Tag: professional organizations

Bioethics Blogs

In Defense of a Physician’s Right to Conscientious Objection, Part 2

Guest post by Cheyn Onarecker, MD

Today, I am continuing my comments on the recent editorial against conscientious objections from the New England Journal of Medicine (subscription required). My previous objections to the elimination of protections for conscientious objections included: 1) the importance of maintaining the traditional balance that has always existed between the needs of the patient and the physician, and 2) the fact that medical societies make decisions on the acceptability of certain procedures that are influenced by society and do not represent the views of a large percentage of its members. I will now add a couple more reasons.

Third, it is impractical and unreasonable to demand that persons considering a career in medicine should be prepared to violate their moral convictions. When the Church Amendment was passed in 1973, allowing physicians to be exempt from performing abortions, there was no outcry from the AMA or any other medical society denouncing the law or declaring that rights of conscience were unethical. Since then, the number of laws and provisions to protect conscience rights have increased, not decreased. Philosopher Mark Wicclair explains that modern medicine, in general, has accepted the right of conscientious objection, and no young person entering medicine today believes that their moral and religious convictions are incompatible with a career in medicine. In fact, the AMA issued a directive to medical schools to excuse students from performing activities that violate their ethical beliefs. Not only that, but how would physicians be able to predict that someday their chosen specialty would develop a controversial treatment?

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

Biofinance: Speculation, Risk, Debt, and Value from Bios: A conference report by Danya Glabau

How does the financialization of life itself figure as a new means of producing value in modern technoscience? That is the question that motivated Kirk Fiereck to convene the panel “Biofinance: Speculation, Risk, Debt, and Value from Bios” at the 2016 American Anthropological Association meeting in Minneapolis, Minnesota this November. Fiereck, panelists Melina Sherman, Danya Glabau, and Emily Xi Lin, discussant Kristin Peterson, and chair David Pederson, offered new ways to think about how financialized life is a source of value, and what this means for the ethics and practice of biomedicine in sites throughout the globe.

In writing this conference report, Fiereck, Sherman, and Glabau each contributed short comments about their talks, which were edited together in the unified first half of this report. The second half includes further reflections that we have attributed to each scholar individually as a way to illustrate the diverse, possibly divergent, uses of “biofinance” as a concept.

 

The Papers

Melina Sherman opened the panel with, “Biofinancial Investments and Disinvestments: Examining the U.S. Opioid Epidemic,” which focused on the cultural and institutional construction of pharmaceutical markets – in particular, the market for prescription painkillers. Markets, especially those situated within the bioeconomy – an economic space in which capital is organized through life (bios) in its various forms – constitute the broader context in which biofinancial practices are situated. Her paper explored the ways in which the selective investments and divestments of federal regulators and opioid consumers condition the growth of this market. The market for prescription opioids is a good example of what Sherman calls an “addiction market” (see also Lovell, 2006), where addiction (understood as a destructive attachment – in this case, of a person to a prescription drug) is built-in to the cultural and economic processes that drive market formation and growth.

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 lure of human-animal chimera research

Andrew Fenton and Letitia Meynell call for moral reflection on the primacy of capacities for determining the moral status of non-human animals used in human-animal chimera research.

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Last week Nature and Cell published research that takes us closer to creating non-human animal hosts for growing human organs. According to their Nature article, Tomoyuki Yamaguchi and colleagues modified rats to grow mouse pancreata that were then used to successfully treat diabetic mice. According to their Cell article, Jun Wu and colleagues modified embryonic pigs and allowed them to develop long enough to confirm that human cells could be successfully integrated into their tissues and organs.

Both studies represent advances in what is known as chimera research. Chimeras are animals (human or otherwise) possessing cells containing a genetic identity distinct from their parents and sometimes from their own species. Human-animal chimera research is largely motivated by shortages in human organs available for transplant. The hope is that in the not too distant future, part-human chimeric animals will grow what are effectively human organs to make up for the shortfall.

Cardiac muscle cells. Photo Credit: David C. Zebrowski, Felix B. Engel

This research is receiving a good deal of media attention. Some scientists express cautious excitement about the breakthroughs while other scientists and ethicists express worries about the use of non-human animals in such invasive research and question its legitimacy.

Ethical confusion is understandable. The non-human animals typically used in this research – mice, rats, pigs and cows – don’t have a high moral status in our society.

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 and the Problem of Silent Neutrality in the age of Trump

by Craig Klugman, Ph.D.

One of the most contentious of all issues in bioethics has been whether as a profession, we should take a stand against issues. Arguments have raged on both sides of the issue. The American Society for Bioethics & Humanities (ASBH) only takes stands on issues of academic freedom. The thinking, as I’ve seen it, is that bioethics has something to offer all political perspectives and by not taking stands on issues, we are more likely to help further conversations among people on  all parts of the political spectrum.

This stance has been tested: When as a nation we learned that torture was regularly being practice by our military some took offense, but only Steven Miles spoke out and resigned from the organization for not taking a stand. Bioethics in general has been criticized for its lack of participation in social justice issues. In Observing Bioethics, Renee Fox and Judith Swazey criticize the bioethical enterprise for this unwillingness to take a stand.

So are there extraordinary times and issues when we as a group should stand up either individually or en masse?

I have been personally struggling with how to respond to the mass upheaval currently taking place in the United States. Plans to re-open Guantanamo Bay, CIA black sites, and torture are violations of human rights and human decency. For example, banning refugees from our shores, keeping people from returning to their jobs/homes/families; even forcing residents at US hospitals to leave the country after returning from trips abroad. Also consider efforts to silence government scientists, health care providers in other countries receiving US aid, and the diplomatic corp.

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

Peanut Allergy: Early Exposure Is Key to Prevention

Credit: Thinkstock (BananaStock, Kenishirotie)

With peanut allergy on the rise in the United States, you’ve probably heard parents strategizing about ways to keep their kids from developing this potentially dangerous condition. But is it actually possible to prevent peanut allergy, and, if so, how do you go about doing it?

There’s an entirely new strategy emerging now! A group representing 26 professional organizations, advocacy groups, and federal agencies, including the National Institutes of Health (NIH), has just issued new clinical guidelines aimed at preventing peanut allergy [1]. The guidelines suggest that parents should introduce most babies to peanut-containing foods around the time they begin eating other solid foods, typically 4 to 6 months of age. While early introduction is especially important for kids at particular risk for developing allergies, it is also recommended that high-risk infants—those with a history of severe eczema and/or egg allergy—undergo a blood or skin-prick test before being given foods containing peanuts. The test results can help to determine how, or even if, peanuts should be introduced in the youngsters’ diets.

This recommendation is turning older guidelines on their head. In the past, pediatricians often advised parents to delay introducing peanuts and other common causes of food allergies into their kids’ diets. But in 2010, the thinking began shifting when a panel of food allergy experts concluded insufficient evidence existed to show that delaying the introduction of potentially problematic foods actually protected kids [2]. Still, there wasn’t a strategy waiting to help prevent peanut or other food allergies.

As highlighted in a previous blog entry, the breakthrough came in 2015 with evidence from the NIH-funded Learning Early about Peanut Allergy (LEAP) trial [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

Internet Censorship in Academia


As a bioethicist a good deal of source material for
scholarship comes not from academic journals but from popular media. Much of
the information regarding bioethical issues is current and timely and will be
found not in the academic literature but appears in newspapers and magazines.
Moreover social media sites such as Facebook, Linked In, and Twitter have a
large presence in the dissemination of bioethics related information and events
which occur on a day to day basis. Both individual bioethicists and bioethics
related academic and professional organizations actively post current events
related to the interests of bioethics scholars and practitioners on a daily
basis. I review several of these sites daily and often follow links to stories,
current events, and opinion pieces of interest. These are activities I consider
important, in addition to keeping up with traditional bioethics related
academic sources, to function knowledgably in this field.


With that introduction you will understand the frustration I
felt when I clicked a link which I knew would take me to a major mainstream
newspaper. Rather than linking me to the article I sought I received a message
that said, in very large letters, “ACCESS DENIED YOU ARE ATTEMPTING TO ACCESS A
FORBIDDEN SITE”. Seriously! Well apparently yes they were serious. Who would
accidently block my access to a major mainstream newspaper. Like I do so often
I emailed the URL to myself so I could access the “FORBIDDEN SITE” from home
that night. Fortunately we have no rules that precluded me from working at home
or at night.

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 Professional Organizations…It’s Not Me, It’s You

by Craig Klugman, Ph.D.

Dear Professional Organizations,

Being an active member of my profession is important for both my personal mission and my professional career. I enjoy coming to your meetings and finding myself among those who speak my scholarly language. At such gatherings I learn about new ideas, network with current, former and potentially new collaborators, and sometimes (when looking) find out about new opportunities for jobs, funding, and publishing. And yes, my university expects me to attend these events in order to share my work, to network, and to help with increasing the visibility and reputation of the institution.

But now, I have to think about breaking up with you. Year after year you increase what you charge for dues and registration. Over that same time, the amount of money my university makes available for travel and membership dues decreases, or in the best years remains flat. This institutional support covers about two-thirds of the costs of attending one conference. Such support is for the 30% of us who are full time faculty. Nearly 70% of the academic workforce is composed of contingent faculty members who receive no institutional support toward membership dues and meetings.

The difference between the cost of meetings and what my institution provides comes out of my pocket and that is not always tax deductible. Also consider that the average faculty salary has not increased by much in decades. The AAUP reported an average 2.2% increase this past year, but those salaries are lower than in the world outside of the academy, and the majority of those increases went to the burgeoning ranks of administrators, not to the diminishing teaching/research class.

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

Consumer Neurotechnology: New Products, More Regulatory Complexity

By Anna Wexler


Anna Wexler is a PhD candidate in the HASTS (History, Anthropology, Science, Technology and Society) at MIT and a 2015-2016 visiting scholar at the Center for Neuroscience and Society at the University of Pennsylvania. Her dissertation focuses on the ethical, legal and social implications of emerging neuroscience technology, with a particular focus on the home use of noninvasive brain stimulation.

Just when it seemed like the consumer neurotechnology market couldn’t get any stranger—after all, who would’ve expected that a sleek white triangle could be placed on the forehead for “calm” or “energy” vibes—two new products recently hit the market that further complicate the challenges of regulating this emerging market. Halo Sport is a brain stimulator marketed for athletic enhancement that utilizes technology similar to transcranial direct current stimulation (tDCS), while Nervana, which began taking pre-orders in March, is the first noninvasive vagus nerve stimulation (VNS) device to be sold directly to the public in the United States.
Halo Neuroscience, the manufacturer of Halo Sport, advertises that its product “accelerates gains in strength, explosiveness, and dexterity.” In many ways, Halo Sport overcomes obstacles that have plagued other direct-to-consumer brain stimulation products. Because Halo Sport only claims to stimulate the motor cortex—which, conveniently for the company, lies beneath the area of the head where a pair of headphones might sit—the product does not utilize stray wires or a futuristic headset, but instead takes the recognizable shape of headphones. The beneficial effect of a familiar design should not be underestimated: many potentially useful technology tools have failed in no small part due to their unusual “look.”

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

U.S. Military Medical Ethics Guidelines in Limbo

As President Barack Obama’s term comes to a conclusion, various initiatives started under his administration remain unfinished.  One of these, the adoption of the recommendations of the Defense Health Board (DHB), “Ethical Guidelines and Practices for U.S. Military Medical Professionals,”  is of utmost importance to health care professionals in our military.

Health care providers in the United States are bound by the Hippocratic Oath, medical ethics, respect for human rights, international declarations, Geneva Conventions, the Nuremburg Code, and the United Nations Universal Declaration of Human Rights. The Declaration of Human Rights states, “No one shall be subjected to torture or to cruel, inhuman, or degrading treatment or punishment.” Medical ethics embodies these historical documents and calls upon health care providers to do no harm to patients, obtain their consent, not violate their bodily integrity, and recognize their vulnerability. These principles apply to patients in civilian or military settings including the care of detainees and prisoners.

After 9/11, conflicts arose between these ethical standards and the duties of health care personnel. These conflicts needed to be settled within a framework that respects the codes of ethical and professional conduct. The DHB report is a response to that overwhelming need. 

Senator Diane Feinstein, vice chair of the Senate Intelligence Committee, has written to Secretary of Defense Ashton Carter urging the adoption of the recommendations. Support has also come from prominent bioethicists and human rights advocates. The World Medical Association, American Medical Association, American Nurses Association, and the American Psychiatric Association (APA) are among the many groups that have condemned the participation of health care providers in interrogation, torture, or force-feeding.

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

Birth, Trauma, and Autonomy

Sylvia Burrow discusses the inadequacy of care for women during labour and childbirth.

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Health care providers are supposed to provide safe, compassionate, and ethical care for all patients. We see this idea represented in bioethical principles and values expressed in the Canadian Nursing Association Code of Ethics and the Canadian Medical Association Code of Ethics. Labouring and birthing women are noticeably vulnerable patients with intimately connected concerns for their emerging newborns. The World Health Organization (WHO) recommends that women seek medical facilities in order to receive the safe, compassionate, and ethical care that the Codes of Ethics of healthcare associations are intended to ensure. However, the reality is that women are routinely mistreated, disrespected, and neglected during labour and childbirth in hospital facilities. How are labouring and birthing women supposed to find safe and compassionate care in this environment? And what if they can’t find it?

I gave birth in a Canadian hospital that admitted a large number of high-risk labouring and birthing women. Shortly after the birth, I felt interrogated by the pediatrician. “Have you taken any drugs? What drugs did you take?” In my innocence I thought he was simply inquiring about my routine prescriptions. But in fact he was interested in getting an admission from me that I had used street drugs. This was almost incomprehensible to me. Of course I had never taken any street drugs, and I was quite willing to allow—indeed, did allow—tests to be run to prove it. In the next day or so the nursing staff barely visited the room.

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.