Tag: justice

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

Silence = Death

May 18, 2017

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

Silence = Death

As Donald Trump fights for his political life following new revelations about wholly inappropriate disclosure of classified materials and potential obstruction of justice, he has quietly issued new orders that will condemn thousands of women and children around the world to death.

Largely overlooked given the media frenzy about the appointment of a special prosecutor to investigate Russian interference in the US Presidential election was an announcement that the TrumpAdministration will vastly expand the scope of the “Global Gag Rule”, the international anti-abortion policy first enacted by Ronald Reagan in 1984.

Also known as the Mexico City Policy, the rule prohibits organizations that receive family planning money from the United States Agency for International Development (USAID) from providing or promoting abortion. This is true even if they do so with private money. In fact, if they take so much as a single dollar from the US, they can’t even mention the word ‘abortion’ regardless of whether or not these organizations actually provide such services.

Every time a Democrat is in the White House, the global gag rule is rescinded. Every time a Republican enters the Oval Office, it is reinstated. President Trump himself did so just three days after assuming office. Until now, family planning organizations around the world have largely learned to deal with this ebb-and-flow. That is all about to change.

On Monday, Trump announced a new policy called Protecting Life in Global Health Assistance. That policy expands the scope of the Global Gag Rule.

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

Oxford Uehiro Prize in Practical Ethics:In It To Win It: Is Prize-giving Bad for Philosophy? Written by Rebecca Buxton

This essay received an Honorable Mention in the Graduate Category of the Oxford Uehiro Prize in Practical Ethics 2017

Written by University of Oxford student, Rebecca Buxton

INTRODUCTORY REMARKS
We live in a culture of prize-giving. The Nobel Prize, the Medal of Honour, the Man Booker and, not least, the Oxford Uehiro Prize in Practical Ethics. But, in giving such prizes, and indeed prize money, we operate under the assumption that prizes are ‘good’. However, the fact that I am offered a prize for writing
a practical ethics paper is itself a practical ethical conundrum. This essay takes a preliminary amble into the ethical problem of prize-giving with regards to Philosophy specifically, offering reasons as to why we should question current practice. Primarily, I will define what we mean by the term ‘prize’ noting its
necessary and sufficient features. Secondly, I discuss the impact of prize-giving on research, considering how the ramifications of ascribing value through prizes affects the course of academia, especially when focusing on the lack of diverse voices within the subject. I then consider the deeper question of philosophical value: does the very act of constructing an ethical argument for a prize diminish the value of the work?

THE IDEA OF ‘THE PRIZE’
Though prize-giving is prolific in our current institutional culture, we lack any analytically clear literature on what constitutes a ‘prize’. There is, however, some work focusing on the philosophical concept of ‘the gift’, most notably Derrida’s argument that the ‘true’ gift is impossible as we can never eliminate the possibility of the counter-gift.[1] Unlike gifts, prizes depend upon a reciprocal process; you receive a prize in virtue of being or doing something.

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 Symposium – More Legitimacy: Social Justice, Vulnerable Populations and Bias

Join Kaiser Permanente from November 2-4, 2017, in Berkeley for “Bioethics Symposium – More Legitimacy: Social Justice, Vulnerable Populations and Bias.”

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 Blogs

Happy 15th Birthday, Neuroethics!

By Henry T. Greely

Henry T. (Hank) Greely is the Deane F. and Kate Edelman Johnson Professor of Law and Professor, by courtesy, of Genetics at Stanford University. He specializes in ethical, legal, and social issues arising from advances in the biosciences, particularly from genetics, neuroscience, and human stem cell research. He directs the Stanford Center for Law and the Biosciences and the Stanford Program on Neuroscience in Society; chairs the California Advisory Committee on Human Stem Cell Research; is the President Elect of the International Neuroethics Society; and serves on the Neuroscience Forum of the National Academy of Medicine; the Committee on Science, Technology, and Law of the National Academy of Sciences; and the NIH Multi-Council Working Group on the BRAIN Initiative. He was elected a fellow of the American Association for the Advancement of Science in 2007. His book, THE END OF SEX AND THE FUTURE OF HUMAN REPRODUCTION, was published in May 2016. 

Professor Greely graduated from Stanford in 1974 and from Yale Law School in 1977. He served as a law clerk for Judge John Minor Wisdom on the United States Court of Appeals for the Fifth Circuit and for Justice Potter Stewart of the United States Supreme Court. After working during the Carter Administration in the Departments of Defense and Energy, he entered private law practice in Los Angeles in 1981. He joined the Stanford faculty in 1985. 
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.

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, sexuality, and dementia in long-term care

Alisa Grigorovich and Pia Kontos suggest that long-term care residents with dementia can benefit from leisure and social activities that are supportive of sexual expression and the formation of intimate and romantic relationships.

__________________________________________

Recently, media stories on dementia have focused on the sexualities of persons living with dementia in residential long-term care settings, such as nursing homes. This media attention has been predominantly negative, consisting of descriptions of sexual violence, and apocalyptic warnings of the legal, ethical, and moral dangers of allowing persons with dementia to express their sexuality.

Often the primary criterion used to determine whether sexual encounters between residents with dementia are involuntary is the cognitive ability of the female resident. Frequently, she is characterized as globally incapable of agreeing to sexual activity because of cognitive impairment.

Consider, for example, the now infamous case of Henry Rayhons. He was accused (and ultimately acquitted) of sexually assaulting his wife who had dementia. As well, there is the lawsuit filed in a case involving two residents with dementia who had intercourse while living in Windmill Manor. While such stories highlight the importance of protecting vulnerable persons from sexual abuse, they ignore the need to also ensure that persons with dementia have opportunities to pursue intimate and romantic relationships.

Sexual expression is a universal human need that transcends age and disability. It has many positive health and wellness benefits, including the opportunity to experience pleasure, decreased pain sensitivity, and increased relaxation. However, older persons living in nursing homes often experience reduced sexual freedom.

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

Oxford Uehiro Prize in Practical Ethics: Prostitution: You Can’t Have Your Cake and Sell It*. Written by Simon-Pierre Chevarie-Cossette

This essay received an Honorable Mention in the Graduate Category of the Oxford Uehiro Prize in Practical Ethics 2017

Written by University of Oxford student, Simon-Pierre Chevarie-Cossette

Abstract:        I offer a new** argument for the thesis that prostitution is not just a normal job. It has the advantage of being compatible with the claim that humans should have full authority over their sexual life. In fact, it is ultimately the emphasis on this authority that leads the thesis that prostitution is a normal job to collapse. Here is the argument: merchants cannot (both legally and morally) discriminate whom they transact with on the basis of factors like the ethnicity or the religion of their client; but if prostitutes are ‘sex merchants’, then they cannot (both legally and morally) discriminate whom they have sex with on the basis of these factors. Yet everyone should have the full discretionary power to refuse to have sex under any circumstances.

1. Introduction

You have made it thus far: the wedding preparation is almost over. You enter your local bakery, cheekily anticipating the moment when you’ll order a wedding cake for ‘John & John’. But to your dismay, the baker turns you down because your marriage goes against his ‘Christian beliefs’.

This is a true story and it is a recurrent one. In 2013, Administrative Law Judge Robert N. Spencer found the owner of Masterpiece Cakeshop guilty of discrimination on the basis of sexual orientation.[1] The decision was then maintained by the Colorado Civil Rights Commission[2] and again by the Court of Appeal[3].

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

Aid in Dying Court Appeal Comes to New York Court of Appeals May 30; Strong, Diverse and Growing Support in Amicus Briefs

The right of terminally ill, mentally competent adults to achieve a more peaceful death is at stake in Myers v. Schneiderman, now before the New York Court of Appeals, NY’s highest state court.  Oral arguments will be held in Albany on May 30.


The appeal seeks to reverse lower court decisions that dismissed the case prior to trial.  The case seeks to establish the right of terminally ill patients to receive a prescription for medication which they can self ingest to achieve a peaceful death if confronted by suffering they find unbearable.


Wide support for the plaintiffs is demonstrated by a multitude of amicus briefs submitted to the court by diverse parties representing patients and their loved ones, medical, religious and civil liberties organizations as well as national legal associations.  Two of these organizations are supporting the legalization of aid in dying as an amicus for the first time.


Kathryn Tucker, Executive Director of End of Life Liberty Project, and co-counsel in the case, said, “We are very pleased to see a large number of important voices joining us in seeking reversal of the lower court dismissal of the case. It is especially interesting to note the appearance of new voices not previously involved in aid in dying cases.”


Ms. Tucker noted, “Two new ‘friends’ of end of life liberty are stepping forward in Myers. For the first time in a case seeking to establish access to aid in dying, a state chapter of the National Academy of Elder Law Attorneys (NAELA) is participating as an amicus in support of patients and physicians.

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

Aid in Dying Court Appeal Comes to New York Court of Appeals May 30; Strong, Diverse and Growing Support in Amicus Briefs

The right of terminally ill, mentally competent adults to achieve a more peaceful death is at stake in Myers v. Schneiderman, now before the New York Court of Appeals, NY’s highest state court.  Oral arguments will be held in Albany on May 30.


The appeal seeks to reverse lower court decisions that dismissed the case prior to trial.  The case seeks to establish the right of terminally ill patients to receive a prescription for medication which they can self ingest to achieve a peaceful death if confronted by suffering they find unbearable.


Wide support for the plaintiffs is demonstrated by a multitude of amicus briefs submitted to the court by diverse parties representing patients and their loved ones, medical, religious and civil liberties organizations as well as national legal associations.  Two of these organizations are supporting the legalization of aid in dying as an amicus for the first time.


Kathryn Tucker, Executive Director of End of Life Liberty Project, and co-counsel in the case, said, “We are very pleased to see a large number of important voices joining us in seeking reversal of the lower court dismissal of the case. It is especially interesting to note the appearance of new voices not previously involved in aid in dying cases.”


Ms. Tucker noted, “Two new ‘friends’ of end of life liberty are stepping forward in Myers. For the first time in a case seeking to establish access to aid in dying, a state chapter of the National Academy of Elder Law Attorneys (NAELA) is participating as an amicus in support of patients and physicians.

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

In the Journals – April 2017 by Danya Glabau

Critical Public Health

On difference and doubt as tools for critical engagement with public health

Catherine M. Will

This paper argues that critical public health should reengage with public health as practice by drawing on versions of Science and Technology Studies (STS) that ‘de-centre the human’ and by seeking alternative forms of critique to work inspired by Foucault. Based on close reading of work by Annemarie Mol, John Law, Vicky Singleton and others, I demonstrate that these authors pursue a conversation with Foucault but suggest new approaches to studying contemporary public health work in different settings. Proposing that we ‘doubt’ both the unity of public health and its effects, I argue that this version of STS opens up a space to recognise multiplicity; to avoid idealising what is being criticised; and to celebrate or care for public health practices as part of critique. Finally I oppose the view that considering technologies, materials and microbes leads to micro-level analysis or political neutrality, and suggest that it allows us to reframe studies of public health to account for inequalities and to draw attention to weak or retreating states, active markets and the entangled relations of humans and non-humans across the world.

 

Biopolitical precarity in the permeable body: the social lives of people, viruses and their medicines

Elizabeth Mills

This article is based on multi-sited ethnography that traced a dynamic network of actors (activists, policy-makers, health care systems, pharmaceutical companies) and actants (viruses and medicines) that shaped South African women’s access to, and embodiment of, antiretroviral therapies (ARVs).

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.