Tag: values

Bioethics Blogs

Treatment of Premature Ejaculation: Alleviating Sexual Dysfunction, Disease Mongering?

by Brian D. Earp / (@briandavidearp)

An interesting new paper, “Distress, Disease, Desire: Perspectives on the Medicalization of Premature Ejaculation,” has just been published online at the Journal of Medical Ethics.  According to the authors, Ylva Söderfeldt, Adam Droppe, and Tim Ohnhäuser, their aim is to “question the very concept of premature ejaculation and ask whether it in itself reproduces the same sexual norms that cause some to experience distress over ‘too quick’ ejaculations.” To prime the reader for their project, they begin with a familiar story:

a condition previously thought of as a variant within the normal range, as a personal shortcoming, or as a psychological issue is at a certain point cast as a medical problem. Diagnostic criteria and guidelines are (re-)formulated in ways that invent or widen the patient group and thus create or boost the market for the new drug.

Those involved in developing the criteria and the treatment are sometimes the same persons and, furthermore, cultivate close connections to the pharmaceutical companies profiting from the development.

Sufferers experience relief from personal guilt when they learn that their problem is a medical and treatable one, whereas critics call out the process as disease-mongering.

Something like this pattern has indeed played out time and time again – methylphenidate (Ritalin) for ADHD, sildenafil for erectile dysfunction, and more recently the development of flibanserin for “hypoactive sexual desire disorder” (see the excellent analysis by Antonie Meixel et al., “Hypoactive Sexual Desire Disorder: Inventing a Disease to Sell Low Libido” in a previous issue of JME).

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

Horse-drawn miscarriage: a case study on culture, pregnancy, and overriding parental requests to limit treatments

Patient autonomy is a well-established principle in both U.S. law and Western medical ethics. When patients have decision making capacity, they decide to accept or decline medical interventions based on of their own goals and values. When medical decisions are made on behalf of children, the best interests standard replaces autonomy. Because children usually lack settled goals and values, the decision about medical care should be made in light of the best decision for the child. Within the context of early pregnancy, the mother’s autonomous preferences are legally recognized as sufficient to make decisions to continue or to terminate the pregnancy. Once the fetus reaches the stage of viability, however, things get a bit more complicated.

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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 News

An Emerging Public Health Crisis

The Executive Order on Refugees: An Emerging Public Health Crisis

 


March 10, 2017 Update:

 

New in The Lancet: The Revised US Refugee Ban, Health, and Security, Leonard Rubenstein and Paul Spiegel

“The new order suspending and then shrinking the refugee resettlement programme does not bring any security gains and imposes tremendous mental and physical harm on people who have suffered more than most of us can even imagine. Let them in.”

 


February 21, 2017 Update:

 

Ethics, Refugees, and the President’s Executive Order, Nancy Kass, ScD

“The values emblematic of our country are often thought to include deep commitments to individual liberties and to entrepreneurship, but also empathy for others, care for the sick, and broad interests –regardless of how we get there– in lifting the tide for all. Mogens Lykketoft, former UN General Assembly President said, “The genuine loss and pain these people are suffering should be unbearable for all of us.

This sentiment should exemplify our common morality.”

 


 

The Executive Order on Refugees: An Emerging Public Health Crisis

 

Please note, due to technical difficulties with sound recording, the first few minutes lack audio, audio begins at 4:15.


 

via Johns Hopkins HUB

 

The Johns Hopkins University Bloomberg School of Public Health hosted a symposium examining the consequences of President Donald Trump’s executive order suspending the U.S. refugee admission program.

 

The symposium, “The Executive Order on Refugees: An Emerging Public Health Crisis,” took place in the Bloomberg School’s Sommer Hall on JHU’s East Baltimore campus and was cosponsored by the Johns Hopkins 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 Blogs

Neuroeconomics and Reinforcement Learning: The Concept of Value in the Neuroscience of Morals

By Julia Haas
Julia Haas is an Assistant Professor in the Department of Philosophy at Rhodes College. Her research focuses on theories of valuation and choice.
Imagine a shopper named Barbara in the pasta aisle of her local market.  Just as she reaches for her favorite brand of pasta, she remembers that one of the company’s senior executives made a homophobic statement. What should she do? She likes the brand’s affordability and flavor but prefers to buy from companies that support LGBTQ communities. Barbara then notices that a typically more expensive brand of pasta is on sale and buys a package of that instead. Notably, she doesn’t decide what brand of pasta she will buy in the future.

Barbara’s deliberation reflects a common form of human choice. It also raises a number of questions for moral psychological theories of normative cognition. How do human beings make choices involving normative dimensions? Why do normative principles affect individuals differently at different times? And where does the feeling that so often accompanies normative choices, namely that something is just right or just wrong, come from? In this post, I canvass two novel neuroethical approaches to these questions, and highlight their competing notions of value. I argue that one the most pressing questions theoretical neuroethicists will face in the coming decade concerns how to reconcile the reinforcement learning-based and neuroeconomics-based conceptions of value.
One popular approach to the problem of normative cognition has come from a growing interest in morally-oriented computational neuroscience. In particular, philosophers and cognitive neuroscientists have turned to an area of research known as reinforcement learning (RL), which studies how agents learn through interactions with their environments, to try and understand how moral agents interact in social situations and learn to respond to them accordingly.

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

Gene Therapy: A Threat to the Deaf Community?

Teresa Blankmeyer Burke considers the problematic nature of gene therapy research aimed at eliminating hereditary deafness.

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Typically, gene therapy involves combining a therapeutic gene with a vehicle known as a viral vector. This vector is used to deliver the therapeutic gene into a target cell by a process known as transduction. In the case of the inner ear, there is a low transduction efficiency in sensory cells using such viral vectors, including the vector known as AAV1. As a result, there has been variable and inefficient uptake of therapeutic genes.

A recent study in mice, however, published in the journal Molecular Therapy, describes a new method for delivering genes to the sensory hair cells of the inner ear as a potential treatment for deafness. This research describes a new type of viral vector, exo-AAV1, which is more efficient than AAV1 and which may be an effective viral vector for delivering therapeutic genes to treat hereditary deafness by gene therapy.

The use of exosome-associated viruses raises important questions about risks (and unwanted side-effects). There is, for example, the risk of transferring genes that might facilitate the spread of disease through the delivery of genetic material and/or pathogenic proteins. These risks, while important, are not as pressing, however, as the larger issue of whether researchers should conduct research that threatens to eradicate a community.

Members of the signing Deaf community argue that research which aims to eliminate or cure deafness is a form of cultural genocide. The argument goes like this: the use of gene therapy to cure hereditary deafness would result in smaller numbers of deaf children.

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

Ethics & Society Newsfeed: February 17, 2017

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Politics

Trump Ethics Monitor: Has The President Kept His Promises?
To track Trump’s ethics-related promises, NPR checked debate transcripts, campaign speeches and press conferences

Trump’s South Florida estate raises ethics questions
Ethics questions and possible conflicts surrounding President Donald Trump’s frequent trips to his sprawling Mar-a-Lago property, especially in regards to the invitation of Japanese Prime Minister, Shinzo Abe, over the weekend; a trip Trump pledged to pay for.

Should Jeff Sessions Recuse Himself From the Russia Inquiries?
Bruce Green, director of the Louis Stein Center for Law and Ethics at Fordham University, comments on whether Attorney General, Jeff Sessions should recuse himself from investigations involving former National Security Adviser, Michael Flynn and Russian hacking.

Trickle-Down Ethics at the Trump White House
Federal ethics guidelines forbid White House officials from using public position and power for their own private gain or to promote the private business interests of others. Trump Administration actions to be reviewed by the White House counsel and by the Office of Government Ethics.

Government Watchdog Presses Jason Chaffetz To Investigate Kellyanne Conway Himself
Jason Chaffetz (R-Utah), Chairman of the House Oversight Committee, requested that The Office of Government Ethics (OGE) investigate Kellyanne Conway’s possible breach of federal ethics rules, indicating that the Chairman may be trying to take pressure off his own committee, which has the most authority to investigate the matter.

Ethics Watchdog Denounces Conway’s Endorsement of Ivanka Trump Products
Federal government’s chief ethics watchdog calls for White House adviser, Kellyanne Conway, to be disciplined after publically endorsing Ivanka Trump’s product line.

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

Human germline genome editing: An ‘impressive’ sleight of hand?

Françoise Baylis wonders how it is that in 14 months (from December 2015 to February 2017), the U.S. National Academy of Sciences and the U.S. National Academy of Medicine have moved human germline genome editing out of the category ‘irresponsible’ and into the category ‘permissible.’

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In December 2015, the U.S. National Academy of Sciences, the U.S. National Academy of Medicine, the Chinese Academy of Sciences and the U.K.’s Royal Society co-hosted an International Summit on Human Gene Editing. At the close of the meeting, members of the Summit Organizing Committee issued a Statement that included four discrete conclusions. In response to the Statement, the Presidents of the four co-sponsoring organizations confirmed that: “Together with academies around the world, and in coordination with other international scientific and medical institutions, we stand ready to establish a continuing forum for assessment of the many scientific, medical, and ethical questions surrounding the pursuit of human gene-editing applications.”

One of the pivotal conclusions in the 2015 Statement was that “it would be irresponsible to proceed with any clinical use of germline editing unless and until (i) the relevant safety and efficacy issues have been resolved, based on appropriate understanding and balancing of risks, potential benefits, and alternatives, and (ii) there is broad societal consensus about the appropriateness of the proposed application.”

This conclusion has since been usefully characterized as a helpful ethics framework for decision-making about heritable germline modification. The framework is both beautifully simple and exquisitely complex. It is simple in that there are only two conditions to be satisfied.

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 Formation of the Global Bioethics Initiative Featured in IMPAKTER

In this series of global leaders, we will highlight an international non-profit healthcare organization that provides a bridge between patient care and the complexities of medicine. This area of healthcare is often referred to as Bioethics and in 2011, Dr. Ana Lita and Dr. Charles Debrovner co-founded Global Bioethics Initiative (GBI). This organization offers an all-inclusive resource that allow young and established healthcare professionals a place to learn about essential information about the ethical dilemmas in medicine. GBI is unique in their approach in that they make Bioethics approachable and tangible to everyone. This first installment of this series will layout the reasons behind making bioethics global, the reasons for forming GBI, and their educational programs.

WHY GLOBAL BIOETHICS?

People are beginning to appreciate more deeply the bonds between human well-being and the unrelenting pace of medical and technological advances. The progress made in life sciences, medicine and biotechnology in recent years has provided us with exciting and novel ways of treating, preventing, and curing human diseases. Some (relatively) recent notable and controversial developments in medical science and biotechnology include: markets in organs and transplantation therapy, the accessibility of biotechnological developments in reproductive healthcare, genetic testing and gene therapy, the End-of-Life, the “right to die” and palliative care, as well as life extension, healthy aging and regenerative medicine. While the positive impact of these advances on individuals and societies must be applauded, the ethical consequences of such developments necessitate our attention. The increasing power that new biotechnologies offer us requires that we consider not only whether something can be done, but whether it should it be done.

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 & Society Newsfeed: February 3, 2017

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Politics

Betsy DeVos’s ethics review raises further questions for Democrats and watchdogs
Betsy DeVos, Trump’s nominee to lead the Education Department, promised to divest from more than 100 entities to avoid potential conflicts of interest with her new job. Questions left unanswered.

Donald Trump warned over ‘unprecedented’ plan to appoint cabinet without ethics office checks, emails reveal
Disclosed emails from the head of the ethics office warn President aides staffing a cabinet with robust oversight is a ‘tradition evolved as a result of hard lessons’

South Dakota Governor Signs Measure Reversing Voter Ethics
Governor of South Dakota signed a bill Thursday overturning an anti-corruption measure passed by a majority of voters in November, to the consternation of government watchdog groups.

Trump And His Organization Lawyer Up For The Ethics War Ahead
President Trump and the Trump Organization are beefing up their legal teams against an expected surge of conflict-of-interest allegations.

Teaching Ethics In The Trump Era
Graduate-level professor asks how to tell students ethics is important when “nothing around them feels ethical” re: Trump administration and conflicts of interest.

Bioethics

Human-pig hybrids might be unsettling. But they could save lives.
A new study out of California unsettled a lot of people last week after revealing that scientists had, for the first time, made part-human, part-pig embryos — referred to as “chimeras.” Raises ethical questions.

Could changing the way doctors are paid help narrow health disparities?
A study suggests that changing the way doctors and hospitals are paid could narrow some of the health disparities between poorer and wealthier patients.

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.