Tag: sociology

Bioethics Blogs

Who is the Father?: Sperm Donor Identification

The issue is whether the donor of sperm obtained via a sperm bank should be identified even though the donor provided the specimen with the understanding of anonymity?
The following are stories of how through current public accessibility to  DNA identification resources anonymity of the “father” is no longer guaranteed. There is an example of this accessibility in a 2010 issue of Slate and a more current example as presented in the Netherland’s Dutch News.

Providing sperm to a sperm bank is of monetary significance to both the donor and finally for the bank itself and the “donation” is still considered a needed action by society. Despite the potential with public-accessible technology and investigations as noted in the two above articles,  should the utilization of the sperm for fertilization continue to permit anonymity of the source?  Well, if the goal is to encourage further donations then a recent study in the journal “Law and the Biosciences” regarding loss of anonymity suggest a problem in procurement as outlined in the Abstract of the article.

Most sperm donation that occurs in the USA proceeds through anonymous donation. While some clinics make the identity of the sperm donor available to a donor-conceived child at age 18 as part of ‘open identification’ or ‘identity release programs,’ no US law requires clinics to do so, and the majority of individuals do not use these programs. By contrast, in many parts of the world, there have been significant legislative initiatives requiring that sperm donor identities be made available to children after a certain age (typically when the child turns 18).

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

Who is the Father?: Sperm Donor Identification

  

The issue is whether the donor of sperm obtained via a sperm bank should be identified even though the donor provided the specimen with the understanding of anonymity?
The following are stories of how through current public accessibility to  DNA identification resources anonymity of the “father” is no longer guaranteed. There is an example of this accessibility in a 2010 issue of Slate and a more current example as presented in the Netherland’s Dutch News.

Providing sperm to a sperm bank is of monetary significance to both the donor and finally for the bank itself and the “donation” is still considered a needed action by society. Despite the potential with public-accessible technology and investigations as noted in the two above articles,  should the utilization of the sperm for fertilization continue to permit anonymity of the source?  Well, if the goal is to encourage further donations then a recent study in the journal “Law and the Biosciences” regarding loss of anonymity suggest a problem in procurement as outlined in the Abstract of the article.

Most sperm donation that occurs in the USA proceeds through anonymous donation. While some clinics make the identity of the sperm donor available to a donor-conceived child at age 18 as part of ‘open identification’ or ‘identity release programs,’ no US law requires clinics to do so, and the majority of individuals do not use these programs. By contrast, in many parts of the world, there have been significant legislative initiatives requiring that sperm donor identities be made available to children after a certain age (typically when the child turns 18).

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

Bending the Odds: Pedagogy and Dialogue in Large Lecture Courses by Sandra Hyde

As academics in large public research universities, I am always amazed that when we speak of an ideal pedagogy, we speak about our small intimate seminars where we have the time and resources to experiment with 25 students or less. In my 13 years of teaching, I look forward to those settings when I get to teach one small undergraduate seminar a year. Over the years, I have also tried to make my large lecture hall shrink by trying to utilize different techniques to foster student based learning and most important, to create more interactive group problem solving and reduce the teacher as lord model of education. While this often works in small seminars, those wonderful nuggets of intimate interactive learning, I find it a challenge to accomplish this when I am in large lecture halls (over 200 students) with limited to graduate student teaching support.

In a large Introduction to Medical Anthropology course (what is called Anthropology 227 at McGill), I have worked over the years to integrate more student-interactive learning. I often compare teaching this course to managing a large ocean-liner with staff of different standing and students who are extremely eclectic as they are drawn from across campus from multiple faculties. For example, students in engineering and medicine will take the course as their one social science requirement and for others they find introduction to medical anthropology intriguing. Students in the humanities are also looking to take their one social science course. There are also medical practitioners and their allied health colleagues often nursing students returning to university to complete their BS.

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

Teaching Medical Anthropology by Ari Gandsman

In the decade since becoming a full time professor, medical anthropology has been one of my core courses. I have taught it seven times.  Although the basic structure of the course remains similar, emphases have shifted over time. Perhaps I can best highlight the evolution of the course through a discussion of readings I use since readings are the backbone of a syllabus.  Even though I generally do not follow texts closely since I see lectures as overlapping but also supplemental and complimentary to readings, I try to mirror topics that they will be reading about, often highlighting a general theoretical literature or approach while the students read a single illustration.

Starting from the beginning, my history of medical anthropology remains the same, focusing on when “medicine” was subsumed into broad and now antiquated anthropological categories of magic and witchcraft. I never stray far from Evans-Pritchard’s Witchcraft, Oracles & Magic Among The Azande, an apparent professional contractual obligation for meAlthough I have given them the entire ethnography [the abridged in print edition] to read twice in the past, I have more lately just given them a short excerpt, often “The Notion of Witchcraft Explains Unfortunate Events.” I once also used W.H. Rivers Medicine, Magic and Religion but, although fascinating and of historic importance, it proved esoteric for an undergraduate course.  When I first started teaching, I tried to include more on non-Western medical systems, including using ethnographies on Traditional Chinese Medicine or Tibetan medicine. More recent students may be disappointed that I do not delve further into non-Western medical systems, what many students with hazy ideas of the discipline may think a medical anthropology course should almost entirely consist of.

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

Water, Health, & Social Justice

Shawn H.E. Harmon and Janice E. Graham advocate for a public interest approach to the governance of water.

__________________________________________

Earlier this month, a boil water advisory was issued for Schreiber Ontario. Such advisories are not uncommon in Canada, despite it being one of the world’s wealthiest and most developed countries. In 2015, there were over 1,838 boil water advisories, including 139 in First Nations and Inuit communities, where an estimated 20,000 Indigenous Canadians have no access to running water or sewage. Boil water advisories were placed in 29 Nova Scotia communities on 21 December 2016. On that same day, the Canadian Radio-television and Telecommunications Commission (CRTC) declared access to broadband internet a basic service. If access to the internet is critical to our economy, prosperity, and society, and to every citizen, as suggested in the CRTC decision, then water can be nothing less than an inalienable right, tied up as it is with life, health, and human flourishing.

Relevant fundamental human rights are enumerated in Articles 1-3 and 26-29 of the Universal Declaration of Human Rights (1948), and in many other legal instruments. As well, the right to “sufficient, safe, acceptable, physically accessible and affordable water” has been recognized by the United Nations Committee on Economic, Social and Cultural Rights. The European Declaration for a New Water Culture, published in 2005, encouraged a holistic approach to water that recognizes its ethical, environmental, social, economic, political, and emotional value, as well as its natural inclusion in the Heritage of the Biosphere. A subsequent 2006 United Nations Report characterized water as an essential component of security and development.

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

#SoComplicatedSyllabus – Check it out and please contribute! by Deborah Levine

“I have to tell you, it’s an unbelievably complex subject…Nobody knew that health care could be so complicated,” said Donald J. Trump on Monday, February 27, at a press conference. This was his answer to a question about the then-seemingly stalled, but as of now reinvigorated, plans to repeal the Affordable Care Act, the 2010 health care law that is—both derisively and affectionately, depending on your political affiliations—known as Obamacare.

Pundits and journalists weighed in quickly with snarky jokes; it seemed they couldn’t help themselves. “Nobody? Nobody! Of course, everybody knows that health care reform is complicated,” said Jordan Weissman at Slate.com. On Twitter, thousands tried their hands at memes and quips, many of which paired pictures of Hillary Clinton or Bernie Sanders laughing next to Donald Trump’s quote. Others remarked that they themselves must be “nobodies,” since they knew well that health care was complicated.

Perhaps unintentionally, the President actually made a really important point. If you aren’t someone who spends much time thinking about or studying the U.S. health care system, it can be stunning just how complex every aspect of the system is. I trained as a historian of medicine, and I teach undergraduate courses on the workings of the American health care system in a policy program. My students are continually surprised by the contradictory inequalities and complexities of our so-called “system.” In the fall of 2015, after participating at a conference with an international audience of scholars in Dublin, Ireland, the overarching question I got over dinner, from a highly educated audience of peer academics, was one of incredulous dismay, and amounted to: Is this really how the health care system in the US works?

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: February 2017 by Christine Sargent

American Ethnologist

Good ramps, bad ramps: Centralized design standards and disability access in urban Russian infrastructure

Cassandra Hartblay

Accessible design seeks to reconfigure the social by restructuring the material. As the idea moves globally, it becomes entwined in local logics of moral obligations between citizens and the state. Wheelchair users in the city of Petrozavodsk, in northwestern Russia, talk about inaccessible infrastructure as being embedded in moral relationships. In their stories, hierarchies of expertise diffuse responsibility for outcomes and devalue user knowledge. When accessible design elements are installed to meet minimum standards, they are “just for the check mark” and often do not “work.” Wheelchair ramps produce value for businesses or governments by representing an idea of access that circulates as a commodity. Failed accessible design draws attention to a moral field governing the responsibilities of actors to produce a “good” built environment, imbricated in teleologies of progress. [disability, design, infrastructure, access, ramps, postsocialism, Russia]

Self-governance, psychotherapy, and the subject of managed care: Internal Family Systems therapy and the multiple self in a US eating-disorders treatment center

Rebecca J. Lester

“The self” has seen a surprising resurgence in recent anthropological theorizing, revitalizing interest in whether and how it can be studied ethnographically. These issues are brought to the fore by a newly popular psychotherapy technique, Internal Family Systems therapy (IFS), as practiced in a US eating-disorders clinic. There, clinicians and clients negotiate tensions between this model’s understanding of a multiple, refracted self and managed-care companies’ insistence on personal responsibility. In considering the moral and pragmatic work of IFS in the clinic, a new critical anthropology of selfhood illuminates the vectors through which economic and political commitments become imbricated in the self.

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

Neuroethics and the Third Offset Strategy

By Jonathan D. Moreno
Jonathan D. Moreno is the David and Lyn Silfen University Professor at the University of Pennsylvania where he is a Penn Integrates Knowledge (PIK) professor. At Penn he is also Professor of Medical Ethics and Health Policy, of History and Sociology of Science, and of Philosophy. Moreno is an elected member of the National Academy of Medicine and is the U.S. member of the UNESCO International Bioethics Committee. A Senior Fellow at the Center for American Progress in Washington, D.C., Moreno has served as an adviser to many governmental and non-governmental organizations, including three presidential commissions, the Department of Defense, the Department of Homeland Security, the Department of Health and Human Services, the Centers for Disease Control, the Federal Bureau of Investigation, the Howard Hughes Medical Institute, and the Bill and Melinda Gates Foundation. Moreno has written several books, including Impromptu Man: J.L. Moreno and the Origins of Psychodrama, Encounter Culture, and the Social Network (2014), The Body Politic, Mind Wars (2012), and Undue Risk (2000). He has also published hundreds of papers, articles, reviews and op-eds, and frequently contributes to such publications as The New York Times, The Wall Street Journal, The Huffington Post, Psychology Today, and Nature. In 2008-09 he served as a member of President Barack Obama’s transition team. His work has also been cited by Al Gore and was used in the development of the screenplay for “The Bourne Legacy.”

A new U.S. strategic doctrine called the third offset poses an important challenge for the field of neuroethics.

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 social scientist’s guide to the Final Rule

On 18 January 2017, sixteen federal agencies announced revisions to the Federal Policy for the Protection of Human Subjects. As I noted earlier, this marks a huge victory for historians, who have spent the last 20 years working to end the inappropriate interference of IRBs with oral history research.

In addition, the final rule includes several provisions of note to scholars in the humanities and social sciences. Here are some of them; I don’t claim it is a complete list.

No biospecimens overhaul; less controversy

The final rule “does not adopt the proposal to require that research involving nonidentified biospecimens be subject to the Common Rule, and that consent would need to be obtained in order to conduct such research.” This was the target of the greatest criticism from groups like the National Academies of Sciences, Engineering, and Medicine and SACHRP. So while this change has little direct bearing on the work of social scientists and scholars in the humanities, it will likely reduce the controversy surrounding the regulatory reform as a whole.

The abandonment of the biospecimens proposal could also reduce opposition to reform by conservatives. The House Freedom Caucus opposed a new Common Rule on the grounds that it would cost $13.334 billion over 10 years. This figure seems to have been drawn from the NPRM’s quantified costs of $13.342 billion (using a 3 percent discount rate), and ignored the NPRM’s quantified benefits of $2.6 billion. If all the Freedom Caucus cares about is money, it may like the final rule a lot more.

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.