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.

A federal complaint filed last month on behalf of a nurse who worked in the Irwin County Detention Center in Georgia alleged that immigrants held in this U.S. Immigration and Customs Enforcement (ICE) facility were medically neglected and forced into solitary confinement for speaking out, and that s...

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.

With all of the tumult surrounding the coronavirus and the upcoming presidential election, few people likely noticed that three important figures in bioethics, medical history, and medical sociology recently died within a month of one another. But for those of us who work in these fields, the deaths...

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.

Language used to describe the response to the pandemic can illuminate, and it can distort. Here I focus on language that obfuscates thinking about the pandemic. As the death toll mounted in New York City in April, New York Governor Andrew Cuomo was reported to have declared, “Ventilators are to th...

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 novel coronavirus pandemic has starkly revealed the vulnerabilities of low-wage immigrants, immigrant-led households, and immigrant communities to coronavirus infection, severe Covid-19 illness, and economic fallout from pandemic. This public health emergency compounds pre-existing social inequa...

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.

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

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.

As the U.S. health care system faces the strain of responding to the coronavirus pandemic, critical services are being provided by international medical graduates, who, in the years and months leading up to this crisis, have found their capacity to contribute limited by increasingly restrictive immi...

The metaphor “flattening the curve” has succinctly captured the challenge of responding to the coronavirus pandemic in the United States. With no vaccine or effective treatment, the use of social distancing measures attempts to delay the spread of infection and keep the need for intensive, hospi...

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

I get off the phone with a dear friend and colleague in Italy, and the news is devastating. Health care workers dying, impossible choices of triaging limited resources, the real human toll is palpable in her voice. She says, this is not political, this is a public health “nightmare.” I then get ...

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.

Like most New Yorkers, I take the subway to work. I commute from Brooklyn to my office in Manhattan. By the time I get on the train, there are no seats available. It is nearly assured I will be standing inches away from a stranger.

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.

Who should decide whether medical intervention on a child’s body is necessary? Ideally, the person who will undergo the treatment should have a say in these decisions. Patients themselves, even if they are children, should understand all their options and assent to whatever procedures are on the t...

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.

It has been 50 years since the medical profession adopted the determination of death according to neurological criteria, known as “brain death.”  This doctrine was codified in 1981 in the Uniform Determination of Death Act (UDDA), which declares,  “An individual who has sustained eit...

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.

What is Don Quixote, Cervantes’ 17th-century Spanish “Ingenious Gentleman of La Mancha,” doing in a 21st-century novel about America? He’s on a quest to wed his Beloved. And what does this obsession have to do with the present-day opioid epidemic?  Salman Rushdie’s new novel Quichotte lin...

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.

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

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.

Last week, the Department of Homeland Security  announced the final public charge rule, which revises the interpretation of “public charge” in the Immigration and Nationality Act. Under the Final Rule, DHS may find applicants ineligible for a visa for admission to the U.S. or a green card grant...

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 will say it: Dan Callahan is the most important person in Bioethics. For his ideas; for his role in creating and nurturing The Hastings Center; and for his ability to spot, encourage, and motivate talent.

There is a strange but charming tradition in the world of classical music of citing musical pedigrees. It’s not unlike the familiar parlor game Six Degrees of Kevin Bacon, but carried out with far greater seriousness.

Daniel Callahan, a national voice for responsible health and science, who pioneered the field of bioethics, died on July 16, three days before his 89th birthday. In 1969, Callahan cofounded The Hastings Center with Willard Gaylin. Callahan served as the Center’s director from 1969 to 1983, preside...

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.

A prominent group of scientists, bioethicists, and other specialists from around the world recently called for a global moratorium on clinical uses of human germline editing—“changing heritable DNA (in sperm, eggs or embryos) to make genetically modified children.” Before a country allows this...

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 injuries when I came across a 1994 article entitled, “A Little Pain Never Hurt Anybody:...

“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 to be improved?  Will better food and gift bags do the trick? Or are more basic changes required?

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 at the home of my neighborhood friend and cofounder, Willard Gaylin.

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 organized researchers on his own to carry out the human embryo gene-editing intended for ...

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 in top-tier science journals reveals marked differences in perspective. These divergences have significant...

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 taking the HIV medicine Truvada or a generic version daily. It is now gradually becoming available across the world...

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 and the world. They can be mapped or identified through these four categories:

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 professionalism actually requires that doctors take a leadership role in gun policy debates, even if (in fact, espe...

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 characterised the key issue involved as “a scientific ethical divide between China and West.” Earlier this year, an art...

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 long suspected that scientists, somewhere, would rush to claim the ‘prize’ of being first to apply CRISPR...

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 to the genes of two baby girls who were born this month in China. Criticism has focused on...

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 in China) on November 25. Three days later, at the Second International Summit on Human Genome Editing held in ...

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.

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 project in third grade, “it was bad in Russia.”

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 democratic medicine? Less a style than a way of being, it embodies five principles born of democratic values related to history, duty...

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 her husband testified that they handed over 150,000 Euros in blackmail money to Melnikov in Moscow in J...

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, I was surprised to receive a communication asking me to disclose the fact that I had written a textbook on dietary supp...

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 Hospitals have apologized repeatedly to the affected patients, and say that they are working to provide ...

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 policy brings England in line with Scotland and Wales, as well as many other countries, and it elimina...

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

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 stopping of eating and drinking as a means of ending his life if he develops dementia and reaches a particular ...

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 undermine ethical practice in health professions and systems.

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 thing.” However, as I grew older and was confronted with more complex situations, I realized that the “right thing” is not always obviou...

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 acknowledged troubling research on the dangers of repetitive brain trauma, but also emphasized that mil...

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 her. California issued McMath’s first death certificate in December 2013.  McMath had been admitted to Children’s Hospital Oakland on...

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 community. To develop this perspective further, it is important to envision a new kind of palliative care system...

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 an example of shrewd pharmaceutical marketing and the potential dangers it can pose to patients.

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 observational research using social media need to obtain consent from their research subjects...

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 are alleged to be among those given to children without their parents’ consent include cl...

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 from their savings and a large bite of their Social Security income. Along the way, I also looked at out-of-pocket medi...

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 prison, desperate for information. One day, after 17 months of “waiting in prison queues,” another woman whispered to her, �...

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 California and Orange County between 1976 and 1986, was identified on the basis of DNA evidence. Although we celebrate the dogged pursuit ...

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 detail here, is the separation of children from their parents.

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 greater. I discussed the state of affairs with Representative Bill Foster, a Democrat from Illinois who prides himsel...

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, it does not include giving government the needed power to bargain with industry for what it will pay f...

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 your spit; return the package using prepaid postage; and wait for the results that will unravel the mysteries of ...

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 and released to a chimpanzee sanctuary. The Court of Appeals allows only about 5 percent of appeals, so the legal outcome was not surp...

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 effective at controlling peoples’ tobacco consumption and which can serve as a “powerf...

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 plans and health care systems. But familial and professional roles often clash in a health crisis.

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 permits competent adults with a terminal illness and a diagnosis of less than six months to live to obtain a...

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 of vaccine candidates, among other possible uses. They...

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 to one president and mother to another. Her death last week after a long illness, with her husband at her side, was a model of palliative care su...

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 progress has never been more robust as the critical need for transplantable organs continues to far exceed the supply. In an article in the M...

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, and Mylan, the report found that manufacturers contributed $9 ...

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 donation and transplantation system, as we discuss in our article in the current issue of the Hastings Center Report. We work...

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: low standards in the rigor, reporting, and transparency of preclinical research...

“It was like he thought we were dirt.”

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

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, two captive chimpanzees. The brief, informally known as “Chimpanzee Personhood: The Philosophers’ Brief,” supports a legal a...

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

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 reflections and misgivings. It had long been the case, I was told in 1970, that if one had the right connections and savvy one could easily find a doctor in...

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 health care in one way or another, is it ever ethical to push people away from an unpreferred health care option by making it m...

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 control increasingly excruciating pain from endometriosis. The decision was difficult because it meant that she would never be ab...

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 stay the same.

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 the potential risks to infants are unjustified.

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 on a wide range of subjects, including human reproduction, euthanasia, neuroscience, and artificial intelligence. ...

“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. You can read Terlizzi’s full story here.

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 the chronically homeless, choosing to protect the previously privileged over the unp...

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 streets has the issue of personal identity and your cranium been of such import. Descartes feared a world that h...

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 by his parents. While he is legally a minor, he may have the capacity to make his own medical decisions. He is...

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 reproductive decision-making. These are admirable goals, set out in an article by Vardi...

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, and surgery often include damage to fertility, such as early menopause or the loss of viable sperm. A recen...

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

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 cutting practices into public conversation once again. Dr. Nagarwala, an emergency medicine physician from a small S...

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 themselves research subjects? A recent article in the Hastings Center Report maintains that the recipients do have a right to know, but that the...

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 are morally obligated do so. (See, for example, his essay “Procreative Benefice...

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 medical histories, who conducted horrific experiments on enslaved black woman.   Removal of the structures alone will not...

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 just because of climate change, which is gradually heating the water and making it more acidic. The solution everyone who cares abou...

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 in the MeCP2 gene. Overexpression of MeCP2 is found in MeCP2 duplication syndrome, a disorder that shares...

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 without him. Ten years later, these occasions happen less frequently, usually connected with an anniversary or a family event. In my i...

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 genetic and other information about these people could be shared with researchers around the w...

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 Trump administration’s expanded immigration enforcement has seen an increased number of arrests at m...

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 York City statue that commemorates him, and accordingly, about the medicine, history, and bioethics that have remembered and/or revered him. The works...

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 age of 50. Reports suggest that in the next decade the opioid epidemic could kill more people t...

“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 statues were, he argued, part of the terrorism campaign that threatened African American citizens for more than...

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 health care reform. This razor’s edge victory is diagnostic. Hyperpartisan debate is conv...

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 for experimental treatment. The move came after tests showed that Charlie had sustained irreversible muscle damage, making...

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 Margaret Atwood, follows Offred, a woman who is isolated and confined for the sole purpose of bearing children for the people who ...

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 that the proposed “broad consent” approach – which involves participants agreeing to the storage of blood and o...

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 Connection, it is the successor to ZPG (Zero Population Growth), started in the 1970s by Paul Ehrlich. Shortly there...

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 to halt pharmaceutical companies from marketing stimulants as treatments for attention deficit-hyperactiv...

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

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 Administration. The story of how this happened is a case study in how industry affects medical discourse, the subject of a PharmedOut confere...

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 2, President Trump announced that our country will withdraw from that agreement.

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 to Jeff Sessions’ nomination as Attorney Genera...

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 country but the impact is likely to be substantial regardless of electoral outcomes.

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 adopt the American Health Care Act (AHCA). During the coming weeks and months, most of the political commentary will focus on the s...

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 recent National Academy of Sciences report on human genome editing and at a recent conference at Harvard on 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 for the now infamous HeLa cell line, the first set of human cells able to reproduce outside the ...

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 individuals. It is also good for their families, communities, nations, and in a world in which people flows are global, heal...

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 political rights,” and to use their scholarship to “clarify how . . .  individual well-being is...

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 climate. They warn of the risk to constitutional democracy posed by the rise of authoritarian populist re...

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 a woman seeking an abortion if she knows the sex of the fetus, and if she does,...

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 that rising global authoritarian populism presents opportunities for (and, one might even s...

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 a fixed annual budget of $100,000 through your local public health department, and it is unlikely that you can obtai...

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. The report concluded that following more research, it would be ethical to initiate clinical trials using h...

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 had some less than endearing traits: its doggedness pursuit of the aging, but also its sudden and often unpredictable destruct...

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? Two public health studies from Arizona suggest that immigration crackdowns change health-s...

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, and the Common Rule” was published in IRB: Ethics & Human Research.  Of course, when we w...

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 vows. Respecting her autonomy means leaving her alone, possibly to die. Intervening to save her means risking her wrath and ...

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 to the organizers of a summit held in Washington DC at the end of 2015. The three day International Summi...

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 and basic protections afforded to humans participating in research. T...

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 Center’s Undocumented Patients project has focused on understanding ethical and policy challenges in providing h...

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.  The knowledge that comes from personal experience is largely missing from research ethi...

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 regular lunches with a respected conservative policy expert. We had come to be friends who respectfully disagreed about embryonic s...

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.

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 2007 and 2016, the price of a pair of epinephrine autoinjector EpiPens, used to counter life-threatening allergic reactions, rose...

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 swat at one in self-defense? Right now the creature we would like to get rid of is one common species of mosquito called Ades aegypti. Unfortunat...

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 at least 50,000 people had been test subjects for around 900 studies done by manufacturers that included le...

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:

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 insured, and also whether or not you are an insurance company. Insurance companies routinely negotiate for lower-than-list ...

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, orangutans, and chimpanzees.) In 2013 the National Institutes of Health issued guidelines, based on a 2011 Institute of ...

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 for almost 20 years. The relationships among those who have worked at or visited Hastings make up a global network o...

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 chimera has a broad interpretation, the NIH proposal addresses a particular kind of chimera...

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 that effectively treats potentially life-threatening allergic reactions. Pharmace...

“The Presidency should not be used as a platform for proving one’s manhood . . .”

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 that natural evolution alone would have produced these things. They depended on human intervention. However, in the past, the scope of huma...

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 but she never confined herself to her room, choosing instead to wheel around the halls of her new home, a much duller environment than the exciting New ...

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 an industry developing such a car. The driver, Joshua Brown, had test-driven it over 45,000 miles and was, along with the company, confident about its sa...

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 the field of bioethics has a grave stake in the outcome.  Modern bioethics is to a great extent a product of the liberal international system ...

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 underserved and vulnerable population. With recent media attention highlighting the U.S. Department of Veteran...

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 memory, never quite matched since. Years later, in 1986, I read Richard Rhodes’s superb book, The Making of The Atom Bomb. I then learned in full...

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 can potentially improve the way medical professionals diagnose and treat illnesses.

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, including their medical and genealogical records. Of course, inferences hav...

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 (DHB), “Ethical Guidelines and Practices for U.S. Military Medical Professionals,”  is...

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 in Kansas have proposed a bill that would require financial compensation to people who encounte...

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 abnormal cells, and at least some of these “mosaic” embryos are capable of developing into healthy...

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 Court of Canada, which stated that competent, mentally ill people and people who do not have a terminal illness are eligible. ...

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 on their research & development costs, marketing and advertising costs, and prices charged to a num...

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 for years: There’s nothing t...

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 uncles and aunts in their 60s and 70s. Occasional news stories, always with a picture, reported on those few people who made it to 100. I am now 85 an...

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 Public Facilities Privacy and Security Act, requires that a person’s biological sex corresponds with the gendered public rest...

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 the University of Oxford, see here and here .The first edition of this public, web-based casebook, “Maki...

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 toxoplasmosis, a disease caused by a parasite that lives inside a third of humans but can cause life-thre...

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 what the future might look like on both costs and decision-making. It came about from an unexpected angle of vision,  the care provi...

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 in a minimally conscious state (after contracting viral encephalitis nearly 10 years ago) cannot be allowed to die (by having artificial ...

Over the past several years, I have served on a couple of panels considering the clinical and ethical challenges posed by pandemic flu. Our concern was the threat posed by the avian variety brewing in China; not once did we discuss an alternative viral vector. Nonetheless, in light of the current fe...

This past week, the AMA officially issued a “mea culpa” for its history of engaging in discrimination against African-American physicians – except it’s more like a “they-a culpa,” since the AMA administrators are actually apologizing for bad behavior on the part of their predecessors. �...