The news that Health and Human Services Secretary Robert F. Kennedy, Jr. cancelled the July 10 meeting of the United States Preventive Services Task Force—and may seek to change its...

Recent reports reveal that the U.S. government is systematically collecting DNA from migrant children, some as young as 4 years old, and storing it (perhaps indefinitely) in the FBI’s national...

A small group of people with a severe form of type 1 diabetes have been successfully treated with pancreatic cells derived from human embryonic stem cells. This moment should not pass without recognition of the historical context.

As family caregivers who are everywhere yet overlooked in aging societies worldwide, we ponder and discuss this question as bioethicists: “Who cast me in this role?”

Tens of thousands of parents have enrolled their newborns in whole genome sequencing research projects. Parents should know what they information from this research can and cannot tell them.

Our forthcoming book, The Art of Flourishing: Conversations on Disability, invites readers to consider the fact that, when provided with adequate social support, people can flourish in all sorts of...

In my role as a clinical ethicist, I regularly explore the risks and benefits of proposed treatments, especially for terminal diseases. But for Sheba this moral question felt unique.

Brain death during pregnancy presents complex ethical and legal questions regarding whether––and under what circumstances–any fetal interests or rights take precedence over those of a pregnant person. Here, we discuss...

The rhyme of history is disturbing, especially when played out by the professionals whom we rely on for ethical leadership, not for unethical manipulation of the law.

On May 11, the Israeli Supreme Court handed down its long-awaited ruling in the case known as the “Assuta Embryo Mix-Up.” The case has drawn widespread attention in Israel and abroad —...

Faster access and fairer benefits for all. It sounds simple. But is it?

The budget bill adopted by the House of Representatives on May 22 is not so much a fiscal blueprint as a manifesto in policy retrenchment. Behind its rhetoric of “restraint”...

Proposed cuts to federal research funding and attacks on universities imperil the longstanding global leadership of the United States in scientific and medical discoveries and raise profound bioethical concerns.

Will bioethics continue to exist and in what form? In the United States, where the discipline is most developed and institutionalized, it is under pressure.

At some point, it occurred to me that I could actually research the emotional burden of ethics cases on clinical ethicists. This was an epiphany.

Colossal Biosciences, a biotechnology company, announced that it has achieved a scientific first -- bringing back an extinct animal: the dire wolf. Crucial questions emerge about scientific hubris, playing God with cool new technological toys, and more.

History is informative in considering how bioethicists should respond to serious new threats to public health and well-being.

The framework below outlines three foundational ethical duties of health care institutions that can be enacted by leaders through policies, processes, and communication with their workforce: (1) the duty to plan for foreseeable situations with impact on patient care and institutional operations, (2) the duty to safeguard patient populations and the health care workforce, and (3) the duty of care, long understood as nonabandonment of patients.

I had never thought much about Alzheimer’s disease, other than to hope that I never suffer from it. But after attending a heavy metal concert, that condition began to weigh on my heart and mind. The songs the band performed that evening were about a character sliding into the mental abyss of Alzheimer’s disease.

Many think that the decision 20 years ago to permit Terri Schiavo to die was a victory for medical choice. On the contrary, her death triggered a series of events that have corroded individual control over medical care in the United States.

As an immigrant, a trained bioethicist, and a lawyer, I am intimately familiar with the impact of fear and injustice on immigrant communities. Maya Angelou’s profound words on courage resonate...

My brother-in-law Mark died a couple of weeks ago. He had struggled with schizophrenia for over 45 years, so at age 64 1/2, he had exceeded the average life expectancy...

What bioethics needs is a rich working definition of spirituality as a common dimension of human life.

We have well-developed playbooks on what health care providers and institutions should do immediately to welcome immigrant patients and make their facilities as safe as possible for them.

It’s time for the medical community to re-examine its relationship with alcohol -- moving away from using it as a reward, a stress reliever, or a social crutch, and instead, finding healthier alternatives.

I am a bioethicist who became a local pro-vaccine activist in New York City to protect vulnerable communities from dangerous misinformation. I have spent much of my time trying to convince people not to believe what RFK Jr. has said.

Bioethics has increasingly turned away from religion, embracing methods of law, philosophy, and empirical sciences. The authors argue that bioethics should welcome religion.

Ms. B is a 45-year-old African American woman who lives in a shelter. She also has a heroin addiction and has end-stage heart failure. She was admitted to the hospital...

After witnessing the first death of a patient, a medical student searches for meaning.

I last saw Jimmy Carter in person on November 4, 1980. The future would unfold in ways that brought bioethics into both of our lives.

AI Jesus is just one of many recent examples in which artificial intelligence systems have taken on roles that have always seemed to require human beings. One can worry what these creations will eventually do to us humans. What will be left for humans to do?

Predicting a patient's suicide risk is hard. Can AI do better than a clinician?

For those committed to realistic responses to our current climate crisis, the results of the presidential election are a major step backward. Announcements of cabinet choices for the second Trump...

Beyond policy disagreements or concerns about qualifications, there was something more foundational that bothered me about the nominees for the Departments of Justice and of Health and Human Services.

With concern about its stability, 23andMe should consider what information and protection it owes its users. So should other DTC genetic testing companies.

After the election, the care needs of our aging society will continue to be met by families showing up, day after day. Whether or not our public officials decide to imagine otherwise and commit themselves to policy changes that could prove highly popular, bioethics needs to keep its eyes on the caregivers.

How we can help reduce emissions at the scale needed to avert the worst of climate change? Vote for leaders who value emissions reduction and carbon neutrality and vote against those who discount, greenwash, or oppose it.

Given its concern with making health and health care more equitable and just, bioethics should pay attention to the Mandate for Leadership: The Conservative Promise, best known as Project 2025....

I was honored (and honestly a bit surprised) to play a pivotal role in a recent federal milestone for patients’ rights. On April 1, the Department of Health and Human...

In a recent interview with conservative radio talk show host Hugh Hewitt, Donald Trump drew a link between immigration, violent crime, and genetics, stating, “we got a lot of bad...

A recent NBC investigative series titled “Dealing the Dead" revealed that thousands of unclaimed bodies were used by the University of North Texas Health Science Center for scientific research and medical education, and to generate profit. These findings raise important ethical questions around the need for ongoing transparency and accountability concerning the use of the deceased in medical research and education.

Clinical ethicists should engage with the injustices of mass incarceration in the United States.

After several decades of being a prolific bioethicist, I am no longer sure I can afford to pay the open-access fees to publish in the field.

The suggestion that obesity is a preventable disease has been weighing heavily on my mind ever since I read a recent article in the Hastings Center Report. The article claims to focus on “ethical, policy, and public health concerns” related to anti-obesity medications, but there is a strong undercurrent of bias throughout. As an endocrinologist who specializes in medical weight management, my clinical experience informs my understanding that obesity is almost never entirely preventable, but bias against those with obesity certainly is.

Louisiana recently became the first U.S. state to permit judges to order surgical castration of sex offenders.

Patients who are members of marginalized groups—women, Black people, trans people, elderly people, disabled people—are often dismissed, minimized, or altogether ignored by health care professionals. Over time, this can lead to gaslighting in which patients question their thoughts, feelings, symptoms, even themselves.

The National Academies “Ending Unequal Treatment: Strategies to Achieve Equitable Health Care and Optimal Health for All” is the 2024 follow-up to its 2003 seminal predecessor “Unequal Treatment: Confronting Racial Bias and Ethnic Disparities in Health Care.” A noticeable difference between them is reflected in their titles; whereas the 2003 version made us aware of the systemic causes of racial disparities in health outcomes, the latest edition has moved beyond naming the problem to naming solutions.

Today’s wars kill far more civilians than soldiers. Bioethics must address war not just as an individual tragedy but as a public health disaster.

Case Narrative W is a 32-year-old man with heart failure. Prior to diagnosis he was relatively healthy and physically fit. A trial of medication was not effective. Some members of...

Last month, Netflix premiered the documentary Tell Them You Love Me, the story of former Rutgers University professor Anna Stubblefield, who was convicted of first-degree aggravated sexual assault in 2015...

Was this experiment ethically problematic? Or was it a useful study involving common practices on Twitter?

The National Research Act was a landmark in research ethics oversight. But it needs to be updated for modern times, including research with biospecimens, AI, and xenotransplantation.

The Biden Administration is struggling with a dilemma that has a clinical ethics component. Where does the President’s right to privacy about his health end and the public’s right to know begin? This question has recurred throughout American history and, unfortunately, has often been answered the wrong way--with deception. Clinical ethics norms and recent legal precedent offer important insights for responding to this ethical dilemma with much-needed transparency in a way that respects all parties involved.

After these children are given the keys to communication, these keys are taken away. The door is locked, and their world goes dark. What had been an opportunity for community and reciprocity is now one for segregation and isolation. How can this be right?

Hugh Culber is talking to his abuela, asking why her mofongo always came out better than his even though he is using her recipe. She replies that it never came...

The Cass Review of gender identity services for children and young people, a recent report in the U.K., has spurred many headlines and much debate, most of which tout the finding of “weak evidence” for gender-affirming care for children and teenagers. Advocates of such care reject the report as anti-trans, while critics hail it for finally outing such care as pseudoscience. However, much of the noise around gender-affirming care in pediatrics, and this report, is misleading and takes away from the substantive improvements needed to provide the best care for transgender youth.

Whether and under what conditions would it be legal and ethical to proceed with a vasectomy requested by D’s parents with D’s assent but without his full understanding, considering the history of forced sterilization of individuals with intellectual disabilities in the United States.

As wounded victims came pouring into the civilian hospital in Kharkov after the Ukraine war began in February 2022, Artem Riga initially was the only surgeon on duty. Some colleagues...

Dualists rejoice! That much-maligned ontology got a new lease on life recently with vividly contrasting cases involving Scarlett Johannsen’s voice and Elon Musk’s brain.

The more time passes, the more Nixon looks like a strange, unlikely political ally.

How can we live a morally decent life in a time of massive, structural threats that seem to implicate us at every turn? Climate change is the paradigm example. Am I permitted to fly? Should I buy an electric car? Go vegan?

Breakthroughs in our ability to change the genes of organisms are generating novel capabilities for biological weapons, a form of warfare that has been largely abandoned for decades. Guidance from scientists and bioethicists is needed to avert the threat.

While working as a medical volunteer in the clinic at the edge of the refugee camp, I quickly realized I was in a clinical environment I had never seen before. I was unprepared for the sheer scale of medical needs among the refugees I was there to serve, and for what resource scarcity meant under these conditions.

I had underestimated the challenges I would face as an ESL speaker when immersed as a clinical ethicist in the dynamic space of the hospital. This was like learning a third language.

This year will be the most important moment for global health since WHO’s founding in 1948, but only if states give major reforms their full political and financial backing.

With a new technology called in vitro gametogenesis (IVG), scientists produced an egg from a male mouse, leading to two male mice having offspring. In mice. IVG could be a game changer for women and men dealing with infertility, women of advanced maternal age, and same-sex couples.

As two people who have ties to Alabama and grew up in the Deep South, we are frustrated by the state’s ceaseless assault on reproductive freedom, while its politicians continue to ignore child health. Because Alabama lawmakers and its Supreme Court justices profess to care about children–and use this as a reason to restrict reproductive freedom–we believe there is a strong responsibility to aid kids who do not have consistent access to groceries or health care.

How can the legitimate concerns of fertility patients whose embryos are negligently lost be addressed without threatening the very existence of IVF?

In a recent commentary, physician Alan Astrow  expressed skepticism about the legalization of medical aid in dying.  He cited the subjectivity of determining whose suffering qualifies for medical assistance and...

The sole virtue of Elon Musk’s report on X, formerly known as Twitter, of the first in-human brain implant by his company, Neuralink, is its brevity: “The first human received...

For the first time, this year’s Super Bowl will have an alternate telecast for children featuring beloved cartoon characters. But as public health researchers, we are alarmed by efforts to promote the full-body collisions of tackle football to young children with animated mascots, enhanced augmented reality, bright colors, 3D iconography, and other child-friendly symbols.

Nitrogen gas was just used for the first time to execute a prisoner on death row. The execution of Kenneth Smith does not answer the many questions raised by this new means of capital punishment. Is it “perhaps the most humane method” of execution,” as the Alabama attorney general has claimed? Or is it cruel and unusual punishment, as Smith’s attorneys and others have argued? Answering these questions is of vital importance, since nitrogen gas has been approved by three states for capital punishment.

Network news correspondent and author Betty Rollin died in November at age 87. Surprisingly, there has been little public comment upon how her life ended. Rollin died in Switzerland at Pegasos, a voluntary assisted dying service. The circumstances of her death underscore the confusion over terminology and the uneasiness some feel regarding efforts to legalize assisted dying in New York State and elsewhere in our country.

In most ways, 2023 was a return to normal. Schools were fully back in person; hybrid work was old hat; travel rebounded. But people are easily agitated. I think in our desire to regain a sense of normalcy we have not grieved properly for the losses and hardships of the past four years.

With ventilator support, Ms. J would have a 50% chance of making a full recovery. Without it she would almost certainly die. That notwithstanding, Ms. J declined to consent to the ventilator.

What is a "reasonable medical judgement" that a patient would be harmed before an abortion is permissible?

Work and life overlapped significantly for me in 2023. The timeframe for the latest project in the  Bioethics for Aging Societies portfolio—a Greenwall Foundation-funded analysis of ways to support aging...

A recent Texas Supreme Court decision with implications for post-Dobbs jurisprudence on abortion seems to have been a victory for those who oppose the practice. It was widely read as upholding Texas’s very strict anti-abortion legislation. I suggest another possible reading of that decision.

The realized promise of xenotransplantation seems to be quickly approaching, following the medical breakthrough of a pig kidney functioning for a record two months in a deceased human body. This milestone has received overwhelmingly positive media attention. Ethicists, physicians, and transplantation specialists have shared their apprehensions about the risks of implanting animal-grown organs into humans. However, conspicuously absent from these discussions is a major stakeholder: the animals.

What is at stake in calling extreme, end-stage anorexia nervosa a terminal condition? It may be thought to have implications for end-of-life decisions. I will argue that this is a mistake, although one that needs explanation.

To mark the 50th anniversary of the end of the United States Public Health Service’s Syphilis Study, the National Library of Medicine recently digitized and released reams of historical documents on the “origin and development of the Tuskegee syphilis study.” The release of these documents is a poignant occasion to consider what qualifies as ethical, just, and respectful use of archival materials.

Despite the medical necessity of the abortion, it was delayed and rescheduled twice that day because individual anesthesiologists, technicians, and nurses did not want to be involved in, what several called, “this kind of procedure.”

It seems to me a kind of magical thinking to assume that explaining the genetic causes of obesity will reduce stigma when that new explanation is lodged firmly within a broader project of treating, preventing, or curing fatness. Today, drugs like Ozempic, Wegovy, and now Zepbound are the favored medical solution.

When I said “yes!” to my partner’s proposal last spring and changed my Facebook relationship status to engaged, I expected targeted advertisements for wedding dresses, flowers, and photographers. What I did not expect were ads to donate my plasma to help pay for my wedding.

New inquiry examines ethics of 1960's experiments involving Punjabi immigrants in the United Kingdom and radioactive chapatis.

Some people advocate giving Alzheimer's disease drugs to people with normal cognitive function who have elevated amyloid levels in their brains. This is not only wrong, but dangerous.

Many post-World War II international structures are what might be called bioethics adjacent: They are not strictly part of the set of widely recognized global bioethics standards and instruments, like the Declaration of Helsinki, but they overlap with concerns routinely expressed in bioethics. One of these is the Chemical Weapons Convention, which celebrated its 30th anniversary this year with the destruction by all States Parties of their declared stockpiles of chemical weapons and dual-use chemicals.

Just one month ago, my mom received an intravenous infusion of CAR T-cells, which have become mythical creatures in my imagination.

Bioethicists should practice linguistic justice, making our work accessible to people by using relatable language. It's key to improving health justice.

The system of mandatory reporting of child abuse is rife with ethical problems and can lead to unjustified custody loss.

. A report last week in the New York Times of a pig heart transplant performed at the University of Maryland Medical Center exemplifies a common myopic view of xenotransplantation research.

Black women are three times as likely to die from preventable pregnancy-related complications as white women in the United States. There are many reasons for this, but one of them is that Black women have lower rates of health insurance. Without insurance, they cannot afford the pre-pregnancy and prenatal care they need to reduce their maternal mortality rate. A fundamental way to address this problem is to expand Medicaid.

“Between the time of my heart transplant and the moment my hair began to fall out, I arguably had suffered enough,” writes Leilani R. Graham. “Transplant brought four open-heart surgeries, ten days on ECMO, an intra-aortic balloon pump, delirium, necrotizing pneumonia, and so much muscular atrophy that I had to re-learn how to walk. [Transplant] was not the miracle I was hoping for.”

Children are returning to classrooms amid another wave of Covid cases, but some public health leaders have leaned into the message that “most of us” can ignore the continued presence of Covid by taking just “a few basic steps,” such as staying up to date with vaccinations. “Most of us,” however, does not include families with young babies, among other groups for whom these steps are unavailable or insufficient.

What happens when a health care provider decides that the patient is not a reliable narrator of their own pain? The Retrievals, a recent documentary podcast, explores this question and the excruciating pain that 12 women endured while receiving fertility treatments.

Despite its intended use as a treatment of last resort, some patients can remain on ECMO for weeks or months. And some are awake, alert, and capable of medical decision-making. RD was one such patient.

There is significant reproductive injustice and lack of access to fertility treatments by diverse populations. Nowhere is this more obvious than with egg freezing.

Recent policies by New York State Governor Kathy Hochul and New York City Mayor Eric Adams to identify homeless mentally ill people and remove them from the streets for involuntary...

Christopher Nolan’s film, “Oppenheimer,” which opens in theaters on July 21, highlights a value judgment that the Manhattan Project scientists had to make before Trinity, the test of the first atomic bomb.

“The Doctor,” a new play by Robert Icke, powerfully dramatizes many controversial issues of medical ethics, along with identity politics.

State medical boards and other government-appointed health officials have an obligation to follow evidence-based medicine to frame their opinions and regulations. However, there is disturbing evidence that, in some cases, political ideology is guiding health policy.

Most patients who die with medical aid in states where the practice is legal are enrolled in hospice, but coordination between those providing hospice care and those providing medical aid-in-dying (MAiD) is woefully inadequate. Many hospice facilities have policies against supporting patients who request MAiD and do not disclose these policies to prospective patients, even in states where disclosure is required.

Many clinicians have followed their conscience to find ways to provide good care within the confines of abortion bans. Henry Morgentaler was a model.

I’ll always feel like I missed an opportunity by sending his call to voicemail. I had no idea that this would be my last opportunity to speak with him.

In its early days, bioethics emphasized patient autonomy in the doctor-patient relationship. But patient autonomy is not the be-all and end-all principle to follow in all health care settings. Especially in lethal, airborne infectious disease pandemics.

Florida’s new anti-immigrant law, SB 1718, has escaped widespread notice, despite the way it will undermine the mission—and core identity--of not-for-profit hospitals as caring institutions that promote the health of the community. Bioethics and health care institutions must take action.

Over the past few decades, many major cities in the United States have become more diverse and gained more residents with limited English proficiency. Health care systems have attempted to accommodate these residents, but their medical interpreter services are inadequate and inefficient. The results can be delayed emergency care for children, an increase in medical errors and health care costs, and a decrease in care quality and patient satisfaction.

Florida Governor Ron DeSantis recently signed SB 1580, a bill that that shields health care providers, institutions, and insurers who decline to treat patients or refuse to pay for care...

AI systems are susceptible to bias; maintenance and repair are essential to detecting and eliminating it.

James F. Drane, a member of the founding generation of bioethicists, passed away on April 17 in Edinboro, Pennsylvania at the age of 93. He was a prolific writer, internationally recognized scholar, and trusted friend.

Prominent science policy reports that set the stage for the recent Third International Summit on Human Genome Editing all raise questions about human enhancement. Enhancement concerns also consistently loom large...

On a cloudy April afternoon, in my home in western Pennsylvania, a headline catches my eye: A federal judge in Texas suspended FDA approval of mifepristone. This abortion-inducing drug has been on the market for more than 20 years. Although the decision is presented with a secular and legal façade, like other recent antiabortion court rulings and legislation, a solid religious motive is at play.

Hospitals' tactics for maximizing revenue may be legal, but they raise ethical concerns.

The country’s leading hospital accreditation body recently eliminated the only performance standard that governed clinical ethics services. We argue the removal of the ethics standard requires additional review, and we have three recommendations.

I am currently writing up the results of a retrospective chart review of patients’ consent or refusal for medical students to perform pelvic exams on them when they’re under anesthesia and sedated. I asked ChatGPT to summarize the ethical issues and tell me what sources it used to generate its response.

How accurately could AI translate complex medical information for lay persons? How well could it identify and distill the ethical dilemmas posed by research findings? What safeguards could be used to prevent the use of AI for misinformation and disinformation? We performed a small nonscientific experiment.

To eliminate a quality metric for clinical ethics is at odds with good clinical practice and it reinforces structural inequality.

The Joint Commission, which accredits our nation's hospitals, eliminated the sole element of performance that governed clinical ethics services. This decision impedes equity and undercuts progress toward fostering ethical practice in health care.

How long does it take to trust someone? Think twice before getting too close to your chatty friend ChatGPT.

This is the second clinical ethics case study in our series. It concerns a patient with delusions and no surrogate decision-maker who refuses all treatment, even after a game-changing finding.

There's a lot of excitement about the possibilities of sophisticated, conversational AI in medicine, but we are already seeing problematic examples of its use. The insight of ethicists is sorely needed.

The Third International Summit on Human Genome Editing is being held in London this week. Chinese biophysicist He Jiankui’s illegal experimentation with heritable human genome editing, announced at the Second International Summit in Hong Kong four years ago, will haunt some of the discussions. To what extent has the Chinese bioethics community addressed gaps exposed by the Crispr Baby scandal and prepared to prevent similar future scenarios?

A bill filed in the Massachusetts House of Representatives would allow prisoners who choose to donate organs or bone marrow for transplantation to be eligible for reduced sentences. Is such a policy ethical?

Quiet quitting, the trend in which people do only the minimum in their jobs, has captured attention in the news and on social media. More than half of U.S. workers are quiet quitting, according to a recent Gallup poll, and most of them are in their 20s and 30s. I was discussing this trend with my bioethics colleagues, and we considered the ethical implications for people’s well-being.

One of the most important aspects of the Canada's medical aid-in-dying process is the respect given for the patients’ wishes concerning organ donation. People dying of other causes should be shown the same respect.

I’ve had the privilege of knowing more than a few extraordinarily brilliant people from whose mouths seemed to spill spontaneous gems of polished prose. None surpassed Will. For those of us who must struggle in our writing to convey with clarity the complicated ideas we are driven to share, Will’s gift for off-the-cuff eloquence was awe-inspiring.

After a string of violent crimes involving mentally ill people who are homeless, New York City Mayor Eric Adams announced a plan for police and emergency medical workers to involuntarily remove people with severe mental illness from the streets and bring them to hospitals for psychiatric evaluation. Mayor Adams said we have a “moral obligation” to help people who are mentally ill. But is this plan moral?

Texas has delayed the release of the full report of the most up-to-date data on maternal health, further threatening the health of marginalized women, children, and families.

A massive wave of Covid infections has begun now that China has ended much of its zero Covid policy. Three steps ought to be taken.

Nonprofit hospitals increasingly rely on philanthropy to supplement decreasing clinical revenues and a decline in the growth of government research funding. Grateful patient fundraising programs, as they are known, employ a strategy in which hospitals seek donations from satisfied patients, often using public data to identify those who are wealthy and requiring their physicians to discuss giving opportunities with them. In a recent issue of Narrative Inquiry in Bioethics, 12 physicians discuss their experiences with grateful patient fundraising and take up legal and ethical issues.

J is a 21-year-old male with multiple disabilities. He has a brain tumor. Would he benefit enough from brain surgery?

In “The Cure for Politicized Pediatric Gender Care,” Moti Gorin argues that a U.S.-based systematic review, conducted by a trusted major medical organization such as the National Institutes of Health or the National Academy of Medicine, is needed to develop consistent standards for pediatric gender care. While the intent behind his call is well-intended, it is based on a flawed premise.

Children and adolescents diagnosed with gender dysphoria receive radically different treatments depending on where they live. With intense politicization of pediatric gender medicine, the U.S. needs a systematic review of the evidence for different care options.

The best case scenario for immunocompromised people like me would be universal masking in all public spaces. But I am willing to compromise.

Severance, a popular Emmy Award-winning show streaming on Apple TV+, is a rich cultural artifact. It concerns a team of office workers at a morally questionable company that performs brain surgery on employees to sever the consciousness of their work and personal lives. The four of us were so taken by the show that we wrote these reflections on its important ethical themes.

In a recent article in The New England Journal of Medicine, Ezekiel Emanuel and colleagues clearly illustrate the relevance of ethical considerations to policy deliberations concerning public health emergencies. But do ethicists belong at the table?

Our patient, weighing over 600 lbs., was above the weight limit of our hospital system’s scanner tables and those of all the other major medical centers that we called in our large city. What to do next? Our radiology department’s answer was, “Well, there’s always the zoo.”

The Center for Disease Control and Prevention’s revised guidelines have done away with universal masking at health care facilities, making masking optional if community Covid transmission isn’t high. It’s the latest attempt of public health officials to adapt their guidance to meet the country’s fatigued sensibilities. Some patients will be at risk.

A recent Science article published the results of an experiment conducted on 20 million LinkedIn users over five years involving the “People You May Know” algorithm. None of these people knew they were part of an experiment, nor did they consent to participate.

President Biden recently declared that the Covid-19 “pandemic is over.”  Some public health experts agreed with this assessment; others disagreed.  What cannot be disputed is that nearly 12,000 Americans have...

Most older Americans want to age “in place” – in the community, not an institution. But there's a poor fit between our nation’s housing stock and our aging demographics.

The American chestnut is basically defunct, unless science can rescue it. Genetic manipulation may be the answer.

Given the well-known environmental and health risks of oil and gas drilling, oil and gas giants that enter developing nations routinely offset these risks with charitable investments. Are these investments sufficient? Do the funds go where they are needed? Answering this question raises ethical issues that need greater attention.

In the nearly three months since the United States Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision eliminated the constitutional right to an abortion, doctors have reported increased in...

It’s back-to-school season in the United States, the third one during the Covid pandemic, but the first in which all schoolchildren are eligible for Covid vaccines. Yet fewer than a third of children ages 5 to 11 are fully vaccinated, while the percentage of those under 5 who have started–let alone completed–vaccination is in the low single digits. Why? The answers are complicated.

What constitutes a medical emergency for a pregnant patient? ER clinicians in states with abortion bans need to know.

Billionaire Mark Cuban and physician Alex Oshmyansky recently launched the Mark Cuban Cost Plus Drug Company (MCCPDC), an online pharmacy that sells generic prescription medicines at significantly lower prices than other sources. But the acclaim for the pharmacy may eclipse attention to the longstanding structural problems of the pharmaceutical industry and MCCPDC’s role in it.

Over the last two years, China has updated some regulations on human genetic engineering and assisted reproduction and established a national committee to guide and supervise bioethics nationwide. But there are legal gaps in some of the regulations and tension between competing values: the desire to encourage new research and to potentially inhibit it by imposing stricter ethics regulations.

In rural Virginia, where I live, there is strong support for the right to own and carry guns. For more than a decade, I have shared public health, mental health, and other scientific findings with the leadership of a statewide Second Amendment rights advocacy group, especially regarding the leading number of deaths by firearms: suicide. We do not agree on what firearms laws and policies might be or do to prevent suicides, but we have sustained our conversations and respectfully learned from each other’s point of view. Such conversations are hard to have.

Health care and society will strive to find ways to undercut crude bans inconsistent with perceived medical need and professional duty.

What are the current and future potential uses of nonhuman primates in research? The National Academies of Sciences, Engineering, and Medicine is examining this question.

“My emotions and insecurities were at an all-time high, so much so that I was no longer comfortable coming into work. Do my coworkers also joke about my culture, my skin tone? Do my patients and families feel uncomfortable with me being their nurse? These were the questions I frequently asked myself as I anxiously braced myself for my next shift. I could no longer walk the streets, sidewalks, or even the hospital lobby without believing someone was looking at me because of the color of my skin.” ¬ This quote from Cecilia Igwe-Kalu describes her experience as a nurse confronting racism in health care.

The reversal of Roe may be the beginning of an onslaught on our freedoms. I want to add one more worry to the list and point to self-determination at life's end. Here we have Justice Neil Gorsuch to worry about.

The end of federal abortion rights is a disability justice issue—but not in the way you might think.

Like medical doctors and nurses, veterinarians experience moral distress and burnout because of the ethical conflicts they face on the job.

DACA, the Deferred Action for Childhood Arrivals program, has been with us for 10 years. Granting a work permit and a renewable two-year stay of deportation to undocumented youth who have grown up in the United States turned out to have enormous benefits for them and for our nation.

Like many other Ukrainians, I woke up on February 24 from the sounds of explosions. I had some difficult decisions to make. I treat cancer patients.

This week, the United States saw two momentous public health events: one million deaths attributed to Covid and the 198th mass shooting of the year. Both the pandemic and gun shootings are threats to public health that are not being adequately addressed.

The California legislature appears to have caved to pressure from opponents of a Covid vaccine mandate for schoolkids. I’d prefer to think of it as a wise and strategic retreat from a battle that mandate advocates could not win.

The Supreme Court decision in Roe v. Wade has played a subtle but critical role in the history of bioethics in America. Would American bioethics discourse be changed with the end of a constitutionally protected right to abortion?

The leaked draft of the Supreme Court’s  majority opinion to overturn Roe v. Wade has sent shockwaves throughout the world. Over the last decade, during which we came into adulthood,...

What “recovery” really means in aphasia is left unsaid in this novel.

The most recent issue of Narrative Inquiry in Bioethics, “Living with Mental Health Challenges: Stories of Recovery from Across the Globe,” revisits a topic discussed a decade ago. For many authors, the answer to the question, “How far have we come in mental health care?” may be: not far enough.

More than 4 million people have fled from war and terror in Ukraine. They are among the 70 million forcibly displaced people worldwide. What is brazenly clear is not only the impotence of the existing international apparatus designed to protect them, but also its asymmetries.

Oregon, which legalized medical aid in dying (MAID) in 1997, has dropped the requirement that had limited MAID access to residents of the state. What are the ethical and social implications of this policy change?

As mask mandates are rolled back and friends and neighbors debate the risks and benefits of masks and the merits or permissibility of mandating their use, we can catch a glimpse of the considerable extent to which values depend heavily on something other than pure reason. It’s a bit disappointing, perhaps. But it might be a useful lesson for democracy.

As I sit here in my office at the Slovak Medical University in Bratislava, my colleagues are experiencing great moral anguish because of Russia’s invasion of neighboring Ukraine. Simultaneously, we are also confronting the Omicron wave of the Covid-19 pandemic. The war complicates and burdens health care here and in other border nations exponentially, and especially so in combination with the pandemic.

Bioethics is an integral part of the liberal international order intentionally developed after World War II. Following the Russian war on Ukraine there is every reason to believe that the set of norms and institutions that preserved peace in Europe through the first Cold War will be revised according to new assumptions that will structure international relations in a second Cold War.

Medical care that is widely considered beneficial for transgender teenagers has been identified as  child abuse in Texas. The state attorney general issued a decision that gender-affirming medical treatments such...

Caregivers are not visitors. Hospital policies that restrict visits from family caregivers can harm patients.

While home and neighborhood environments matter to all people, older age brings particular considerations related to housing cost, safety and accessibility, neighborhood livability, links between the home and supportive services,...

The recognition of the social injustices surrounding the pandemic is an important opportunity to understand the longstanding links between health and social and global justice.

We believe that the concept of brain death, though flawed in its present application, can be preserved and promoted as a pathway to organ donation, but only after particular changes are made in the medical criteria for its diagnosis.

Here is what I find particularly sad about this Winter Olympics. Kamila Valieva is 15 years old. Her Russian coach is notorious for employing ethically dubious training techniques. Who should be punished?

A bill for $476 for inquiring about participating in a medical research study? This is no joke.

When Covid-19 vaccines first became available last year, Somali Muslims in Minnesota--the largest Somali Muslim population in North America-- were fearful and, consequently, their vaccination rate was low and their Covid-19 rate was high. But health professionals and community representatives worked together to understand and overcome their vaccine hesitancy.

Advance care planning has recently come under fire from physicians who say that it does not work and that there is too little evidence in favor of it. Giving up on advance care planning is not called for by the evidence and doing so would mean giving up significant benefits.

News of the first transplant of a pig’s heart into a human raises hope that the procedure could one day help alleviate the shortage of organs. But before we forge ahead with xenotransplantation trials, we should be concerned about several issues: the potential to spread pathogens, exploitation of human research participants, and animal welfare.

There has been much criticism of the decision by the Centers for Disease Control and Prevention (CDC) to let Covid-infected people who are feeling better to stop quarantining after five days and simply wear a mask. But this sort of pragmatic decision has a long history in public health.

Pfizer recently announced that its trials in children 2 to 5 years old produced a weaker than expected antibody response and that it would hold off requesting authorization from the Food and Drug Administration. This news creates opportunities – and additional challenges – for off-label use of Covid-19 vaccines in children,

Bioethics in the Margins is a new podcast that addresses fundamental moral issues facing society that don’t get the attention they deserve.

The role of doctors, nurses and other clinicians is to treat patients without passing judgment and to fulfill their fiduciary duty. However, the Covid-19 pandemic has muddled these obligations.

Some health care providers are prioritizing patients who are fully vaccinated against Covid-19 over those who are unvaccinated. This is unethical.

The field of bioethics has a moral responsibility to respond to the continued racial and health inequities confronting Black, Indigenous, and other people of color. Along with several colleagues, we formed an antiracism task force to interrogate that moral responsibility. Here are key takeaways from a recent panel discussion that we organized.

Children have suffered both physical and mental illness during the pandemic. Nearly 200 children in the United States have died. Acute mental health crises increased during the pandemic. Getting children immunized is the best way to get back to normal. We suggest an option that would permit children under 5 to be vaccinated without waiting until traditional prospective randomized trials can be completed.

Like the pandemic, uncertainty, growing confidence, and the return of doubt come in waves. The Omicron variant is just the latest twist in this plot.

In a 1988 essay on pandemics, Nobel laureate Joshua Lederberg wrote, “We have no guarantee that the natural evolutionary competition of viruses with the human species will always find ourselves the winner.”

For millions of health-conscious Americans, digital technology has been a boon, providing increasingly sophisticated fitness trackers. Researchers speak excitedly about a new frontier of “continuous health monitoring,” with the potential to detect diseases and aliments in their incipient stages. It also raises a host of disturbing questions about health surveillance. Will these devices really empower us? Will they compromise us as autonomous individuals?

In a new essay in the Hastings Center Report, we argue it is not. Yet the practice is prohibited.

States and school boards around the country are engaged in a debate about whether to require middle and high school students to be fully vaccinated against Covid-19. The debate is not so much about whether to mandate. It's when to do so.

A remarkable experiment raises anew questions about whether brain-death is really death.

I'd be happy to go along with a ban on elective abortion after 15 weeks if, but only if, certain conditions accompanied it.

Last month, Bloomberg reported on what seems to be the first child born following a new kind of genome-wide screening. Four embryos were screened, and the embryo selected for implantation was the one given the best genetic odds of avoiding heart disease, diabetes, cancer, and schizophrenia in adulthood. The news has been met with some concerns about the degree of control we may now have over future generations.

Faced with mandatory Covid vaccination, students and employees have appealed to religion as grounds for exemption. This latest conscience war within our culture wars presents a minefield of legal and philosophical complexities for states and health care systems.

In her new book, Kathryn Paige Harden is full of hope that insights from genetics will become powerful tools for advancing a left-leaning political agenda. Her hope rests on the...

Even though the circus exists in the same world as theater and movies, it has been largely exempt from public criticism, apart from accusations of animal cruelty. But under the broad rubric of “contemporary circus,” this familiar entertainment genre is distancing itself from its past and creating a new and vibrant art form. And underlying this transformation is an ethical commitment to social justice, inclusion, and equity.

The pandemic has laid bare the significant shortcomings of a health system rooted in an unsustainable financial model that exploits the physical and emotional labor of its nurses.

The devastation of Hurricane Ida and the global threats of climate change are not on the fringe of bioethics. They call to mind the language of priority-setting typical of bioethics discourse. Who lives and who dies? What can be accomplished with prevention and more levees? And if more are built, how do we set priorities with limited resources?

I have always wanted to see a woolly mammoth. From the time I first read about them up until, well, a few moments ago, I’ve fantasized about going back in time to see a herd shoving its way through an Ice Age snowstorm. Alas, it cannot be, even if George Church and a new company, Colossus, bend heaven and earth to make it happen.

The commitments made by the wealthiest countries to share Covid vaccines and funding for international cooperation mechanisms are crucial, but insufficient. They reflect the “securitization of health,” a 21st century phenomenon whereby states turn health issues into national security issues.

In South Carolina, where I live, we are not just ignoring good arguments, but actually legislating on the basis of bad ones. The budget rule, Proviso 1.108, threatens the funding of schools that require masks.

The opposition to mask and vaccine mandates transcends the issue of individual liberty.

As the Covid-19 pandemic continues to strain health systems’ capacity to provide adequate care for critically ill patients, should patients’ vaccination status be considered in making triage decisions? This question sparked debate recently after the leak of an internal memo of the North Texas Mass Critical Care Guideline Task Force that proposed using patients’ Covid-19 vaccination status as a factor to assign intensive care beds.

The Covid-19 pandemic has significantly affected the practice of clinical research. Researchers and IRBs have felt an urgency to respond more quickly than usual, aware that lives are at stake.

As the parent of a child under 5 years old, I am worried about what lies ahead for kids and Covid-19. The more contagious Delta variant is widely circulating, infecting...

Why is the FDA dragging its feet in approving Covid vaccines for children under 12? Justifications lack moral weight.

The moral justification for mandating covid vaccination for health care workers is clear. But what happens if some health care workers still refuse to be vaccinated, and there aren't enough vaccinated staff to care for all the patients in a hospital?

There is a growing call for the lifetime risk of living kidney donation to be disclosed to prospective donors. This information is essential for informed consent.

Colleges and universities have an ethical obligation to mandate covid vaccines to protect the health and futures of both their students and the larger communities, in addition to promoting equality through education.

It would be easy for bioethicists, to ignore attacks on critical race theory—not in our wheelhouse, too politically charged, and so on. But the attacks on CRT are squarely relevant to our work.

The government and many residents of the state of Texas like to brag about their love of personal freedom and individual choice. That is why it is so strange and morally repugnant that the state has turned for guidance on how to manage reproductive decisions to the Chinese Communist Party of the Mao Zedong era.

Many hospitals are providing incomplete or subpar professional medical interpretation to the patients who need it--many of whom are disproportionately affected by Covid.

In the more than 35 years since federal legislation created organ procurement organizations (OPOs) to recover organs from deceased donors for transplantation, there has been a disparity in their performance,...

The pandemic magnified the inherent difficulty and stress of conversations involving life-sustaining treatment by forcing clinicians and patients to engage in life-altering discussions via telephone and video conference, restricting nonverbal communication and eye contact, and eliminating the benefit of simply having another person nearby in time of crisis.

In recent years, court cases and scholarly articles have increasingly highlighted discrepancies between the legal definition of death in the United States and the medical diagnostic standards for determining brain death. It has become clear to many that the 40-year-old Uniform Determination of Death Act, the legal standard, should be updated.

Several years ago, one of us decided to donate a kidney to someone who needed one. She didn’t anticipate the difficulties that would arise from the process by which donors are evaluated.

Aducanumab has just been approved by the Food and Drug Administration to slow the progress of Alzheimer’s disease. It is likely that many people who are candidates for the drug will no longer be competent to make their own health care decisions, and will be relying heavily on others to make the decision with them or for them. As a layperson, how would I evaluate the risks and benefits of this drug, were I acting as a health care proxy for someone with Alzheimer’s disease?

June 7, 2021, was a bad day for science. That was the day Food and Drug Administration approved aducanumab for the treatment of Alzheimer’s disease, even though a committee of its own selected experts recommended strongly against approval.

In late May, an international organization eliminated a 40-year prohibition against human embryo research beyond 14 days. The legal and scientific consequences will vary around the world.

The American myth of rugged individualism, which often means “pulling yourself up by your own bootstraps,” is outdated, was never completely accurate. It is on full display during the coronavirus pandemic, contributing to cases and deaths.

The United States, Russia, and China support temporary patent waivers for Covid vaccines. The waivers, which need support from other countries, would likely save lives in low- and middle-income countries.

Changes in abortion law threaten to undermine a major benefit of prenatal diagnosis, namely the ability of pregnant women to choose whether or not to continue their pregnancies upon learning of a serious fetal condition.

In Costa Rica, where I live, only 24% of the population has received at least one vaccine dose because we have received very small amounts of vaccines. The Costa Rican president suggested that every person who can travel to the U.S. to get the jab, should do it. Vaccine tourism, then, seems to be another promising business opportunity for the powerful countries that have accumulated vaccines instead of redistributing them soon and fairly.

Many Latin American countries are being devastated by excessive loss of life from Covid-19, many sectors of society falling below the poverty line, and health systems being overwhelmed. As collateral damage, some countries in the region are witnessing an eruption of populism and autocratic trends and an increasing erosion of already weak and unstable democracies. Can bioethics be a useful tool for managing this crisis? Argentina provides a case study.

The C.D.C.'s latest policy guidance that people who have been fully vaccinated against the coronavirus virus no longer need to wear face masks indoors gets the science right, but policymaking wrong.

Citing the Yellow Card as precedent for Covid-19 travel passes that exempt those with proof of vaccination from testing and quarantine mandates when crossing certain borders is an erroneous policy assumption that could prolong the pandemic and imperil global health.

More than 100,000 people in this country are waiting for a life-saving transplant and on average 30 people die each day while waiting. The nonprofit organizations responsible for coordinating organ transplants between donors and recipient could be doing more to lower these numbers. A new government proposal designed to more closely regulate OPOs could, in some respects, actually make the situation worse.

Millions of patients are discharged from hospitals each year, but the individual and systemic forces that shape discharge planning and care transitions frequently lead to “failures that compromise patient health and well-being.”

My partner and I are thinking a lot about this question. Moderna and Pfizer trials are running in our community–at the children’s hospital where I work as a clinical ethicist....

Anniversaries are complicated. In rehabilitation psychology, the anniversary of an accident that caused a brain or spinal cord injury can be a time for profound gratitude and for grief. Now that we have passed the one-year anniversary of the Covid pandemic, each of us continues to deal with the repercussions and wondering what the "new normal" may look like.

As access to vaccines increases, the popular press reports waning demand for vaccines in rural residents and points to vaccine hesitancy. But there may be other reasons why doses distributed to rural areas remain unclaimed.

Disagreements among biomedical experts regarding whether the scientific evidence supports delaying the second shot of Covid-19 vaccines or pausing the AstraZeneca and Johnson & Johnson vaccines because of very rare side effects bring to the fore missing aspects in exhortations to trust biomedical experts.

The pandemic is not over, but light is beginning to crest the horizon. Vaccination rates, especially among older adults and their caregivers, are rising. As we begin to relax physical...

The practice of informed consent in clinical medicine is broken. Globally, the process varies widely, and even in the United States informed consent looks little like the formal, legal, autonomy-based...

The World Health Organization recently released a long-anticipated report on SARS-CoV-2 origins, based on 28 days of field research and site visits in China conducted jointly by 17 international and...

There are a whole lot of us who think that, if we had dementia and were unable to live independently, we would prefer death. The idea that someone suffering from dementia and confined to a nursing home might actually welcome death is apparently so taboo that it cannot be openly contemplated.

Is it wrong for doctors to judge their patients’ choices? I have reflected on this question while being on the frontline of the Covid-19 pandemic in New York City. Health...

How should the American bioethics community respond to the latest “crisis at the border,” focused on record numbers of unaccompanied minors – children and teenagers traveling from the Northern Triangle...

As Covid-19 continues to plague the United States, insufficient attention has been paid to the role that incarcerated persons play in the persistence of this pandemic and the work that...

The Covid-19 vaccine rollout is currently a hub of individual, sociopolitical, and ethical activity.  As we watch the numbers of daily doses administered rising, we may feel engaged in a...

Reparations in various forms of compensation to the American victims of preventable Covid, who may experience lifelong health effects, is obligatory.

Now, with limited distribution of vaccines with varying degrees of efficacy there is renewed interest in immunity passports; more accurately described as vaccination certificates. What remains to be determined is who may use this documentation for what purpose.

Willingness to be vaccinated is not the only factor that may reduce vaccination rates. Fear is a powerful deterrent for individuals in hidden populations, especially undocumented immigrants. Even if their work or other circumstances place them at high risk of infection, many would be unlikely to risk the consequences of coming forward to be vaccinated.

Vaccine navigators have emerged as a response to the complexity of mass vaccination for Covid-19.

Congress recently announced plans for an independent commission to investigate the facts and causes of the January 6 insurrection at the U.S. Capitol. This 1/6 Commission is to be modelled after the 9/11 Commission. A national commission to investigate the disaster that the Covid-19 virus has caused in America must also be launched.

In January, right before President Biden took office, the Food and Drug Administration proposed permanently exempting “software as a medical device” from regulatory review. The agency waived the approval process last year to streamline regulatory oversight during the Covid emergency. But the growing use of artificial intelligence programs and digital devices in health care raises safety and ethical concerns that require more attention. The Biden administration put the proposal on hold for now. Meanwhile, bioethicists should weigh in as the FDA reviews its action plan.

Fewer vaccines are going to Black people. While it’s easy to fall back on vaccine hesitancy as an excuse, systemic racism is to blame.

The television show The Good Doctor has always focused on issues of diversity and inclusion in medicine from its storylines to its casting. This week’s episode “Irresponsible Salad Bar Practices”...

It was especially disappointing to read about Bruce Springsteen’s recent arrest for suspicion of driving while intoxicated (DWI). Here's hoping the famous rocker will use his arrest to refocus attention on a risky and dangerous behavior that is thoroughly preventable.

Science has replaced populism in the White House. For the first time, the president's science advisor will be elevated to cabinet rank. There are other good omens, as well.

Vaccine hesitancy is a concern around the world, but negative attitudes among Muslims in particular toward some coronavirus vaccines have been the focus of attention in the media. Some scholars in Asia recently issued fatwa against the Chinese Covid-19 vaccine. Media coverage has characterized the Muslim world as a hotspot for vaccine hesitancy, but experts point out biases in this coverage and explain the underlying reasons.

Last month, with concerns over the supply and coordinated administration of coronavirus vaccines escalating, the Centers for Disease Control and Prevention conceded that “any available mRNA COVID-19 vaccine” may be used to complete vaccination in “exceptional situations” preventing multi-dose manufacturer matching. While presented solely as a last resort, this guidance reflects a dilemma currently sweeping across the medical and health policy worlds: given limited supply, should vaccination efforts—still only authorized for emergency use in this country—deviate from evidence-driven, studied regimens to maximize individuals reached?

A third Covid vaccine candidate moving closer to potential FDA authorization is less effective than the two Covid vaccines already authorized in the United States. Is it ethical to offer a vaccine with lower efficacy? Is it ethical not to offer it in a public health emergency?

Vaccine allocation guidelines that prioritize people at greatest risk of Covid-19 require considerable administrative work (sometimes taking weeks). This is creating a bottleneck that has resulted in doses stuck in freezers not in arms. There's a better, more ethical way to allocate vaccines.

Contrary to the expectations of many fertility clinics, demand for egg freezing has increased sharply during the Covid-19 pandemic, highlighting longstanding ethical concerns about egg freezing clinics.

Many people are deeply interested in the political process and awash in relevant information., but nevertheless often grossly misinformed, holding confident but unfounded opinions at odds with widely accessible evidence The recent riot at Capitol Hill is just one illustration–albeit a horrifying one–of such misinformation and its potential consequences. The anti-vaccine movement is another example.

Around the world, an alarming percentage of Covid-19 deaths occurred in long-term care facilities. Some of these deaths may have been avoided by changes in design. It's time that bioethicists to take a closer look at the built health care environment.

Finally, the Centers for Disease Control and Prevention is working on developing standards for masks to see which ones actually block viruses. In the meantime, though, we should all be acting on what we do know about the effectiveness of various masks against Covid.

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?

The headlines are terrifying: A highly contagious new variant of the coronavirus is circulating in England. As the story spread, politicians and media outlets reported a devastating statistic: the new strain is 70% more transmissible than other strains of the virus. This has led to new lockdowns; many border closures; flight cancellations; and people fleeing the U.K. by train, boat, and plane. But is any of this necessary? Is the world suffering from mutation panic?

Robert M. Veatch, a bioethics pioneer and the first research associate at The Hastings Center, died on November 9. An overarching theme was his commitment to human rights.

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?

A Covid-19 vaccine developed by Pfizer and BioNTech has received emergency authorization in the United States and has been authorized in the countries, and a vaccine by Moderna is likely to be authorized soon. In spite of this good news, at least for the first couple of years, Covid-19 vaccines will be a scarce resource. Because low-income countries are likely to lose out in the scramble to get access to them, there have been calls for global solidarity. While equitable allocation of vaccines around the world would be ideal, it is unrealistic as a near-term goal.

The year 2020 will be remembered as the first year of the coronavirus pandemic. But the pandemic was not alone in creating fear and dismay and raising ethical questions. Think of the rise in antisemitism, police violence against Black people, protests against immigration, and rallies by groups espousing Nazi slogans and symbols. Hate crimes, including murder, are the highest in years, according to the most recent FBI report, and were particularly aimed at Jews and Hispanics. Asian-Americans have been targeted as carriers of the so-called “China virus.”

One of the most surprising aspects of the Covid-19 pandemic for those of us who teach the history of public health is how unwilling many Americans have been to adopt health measures to protect others. Over the Thanksgiving holiday, tens of millions of Americans traveled, despite the fact that the Centers for Disease Control and Prevention urged them to stay home and the overall death rate from the coronavirus is approaching 300,000. Should recent events make us revisit aspects of the history of public health? And how can these stories inform future public health efforts during pandemics?

In his recent piece, “The genes we’re dealt,” Erik Parens puts his finger on cause for concern with what he calls social genomics: while progressives can use insights from this new field to justify combating inequality, conservatives can use them to justify the existence of that same inequality. This pessimistic conclusion—which Parens argues convincingly for—follows from a focus on insights at the societal level, that of a whole population. But there are grounds for optimism by focusing instead on potential insights from social genomics derived from local-level comparisons between different environments. Such insights could point to interventions that progressives and conservatives might just be able to agree on.

The procurement of human plasma as a potential therapy for Covid-19 is one of the latest examples of bioethics nationalism, defined by Jonathan Moreno in this blog as “distinct bioethics standards [which] are formally proclaimed as a matter of right by a sovereign state.” The race for a Covid cure pushes at the weak seams in the international liberal order in much the same way that Covid appears to be pushing at health care systems.

Leah Zallman's meticulous research helps us all to tell the story of what immigrants give to this nation and what they should receive from this nation.

Newly published first-person stories of the challenges, struggles, and joys of providing care for family members or another close person with Alzheimer's disease and other types of dementia "depict humanity on the brink."

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.

Albert R. Jonsen, a pioneer of medicine and a founder of the field of medical ethics, died peacefully in his home on October 21 at 89. We first met in 1973, when I was a medical student and I was interested in medical ethics. He gave me the best career advice I have ever received. “Don’t do it,” he said. “Finish your medical training first. If you don’t have the same credentials as the doctors, and share their world, they won’t listen.”

The Food and Drug Administration's rigorous guidance for an emergency use authorization of a Covid vaccine was met by resistance from the White House, since some of the terms would make it virtually impossible to issue a vaccine-related emergency authorization before Election Day. Understanding the ethical dimensions of issuing it for a vaccine can provide clarity on the necessity of the FDA’s stringent guidelines.

Multiple candidate vaccines for coronavirus are being evaluated scientifically in a process of unprecedented speed, and thousands of individuals around the world have volunteered to participate in placebo-controlled phase III field trials. If, or when, one of these candidate vaccines is proved to be safe and effective and receives an emergency use authorization by the Food and Drug Administration, will it continue to be ethical to enroll participants in other coronavirus trials that randomize half of them to a placebo?

This year’s Intersex Awareness Day, October 26, marks a historic pivot. Last week, Boston Children’s Hospital revealed that its physicians would no longer perform certain nonconsensual infant genital surgeries on babies born with atypical genitals. They join the Ann and Robert H. Lurie Children’s Hospital in Chicago, which made a similar announcement in July and even apologized to its former intersex patients. Intersex advocates have been working toward this goal for decades.

How could I, the grandchild of four Holocaust survivors, be obligated to provide not just satisfactory, but exceptional care to such a morally repugnant character?

Empathy does not need to dissipate as we endure medical training. Both the pandemic and the national reckoning over racial injustice and police brutality have touched every aspect of life as we know it, and medical training and education have been no exception.

In an essay published in Scientific American, we call for immediate and intensive research into the possibility that exposure to one of the coronaviruses that cause the common cold could decrease the severity of Covid-19, and could be leveraged to expand what’s been called “pre-existing” immunity to the disease by deliberate transmission of common cold coronaviruses. Here, we expand on our proposal.

Volunteering for a Covid-19 vaccine trial satisfied my altruistic goals and harmonizes with my Hindu beliefs. But I am troubled that a drug company is going to profit from my altruism and my religious obligations.

Years before George Floyd begged to be released from under the knee of Officer Derek Chauvin, Barbara Dawson, a 57-year-old Black woman, died begging a police officer, John Tadlock, not to remove her oxygen mask. Her death occurred right outside the Calhoun Liberty Hospital in Blountstown, Florida, shortly before Christmas in 2015.

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.”

As multiple Covid vaccine candidates enter clinical trials and hopefully move closer to approval, one important unanswered question is how to compensate the rare cases of serious vaccine harm.

Covid isn’t merely overshadowing the drug overdose crisis—it’s directly worsening it.

Physicians have been vocal in condemning the anti-lockdown protests while endorsing and even participating in the Black Lives Matter protests. This has led to criticism of the medical community for being inconsistent and hypocritical. What does an ethical analysis reveal?

I am hard-of-hearing; I wear two hearing aids, and Covid-19 has made all forms of human interaction extraordinarily difficult.

Along with the announcement that his government had approved Sputnik V, the supposed Russian coronavirus vaccine, Vladimir Putin also indulged in a moment of paternal pride: Wanting to confirm his personal confidence in the vaccine, he mentioned that one of his daughters was among the early recipients. This raises a couple of intriguing questions: Which daughter was it? And why does it matter?

The Covid-19 pandemic continues to test and occasionally overwhelm health care institutions. Many practitioners may face the ethically challenging scenario of having to ration ventilators while triaging patients in “crisis care.” Ventilator shortages have led to innovative ventilator design “hacks.” Are these improvised ventilators ethical?

The global crisis created by the coronavirus pandemic and the rush to create and distribute a vaccine widely hoped to be a “silver bullet” that can facilitate a return to “normalcy” threatens to upend seven decades of assumptions about bioethical norms.

In many ways, black bioethics can be explained very simply as the exploration and interrogation of any event, ideal, technological advancement, person, or institution that directly or indirectly affects the health or well-being of black (loosely defined) individuals or the black population. Black bioethics is taking what we do in bioethics and specifically applying it to black people. But in other ways black bioethics is more than this; it is a rebellion against bioethics.

Police consider tear gas, stun guns, and other "less-lethal" weapons essential to public safety. But, too often, it’s their use that threatens safety. It’s time to explore medicine’s complicity in perpetuating brutality that disproportionately impacts nonwhite communities, especially Black Americans.

Personal ventilators used by people with disabilities should not reallocated to people with Covid-19. Triage protocols should be immediately clarified and explicitly state that personal ventilators will be protected in all cases.

As more workplaces open up, a seldom-used legal action is being taken against employers charged with inadequately protecting employees from the coronavirus: public nuisance lawsuits.

A central mandate of the ADA is to make the goods of society accessible to people with disabilities and overcome their segregation in civil society through reasonable accommodation that allows them to go to work, live with their neighbors, and avoid institutionalization. But let’s not delude ourselves with historic sentimentality as disability law is placed under tremendous stress by the pandemic.

I knew that being a foster parent would be demanding, but I was unprepared for the extent of the challenges, which were exacerbated by the pandemic.

Is it unrealistic to believe that phone apps for digital Covid contact tracing can be designed and regulated in ways that prevent the information they collect from being misused? It's worth remembering surveillance of Vietnam War protesters and Martin Luther King Jr.

In his recent JAMA article, Donald Berwick eloquently describes what he termed the “moral determinants of health,” by which he meant a strong sense of social solidarity in which people in the United States would “depend on each other for securing the basic circumstances of healthy lives,” reflecting a “moral law within.” Berwick’s work should serve as a call to action for bioethicists and clinical ethicists to consider what they can do to be forces of broad moral change in their institutions.

Several states, including Ohio, Alabama, Arkansas, Texas, Iowa, and Oklahoma, declared abortion a nonessential service at some point during the pandemic, meaning that it was effectively banned until the crisis passed. Supporters of the policies maintain that abortion is an elective procedure whose medical resources are better off used in the fight against the pandemic. But abortion opponents have been taking advantage of the current circumstances to limit abortion access.

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.

The Covid-19 pandemic is unlikely to end until there is a safe, effective, and widely distributed vaccine. How soon can researchers achieve this goal? The answer largely depends on which strategies researchers are willing to adopt. One potential strategy is to conduct human challenge studies, in which researchers give an experimental vaccine to healthy volunteers and then test—or “challenge”—the vaccine by purposely exposing volunteers to the virus. Although a growing number of voices are calling on researchers to employ this strategy, the proposal is generating a heated debate about the ethics of such research.

The United States leads the world in coronavirus cases and deaths. Although many people have called out the inadequacies of our health care system, Covid-19 has exposed the most significant shortcomings. The need for change can no longer be ignored. Here are three lessons from this pandemic that should be leveraged for change.

Growing isolation, financial challenges and disease burden during the Covid-19 pandemic threaten to worsen the mental health needs of the entire U.S. population. These challenges are heightened among immigrants with untreated chronic mental health conditions as they experience added psychological distress owing to harsh immigration policies and worsening structural barriers to health during the pandemic.

Covid-19 is a matter of public and global health ethics, and the pandemic is currently accelerating cooperation within and contributions from these fields. A meeting on June 27, hosted by the European Union and Global Citizen, is the latest example another global pledging event on June 27, will include governments and large institutions, as well as individuals and communities worldwide.

The rewards of social distancing are beginning to accrue in former hotspots such as Seattle, the New York metropolitan area, and the San Francisco Bay Area, where the number of new Covid-19 cases requiring hospitalization is declining. Assuming the rewards hold in the face of pressures to reopen the economy, hospitals will now face challenges of reopening their own nonpandemic services for patients whose elective surgeries and other procedures were postponed. Which patients should get priority?

One of the factors considered most important by dying patients and their families is the opportunity to be together. For many of our hospitalized patients in palliative care, the presence of loved ones at the bedside is such a given that we don’t even address it explicitly in advance care planning discussions. So, it comes as no surprise that Covid- 19-related visitor restrictions affecting hospitalized patients might impact end-of-life decision-making, potentially in ways that are ethically problematic.

Experts in infectious disease and public health warn that the Covid-19 pandemic will be with us until there is an effective vaccine, possibly 12 to 18 months in the future. This situation has given rise to calls for human challenge studies, in which healthy volunteers are injected with an experimental vaccine and then infected with the disease to test the vaccine’s efficacy. Is this ethically justifiable?

We have reached a very sad, painful moment in the United States. It feels like a cascade of calamities, one compounding the next. An infectious disease pandemic that we cannot yet cure has precipitated an economic crisis. An episode of police brutality against a black man has added the name George Floyd to a long list of victims of unfair policing practices in black communities. Bioethicists have not been doing enough in our professional capacities to actively denounce or address the persistent problems of structural racism. We invite our fellow bioethics colleagues to join us in candid, uncomfortable conversations about what we can and should be doing differently.

The major success story of health care ethicists in the pandemic has been their role in establishing ventilator triage policies. But they have more to offer the C-suite of health care institutions.

When scientists first suggested population-wide social distancing as the only feasible way to suppress Covid-19, they were the first to admit it may not work in a free society. We are now months into placing mass restrictions on human behavior to suppress a virus that lacks an effective vaccine or treatment. Now is the time to ask: is this the authoritarian nightmare many feared, or will freedom and democracy survive Covid-19?

In places where Covid-19 is increasing – and in preparation for a possible second wave of the pandemic-- hospitals are preparing to triage critical resources if necessary. Some are prioritizing health care workers for ventilators. We think this is a mistake.

George Floyd could not breathe while his neck was trapped under the knee of a police officer for nearly nine minutes. Yet despite the impressive scholarship of bioethics on ventilation and other technologies that prolong human breathing capabilities, it is largely silent on the suffocating effects of racism. Bioethics must speak out against racial injustice.

It takes less time than ever to publish papers. But is quality sacrificed by doing bioethics at warp speed, especially during the Covid pandemic?

Protesters questioning the ongoing need for lockdown measures aimed at controlling Covid19 are marching to make their concerns known, in some cases with arms and other military paraphernalia. Some ethicists think these protectors should sign a pledge to forego scarce medical care in the name of their political ideas. We disagree.

Hospitals in the United States are losing money taking care of patients with Covid-19. The pandemic casts a harsh spotlight on the misallocation of health care resources in the U.S.

Older black Americans are half as likely as older whites to have advanced directives. My patient, a black man in his 70s,, first made his wishes known when he was in the hospital with Covid-19.

The cries of millions of people in Sub-Saharan Africa and in low- and middle-income countries elsewhere who are struggling to stay alive because of Covid-19 and the lockdowns call for us to revisit the conceptual framework of the human right to health.

Covid-19 is making bioethics more relevant than ever. The ethical dilemmas raised by the pandemic are urgent and heart-wrenching. Who should get a ventilator if we do not have enough? How can we protect the most vulnerable from discrimination in the face of difficult triage decisions? How do we weigh individual liberty against the public interest of keeping people confined? While such questions are not new for bioethicists, the need to answer them urgently, globally, and in very concrete settings, creates unprecedented circumstances. Is this an opportunity for bioethics to learn some important lessons? What should post-Covid bioethics look like?

Covid-19 is teaching us the stern lesson that economic well-being and health justice are two sides of the same coin. To weather pandemics and restore the social contact that economic life demands, we need to sign a new social contract with public health.

Some bioethicists support age-related rationing of ventilators during the Covid-19 pandemic as a way to save the most lives. But that goal might be better realized without strict age cutoffs.

There's a long history of conflict between the institution of medicine, bioethics, and the disability community. With Covid-19 disproportionately affecting people with disabilities, we must do everything we can to avoid a triage decision-making process that pushes disabled people to the side. One important action is to appoint people with disabilities, and especially those of color, to hospital triage committees. To our knowledge, no hospital or state crisis standards of care protocol mandates this kind of representation.

Of all the “isms,” ageism is arguably the hardest to address because old age neither a valued stage of life nor an identity that many claim. The coronavirus pandemic may have made that effort even harder.

Covid-19 imposes burdens in different—but very serious—ways on different individuals and groups. We see it in policies that address what to do in the face of shortages of scarce resources. We begin by challenging a common claim—that people with disabilities as a group will be harmed by triage policies that consider patients’ prospect of medical benefit.

The Covid-19 pandemic has been characterized by many unknowns, chief among them in the world of pediatric ethics is the question of separating mothers who are infected or suspected of being infected from their newborns after delivery to reduce the risk of mother-to-child transmission. Guidance on this issue is conflicting.

The Covid-19 pandemic has imposed tremendous risk on doctors, nurses, and other health care workers not seen in a century. It is time to reconsider prioritization of health care workers’ access to scare critical resources. Historically, for multiple reasons, health care workers have not been prioritized for access to medical care during a pandemic. However, given the unprecedented circumstances surrounding the Covid-19 pandemic, it is justifiable to prioritize health care workers when all else is equal between two patients.

As Covid-19 continues to spread throughout the United States, doctors, nurses, and oth-er clinicians are facing unmistakable tragedies. But something less perceptible is afoot. Empathy in medicine is under siege.

Despite the disruptive changes to my undergraduate medical ethics class this semester, my students have learned a lot about the paradox that the coronavirus presents: it is an unprecedented event, beyond the experience of nearly everyone alive today, and yet it puts on grim display the well-known problems of inequality that chronically plague the United States. Since week six of the semester, I have readjusted each unit on the syllabus to address some of the ethical issues that Covid-19 has brought to the fore, familiar challenges that have been stressed and distorted in astonishing ways by the pandemic.

Around the world, governments are looking for safe ways to lift unprecedented restrictions on public activities to curb the spread of Covid-19. So-called immunity passports could be key to the effort to selectively ease restrictions for people presumed to be immune to the virus. But there are scientific and ethical questions to be worked out before they can be deployed. .

Dilemmas that clinicians face in the coronavirus pandemic–who gets the ventilator, the 80-year-old grandmother or the 20-year-old student?–are the bread and butter of mainstream bioethics. In medical school, my classmates and I memorized the four principles (beneficence, nonmaleficence, justice, and autonomy), which we were told would help us make hard clinical decisions in ethically ambiguous terrain. But Covid-19 shows that medical ethics means much more than what generally falls under bioethics. Medical ethics is deeply political, and to act ethically in medicine means engaging the larger context in which it operates.

There is little doubt about the urgent need for Covid-19 treatment. But premature publication of definitive recommendations based on inappropriate conclusions grounded in scant, hastily-acquired data serve only at best to confuse and at worst mislead at a time when tensions are high and need for help is great.

Double-blind randomized clinical trials are the gold standard for answering the scientific question of whether a drug produces any effect, positive or negative, in Covid-19 patients. But is rational for a patient to choose to try a drug such as chloroquine for Covid-19 outside of a trial? Some patients may correctly hold that they have little to lose.

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?

Congregational rituals of religious communities around the world have attracted attention for their possible threat of spreading the coronavirus. Negative Media coverage has generally depicted members of religious communities as more or less “reckless” groups whose “fanatic” convictions can make them harm others from inside or outside their religious traditions. However, what hasn’t been discussed is how this issue should be approached as a complex bioethical issue that concerns people worldwide. With the beginning of Ramadan, paying attention to the nuances and complexities of this issue becomes especially pressing.

The Covid-19 outbreak has forced health care providers, administrative officials, and the general public to each play their part in doing no harm to others. It may come as a surprise to many people, but health care workers may unknowingly spread Covid-19 in their communities simply by wearing scrubs in public.

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.

It’s been painful to watch health leaders twist themselves into moral knots denying that recently created ventilator rationing guidance will differentially affect Blacks, Latinx, and other people of color. On television, in newspapers, and on listservs, when the predicted disproportionate impacts of these policies are raised, some bioethicists-often white, stonewall. Or repeat a policy’s assertions that race, ethnicity, disability, etc. are irrelevant to care decisions. Or default to the intent of the policymakers.

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.

In the rush to find a Covid-19 vaccine and one or more drugs to treat the deadly disease, concerns are being raised that ethical standards for conducting human clinical trials and the evidentiary standards for determining whether interventions are safe and effective, might be loosened.

Canada has a fraction of the number of cases of Covid-19 as the U.S. Canadians feel vulnerable. But Canadians and Americans need to find ways to build and maintain trust within and across our borders.

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.

This week, the Department of Health and Human Services Office of Civil Rights resolved one of many civil rights complaints alleging discrimination on the basis of disability–the first instance of federal intervention to enforce civil rights laws in rationing protocols since the beginning of the Covid-19 crisis. But more work is needed to protect patients with disabilities in the allocation of scarce medical resources.

As a 71-year-old bioethicist, I consider rationing mechanical ventilation based on age to be one morally relevant criterion during the Covid-19 pandemic.

The views of the New York State Task Force on Life and the Law on ventilator-dependent chronic care patients evolved over the years. Here's how, and why.

There is a lack of clarity about the New York State Task Force guidelines on ventilator allocation. I believe disability rights concerns regarding the recommendations on chronic ventilator users are well-founded. This lack of clarity may cost lives.

I am a member of the New York State Task Force on Life and the Law and helped write its 2015 guidelines on the allocation of ventilators during a public health emergency. The position outlined by the Task Force report has been a point of confusion in the media. I don't believe that the Task Force recommendations discriminate against people with disabilities.

One-third of all new GoFundMe campaigns in the United States are for COVID-19-related needs. This shows where we have failed as a society. It is a makeshift response to institutional failures and not a fair or sustainable solution to crises.

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

Influenza and coronavirus cause similar symptoms probably through similar modes of transmission. What is unique about coronavirus is that misinformation, missteps, conspiracies, and cover-ups have left their mark on public trust.

The theme of National Eating Disorder Awareness (NEDA) week , “Come as you are: Hindsight is 20-20,” is designed to encourage those recovering from eating disorders to reflect on their journeys towards body acceptance. It also affords doctors and other health professionals an opportunity to evaluate how well they are doing to help patients reach this goal.

The public charge rule went into effect nationwide yesterday, formalizing the “public charge era” that began when the draft rule was leaked three years ago. The rule jeopardizes eligibility for legal permanent residency if applicants are deemed public charges based on even short-term use of federally funded programs, such as health insurance, housing subsidies, or food stamps. Anticipation of the rule has had chilling effects on the behavior of immigrants, who have avoided or withdrawn from health-related programs for which they are eligible. What follows is a selected bibliography designed to support learning and progress on immigrant health in a complex policy environment.

The arrest of Harvard chemist and nanobiologist Charles Lieber on charges of lying about his research funding from China encapsulates two phenomena currently in tension: the global nature of modern science and attempts to nationalize the fruits of science.

The death of Dr Li Wenliang from COVID-19 is heartbreaking for our country and people. Dr. Li was reprimanded for messages he posted in a chat group warning fellow doctors about a mysterious infection. His death from coronavirus underscored gaps and deficiencies in our country’s health care system and system of governance.

Tinslee Lewis, a critically ill 1-year-old girl born with a rare heart defect and severe lung disease, has spent her entire life in the intensive care unit at Cook Children’s Hospital in Texas and undergone multiple surgeries in attempts to save her life. Tinslee’s care team has determined that she has no chance for any meaningful survival and that ongoing intensive care is harmful and causing her undue suffering. They recommend withdrawal of life-sustaining treatment, against the parent’s wishes. Tinslee’s fate is being debated in court.

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.

Hastings Center fellows in China discuss ethical questions about the response to the spreading coronavirus.

To address recent lawsuits that question whether the persistent of hormonal functions is consistent with death by neurologic criteria (such as the case of Jahi McMath), we proposed specific mention in a UDDA that loss of hormonal functions is not required for declaration of death by neurologic criteria.

As debates continue about the decisions people make about how to die, I wish to draw wider attention to the death of Paul Drier. There was little extraordinary about his death. He was a widower, had suffered from multiple health problems, and had been on kidney dialysis for 18 months. Considered to be too ill to qualify for a transplant, he decided to end dialysis. Two aspects of Mr. Drier’s death seem worth putting on record for bioethicists to remember.

Health care in America is at a critical juncture. The number of people who need it continues to grow and costs have skyrocketed. But instead of being a beacon of healing, many health care organizations are beleaguered and overwhelmed. Burnout has become a rallying cry for nurses and doctors because it impedes their ability to uphold the foundational values of their professions and to serve in accordance with them. These realities have eroded the fundamental humanity of health care.

When the rapper T. I. disclosed on a podcast that he takes his 18-year-old daughter to a yearly gynecological examination to ensure that her hymen is still intact, the reaction of most people was condemnation. His obsession with her virginity is creepy, his subjecting her to an invasive procedure that has no medical value is controlling, and his willingness to talk about it publicly displays contempt for her rights to privacy and dignity. Some think that the law should prohibit physicians from performing or supervising virginity examinations. But the law is not the best means for dealing with the problem, and the problem is not simply virginity testing.

The bioethics and legal communities must come together to find ways to move with the same ease of the scientific research community--to transcend the geopolitical borders and jurisdictional concerns that make international regulation so difficult.

Professionals and the public in China first learned of the jail sentence of He Jiankui from the report of Xinhua News Agency. No information, including any interpretation, was provided by the Court. But the reported words of the sentence are so ambiguous as to leave room for different interpretations. We believe that the public has the right to know more than Xinhua News Agency reported.

An essay for Bioethics Forum earlier this month concludes that medical aid in dying is not a human right. But we should have a right to decide what suffering we are willing to endure and receive medical assistance necessary to avoid the suffering we want to avoid.

A New York Times special report on euthanasia of a Paralympics champion in Belgium was ethically problematic for several reasons.

The American species of the common house mouse (Mus musculus) does an odd thing when going through opioid withdrawal. It jumps involuntarily, rearing up on its hind legs and leaping 3-to-4 feet in the air. I was a spectator to this phenomenon this summer, while working at a research hospital in New York City.

The Kings County Medical Society in New York recently hosted a brunch with New York State legislators. One of the guests was Richard Gottfried, chair of the New York State Assembly Health Committee, who is cosponsoring A2694, a bill legalizing medical aid in dying (MAID). As a medical oncologist with 30 years’ experience treating seriously ill patients, I have concerns about it, and I expressed them to Gottfried.

Are we ethically obliged to eat less meat? Bioethicists consider that question, and their role in addressing it.

The National Institutes of Health recently announced that it will retire-in-place the remaining 44 chimpanzees at the Alamogordo Primate Facility in Alamogordo, New Mexico, rather than transfer them to a sanctuary as originally planned. NIH’s decision is disappointing for those who believe that the chimpanzees—many of whom have spent decades in research—should experience the freedom and quality of life a sanctuary would provide.

Last week, the Trump Administration proposed a new rule that would “require DNA-sample collection from individuals who are arrested, facing charges, or convicted, and from non-United States persons who are detained under the authority of the United States.” Collecting DNA of people detained under the Department of Homeland Security is not permitted under U.S. law. The proposed rule aims to change that.

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?

Amazon.com made waves in health care when it announced that its Alexa Skills Kit, a suite of tools for building voice programs, would be HIPAA compliant. Using the Alexa Skills Kit, companies could build voice experiences for Amazon Echo devices that communicate personal health information with patients. Alexa’s various roles in health care stand to confuse (or potentially exploit) users.

Many survivors of sexual assault are not receiving the justice they deserve. For one thing, an estimated hundreds of thousands of rape kits are left unused, reducing the odds that the perpetrators will be identified and prosecuted. When rape kits are used, many survivors are flooded with bills, in some cases for many years. This system is unethical and illegal.

Last month, an international commission convened to consider whether and how germline editing – changing the genes passed on to children and future generations -- should proceed. The discussions focused mainly on the safety risks of the technology, which, while important, are not the only issues to consider. Any conversation regarding germline editing must also honestly and thoroughly assess the potential benefits of the technology, which, for several reasons, are more limited than generally acknowledged.

What would it take for the first case of gene editing of a human embryo, egg, or sperm to proceed in the U.S.? Many legal and ethical hurdles involving clinical trials, for starters.

Kathy Brandt, a leader in the hospice and palliative care movement in the United States, died on August 4. She was 53 and had been diagnosed with a rare, highly aggressive form of ovarian cancer in January. Brandt and her wife regularly posted on social media about their family's end-of-life experiences.

Daniel Callahan's final interview was with an undergraduate eager to learn about bioethics. "I could tell that bioethics was far more than a job to him," she writes.

I have been leading a weekly ethics class for middle- and early-high school-aged youth. My preconceived assumptions about the abilities of adolescents to discuss bioethics issues have been dispelled by the depth and nuance of their insights.

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.

What does it mean to live well on a warming planet? And as the climate changes, how might health care, education, and other sectors support, or obstruct, our ability to respond? The answers to these profound, and profoundly bioethical, questions will critically influence human well-being in this century and beyond. A group of scientists, educators, and bioethicists convened at The Hastings Center recently to consider these questions and begin an interdisciplinary conversation on how bioethics might address the challenges posed by climate change.

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 the opioid crisis reaches a fever pitch, public perception often lumps chronic pain patients and opioid abusers under the stigma-tainted umbrella of drug user. But the full picture of human interaction with pain, pain management, and addiction is far from black and white. In its most recent narrative symposium, Narrative Inquiry in Bioethics published personal stories from those living with chronic pain or opioid abuse disorder. Both groups comment on their need for medical treatment and ethical care.

The protections of GINA play a key role in the decision of many of my healthy patients to decide to undergo genetic testing. My criticism is that GINA is unfair to people who might suffer discrimination in health. insurance for non-genetic reasons.

The creation of humanlike intelligence in a nonbiological being would be the greatest achievement in human history. Many experts believe this will happen within decades. What role should, or could, regulatory bodies play?

The federal government's proposed rule to disqualify families from public housing if any member is undocumented will harm children, families, and cities.

Should religion play a role in a doctor's care of seriously ill patients? The author, a hematologist/oncologist who teaches Jewish medical ethics, writes: "A physician's outlook may be shaped by religious standards without having to impose it on the patient."

The Court of Arbitration for Sport has decided that female athletes with atypically high levels of testosterone must take testosterone-lowering medication in order to compete in certain events. I'm troubled by the precedent this sets.

If virtuous perfection of natural talents is what sports is all about, sports needs more people like Caster Semenya, the South African runner. But she is now ineligible for competing in middle distance events unless she takes medication to suppress her naturally high testosterone levels. Is this fair?

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?

The new indie movie William explores the question, What would it be like if a Neanderthal were born and raised in a modern, industrialized society today?

Should an elderly person in decent health but "tired of life" be able to die with a physician's assistance? The Netherlands is grappling with this question.

It is a truism that good ethics begins with good facts. Here are some of the facts about the ethics and politics of heritable human genome editing from 2015 to 2019.

Last month, the journal Nature published a call for a global moratorium on heritable human genome editing. Despite criticism, notably from CRISPR pioneer Jennifer Doudna, the moratorium is just what's needed now.

As a public health researcher interested in brain injuries in sports, I was searching for peer-reviewed literature that examined cultural pressures that cause athletes to minimize symptoms of potentially serious...

“Improving patient experience” has become the mantra of many health care facilities in a highly competitive and regulated environment. But just what is it about the patient experience that needs...

This year, The Hastings Center will celebrate its 50th anniversary. The Center was first located on the second floor of my house in Hastings-on-Hudson, N.Y., with some overflow paperwork stored...

A preliminary investigation by Guangdong Province in China of He Jiankui, the scientist who created the world’s first gene-edited babies, found that “He had intentionally dodged supervision, raised funds and...

Despite the appearance of agreement, scientists are not of the same mind about the ethics and governance of human germline editing. A careful review of public comments and published commentaries...

The introduction of pre-exposure prophylaxis (PrEP) as a means of preventing HIV infections in those at high risk marked a significant step in the fight against the virus. PrEP involves...

In their single-minded venture of “producing” (shengchan, in their own word) the world’s first gene-edited babies, He Jiankui and his associates have posed numerous and daunting ethical challenges to China...

In the wake of the recent Twitter fight between the National Rifle Association and U.S. physician groups over whether doctors should speak out about firearm policy issues, we argue that...

When the world’s first research on editing the genes of human embryos by Chinese scientists  was published in an international journal in 2015, a report in the New York Times...

In response to news of the world’s first babies born in China from gene-edited embryos, Sam Sternberg, a CRISPR/Cas9 researcher at Columbia University, spoke for many when he said “I’ve...

The global scientific community has been unanimous in condemning Chinese scientist He Jiankui, who announced last week that he used the gene-editing technology called CRISPR to make permanent, heritable changes...

The birth of gene-edited twin girls was announced by a young Chinese scientist He Jiankui through one of four self-made promotional videos in English on YouTube (a website officially banned...

Across the country, billboards are popping up suggesting that vaccines can kill children, when the science behind vaccination is crystal clear – vaccinations are extremely safe. Researchers who study the beliefs of anti-vaxxers have found many...

Old Jews are why I am who I am. Not only the old Jews you’d expect–my grandparents and great-grandparents, who came here because, as I learned for a family history...

When people ask me what kind of medicine I practice, I most often say family medicine. Now, however, I am also apt to say I practice “democratic medicine.” What is...

I suspected the two alibi witnesses were lying. The accused in the case, Alexei Melnikov, coached long distance walkers and runners for ARAF, the All-Russia Athletic Federation. Lilya Shobukova and...

In 2012, I coauthored a case report about the successful use of dietary supplements in treating a case of male infertility in the American Family Physician. Before it was published,...

Last March, 4,000 frozen eggs and embryos were lost at University Hospitals Fertility Center in Cleveland when the temperature in cryogenic tanks spiked due to human error. Officials at University...

Last month, England announced that it would allow women to take the second pill required for a medical abortion–misoprostol–at home, rather than requiring them to travel to a clinic. The...

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...

In “Avoiding Deep Dementia,” an essay in the current issue of the Hastings Center Report, legal scholar Norman Cantor explains why he has an advance directive that calls  for voluntary...

A long-anticipated policy change proposed by the Trump administration that would count the use of many federally-subsidized programs against immigrants currently eligible to use them threatens public health and would...

I founded a bioethics club at my high school in the beginning of my sophomore year. From a very young age, I always considered it important to do the “right...

Earlier this month, The Seattle Times published an op-ed by Samuel Browd, medical director of Seattle Children’s Sport Concussion Program, on the risks of brain injury in youth sports. Dr. Browd...

Twice upon a time, there was a girl who died. The death certificate that New Jersey issued to 17-year-old Jahi McMath on June 22 was the second one issued for...

Dying cannot be understood properly, or responded to well, without recourse to the connections between the dying experience and the larger social structures that make up a social and civic...

Addyi, a drug that made a splash when it was approved in the summer of 2015 as the first “female Viagra,” is back. Its rise, fall, and rise again is...

The advent of social media technology has opened many new avenues of research in population health, demographics, psychology, and the social sciences. It is crucial to consider whether researchers conducting...

Amid the volume of coverage and commentary on the politics of immigration and the consequences of crackdowns and criminalization, here is a selection of recent work – analysis, personal essay, fiction, mixed-media – that can spark the moral imagination.

Reports that migrant children held by the Office of Refugee Resettlement are being drugged require an immediate and unambiguous response by the Trump administration. According to court filings, the drugs that...

In an earlier piece, “Trumping Drug Costs,” I looked at out-of-pocket costs as the pivotal issue with drugs. They can be a particularly heavy burden on the elderly, taking money...

The Russian poet Anna Akhmatova was a mother separated from her child by a state policy of terror. During the 1930s, she and other mothers would gather outside a Leningrad...

In late April, a suspect thought to be the Golden State Killer, a man who had eluded police for decades after committing a string of murders and rapes in Northern...

In April, the U.S. Justice Department announced that it would criminally prosecute migrants who had been apprehended after crossing the U.S.-Mexico. border. An immediate consequence of this announcement, explained in...

At a time when facts are distorted, disregarded, and ignored in policy making and political discourse, the need in Washington for seekers and defenders of truth has perhaps never been...

I usually have trouble finding a good word to say for President Trump’s policy ventures, but his aim to better control out-of-pocket drug costs is worth support. Distressingly, but unsurprisingly,...

The process is fairly simple. You select one of the companies that offer direct-to-consumer genetic tests; pay online; receive a neatly packed kit that contains a tube designed to collect...

On May 8, the New York Court of Appeals denied an appeal to have two captive chimpanzees, Kiko and Tommy, recognized as legal persons with the right to bodily liberty...

In “Tackling Obesity and Disease: The Culprit Is Sugar; the Response is Legal Regulation,” published in the Hastings Center Report, Lawrence O. Gostin describes four coordinated interventions that have been...

Many privileges come with having a doctor in the family: appointments squeezed into busy schedules as personal favors, a conspicuous lack of financial strain, an ability to comprehend both treatment...

Last month, Hawaii became the seventh state, with the District of Columbia, to legalize physician-assisted suicide. Similar to some of the other state laws, Hawaii’s Our Care, Our Choice Act...

Human infection challenge studies, which deliberately expose healthy volunteers to disease-causing infectious agents under carefully controlled conditions, offer a valuable method of biomedical research aimed at efficient initial efficacy testing...

The death of former first lady Barbara Bush at age 92 was noteworthy in many ways. She was by all accounts smart, sharp and funny, and a fine, helpful wife...

While the U.S. system of organ donation and transplantation is in a state of growth for the fifth year in a row, the call for new strategies to accelerate that...

In February, Senator Claire McCaskill (D-Missouri) published a report that revealed the unsettling relationship between opioid manufacturers and pain advocacy groups. Focusing on five opioid manufacturers, Purdue, Janssen, Depomed, Insys,...

The Uniform Anatomical Gift Act, a landmark law adopted 50 years ago this summer, has provided a sound and stable legal platform on which to base an effective nationwide organ...

An investigative report The BMJ published recently about a failed tuberculosis vaccine trial conducted with infants in South Africa underscores several issues in translational science that are gaining increased attention:...

“It was like he thought we were dirt.” This is how Jahi McMath’s grandmother, Sandra, describes having been treated by one of the doctors at the Oakland’s Children Hospital ICU....

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,...

Last month, a group of 17 North American philosophers (myself included) filed an amicus curiae brief with the New York State Court of Appeals on behalf of Kiko and Tommy,...

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...

I have been opposed to physician-assisted death for well over 30 years. I need to go back to my early days with this issue to lay out some of my...

An article in the Hastings Center Report asks whether it is ethical to ration health care by inconvenience and red tape. In other words, given that all societies must ration...

In a recent essay in Vogue the actress, writer, and director Lena Dunham described her decision to have a hysterectomy at age 31 after a decade of unsuccessful attempts to...

An opinion piece in the New York Times, “Doctors Fail Women Who Don’t Want Children,” serves as a striking reminder that the more things seem to change, the more they...

A transgender woman has successfully breastfed a baby. This case has been hailed as a “breakthrough” for transgender families. I will argue that being transgender is only peripherally relevant, and...

Little noticed in the United States but a big deal in France, President Emmanuel Macron announced in January that he is creating a bioethics commission to review the country’s policies...

“It felt selfish to put my baby at serious risk by pursuing a vaginal birth,” writes Kristen Terlizzi in a collection of essays published recently in Narrative Inquiry in Bioethics....

Hurricane Harvey dissipated in September, but much of the destruction that it wreaked on Texas and Louisiana remains. When addressing residential concerns, disaster relief officials prioritize the newly homeless over...

Not since Rene Descartes gazed from his garret window in early 17th-century Paris and wondered whether those were men or hats and coats covering “automatic machines” he saw roaming the...

It’s one o’clock in the morning in the pediatric intensive care unit.  A 16-year-old patient tells his nurse that he disagrees with the medical treatment plan that was agreed to...

Before noninvasive prenatal screening becomes a routine part of gestational care, society needs to have difficult conversations about the ethical implications and establish a paradigm for truly informed consent in...

As modern medicine improves survival odds, many young cancer patients are living long lives that bear the markings of the disease and its treatment. The side effects of chemotherapy, radiation,...

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 arrest of Jumana Nagarwala and her colleagues, in what has become the first case to be tried under the federal law prohibiting female genital mutilation, has brought female genital...

Do the recipients of organ transplants have a right to know if the organs they are about to receive were part of a research study? If so, are the recipients...

The Oxford philosopher Julian Savulescu, among others, has argued that prospective parents engaging in embryo selection using preimplantation genetic diagnosis not only may seek to have genetically enhanced children but...

Along with the recent public debates over  Confederate memorials, there have been calls to remove or modify the statue of Dr. J. Marion Sims, called the father of gynecology in...

Possibly as many as half of the coral reefs that existed 100 years ago have been destroyed, sometimes by removing them, covering them up, or blowing them up, but mostly...

In early 2016, Nature published a letter from a group of Chinese researchers reporting that they had created rhesus macaques with “autism-like” behaviors. The macaque was bred with a mutation...

For the first few years after my husband Howard died, I talked to him often. These were not ghostly, paranormal encounters; I was just thinking out loud about my life...

The Precision Medicine Initiative plans to collect data and biological samples from one million or more individuals in the United States and engage in internationally collaborative research. That means that...

An  article in the New England Journal of Medicine last March warned of the “chilling effect” of recent federal immigration policy changes on health care access for undocumented immigrants. The...

My  colleague Susan Reverby surely got this right: It is time to consider anew what to do about Dr. J. Marion Sims, that is, what to do about the New...

On August 5, the World News Daily Report published an article that has been circulating on my Facebook newsfeed every day since: “Hermaphrodite Impregnates Self, Gives Birth to Hermaphrodite Twins.”...

The magnitude of the opioid epidemic is increasing across North America, stretching its harmful reach across socioeconomic borders. Drug overdoses are currently the number one killer of Americans under the...

“There is a difference between remembrance of history and reverence of it,” Mayor Mitch Landrieu declared to explain the removal of four Confederate monuments in New Orleans in May. The...

With Senator John McCain’s heroic return and Vice President Mike Pence’s tie-breaking vote on a health care bill July 25, Senate Republicans managed to cobble together 51 votes simply to agree to debate...

The case of Charlie Gard continued to unfold this week as Charlie’s parents, Connie Yates and Chris Gard, withdrew their appeal for permission to bring him to the United States...

With the wild popularity of the new TV series The Handmaid’s Tale, surrogacy is back in the limelight. The Hulu show, based on the cautionary novel of the same name by...

In an essay in the May-June 2017 Hastings Center Report, Holly Fernandez Lynch and Michelle N. Meyer assess the impact of the revised Common Rule on biospecimen research. They believe...

Not long ago, I received a questionnaire from an organization on a crusade to lower birthrates to protect the health and well-being of people and the environment. Called the Population...

In 1971, the United Nations passed a resolution prohibiting its member nations from advertising psychotropic drugs to the general public. More than 40 years later, this resolution has done little...

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...

Three years ago, a small pharmaceutical company with a big agenda created a fake feminist group so that they could get a bad drug approved by the Food and Drug...

After years of fluctuating and troubled efforts, the nations of the world in December of 2015 came to the remarkable agreement to work together to reduce global warming. On June...

Reading “After DNR: Surrogates who persist in requesting cardiopulmonary resuscitation” in the Hastings Center Report, I was reminded of Senate Majority Leader Mitch McConnell’s chastisement of Senator Elizabeth Warren’s opposition...

Populism has been influencing public discourse and election outcomes in several countries recently. The degree to which populism has a sway on elections varies with the electoral system in each...

There is a broad and deep moral conviction that health care should be distributed according to genuine need and not left to the cold mercy of pure market forces or the logic of actuarial fairness. Unfortunately, the proposed American Health Care Act (AHCA), passed last week in the House of Representatives, and other legislation threaten to undermine that moral commitment.

On May 4, 2017, just over one month after abandoning a previous version of the bill, the U.S. House of Representatives voted by a 217-213 margin (with one abstention) to...

Is it reasonable to hope that concerns about “cultural harms” can be integrated into oversight mechanisms for technologies like gene editing? That question was raised anew for me by the...

After much anticipation, on April 22, HBO debuted The Immortal Life of Henrietta Lacks, a film based on Rebecca Skloot’s bestselling book, starring Oprah Winfrey. Lacks’s cells provided the foundation...

People value their health. It allows them to pursue their aims and enjoy their lives, and it contributes to their well-being. But health is not only good for particular healthy...

In a recent  article in the Hastings Center Report two leading bioethicists, Mildred Solomon and Bruce Jennings, called on fellow bioethicists to “come to the aid of civil liberties and...

In their paper “Bioethics and Populism: How Should Our Field Respond?” Mildred Solomon and Bruce Jennings have sparked an important debate about the role of bioethics in our current political...

Arkansas has recently joined seven other states (Arizona, Kansas, North Carolina, North Dakota, Oklahoma, Pennsylvania, and South Dakota) in banning abortions for sex selection. Arizona’s law requires doctors to ask...

Franklin Miller’s recent post in Bioethics Forum responded to our essay, “Bioethics and Populism: How Should Our Field Respond?”  in the current issue of the Hastings Center Report. There, we suggested...

Given the chance, would Supreme Court nominee Neil Gorsuch vote to overturn Roe v Wade? Challenge state "death with dignity" laws?

Imagine you are a doctor running a clinic in a primarily lower-income neighborhood, where many of your patients are recent immigrants from different parts of the world. You are granted...

In the past few weeks media outlets have been reporting on the release of Human Genome Editing: Science, Ethics, and Governance from the National Academies of Science, Engineering, and Medicine....

Death is beginning to show its age, though I hesitate to even mention that possibility.  With an obviously big ego and its intimidating black cloak and scythe, it has always...

On February 21, the Department of Homeland Security released new policies prioritizing deportation of undocumented immigrants. Will this policy shift affect health care access for this population of 11 million?...

It’s the conversation that really interests me. The NASEM report is plop in the middle of a national and indeed a global inquiry into how genetic science can let us tweak the world—human beings, human nature more generally, other organisms, ecosystems, the biosphere at large. What are the terms of that inquiry?

On January 19, the day the final revisions to the Federal Policy for the Protection of Human Subjects were published in the Federal Register, our essay “Public Engagement, Notice-and-Comment Rulemaking,...

An old woman desperately needs medical attention. Yet she fiercely refuses every offer of help from friends, neighbors, and the local doctor. No one will get past her door, she...

Should scientists pursue research that would enable prospective parents to edit the genes of their future children in ways that could be passed onto subsequent generations? Not for now, according...

Scientists acknowledge biological, behavioral, and psychological similarities between human and nonhuman primates; hence their use as proxies in biomedical research. At the same time, primates are denied many ethical considerations...

The 11 million undocumented immigrants in the United States live in all 50 states and rely on local safety-nets and state-level provisions for health care. Launched in 2011, The Hastings...

Mainstream research ethics rests on an incomplete foundation.  For the most part, human subjects regulations and guidelines reflect the views of professionals and others who have never been subjects themselves. ...

About eight years ago, as the controversy about research involving human embryonic stem cells was winding down and Barack Obama was about to take office, I had one of my...

On September 21, Heather Bresch, CEO of Mylan, took heat at a Congressional hearing about high EpiPen prices. EpiPens are definitely overpriced – but they are also overprescribed. An EpiPen is...

Drug spending in the United States increased more than 12 percent in 2014 and is projected to rise faster than overall health care spending over the next 10 years. Between...

When Woody Allen said he was “at two with nature,” perhaps he had in mind insects that sting or bite. Who can argue with that, and who hasn’t taken a...

In 2013 the influential German magazine Der Spiegel published an expose about clinical trials conducted by Western drug companies in East Germany during the Cold War. The magazine reported that...

Three rules for driverless vehicles were announced by the German Transport Minister, Alexander Dobrindt, in a September 8th interview with Wirtschafts Woche.  In English translation the rules are: (1) “It...

High drug prices are a fact of modern American life. They are not, however, equally high for all Americans. Their magnitude depends on whether you are un-, under-, or adequately...

The use of animals in medical research has been a hotly contested moral issue for years. In 2010, the European Union banned virtually all research on great apes (gorillas, bonobos,...

In the bioethics world, all roads eventually lead to Hastings, whether that means the Center in Garrison, N.Y., or Hastings-on-Hudson, N.Y., where the Center was born in 1969 and lived...

On August 4, the National Institutes of Health called for public comment on proposed changes to its guidelines governing the funding eligibility of research involving human-nonhuman chimeras. Although the term...

The furor around the price of an EpiPen has exposed the contradictions of patient advocacy groups with funding from the pharmaceutical industry. EpiPens contain epinephrine, an oldie-but-goodie, inexpensive generic drug...

“The Presidency should not be used as a platform for proving one’s manhood . . .” “Inwardly he is a frightened person who sees himself as weak and threatened by...

We have long had the ability, we humans, to work outside the bounds of evolution. Dairy cattle, maize, and all sorts of dog breeds attest to that. It is unlikely...

Ms. Rita, whom I met as a volunteer at a local nursing home, was the most ardent lover of grapes I have ever known. She was confined to a wheelchair...

The death in May of a technology expert driving a Tesla driverless car was surely a sad event for his family, but no less a shock for a company and...

It is too soon to know how the crisis that has been created by Britain’s vote to leave the European Union will play out.  But it is worth considering that...

Perhaps we were naïve. Our plan was relatively simple: we would chart the legislative evolution of programs for veterans with traumatic brain injuries (TBI) to identify policy gaps for this...

At the age of 15, in August 1945, I heard the radio announcement of the dropping of the atom bomb on Hiroshima. It left an indelible unsettled mark on my...

Big Data, which is derived from a multitude of sources including, social media, “wearables,” electronic health records, and health insurances claims, is increasingly being used in health care and it...

The Icelandic biotech firm deCODE Genetics has pioneered a means of determining an individual’s susceptibility to various medical conditions with 99 percent accuracy by gathering information about that person’s relatives,...

As President Barack Obama’s term comes to a conclusion, various initiatives started under his administration remain unfinished.  One of these, the adoption of the recommendations of the Defense Health Board...

North Carolina recently adopted a statute that requires people to use public restrooms consistent with the sex assigned to them at birth, and other jurisdictions are debating similar proposals. Legislators...

Couples undergoing IVF routinely undergo preimplantation genetic screening, or PGS, to make sure that their embryos are viable and free of genetic disease. However, some embryos have both normal and...

On April 14, Canada’s justice minister presented to the House of Commons a bill to govern medical assistance in dying. The bill did not follow the direction of the Supreme...

On Monday, the Massachusetts Joint Committee on Health Care Financing held a hearing on Senate bill 1048, which would require pharmaceutical companies to report to the state a range of information...

When the Tribeca Film Festival canceled its controversial screening of Vaxxed, a “documentary” (with scare-quotes) alleging a Centers for Disease Control cover-up of the debunked vaccine-autism link, it vindicated what scientists have collectively been saying...

Sometime around my mid-50’s I began to ask myself a question: how long should I want to live? My father had died at 64, my mother at 85, my various...

In an 11-hour emergency session on March 23, the North Carolina General Assembly passed the first statewide “bathroom bill” in the nation. The law, known as HB 2, or the...

For previous posts on the Singapore Casebook project, a collaboration among the Centre for Biomedical Ethics at the National University of Singapore, The Hastings Center, and the Ethox Centre at...

Last month, the New York Times reported that the price of a 62-year old little-known drug, Daraprim (pyrimethamine), rose overnight from $18 to $750 a pill. About 100 pills are needed to treat...

For some years I have been writing about end-of-life care and, of late, focusing on the high costs of that care. I recently had a painful but revealing insight into...

Another landmark right-to-die case hit the U.K. headlines last week. A High Court judge ruled, in W v M & Ors [2011] EWHC 2443 (Fam), that a 52-year- old woman...

President Obama’s announcement that he will replace the members of the President’s Council on Bioethics has led to speculation about appointments and the issues a reconstituted commission might address. White...

Over the last four decades, conservative think tanks such as the Heritage Foundation, American Enterprise Institute, Cato Institute, Competitive Enterprise Institute, Hoover Institute, and Manhattan Institute have dominated the public...