Tag: mortality

Bioethics Blogs

Harvey and Irma: Bioethics in Natural Disasters

by Craig Klugman, Ph.D.

This is a time of disaster. Last week Hurricane Harvey devastated Southeast Texas, a place where I did my doctoral studies. This week we are awaiting Hurricane Irma, the strongest hurricane to head toward South Florida in 25 years. My family lays in the path of that coming storm. I first became interested in natural disaster in 1989 when my college campus was jolted by a 7.1 earthquake in Northern California.

Bioethics has a role in responding to and preparing for these natural disasters. Most every state, large city and county, and most hospitals have been working on crisis standards of care plans. In 2009 and again in 2012, the Institute of Medicine recommended governments to undertake such planning. Many of us working in bioethics have been involved in these efforts. More specifically, we have been involved with developing ethical frameworks for decision-making, policy-making, and operations during emergency planning.

I worked with Texas during its planning for pandemic flu and for the last 3 years have been part of the ethics subcommittee of Illinois’ workgroup, most recently as chair. Similar groups have produced excellent reports in many places such as Delaware, North Carolina, Michigan, Minnesota, Tennessee, Texas and Toronto. They offer guidance and justification for a varied set of guiding principles and ethical frameworks. All of them hold certain core ideals in common.

First, all of the reports agree that transparency and open communication is essential. Planning needs to involve not only government officials, but also community members.

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

Human genetic architecture, mapped for the first time, shows objective sexual differences

Men and women is not just a social construct as affirm gender ideology. This work provides evidences of the sex-differential transcriptome and its importance to human entire body and physiology. Around 6,500 genes with activity that was biased toward one sex or the other in at least one tissue.

Shmuel Pietrokovski and Moran Gershoni, both researchers in the Molecular Genetics Department at the Weizmann Institute of Sciences, have revealed that close to 6,500 protein-coding human genes react differently in males and females (BMC, 6 – 1 – 2017, see HERE).

This finding is contrary to gender ideology, which considers that the difference between men and women is a social and/or cultural fact, i.e., a construct, rather than something biological or natural (see HERE). In a recent article, the scientists said that, in order identify the thousands of genes, they turned to the GTex project, a very large study of human gene expression in which numerous organs and tissues of the body had been examined in more than 550550 adult donors

Human sex genetic architecture differences were mapped

According to the authors, “that project enabled, for the first time, the comprehensive mapping of the human sex-differential genetic architecture”.

The researchers examined close to 20,000 protein-coding genes, classifying them by sex and searching for differences in expression in each tissue.

The eventually identified “around 6,500 genes with activity that was biased toward one sex or the other in at least one tissue”.

In the same manner, many genes that are associated with sexually dimorphic traits might undergo differential selection, which will likely impact reproduction, evolution, and even speciation events.

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

Rural-Urban Gap in Some Vaccination Rates Leaves Health Officials Puzzled

August 25, 2017

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New data on vaccination rates among U.S. teenagers provide some heartening news — but also pose a bit of a mystery.

The report, from the Centers for Disease Control and Prevention, shows parents of teenagers are in the main following the CDC’s advice and keeping their children up to date on vaccines that should be administered in the early teens.

But the 2016 survey revealed big differences in the rates of teenagers who are vaccinated with some but not all recommended vaccines, depending on whether they live in cities or more rural locations. And that fact is puzzling the CDC scientists who analyzed the data, published Thursday in the CDC journal Morbidity and Mortality Weekly Report.

… Read More

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STAT

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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

Intent On Reversing Its Opioid Epidemic, A State Limits Prescriptions

August 23, 2017

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Maine’s law, considered the toughest in the U.S., is largely viewed as a success. But it has also been controversial — particularly among chronic pain patients who are reluctant to lose the medicine they say helps them function.

Ed Hodgdon, who is retired and lives in southern Maine, was just that sort of patient — at least initially.

Name a surgery, and there’s a decent chance Hodgdon has had it.

“Knee replacement. Hip replacement. Elbows. I’ve got screws in my feet,” he says.

… Read More

Image via Flickr Attribution Some rights reserved by somegeekintn

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NPR Shots

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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 Feminist Neuroethics of Mental Health

By Ann E. Fink
Ann Fink is currently the Wittig Fellow in Feminist Biology at the University of Wisconsin–Madison, with an appointment in Gender and Women’s Studies and concurrent affiliations with Psychology and the Center for Healthy Minds. Her research in cellular and behavioral neuroscience has appeared in the Journal of Neuroscience, Journal of Neurophysiology, PNAS and other journals. Ann’s interdisciplinary work addresses the ethics of neuroscience in relation to gender, mental health and social justice. 

Emotionality and gender are tied together in the popular imagination in ways that permeate mental health research. At first glance, gender, emotion, and mental health seem like a simple equation: when populations are divided in two, women show roughly double the incidence of depression, anxiety, and stress-related disorders1-3. Innate biological explanations are easy to produce in the form of genes or hormones. It could be tempting to conclude that being born with XX chromosomes is simply the first step into a life of troubled mood. Yet, buried in the most simplistic formulations of mental illness as chemical imbalance or mis-wiring is the knowledge that human well-being is a shifting, psychosocial phenomenon. Learning and memory research offers a treasure trove of knowledge about how the physical and social environment changes the brain. Feminist scholarship adds to this understanding through critical inquiry into gender as a mode of interaction with the world. This essay explores how a feminist neuroethics framework enriches biological research into mental health. 
Problems with “Biology-from-birth” stories 
What if understanding gender and health isn’t a tale of two gonads (or genitalia, or chromosomes)?

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

Many Nurses Lack Knowledge of Health Risks for New Mothers, Study Finds

August 17, 2017

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In recent months, mothers who nearly died in the hours and days after giving birth have repeatedly told ProPublica and NPR that their doctors and nurses were often slow to recognize the warning signs that their bodies weren’t healing properly. Now, an eye-opening new study substantiates some of these concerns.

The nationwide survey of 372 postpartum nurses, published Tuesday in the MCN/American Journal of Maternal/Child Nursing, found that many of them were ill-informed about the dangers new mothers face. Needing more education themselves, they were unable to fulfill their critical role of educating moms about symptoms like painful swelling, headaches, heavy bleeding and breathing problems that could indicate potentially life-threatening complications.

By failing to alert new mothers to such risks, the peer-reviewed study found, nurses may be missing an opportunity to help reduce the maternal mortality rate in the U.S., the highest among affluent nations. An estimated 700 to 900 women die in the U.S. every year from pregnancy- and childbirth-related causes and 65,000 nearly die, according to the Centers for Disease Control. The rates are highest for black mothers and women in rural areas. In a recent CDC Foundation analysis of data from four states, nearly 60 percent of maternal deaths were preventable.

… Read More

Image via flickr: AttributionNoncommercial Some rights reserved by Pan American Health Organization PAHO

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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

Opioid Overdoses Leading to More ICU Admissions and Deaths

August 17, 2017

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“People who use injection drugs should obtain naloxone, the overdose reversal drug, and use drugs with partners who can help them,” said Brendan Saloner, a researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore who wasn’t involved in the study.

In many states, family members can get naloxone, sometimes without a prescription, Saloner said by email. Two medications, buprenorphine and methadone, can also help reduce drug use.

“There is unfortunately a lot of stigma about medication treatments, but they are safe and work,” Saloner added. “Long-term change is possible and recovery is a realistic goal, but it requires time and patience.”

… Read More

Image: By Bullenwächter – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17856929

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Reuters

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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 Opioid Epidemic is an Epidemic of Stigma

Kristie Serota and Daniel Z. Buchman argue that eradicating the stigma associated with opioid use is an ethical necessity and is critical for population health.

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The Government of Canada reports that over 2458 Canadians died of apparent opioid-related deaths in 2016 (excluding Quebec). Last November, an average of 4 people died from overdoses every day in British Columbia. Recent U.S. estimates project opioid-related deaths at over half-a-million people over the next decade. Interventions have been implemented in many jurisdictions to minimize opioid-related mortality, but each year the death toll continues to rise and shows no signs of relenting.

While people dying from opioids in large numbers is not new, the present epidemic arose due to several complex factors. For example, OxyContin was aggressively marketed and prescribed for chronic non-cancer pain. Doctors and the public were misled about OxyContin’s addiction risks. In addition, health professionals receive limited training on pain and addiction. There are also inequities due to the social determinants of health and the harmful effects of substance use-related stigmas.

Stigma, operating at individual, institutional, and social levels, has led to punitive legal, policy, and clinical responses toward people who use drugs. Stigma has also led to chronic underfunding of addiction research and treatment services relative to the burden of disease. Although the current epidemic does not discriminate across the social gradient, stigma disproportionately burdens people from less privileged social groups more frequently and harmfully than others. People with no history of a substance use disorder risk the pejorative label of ‘addicts’ when they are prescribed opioids for pain management.

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

Festival of Death and Dying

In contemporary Western culture death and dying are generally regarded as something to fight against, deny, hide from public view and above all fear. 


But what if we were to look at them differently? Despite understandable fear and denial, we may have very good reasons to want to learn more about death and dying. Thinking about and experiencing mortality–our own and that of others–can make us our lives richer, deeper and more valuable to us. Mortality in truth is the intensification of life.


This September, check out the first Melbourne edition of the Festival of Death and Dying. There will be over 20 participatory workshops, performances, talks and ceremonies on different aspects of death and dying over two days. In addition to talks and discussions, you will have experiences, which do justice to the full spectrum of what is at stake in mortality. 

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 Opioid Epidemic, Explained

August 4, 2017

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If nothing is done, we can expect a lot of people to die: A forecast by STAT concluded that as many as 650,000 people will die over the next 10 years from opioid overdoses — more than the entire city of Baltimore. The US risks losing the equivalent of a whole American city in just one decade.

That would be on top of all the death that America has already seen in the course of the ongoing opioid epidemic. In 2015, more than 52,000 people died of drug overdoses in America — about two-thirds of which were linked to opioids. The toll is on its way up, with an analysis of preliminary data from the New York Times finding that 59,000 to 65,000 likely died from drug overdoses in 2016.

If you want to understand how we got here, there’s one simple explanation: It’s much easier in America to get high than it is to get help.

… Read More

Image via Flickr Attribution Some rights reserved by Key Foster

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Vox

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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.