Tag: women

Bioethics News

Tennessee Inmates Consenting to Vasectomies or Birth Control Implants Offered Reduced Time

If Tennessee inmates consent to receiving a free vasectomy or birth control implant, Judge Sam Benningfield has ruled that they can have their jail time reduced by up to thirty days. Critics are claiming that the initiative violates inmates’ constitutional rights, amongst them the American Civil Liberties Union and numerous district attorneys. Advocates are claiming that the program, in effect since May 15th, precludes the potential burden of childrearing for otherwise unintentional parents.

In response to the backlash, Benningfield has emphasized that the procedures are reversible and do not involve sterilization. According to Reuters, he said that “the idea grew out of an earlier program he created with the state’s Department of Health under which inmates’ sentences were reduced by two days if they completed an education program on the risks of raising children while using illegal drugs… Unplanned and unwanted children and the resulting obligations complicate their lives and make their reintegration into society more difficult.”

Nashville’s News Channel 5, which drew attention to the program earlier this week, has stated that 32 women have received the four-year birth control implant and 38 men have signed up for vasectomies. Initially designed for women at risk of birthing children with drug dependencies, the program now encompasses procedures for both sexes in order to avoid discriminatory practices.

“We do not support any policy that could compel incarcerated individuals to seek any particular health services,” said a spokeswoman for Tennessee’s Department of Health. Despite assurances from Benningfield about the procedures’ reversibility, District Attorney Bryant Dunaway said that “it’s comprehensible that an 18-year-old gets this done, it can’t get reversed and then that impacts the rest of their life.”

In order to partake in the program, men must be at least 21 years old.

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

Grounding ethics from below: CRISPR-cas9 and genetic modification

By Anjan Chatterjee

The University of Pennsylvania

Anjan Chatterjee is the Frank A. and Gwladys H. Elliott Professor and Chair of Neurology at Pennsylvania Hospital. He is a member of the Center for Cognitive Neuroscience, and the Center for Neuroscience and Society at the University of Pennsylvania. He received his BA in Philosophy from Haverford College, MD from the University of Pennsylvania and completed his neurology residency at the University of Chicago. His clinical practice focuses on patients with cognitive disorders. His research addresses questions about spatial cognition and language, attention, neuroethics, and neuroaesthetics. He wrote The Aesthetic Brain: How we evolved to desire beauty and enjoy art and co-edited: Neuroethics in Practice: Mind, medicine, and society, and The Roots of Cognitive Neuroscience: behavioral neurology and neuropsychology. He is or has been on the editorial boards of: American Journal of Bioethics: Neuroscience, Behavioural Neurology, Cognitive and Behavioral Neurology, Neuropsychology, Journal of Cognitive Neuroscience, Journal of Alzheimer’s Disease, Journal of the International Neuropsychological Society, European Neurology, Empirical Studies of the Arts, The Open Ethics Journal and Policy Studies in Ethics, Law and Technology. He was awarded the Norman Geschwind Prize in Behavioral and Cognitive Neurology by the American Academy of Neurology and the Rudolph Arnheim Prize for contribution to Psychology and the Arts by the American Psychological Association. He is a founding member of the Board of Governors of the Neuroethics Society, the past President of the International Association of Empirical Aesthetics, and the past President of the Behavioral and Cognitive Neurology Society. He serves on the Boards of Haverford College, the Associated Services for the Blind and Visually Impaired and The College of Physicians of Philadelphia. 

In 1876, Gustav Fechner (1876) introduced an “aesthetics from below.” He contrasted this approach with an aesthetics from above by which he meant that, rather than defining aesthetic experiences using first principles, one could investigate people’s responses to stimuli and use these data to ground aesthetic theory.

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

Eugenics in Tennessee

A recent news story from my home state of Tennessee brings up questions of informed consent, reproductive ethics, eugenics, opioid abuse, and other bioethical issues.  In May, White County judge Sam Benningfield issued an order that allows inmates to have their sentences reduced by thirty days if they consent to sterilization procedures: vasectomies for men and (reversible) Nexplanon implants for women.  Benningfield’s order is his response to the repeat drug offenders he sees in the courtroom.  He describes the sterilizations as a means to “encourage personal responsibility,” and also states that, “…if you reach two or three people, maybe that’s two or three kids not being born under the influence of drugs. I see it as a win, win.”

This order is less surprising, perhaps, when considered in light of the United States’ very recent history of eugenics and forced sterilizations. As Kyle Sammin writes at The Federalist,

“[Benningfield’s] idea of ‘trying to break a vicious cycle of repeat offenders’ is, nearly word-for-word, an echo of the Supreme Court’s reasoning in Buck v. Bell, the 1927 case that upheld Virginia’s policy of sterilizing state asylum inmates without their consent. The decision by Justice Oliver Wendell Holmes laid out a similar desire to break a cycle of reproduction by people the judge viewed as unworthy of life: ‘It is better…if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind….Three generations of imbeciles are enough.’”

Benningfield’s order deems inmates’ potential future children as unworthy of life because of their parents’ situations.

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

Striking a Balance

By Peter Young

 

In April of this year, the Berman Institute and Johns Hopkins Hospital Ethics Committee held its monthly Ethics for Lunch case presentation focusing on how to manage patients who make racist, sexist, and otherwise offensive comments. The discussion, moderated by Dr. Joseph Carrese, featured panelists who have experienced racism/sexism in the clinic, and it allowed audience to gain insight from their perspectives.

 

During the discussion, there was mention that minority patients in an in-patient setting cannot choose their own doctor based solely on race, because Hopkins’ practice is to pair the best doctor with a patient’s medical needs. I was a bit confused how minority patients not being able to choose race-based concordance in an in-patient setting fits into the larger, nation-wide conversation of minority groups wanting safe spaces. For example, some argue the race of the physician affects the quality of care, and when the provider and patient’s race align, the provider can speak better to certain beliefs, religious practices, nutritional knowledge, and cultural norms. Also, there may be even subtler, yet equally important benefits of having your provider look like you, especially in our current political climate. This includes patient-compliance as well as the potential for less polarizing power dynamics in the provider-patient relationship.

 

Scholars like Dr. Dayna Bowen Matthew, author of Just Medicine and professor at University of Colorado, might argue that if a white, middle-class person tells an intercity, minority person to take their medication, that patient may be less likely to adhere.

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 bit of a compromise’: Coming to terms with an emergency caesarean section by Terena Koster

During the midwife-hosted antenatal class Cath attended in a private hospital in Cape Town, South Africa, where she would eventually give birth, pregnant women were encouraged to name the kind of birth they wanted. They were presented with three options: “natural all the way with no medication”, “natural but open to medication”, or “elective caesarean”. The ‘choice’ women were expected to make featured as an important point of concern in their antenatal care and in their preparations for birth.

Hannah, a participant in the class, recalls a particularly striking moment when the midwife went around the room and pointed at each of the participants and asked, “Who is your gynae”. She went on to predict diverse birth outcomes, irrespective of participants’ stated intentions to birth vaginally. For Hannah this was an “eye opening” experience. A first time mother, she was now invited into a highly politicised birthing environment. Hannah had been uncertain about what kind of birth she wanted, but at 8 months pregnant she had decided on a ‘natural’ birth as opposed to a ‘caesarean’, with the caveat that in the event that an emergency caesarean section was a likely outcome, she would proactively opt for an elective caesarean.

At 39 weeks and near the end of her pregnancy, she found herself sitting opposite her obstetrician who told her there was “a real threat of the umbilical cord wrapping around [the baby’s] neck as she … drop[s] down,” adding that because the baby was “so big” there was “a high likelihood of [Hannah] tearing”. For the first time, the obstetrician instructed her to make a birthing decision: to continue trying for a vaginal birth or to opt for an elective caesarean section.

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

First case of deceased donor uterine transplantation. It is a relevant medical and social issue

Being able to resolve the reproductive problems suffered by women who have no uterus – whether due to an organic cause or functional abnormality of the uterus – is unquestionably a major medical and social issue.

The two possible solutions to this problem are uterus transplantation or surrogacy, the latter solution presenting objective ethical difficulties.

Uterus transplants to date have been performed using living donors, with unpredictable outcomes. Now, the first case of deceased donor uterine transplantation performed in the United States has been published. The recipient of the uterus was a woman with Mayer-Rokitansky-Kuster-Hauser syndrome, that is, she had no uterus.

The journal Fertility and Sterility has disseminated a video describing the essential steps in this transplantation process, particularly as regards selection of a suitable donor with no history of infertility or uterine malformations. The death of the donor should be determined by presentation of brain death but not cardiac death. The authors concluded that: “Uterine transplantation, although currently experimental, has gained the potential to become the first true treatment for uterine factor infertility. This procedure can become a promising option for the approximately 1.5 million women worldwide for whom pregnancy is not possible because of the absence of the uterus or presence of a nonfunctional uterus. Deceased donor uterine transplantation will further serve to broaden accessibility for this treatment.”

Ethical approach

For our part, as the organ donor is a deceased person with brain death (see true definition of this death HERE), we see no ethical issue for this practice; on the contrary, it seems an encouraging medical prospect to resolve the reproductive problem of women who have no uterus or whose uterus is not functionally useful, although the risk-benefit balance must always be taken into account, especially as regards the surgical act.

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

Cholera Is Slaughtering Yemen and We’re Letting It Happen

July 21, 2017

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But the Haitian debacle, in which United Nations Peacekeepers carried the Vibrio cholerae in their bodies from Nepal, passing the bacteria into local streams to spawn a massive epidemic that continues today, spread in a nation shattered by natural disaster. There is nothing “natural” about the carnage of Yemen: This is war, waged from 10,000 feet by Saudi bombers that have damaged or destroyed every hospital, clinic, water treatment plant, pumping station, and sewer system from Sanaa to Ibb.

According to the World Health Organization (WHO), 14.5 million Yemenis no longer have access to clean water: Cholera is a water-borne disease. UN officials reckon 17 million Yemenis are “one step away from famine,” civil war rages across the land, the region is locked in a climate change-compounded record drought, and the country’s Arab neighbors feed the flames with steady flows of arms and carpet-bombing campaigns.

Every day the WHO issues a new, always grimmer data set, estimating the toll cholera is taking. Inside the country, humanitarian groups and Yemeni medical personnel stack ailing men, women, and children three and four to a bed, hooking each one up to life-sparing hydration IV drips, even as the sound of gunfire and bombings resonate outside meager facilities.

… Read More

Image: By yeowatzup from Katlenburg-Lindau, Germany – San’a, Yemen, CC BY 2.0, https://commons.wikimedia.org/w/index.php?curid=24520831

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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

Trump is Gross: Taking Political Taste (and Distaste) Seriously

by Shelley Park 

ABSTRACT. This paper advances the somewhat unphilosophical thesis that “Trump is gross” to draw attention to the need to take matters of taste seriously in politics. I begin by exploring the slipperiness of distinctions between aesthetics, epistemology, and ethics, subsequently suggesting that we may need to pivot toward the aesthetic to understand and respond to the historical moment we inhabit. More specifically, I suggest that, in order to understand how Donald Trump was elected President of the United States and in order to stem the damage that preceded this and will ensue from it, we need to understand the power of political taste (and distaste, including disgust) as both a force of resistance and as a force of normalization.

My 5-year-old granddaughter refers to foods, clothes, and people she does not like as “supergross.” It is a verbiage that I have found myself adopting for talking about many things Trumpian, including the man himself. The gaudy, gold-plated everything in Trump Towers; his ill-fitting suits; his poorly executed fake tan and comb-over; his red baseball cap emblazoned with “Make America Great Again;” his creepy way of talking about women (including his own daughters); his racist vitriol about Blacks, Muslims and Mexicans; his blatant over-the-top narcissism; his uncontrolled tantrums; his ridiculous tweets; his outlandish claims; his awkward hand gestures and handshakes; the disquieting ease with which he is seduced by flattery; his embarrassing disregard for facts; his tortured use of language; his rudeness toward other world leaders; the obsequious manner in which other Republicans are treating the man they despised mere months ago; the servility of many Democrats in the face of a military–industrial coup.

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

All the Difference in the World: Gender and the 2016 Election

by Alison Reiheld

ABSTRACT. In this paper, I analyze multiple aspects of how gender norms pervaded the 2016 election, from the way Clinton and Trump announced their presidency to the way masculinity and femininity were policed throughout the election. Examples include Hillary Clinton, Donald Trump, Barack Obama, and Gary Johnson. I also consider how some women who support Trump reacted to allegations about sexual harassment. The difference between running for President as a man and running for President as a woman makes all the difference in the world.

 

IMAGE DESCRIPTION: This image shows Donald Trump on the left and Hillary Clinton on the right. Trump’s eyes are narrowed, his brow furrowed. He looks serious, and there is no hint of a smile. On the right, Clinton has a composed look with a slight, close-mouthed smile, her eyes open to a typical degree. Both are white and have greying blonde hair.

The May 21, 2007 cover of TIME magazine showed a close-up image of Mitt Romney’s face with the cover tagline “. . . he looks like a President . . .”, the first of many such claims. In 2011, as Texas Governor Rick Perry geared up for a run at the presidency, Washington Post opinion writer Richard Cohen said that Perry “actually looks like a President” (Cohen 2011). The term, here, is used as praise. Yet the power of its use as an epithet when people fail to look adequately presidential cannot be understated. During the primaries for the 2016 election, while watching Republican candidate Carly Fiorina, Donald Trump said in front of a reporter, “Look at that face!

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

Zika Rewrites Maternal Immunization Ethics

July 20, 2017

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Ever since the shocking realization in 1961 that the morning sickness pill thalidomide caused shortened limbs in babies, doctors have been extremely wary of giving any medicine to a pregnant woman—and testing experimental drugs has raised even more concerns. But the recent discovery that exposure to Zika virus in utero can cause severe brain damage and other problems in children triggered an international effort to develop a vaccine for pregnant women. A new report written by an ad hoc group of prominent researchers, bioethicists, clinicians, and drugmakers concludes that pregnant women should be included in trials of Zika vaccines, once safety in animals and nonpregnant adults is demonstrated. The risk/benefit issues spelled out in the report also apply to experiments with maternal immunization for other diseases, which are winning increasing support.

Researchers have been too reticent to include pregnant women in clinical trials of vaccines, contends the working group behind the report. “Even for the vaccines we now recommend in pregnancy, pertussis and flu, the original trials did not include pregnant women,” says Carleigh Krubiner, a bioethicist at the Johns Hopkins Berman Institute of Bioethics in Baltimore, Maryland, who is part of the group, which was sponsored by the London-based Wellcome Trust. “This project is trying to be more proactive.”

The half-dozen Zika vaccine trials now taking place only enroll women of childbearing age who are on contraception or have a sterile male partner. That is appropriate, according to the risk/benefit analyses spelled out in the report, as these early studies assess only safety and basic immune responses.

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.