Tag: women

Bioethics Blogs

Neil Gorsuch, Aid in Dying, and Roe v. Wade

In the absence of any “paper trail” that would give clues to Supreme Court nominee Neil Gorsuch’s views on abortion, many commentators have turned to his book, The Future of Assisted Suicide and Euthanasia, based on his doctoral dissertation at Oxford, where he worked with natural law theorist John Finnis.  Ronald M. Green notes with alarm that Gorsuch relies on an inviolability-of-life principle that would likely lead him to vote to overturn Roe v. Wade.  Furthermore, Green writes that Gorsuch’s conservative preference for allowing states to make their own decisions, would lead to a return to the pre-Roe reality in which women would have to travel long distances for abortions in those states that allowed it.  (https://ronaldmgreen.com/2017/02/17/how-will-neil-gorsuch-vote-on-roe-v-wade/)

However, there are more dire possibilities to consider. In a long and fascinating essay in Vox (March 20, 2017), J. Paul Kelleher argues that Gorsuch is not an originalist in the Scalia mold, but actually a natural law adherent like his mentor Finnis.  Natural law theorists believe that there is an over-arching moral law that judges can and must rely on when existing laws are unclear, or manifestly unjust.  The recognition of human life as a “fundamental good” that can never be intentionally harmed, is an example of such a moral law, and one that Gorsuch relies on in his condemnation of assisted suicide.

It’s important to see that Gorsuch is not merely agreeing with the current legal status of assisted suicide in our country.   In Washington v. Glucksberg, in 1997, the Court declined to follow the logic of the “privacy” cases stretching from contraception through abortion and find a constitutional right to assistance in ending one’s life.  Glucksberg leaves the country, with respect to assisted suicide, in the same position in which we would left with respect to abortion, if Roe were overturned: at the mercy of the legislative wisdom of the individual states.   Gorsuch goes further in arguing that the equal protection clause of the 14th amendment forbids treating the lives of terminally ill people differently from those of the healthy, by allowing the “killing” of the first but not the second (a view often argued by philosopher Felicia Nimüe Ackerman).  In other words, Gorsuch would presumably view favorably an appeal to the Court to strike down existing “death with dignity” laws in Oregon and elsewhere.

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 “disabled” person speaks out against a particular form of discrimination

Amidst lots of dark and tragic stories, a bright ray on the BBC website this week: Kathleen Humberstone, a 17 year-old English girl with Down syndrome, addressed the UN in Geneva to mark World Down Syndrome Day.

Rather than reading anything I have to say, a far better use of your time would be to read what Ms. Humberstone said. You can find the full text here; if you scroll down you can listen to her speech and an eloquent talk her mother gave afterwards.

The speech is only 3 minutes 42 seconds, and the mother’s talk 5 minutes 48 seconds. It is well worth every second of your time to listen to these women. However, for those of you who don’t have the time or place to listen, I will give a few highlights here.

From Kathleen’s talk (when she refers to “testing,” she’s talking about prenatal genetic testing to detect and abort fetuses suspected to have Down syndrome):

Bonjour, Hello! I can’t believe I’m here! I’m at the UN, in Geneva! Do you know why? Because I have 47 chromosomes. That’s just crazy!! Thank you Down syndrome! I’m here to talk to you about my life and why it is worth living . . . I love everybody. I can’t help it! I hope everybody loves me. I have Down syndrome. Yes. Is that so wrong? So, why all this testing? Why? My name is Kathleen Humberstone and I love my life!!

From Kathleen’s mother’s talk:

You know that trisomy 21 happens to be one of the easiest disabilities to identify at the moment in utero. More will follow. And eventually all disabilities will be identifiable in utero. So, parents of future generations will have quite a few choices to make.

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

Scales and the Emotional Underside of Fatphobia

Michael Orsini explains the pervasiveness of discrimination, fear, and hatred related to ‘fatness.’

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It’s convenient to dismiss the recent flap over the removal of scales at the Carleton University gym as yet another case of political correctness run amok.

Did Carleton Athletics simply cave in to pressure from overly sensitive gym patrons who were ‘triggered’ by the sight of a scale? While tempting, that would be the wrong question to ask in the wake of this controversy. Rather, what is it about weight itself that would unleash such a torrent of emotion and name-calling?

Conservative media commentators mocked the University for its decision, revealing the extent to which the conservative battle against political correctness is fueled by ugly views about fatness.

That is not to say that all liberals are fat-loving citizens. Far from it. Fatness arouses a range of complex moral emotions in all of us, from feelings of pity and sympathy to fear and disgust, regardless of our ideological leanings.

In a world in which we come to rash conclusions about people based upon their appearance, being fat or ‘obese’ is shorthand for being slovenly, lazy, and ‘out of control.’ As Nobel Prize winner Daniel Kahneman argues in his best-selling book, Thinking, Fast and Slow, we often make decisions based on visceral feelings, strongly felt emotions that typically serve as poor guides. For example, in discussing the palpable fear of shark attacks, Freeman Dyson notes that we pay more attention to sharks because they frighten us, even though “riptides occur more frequently and may be equally lethal.”

How does this matter here?

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

Conscientious Objection Accommodation in Healthcare – Clashing Perspectives

by Brian D. Earp / (@briandavidearp)

On behalf of the Journal of Medical Ethics, I would like to draw your attention to the current issue, now available online, which is almost entirely dedicated to the vexing question of conscientious objection in healthcare. When, if ever, should a healthcare provider’s personal conviction about the wrongness of some intervention (be it abortion, euthanasia, or whatever) be accommodated?

In a paper that has already attracted much attention, Ricardo Smalling and Udo Schuklenk argue that medical professionals have no moral claim to conscientious objection accommodation in liberal democracies.

In part, they base their argument on their judgment that “the typical conscientious objector does not object to unreasonable, controversial professional services—involving torture, for instance—but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive” (emphasis added).

It seems clear that a lot hinges on what is meant by “unreasonable” there–and on who should get to decide what falls under that label. One answer to this question might be, “society should get to decide, through the enactment of laws, which ideally express the view of the majority of people as to what is reasonable or unreasonable in medical and other contexts.”

“Therefore,” this answer continues, “if a doctor thinks that some legally allowed service X is immoral, then she should rally her fellow citizens to lobby their representatives to change the relevant law; but she should not be excused from providing the service, if by law the patient is entitled to receive it.”

“And if she really doesn’t want to do X,” the answer concludes, “she can always leave the profession and take up some other line of work.”

This is a rough summary of what Smalling and Schuklenk do in fact say.

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

Gender Bias Distorts Peer Review Across Fields

In many scientific fields, women publish fewer papers than men, are less likely to be listed as first authors and are less likely to receive glowing letters of recommendation from their advisers. These disparities have decreased over time, but they persist. Now, a study finds that some journal editors might be inadvertently taking gender into account when selecting reviewers for papers.

Source: Bioethics Bulletin by the 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

Intersectionality and the Dangers of White Empathy when Treating Black Patients

by Keisha Ray, Ph.D.

(Originally presented at the 7th International Health Humanities Consortium meeting in Houston, Texas)

I’ve had many odd, seemingly racially motivated experiences with racially uneducated and racially insensitive doctors and nurses. From being told by one of my white physicians that I sound white when I speak, to another physician calling me “sista girl” for what seemed like 100 times during our brief 15-minute interaction, or another physician who in disbelief kept asking me “Are you sure you’ve never been pregnant? It’s very rare for a black woman your age to not have had any pregnancies. Maybe you think I mean births, when I mean pregnancies?” At the time, I was only 25 years old. Although these stories made for good laughs between my friends and I, there is one experience that I have had with the medical profession that was less comical because my doctor’s attitudes about race could have had serious effects on my health.

When I was a senior in college I discovered I had hypertension. I went to see a doctor at a family medicine facility and was prescribed a common hypertension drug. While meeting with the doctor in her office, she was very reassuring and told me not to worry that this drug has been known to work very well for black people.

But this drug did not work for me at all. Consistently my blood pressure readings were 140/120 (what is considered “normal” varies but typically 120/80 is the standard). So after taking the drug for a month as instructed, I went back to see my doctor.

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

Pornography as a Public Health Issue

Jacqueline Gahagan advocates for a national sexual health promotion strategy.

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Pornography is concerned with the development and the circulation of sexually explicit books, magazines, videos, art, and music aimed at creating sexual excitement. Public health is concerned with keeping people healthy and preventing illness, injury and premature death. With the growing use of internet-based pornography and the relative ease by which it can be accessed, the effects of “online violent and degrading sexually explicit material on children, women and men” have become an important public health issue. This issue is best addressed through the development and introduction of a national sexual health promotion strategy – a strategy that includes current and comprehensive sexual health education in our primary, secondary, and post-secondary schools.

Health promotion, in concert with public health, involves encouraging safe behaviours and improving health through healthy public policy, community-based interventions, active public participation, advocacy, and action on key determinants of health. I am confident that several of these strategies can be used to address concerns about the ready access to internet-based pornography. For example, health promotion initiatives that take a harm reduction approach to healthy sexuality include an emphasis on screening and testing for sexually transmitted infections, the use of condoms, a shared understanding of consensual sex, as well as the use of other safer sex interventions.

A review of existing sexual health education in Canadian schools, however, reveals that many Canadian youth do not receive the level of sexual health education they need to help them make informed decisions about sexual risk-taking.

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 Semantics of Therapy, Part II

A previous blog post of “The Semantics of Therapy” posed three questions about the human genome being a “patient” to be treated. One reader found the post “provocative and disturbing” and called for further explanation and discussion of the questions posed. That will take some time and several postings.

The first of the questions to be considered is this: If the “patient” is a genome, to whom does the researcher answer?   An answer from recent history may shed some light on this important issue.

33 infertile couples underwent a novel procedure at New Jersey’s Saint Barnabas Medical Center during the years 1996-2001. Embryologist Jacques Cohen used cytoplasmic transfer–ooplasm from the oocytes of fertile women was transferred into the eggs of infertile women–in the hope of establishing pregnancies in the latter. The outcome was 13 pregnancies and 17 babies from the Saint Barnabas experience (see accounts here and here).

According to a 2014 BBC article, one resulting pregnancy, which ended in miscarriage, revealed a missing X chromosome in the fetus. The same anomaly was noted in another child: one of a set of twins from a different pregnancy. Later, one child showed evidence of developmental delay. In 2014, Cohen estimated that the worldwide experience of cytoplasmic transfer between oocytes had resulted in the births of 30-50 babies, although the FDA had effectively stopped the procedure in the U.S. in 2002.

What had the follow-up on the babies born through cytoplasmic transfer been in 2014?

Due to a lack of funding, Cohen says, it hasn’t been possible to find out about how any of the children like Alana who were born from cytoplasmic transfer are doing.

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

When stem cell treatments go wrong, they really go wrong

Three elderly women in Florida have been blinded by an unproven treatment, as a reminder of how dangerous stem cell therapies can be. The New England Journal of Medicine reports that the women signed up for a purported clinical trial in 2015 – for which they had to pay US$5,000. Within a week, they experienced a variety of complications, including vision loss, detached retinas and haemorrhage. Before the surgery, the vision in their eyes ranged from 20/30 to 20/200. They are now blind.

The article is a “call to awareness for patients, physicians and regulatory agencies of the risks of this kind of minimally regulated, patient-funded research,” said Jeffrey Goldberg, of Stanford University School of Medicine and a co-author.

“There’s a lot of hope for stem cells, and these types of clinics appeal to patients desperate for care who hope that stem cells are going to be the answer, but in this case these women participated in a clinical enterprise that was off-the-charts dangerous,” said Thomas Albini, another co-author.

At the clinic, U.S. Stem Cell Inc, fat cells from the patients’ abdomens were processed to obtain stem cells which were injected into their eyes. Patients reported that the entire process took less than an hour. The patients had both eyes treated at once — even though most doctors would opt for a conservative approach to observe how the first eye responds.

“There is a lot of very well-founded evidence for the positive potential of stem therapy for many human diseases, but there’s no excuse for not designing a trial properly and basing it on preclinical research,” Goldberg said.

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

Costa Rica’s resistance to legal IVF crumbles

Ronald Reyes/The Tico Times    

A girl named Maria José has become the first IVF baby to be born in the Central American nation of Costa Rica. Her parents, Jenny Garbanzo y José Barana, had been lobbying for the right to access IVF in Costa Rica since 2007. However, under a ruling by the Supreme Court in 2000, IVF was banned because it resulted in the destruction of embryos. It took substantial international pressure to force the government to give in.

The first IVF procedures were carried out in middle of last year at two certified private clinics.

The Inter-American Court of Human Rights (IACHR) has also ordered the government to make IVF available at public hospitals. Construction of a public fertility clinic is scheduled to begin in August next to the National Women’s Hospital, near the Costa Rican capital of San José. The government is also funding overseas training of IVF specialists from Costa Rica for the clinic. The first procedures in public hospitals will begin in 2018. 

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Source: BioEdge.org.

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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.