 Very Early Embryo & Its Moral Signifiance

by Andrew J. Prunty

As technology and biological research continue to develop in the twenty-first century, it is necessary to address and further define the ethical considerations of embryonic research and the appropriate rights that may limit the extent of human research on zygotes, blastocysts, and fetal scientific advancement. Because the area of harvesting embryonic stem cells remains significantly undefined, both legally and morally, there are vastly different opinions between researchers and bioethicists, mainly because of ethical limitations, on the rights that should be granted to cells with the potential to develop into human beings and the consequences of neglecting significant scientific research or advancement.

Current laws in the United States differ at the federal and state level, but there is no consistency in recognizing human embryos as humans, or affording them the same legal rights granted to a child; in fact, legal precedent actually detracts certain rights from developing embryos, favoring a human’s ability to destroy a potential human being (i.e. Roe v. Wade[i]) or the categorization of embryos as property (i.e. Davis v. Davis[ii], A.Z. v. B.Z.[iii], Marriage of Dahl[iv], or Reber v. Reiss[v]). These case law samples suggest the courts’ inability to reach a conclusion as to what is the status of an embryo.

The debate is not only circumscribed to matters of research, but to fundamental controversial and intertwined issues of bioethics such as: when life begins, embryonic stem cells, fetal rights, abortion, et cetera. All these topics are contentious and when one topic arises, they begin to comingle.

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

Research Ethics Roundup: Nature Argues Against Research Censorship, New Comparative Genetics Study, WHO Considers Deploying Experimental Ebola Vaccine, Majority of Completed Stem Cell Clinical Trials Never Published

This week’s Research Ethics Roundup highlights a Nature editorial that encourages researchers to push back against both public and private forms of censorship in research contracts, the National Institute of Health (NIH)’s Comparative Genomics Branch issues new study with implications for both human and dog disease research, the World Health Organization (WHO) speaks with Doctors Without Borders about using an experimental vaccine to target a new Ebola outbreak, and bioethicists’ concern about stem cell researchers’ failure to publish study results including discoveries on side effects.

The post Research Ethics Roundup: Nature Argues Against Research Censorship, New Comparative Genetics Study, WHO Considers Deploying Experimental Ebola Vaccine, Majority of Completed Stem Cell Clinical Trials Never Published appeared first on Ampersand.

Source: Ampersand, the blog of PRIM&R.

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.