Tag: health care

Bioethics Blogs

Scales and the Emotional Underside of Fatphobia

Michael Orsini explains the pervasiveness of discrimination, fear, and hatred related to ‘fatness.’

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It’s convenient to dismiss the recent flap over the removal of scales at the Carleton University gym as yet another case of political correctness run amok.

Did Carleton Athletics simply cave in to pressure from overly sensitive gym patrons who were ‘triggered’ by the sight of a scale? While tempting, that would be the wrong question to ask in the wake of this controversy. Rather, what is it about weight itself that would unleash such a torrent of emotion and name-calling?

Conservative media commentators mocked the University for its decision, revealing the extent to which the conservative battle against political correctness is fueled by ugly views about fatness.

That is not to say that all liberals are fat-loving citizens. Far from it. Fatness arouses a range of complex moral emotions in all of us, from feelings of pity and sympathy to fear and disgust, regardless of our ideological leanings.

In a world in which we come to rash conclusions about people based upon their appearance, being fat or ‘obese’ is shorthand for being slovenly, lazy, and ‘out of control.’ As Nobel Prize winner Daniel Kahneman argues in his best-selling book, Thinking, Fast and Slow, we often make decisions based on visceral feelings, strongly felt emotions that typically serve as poor guides. For example, in discussing the palpable fear of shark attacks, Freeman Dyson notes that we pay more attention to sharks because they frighten us, even though “riptides occur more frequently and may be equally lethal.”

How does this matter here?

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

Why Trumpcare Is DOA: It Doesn’t Address Outrageous Healthcare Prices

Paul Ryan is “excited” that the American Health Care Act, as Republicans call their bill, will trim the federal budget by several hundred billion dollars over the next decade. The 24 million people who are expected to lose insurance under the AHCA aren’t excited about the bill, which will cut government spending at their expense, with potentially fatal consequences for those who go without timely medical care.

Debates over healthcare reform often ask us to pick our poison. We either save money or we save lives.

But these debates ignore an antidote to this poisonous choice. If we tackle high healthcare prices, we can insure Americans at the same time as we curb healthcare expenditures.

This antidote is not theoretical conjecture. In fact, most developed countries provide universal insurance to their residents while spending far less per capita than the U.S. This affordable coverage exists in countries where healthcare payment is socialized, like the UK and Canada, and where it is privatized, like Germany and Switzerland. That’s because all these healthcare systems work to rein in high healthcare prices. As a result, appendectomies cost half as much in Switzerland as in America; and knee replacements cost 30% less in the UK than in the U.S.

Unfortunately, prices have been largely absent from healthcare reform debates in the U.S., whether those reforms are crafted by Democrats or Republicans. It’s true that politicians from both sides of the aisle occasionally speak out about pharmaceutical prices. Both Donald Trump and Hillary Clinton criticized pharmaceutical CEOs, like smirking Martin Shkreli, who made the news after enacting outrageous price hikes.

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

Conscience Based Objection in Healthcare and Limiting Patient Liberty- Arizona Gives Broad Right

Governor Ducey

The Arizona Legislature has just passed a bill that permits healthcare providers to refuse patient-requested end-of-life treatment.  On March 22, S.B. 1439 was sent to Governor.  

The bill provides in part:

“A health care …

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

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

9 Health Reform Lies Congress Members Are Telling Their Constituents

The takeaway from a review by ProPublica and its partners at Kaiser Health News, Stat, and Vox of more than 200 letters that members of Congress sent out to their constituents in response to the public’s questions and concerns about the Affordable Care Act and its proposed replacement, the GOP’s American Health Care Act

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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

The Future of Bioethics: Organ Transplantation, Genetic Testing, and Euthanasia

By Ana Lita

When you think of bioethics, some of the first hot-button topics you may consider are organ transplantation, fertility and genetic engineering, and end-of-life-care. The Global Bioethics Initiative serves as a platform to address many bioethical questions and engages in public debates to develop resolutions to present and emerging issues.

Dr. Ana Lita, founder of the Global Bioethics Initiative, discusses the various areas GBI addresses and highlights the organization’s contributors in their prospective fields. She acknowledges the valuable contribution of the current president of GBI, Dr. Bruce Gelb, in the field of organ transplantation. She also addresses the original co-founder of GBI, Dr. Charles Debrovner, and his lifelong passion in the field of fertility and genetic engineering. Lastly, Dr. Lita offers a brief insight into the future of Bioethics in these uncertain times.

ORGAN MARKETS AND THE ETHICS OF TRANSPLANTATION 

Recent developments in immunosuppressive drugs and improved surgical techniques have now made it much easier to successfully transplant organs from one human body to another. Unfortunately, these developments have led to the rise of black-markets in human organs. This underground market is where people who need kidneys to survive or to improve the quality of their lives, for example, purchasing such organs from impoverished persons in the developing world. In January 2017, scientists announced that they successfully created the first human-pig hybrid and a pig embryo with some human characteristics. Given the increasing need for transplant organs, should such markets be regulated and legalized?  Could the success of therapeutic cloning eliminate the need to consider this option?

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

A Public Cervix Announcement

January 27, 2017

by Sean Philpott-Jones, Chair, Bioethics Program of Clarkson University & Icahn School of Medicine at Mount Sinai

A Public Cervix Announcement

On Monday, just days after millions of women (and their allies) marched in political demonstrations, researchers reported a disturbing new finding that could affect the health and wellbeing of these protestors. In a study published in this month’s issue of the journal Cancer, scientists found that a woman’s risk of dying from cervical cancer was much higher than originally suspected.

Cervical cancer is the fourth most common cancer in women worldwide. It also has the fourth highest mortality rate. Approximately 13,000 cases of invasive cervical cancer are diagnosed annually among American women. The number of women diagnosed with cervical cancer has decreased significantly over the past 40 years, largely due to widespread use of the Pap test (or smear) to screen for the presence of precancerous lesions on the cervix, but over 4,000 women still succumb to the disease every year.

Previously, health experts had used those numbers to estimate that cervical cancer killed approximately 5.7 of 100,000 black women and 3.2 of 100,000 white women in the US. That racial disparity in death rates is pretty stark, particularly when you consider rates of cervical cancer incidence and mortality among other racial and ethnic groups. For example, Latinas have even higher incidence rates than black women — Hispanic women in the US are more likely to be diagnosed with cervical cancer — but in recent years the death rate in this group has fallen to the point where it is similar to that of white women.

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

Means to an End

According to a recent survey of nearly 8,000 Americans, over two-thirds do not have an Advance Directive, Living Will, Health Care Proxy or similar document. They don’t because they don’t know about them or because they assume their families already know their end-of-life wishes. Unfortunately, the few studies that have looked at the accuracy of family decision-making have also found that most health care proxies might as well just guess what their loved one wants. Surrogate accuracy is only slightly above chance, with rates of accuracy running about 50-65%. This is largely because too many people avoid conversations about end-of-life planning. Talking about death is difficult even under the best of circumstances, let alone our own end-of-life wishes. We all expect to live for decades more. But life is unpredictable, and the only thing that is certain is that none of us get out of it alive. While it might be difficult to contemplate our own mortality, we owe it to those that we love to make sure that they know what we want when the inevitable comes.

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Source: The Bioethics Program Blog, by Union Graduate College & The Icahn School of Medicine at Mount Sinai.

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

Ethics of the Trump Budget: The Social Contract is Dead

by Craig Klugman, Ph.D.

President Trump released his blueprint for a 2018 federal budget. From an ethical standpoint, the President seems to operates from a Hobbesian standpoint—life is nasty, brutish and short. However, unlike Hobbes who believed that we came together to protect ourselves from this reality, the new budget seems to encourage this idea. The new budget makes deep cuts to all social and scientific programs while boosting the military. In Hobbesian terms, Trumps’ social contract is all about bullying outsiders while leaving insiders in a state of hopeless diffidence.

Since World War II, the United States has invested heavily in science and technology, developing transportation, and building a better world (and winning wars). Since the 1960s, the US has provided a safety net for the poor, support for the arts, and public broadcasting. Since 1970, the U.S. has worked to ensure that people have the opportunity for flourishing by protecting the environment, providing financial aid for college, and strengthening our relationships with international partners—peace through diplomacy.

The 2018 budget undoes 80 years of social progress and support. The new budget defunds the Corporation for Public Broadcasting, National Endowment for the Humanities, National Endowment for the Arts, and most development agencies. Also eliminated are environmental management, research and education; after school programs, clean energy, chemical safety, community services and development, national service programs, clean air, home investment programs, energy assistance programs for low income adults, minority business development, science education, support for the homeless, and peace.

In addition, the budget significantly reduces funding for science (medicine, basic research, NASA, climate science), health care, the Environmental Protection Agency, the State Department, Departments of Labor, Agriculture, Commerce, Education, Housing & Urban Development, Transportation and Interior.

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 private should genetic information be?

One of the issues regarding genetic testing is the privacy of that information. It has been recognized for some time that employers and others could use genetic information in ways that would cause problems for those whose genetic information they were able to access. Because of that the federal Genetic Information Nondiscrimination Act (GINA) and the Americans with Disabilities Act (ADA) prohibit employers from asking employees to have genetic testing done. According to a recent article in the National Law Review, there is a bill currently in Congress, HR 1313 that would exempt employers from the restrictions of the GINA and ADA if the testing is being done as part of a workplace wellness program. Employers would be able to require employees to have genetic testing done as a part of the program and employees who refused would be subject to a significant increase in their health insurance premiums.

I think there are significant moral concerns about this change. Privacy regarding medicine information and genetic information in particular is important. People should be able to choose who they allow to have that information and they should be able to choose whether they want to undergo genetic testing. There are situations in which people would prefer not to know some things. There are limits to privacy and when another person is act risk of harm. Privacy may be less important than preventing harm to that person. However, workplace wellness programs which may be well meaning and may provide some benefit to the employees are being done as much for the benefit of the employer to try to lower health care costs as they are for the employees.

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

Repeal, Replace and Leave Out Immigrants: The American Health Care Act’s Impact on Immigrants

Given the Trump Administration’s stance on immigration, it probably shouldn’t be surprising that the new health law it is touting, the American Health Care Act (AHCA), will likely have a devastating effect on immigrant and their families. Although not surprising, … Continue reading

Source: Bill of Health, examining the intersection of law and health care, biotech & bioethics.

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.