Bioethics Blog Posts Tagged health care

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Advance Care Planning and its Detractors

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Source: bioethics.net, a blog maintained by the editorial staff of The American Journal of Bioethics.

Excerpt:

The default mode of our technologically advanced medicine is to use our technology. Nowhere is this more true than close to the end of life. And our technology is really impressive; with it, we can keep chests going up and down and hearts beating for a long, long time.

The troubling thing is that there are many people who would rather not have lots of machines keeping their bodies going, thank you, maybe you could just give me some oxygen and pain medicine and let me die at home with my family? But they never get a chance to talk about it with their doctors, mostly due to doctors’ lack of time or comfort in addressing such questions. And, unlike every other procedure in medicine, doctors don’t need your permission to do one of the most invasive procedures of all to you: CPR. Of course, CPR is generally performed on someone who is indisposed and unable to give their informed consent to the procedure. And CPR is often the first step on the technological path of ventilators, tubes, dialysis, medications to support the blood pressure, machines that keep the heart pumping, and all of those wonderful interventions that are life-saving when used appropriately and death-prolonging when used indiscriminately. Treatments that treat . . . nothing.

Ideally, doctors take time to discuss patient preferences about such treatments with patients and their families before the occasion to intervene arises; however, the factors noted above make such discussions rare.

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

Human germline genome editing: An ‘impressive’ sleight of hand?

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Source: Impact Ethics: Making a Difference in Bioethics.

Excerpt:

Françoise Baylis wonders how it is that in 14 months (from December 2015 to February 2017), the U.S. National Academy of Sciences and the U.S. National Academy of Medicine have moved human germline genome editing out of the category ‘irresponsible’ and into the category ‘permissible.’

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In December 2015, the U.S. National Academy of Sciences, the U.S. National Academy of Medicine, the Chinese Academy of Sciences and the U.K.’s Royal Society co-hosted an International Summit on Human Gene Editing. At the close of the meeting, members of the Summit Organizing Committee issued a Statement that included four discrete conclusions. In response to the Statement, the Presidents of the four co-sponsoring organizations confirmed that: “Together with academies around the world, and in coordination with other international scientific and medical institutions, we stand ready to establish a continuing forum for assessment of the many scientific, medical, and ethical questions surrounding the pursuit of human gene-editing applications.”

One of the pivotal conclusions in the 2015 Statement was that “it would be irresponsible to proceed with any clinical use of germline editing unless and until (i) the relevant safety and efficacy issues have been resolved, based on appropriate understanding and balancing of risks, potential benefits, and alternatives, and (ii) there is broad societal consensus about the appropriateness of the proposed application.”

This conclusion has since been usefully characterized as a helpful ethics framework for decision-making about heritable germline modification. The framework is both beautifully simple and exquisitely complex.

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