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HASTINGS CONVERSATIONS: A SERIES Although roughly 60% of adults in the United States have had at least one Covid vaccine shot, many Americans remain reluctant, or outright opposed, to getting vaccinated. This hesitancy poses a major hurdle to achieving herd immunity. Therefore, some experts reco...

A HASTINGS CENTER CONVERSATION WITH RHEA BOYD, MAYA GOLDENBERG, AND MILDRED SOLOMON The Hastings Center hosted “Vaccine Access, Vaccine Hesitancy: Challenges to Herd Immunity,” an online discussion of the ethical issues related to vaccine access and hesitancy in the United State...

TRANSCRIPT: February 9, 2021

Suppose you are young, healthy, employed in a health care system and that your line of work does not require leaving the low-risk comfort of your home. Now suppose that your employer offers you a vaccine. You know there are others in your community who are at greater risk of contracting and dying from Covid-19 than you. Should you accept the dose?

Beginning this week, guarded vehicles loaded with the first Covid-19 vaccine authorized in the United States are fanning out to hospitals across the country. In vaccine prioritization protocols health care workers, along with nursing home residents, make up phase “1a” – those who are first in line to be vaccinated. While much attention has been paid to who should come next, less is known about how hospitals are allocating vaccine doses among their staff. For many medical centers, the first shipments will only be enough to vaccinate a fraction of their workers. Who goes first within the “1a” category, and how are such decisions made?

FOUR STEPS TO PROTECT COMMUNITIES FROM COVID-19 AND RESTORE THE ECONOMY

Concerns about the health status of sitting presidents of the United States can raise significant questions in medical ethics, notably regarding the scope of a president’s right to confidentiality and of the public’s need—or right—to know about the president’s health, the role and responsibilities of the president’s physician, and the appropriateness of offering unapproved treatments. These concerns are heightened during the global pandemic for which there is no cure or vaccine and limited information about treatments.

Artificial intelligence has the potential to reduce inequities in health care and even help restore empathy to the doctor-patient relationship—if, and only if, key ethical barriers are addressed and opportunities grasped. That was Eric Topol’s overarching message at The Hastings Center’s 50th ...

Big Data in health care is growing, and it is coming from an increasing number of sources, including electronic health records, patient monitors and physical activity trackers, and smartphone applications. How accurate is this data? What biases does it contain? How do errors and biases ultimately af...

In New Zealand we have been saved from the worst devastations of Covid-19 by a firm government, courage and care for one another, and our geographic “moat.” With the recent minor surge of cases, our government has, once again, encouraged us to respond as a team of 5 million. We have been guided by the slogan “Be kind.”

Before there was the Covid-19 pandemic, there was Pandemic. This tabletop game, in which players collaborate to fight disease outbreaks, debuted in 2007. Expansions feature weaponized pathogens, historic pandemics, zoonotic diseases, and vaccine development races. Game mechanics modelled on pandemic vectors provide multiple narratives: battle, quest, detection, discovery. There is satisfaction in playing “against” disease–and winning. Real pandemic is not as tidy as a game. But can games support understanding about the societal challenges we now face? Yes.

As the world reels from the Covid-19 pandemic, two things have become very clear: the health impacts of the disease are devastating, but the aggressive social distancing policies currently being used to flatten the curve also have serious costs. As a result, the question of when and how to reopen the nation is on everyone’s mind. Do we open quickly in an effort to kick-start the economy? Or do we remain under lockdown as long as possible to stop the spread of the virus?

Previously-stated DNR status would seem irrelevant to ventilator allocation, and yet some existing and proposed guidelines for triage during a public health emergency list DNR status in the list of criteria for excluding patients from getting ventilators or other life-saving health care. This approach is in direct opposition to the generally agreed-upon goal of maximizing the number of survivors, and could result in confusion and public mistrust of the health care system.

I helped develop guidelines for the ethical allocation of scarce resources during a public health emergency, such as a pandemic..I hope my contributions have an impact. I especially hope to see my work used since it emphasizes the perspectives of minority and underserved communities, who tend to have less voice in health policy. But now I find myself dreading the use of my work.

Do the elderly have special obligations during a pandemic, that is, something more than the duty we all have for hand washing, social distancing, and so on? I believe the answer is, yes, and foremost among these is an obligation for parsimonious use of newly scarce and expensive health care resources.

President Donald Trump had, until very recently, spent as much time in his public appearances proclaiming victory over the Covid-19 pandemic rippling across the nation as he had offering directives that would diminish it. Again and again, he promised that it would soon be over, especially as the wea...

Nearly 1,400 of the nation’s most prominent bioethicists and health leaders signed an urgent letter to Congress and the White House, imploring the U.S. government to immediately use its federal power and funds to respond to the COVID-19 pandemic as a matter of moral imperative. The petition was developed by Mildred Solomon, president of The Hastings Center, and Lawrence Gostin, a Hastings Fellow and director of the O’Neill Center for National and Global Health Law at Georgetown University.

Since the initial outbreak in Wuhan last December, the national and global responses to COVID-19 have been in ethics freefall.

There is big money in using technology to find information in patient and medical staff data. Companies are rushing to cash in. The Food and Drug Administration has approved more than 40 artificial intelligence-based products for use in medicine. Tens of thousands of medical phone apps are tracking patients and gathering detailed medical information about them. These new technologies bring new ethical questions that health care organizations are poorly equipped to answer.

The Hastings Center is pleased to announce the election of 12 new Fellows. Hastings Center Fellows are a group of more than 200 individuals of outstanding accomplishment whose work has informed scholarship and public understanding of complex ethical issues in health, health care, science, and techno...

Gretchen Greene, an internationally recognized expert on artificial intelligence policy and ethics, including face and emotion recognition, has been named a senior advisor to The Hastings Center. 

The Compassionate Use Advisory Committee, headed by Hastings Center Fellow Arthur Caplan, of NYU Langone, received the Reagan-Udall Foundation for the Food and Drug Administration’s Innovation Award. The committee was recognized for transforming how expanded access requests, also known as compassionate use requests, are granted by drug developers.

Why do citizen science projects get started, and what are the ethical challenges facing them? These questions underlie “When Citizens Do Science: Stories from Labs, Garages, and Beyond,” published in Narrative Inquiry in Bioethics,  which explores the world of science happening outside the ...

Neither one of us expected to be talking about Hannah Arendt at the Vatican. We had been invited to give talks at the Pontifical Academy of Sciences on the scientific and ethical challenges posed by personalized medicine. Walking across the cobblestones of St. Peter’s Square we began to discuss how society regulates biomedical research. Are institutional review boards capable of dealing with innovations like personalized medicine? Are they too bound by regulations? Can they ask larger questions of meaning when simply following the rules won't suffice? And most worrisome, has their bureaucratic function caused them to mistake regulatory compliance for ethical reflection?

New book edited by Hastings Center scholars explores fundamental questions about the nature and well-being of human beings at a time when a revolutionary new biotechnology could permanently change the human species.

The U.S. government is using dental scans to determine if migrant youths are over age 18. The scans are inaccurate for this purpose, and yet they determine if children are sent to adult detention centers.

Another June. Another public outcry about cruelty as policy harming migrants in United States custody. This summer, the photo of a drowned family, Óscar Alberto Martínez Ramírez and his daughter, Valeria, of El Salvador, shocks the conscience. Reporters are documenting the inhumane conditions in a Border Patrol facility where hundreds of children have been held. How should our field respond?

As artificial intelligence transforms health care, what should be done to assure that it brings about improvements and greater equity? To address those questions, Hastings Center President Mildred Solomon joined a panel at the Aspen Ideas: Health Festival called “Ethical Artificial Intelligence: Oxymoron or Possibility?”

It was unethical for a fertility doctor to use his own sperm to inseminate patients without their consent. But what are the legal harms to the women? To their children?

Four articles in the Hastings Center Report make an array of claims about  whether advance directives should or should not be used to instruct caregivers to withhold oral feeding of a person who reaches a designated stage of  dementia. I would like to advance some central ethical observations on th...

The language of shame has been prominent in the aftermath of the mass shooting at a high school in Parkland, Florida. In a March 23 essay in The New Yorker, filmmaker A.J. Schnack, who in 2015 began a video project, “Speaking Is Difficult,” to document initial reports of mass shootings, wrote abo...

The mass shooting at Marjory Stoneman Douglas High School in Parkland, Fla., resulted in the deaths of 17 people. Tragically, from January 1 to March 21, 2018, there were 3,088 gun-related deaths and 5,355 gun-related injuries in the United States. Gun violence is a public health problem. But it’s ...

For the last quarter century, researchers have been asking whether genetic test results might have negative psychosocial effects. Anxiety, depression, disrupted relationships, and heightened stigmatization have all been posited as possible outcomes—but not consistently found. What accounts for the ...

As I read a recently published report of an interesting and important placebo-controlled trial of arthroscopic shoulder surgery, one sentence in particular caught my eye: “The study was designed under the ethical supervision of an academic ethicist (JS) with placebo trial experience.” I regularly...

Fake news proliferates on the internet, and it sometimes has consequential effects. It may have played a role in the recent election of Donald Trump to the White House, and the Brexit referendum. Democratic governance requires a well-informed populace: fake news seems to threaten the very foundations...