Bioethics Forum Essay
Making an Example of Martin Shkreli
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...Bioethics Forum Essay
The Death of a Pet: A Glimpse into the Human Future
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...Bioethics Forum Essay
Singapore Case Notes: In the Community, Who is Ethics Education For?
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...Read “Singapore Case Notes: In the Community, Who is Ethics Education For?”
Bioethics Forum Essay
Bathroom Bills, Bigotry, and Bioethics
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...Bioethics Forum Essay
“M,” Polly, and the Right to Die
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...Bioethics Forum Essay
On Living to 100 or More
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...Bioethics Forum Essay
Do Documentaries Have to Tell the Truth?
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...Bioethics Forum Essay
Pharmaceutical Transparency Bills: What’s the Real Purpose?
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...Read “Pharmaceutical Transparency Bills: What’s the Real Purpose?”
Bioethics Forum Essay
Questions About Using “Mosaic” Embryos in IVF
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...Bioethics Forum Essay
What’s Behind Gender Panic in the Restroom?
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...Bioethics Forum Essay
U.S. Military Medical Ethics Guidelines in Limbo
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...Bioethics Forum Essay
Canada Backpedals on Medical Aid in Dying
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...Bioethics Forum Essay
Use of Estimated Data Should Require Informed Consent
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,...Read “Use of Estimated Data Should Require Informed Consent”
Bioethics Forum Essay
Making Big Data Inclusive
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...Bioethics Forum Essay
Gene Drive Technology: Lessons of the Atomic Bomb
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...Bioethics Forum Essay
Lincoln’s Promise: Congress, Veterans, and Traumatic Brain Injury
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...Read “Lincoln’s Promise: Congress, Veterans, and Traumatic Brain Injury”
Bioethics Forum Essay
Bioethics after Brexit
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...Bioethics Forum Essay
Driverless Cars: Can There Be a Moral Algorithm?
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...Bioethics Forum Essay
Sweet Grapes at the End of Life
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...Bioethics Forum Essay
Challenging Evolution?
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...Bioethics Forum Essay
The Real Story Behind the Goldwater Rule
“The Presidency should not be used as a platform for proving one’s manhood . . .” “Inwardly he is a frightened person who sees himself as weak and threatened by...Bioethics Forum Essay
EpiPen Furor: Patient Groups Take Money, Stay Mum
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...Bioethics Forum Essay
Public Comment: Should NIH Fund Research on Human-Animal Chimeras?
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...Read “Public Comment: Should NIH Fund Research on Human-Animal Chimeras?”
Bioethics Forum Essay
Hastings, Botswana, and Edinburgh: Bioethics Meets Detective Fiction
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...Read “Hastings, Botswana, and Edinburgh: Bioethics Meets Detective Fiction”
Bioethics Forum Essay
Experiments on Nonhuman Primates: Q & A with Anne Barnhill
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,...Read “Experiments on Nonhuman Primates: Q & A with Anne Barnhill”
Bioethics Forum Essay
Why EpiPen Prices Are No Shock
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...Bioethics Forum Essay
Imperfect Solutions to Driverless Car Dilemmas
Three rules for driverless vehicles were announced by the German Transport Minister, Alexander Dobrindt, in a September 8th interview with Wirtschafts Woche. In English translation the rules are: (1) “It...Bioethics Forum Essay
“Testing in the East”: An Episode in Cold War Bioethics
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...Read ““Testing in the East”: An Episode in Cold War Bioethics”
Bioethics Forum Essay
Being at Two with Nature and Mosquitoes
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...Bioethics Forum Essay
The Challenge of High Drug Prices in the U.S.
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...Bioethics Forum Essay
EpiPens and the Sale of Fear
On September 21, Heather Bresch, CEO of Mylan, took heat at a Congressional hearing about high EpiPen prices. EpiPens are definitely overpriced – but they are also overprescribed. An EpiPen is...Bioethics Forum Essay
The Era of the Motherless Embryo Just Got a Lot Closer
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...Read “The Era of the Motherless Embryo Just Got a Lot Closer”
Bioethics Forum Essay
Insights from Fictional Research Subjects
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. ...Bioethics Forum Essay
Undocumented Patients in the Local Safety-Net: Tools for Teaching, Learning, and Practice
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...Read “Undocumented Patients in the Local Safety-Net: Tools for Teaching, Learning, and Practice”
Bioethics Forum Essay
Missing from NIH Primate Research Ethics Review: the Ethics
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...Read “Missing from NIH Primate Research Ethics Review: the Ethics”
Bioethics Forum Essay
The Nebulous Ethics of Human Germline Gene Editing
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...Bioethics Forum Essay
The Lady Writer and the Valkyrie: Magda Szabo’s Novel The Door
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...Read “The Lady Writer and the Valkyrie: Magda Szabo’s Novel The Door”
Bioethics Forum Essay
Common Rule Revisions: Impact of Public Comment, and What’s Next?
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,...Read “Common Rule Revisions: Impact of Public Comment, and What’s Next?”
Bioethics Forum Essay
Human Gene Editing Report: Moving Forward Incrementally
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?Read “Human Gene Editing Report: Moving Forward Incrementally”
Bioethics Forum Essay
New Homeland Security Rules and Health Care Access for Undocumented Immigrants
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?...Read “New Homeland Security Rules and Health Care Access for Undocumented Immigrants”
Bioethics Forum Essay
Engineering Consensus in the Development of Genome Editing Policy
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....Read “Engineering Consensus in the Development of Genome Editing Policy”
Bioethics Forum Essay
A Doctor’s Dilemma: A Case of Two “Right” Answers
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...Bioethics Forum Essay
Continuing the Dialogue on Bioethics and Populism
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...Bioethics Forum Essay
Preventing Sex-Selective Abortions in America: A Solution in Search of a Problem
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...Read “Preventing Sex-Selective Abortions in America: A Solution in Search of a Problem”
Bioethics Forum Essay
The Symbolic Value of the Bioethics and Populism Debate
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...Read “The Symbolic Value of the Bioethics and Populism Debate”
Bioethics Forum Essay
Bioethics’ Best Response to Populist Polemics: Sticking to Its Roots
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...Read “Bioethics’ Best Response to Populist Polemics: Sticking to Its Roots”
Bioethics Forum Essay
How “America First” Undermines Our Health
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...Bioethics Forum Essay
A Right to Seek Payment for One’s Tissue
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...Bioethics Forum Essay
Gene Editing, “Cultural Harms,” and Oversight Mechanisms
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...Read “Gene Editing, “Cultural Harms,” and Oversight Mechanisms”
Bioethics Forum Essay
Health Reform and Competing Visions of Justice
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...Bioethics Forum Essay
Morally Indefensible Health Care Bills
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.Bioethics Forum Essay
The Value of Bioethics Against Authoritarian Populism
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...Read “The Value of Bioethics Against Authoritarian Populism”
Bioethics Forum Essay
Who “Persists” in Opposing DNR Orders? Demographics Matter
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...Read “Who “Persists” in Opposing DNR Orders? Demographics Matter”
Bioethics Forum Essay
The Climate Agreement: Understanding, and Leveraging, Public Opinion
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...Read “The Climate Agreement: Understanding, and Leveraging, Public Opinion”
Bioethics Forum Essay
The Score is Even
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...Bioethics Forum Essay
Fake News: A Role for Neuroethics?
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...Bioethics Forum Essay
Masked Marketing: Pharmaceutical Company Funding of ADHD Patient Advocacy Groups
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...Read “Masked Marketing: Pharmaceutical Company Funding of ADHD Patient Advocacy Groups”
Bioethics Forum Essay
Should We Stop Having Children?
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...Bioethics Forum Essay
Is There a Duty to Participate in Biospecimen Research?
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...Read “Is There a Duty to Participate in Biospecimen Research?”
Bioethics Forum Essay
“The Handmaid’s Tale” and Modern-Day Surrogacy
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...Bioethics Forum Essay
Charlie Gard, Compassionate Use, and Single-Payer Health Care
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...Read “Charlie Gard, Compassionate Use, and Single-Payer Health Care”
Bioethics Forum Essay
When Pat and Bob Nearly Saved Health Care Reform: A Lesson in Senatorial Bedside Manner
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...Read “When Pat and Bob Nearly Saved Health Care Reform: A Lesson in Senatorial Bedside Manner”
Bioethics Forum Essay
This Doctor Experimented on Slaves: It’s Time to Remove or Redo His Statue
“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...Read “This Doctor Experimented on Slaves: It’s Time to Remove or Redo His Statue”
Bioethics Forum Essay
Removing the Stigma from “Stigmatopin” to Help Curb Opioid Dependence
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...Read “Removing the Stigma from “Stigmatopin” to Help Curb Opioid Dependence”
Bioethics Forum Essay
What’s Truly Outrageous About Intersex?
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.”...Bioethics Forum Essay
On Sims’s Legacy: Work for Bioethics
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...Bioethics Forum Essay
Being a Good Doctor When Patients Fear Deportation: Lessons for Future Physicians
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...Read “Being a Good Doctor When Patients Fear Deportation: Lessons for Future Physicians”
Bioethics Forum Essay
International Sharing of Biological Specimens and Health Data: A Gap in the Consent Process?
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...Read “International Sharing of Biological Specimens and Health Data: A Gap in the Consent Process?”
Bioethics Forum Essay
Should We Get Ready for Prime Time?
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...Bioethics Forum Essay
Is it Ethical for Scientists to Create Nonhuman Primates with Brain Disorders?
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...Read “Is it Ethical for Scientists to Create Nonhuman Primates with Brain Disorders?”
Bioethics Forum Essay
Fix the Planet, or Change the Creatures In It?
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...Bioethics Forum Essay
A Call for Medical Students to Learn the Full Story about the “Father of Gynecology”
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...Read “A Call for Medical Students to Learn the Full Story about the “Father of Gynecology””
Bioethics Forum Essay
Do We Have a Moral Obligation to Genetically Enhance our Children?
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...Read “Do We Have a Moral Obligation to Genetically Enhance our Children?”
Bioethics Forum Essay
When Are Organ Recipients Human Research Subjects?
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...Bioethics Forum Essay
Medicine, Morals, and Female Genital Cutting
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...Bioethics Forum Essay
Ethical Supervision?
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...Bioethics Forum Essay
Cancer and Fertility: Learning from Survivors
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,...Bioethics Forum Essay
Is Noninvasive Prenatal Genetic Testing Eugenic?
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...Bioethics Forum Essay
Improving Ethics at the Bedside
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...Bioethics Forum Essay
A New Mind-Body Problem
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...Bioethics Forum Essay
After Hurricane Harvey, Injustice in Houston
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...Bioethics Forum Essay
Natural, Medical, Political Childbirth
“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....Bioethics Forum Essay
Breastfeeding and Transgender Women
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...Bioethics Forum Essay
Reproductive Freedom: The More Things Change . . .
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...Bioethics Forum Essay
Lena Dunham’s Lesson for Doctors
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...Bioethics Forum Essay
Being Poor Is a Full-Time Job
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...Bioethics Forum Essay
Businesses, Guns, and Human Rights
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...Bioethics Forum Essay
Chimpanzees: Persons or Things?
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,...Bioethics Forum Essay
Gun Violence, Shame, and Social Change
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,...Bioethics Forum Essay
“No one was listening to us.” Lessons from the Jahi McMath Case
“It was like he thought we were dirt.” This is how Jahi McMath’s grandmother, Sandra, describes having been treated by one of the doctors at the Oakland’s Children Hospital ICU....Read ““No one was listening to us.” Lessons from the Jahi McMath Case”
Bioethics Forum Essay
The Need for Open and High Quality Preclinical Science
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:...Read “The Need for Open and High Quality Preclinical Science”
Bioethics Forum Essay
Organ Donation and Transplantation in the U.S.: 50 Years of Success, Strategies for Improvement
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...Bioethics Forum Essay
Fentanyl at Your Door: Who are Pain Groups Advocating For?
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,...Read “Fentanyl at Your Door: Who are Pain Groups Advocating For?”
Bioethics Forum Essay
Evaluating Recommendations to Increase Organ Donation
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...Read “Evaluating Recommendations to Increase Organ Donation”
Bioethics Forum Essay
Palliative Care vs. Cancer Research
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...Bioethics Forum Essay
Navigating Ethics Review of Human Infection Trials With Zika
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...Read “Navigating Ethics Review of Human Infection Trials With Zika”
Bioethics Forum Essay
Should Doctors Treat Family Members?
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...Bioethics Forum Essay
Is it Time to Regulate the Sale of Sugar to Minors?
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...Bioethics Forum Essay
Might Chimpanzees Have Legal Rights?
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...Bioethics Forum Essay
Addressing Questions About DTC Genetic Tests and Privacy
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...Read “Addressing Questions About DTC Genetic Tests and Privacy”
Bioethics Forum Essay
Trumping Drug Costs
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,...Bioethics Forum Essay
The Only PhD Scientist in Congress Speaks About Truth, Politics, and Human Flourishing
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...Read “The Only PhD Scientist in Congress Speaks About Truth, Politics, and Human Flourishing”
Bioethics Forum Essay
Shocking the Conscience: Justice Department versus the Health of Immigrant Women and Children
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...Read “Shocking the Conscience: Justice Department versus the Health of Immigrant Women and Children”
Bioethics Forum Essay
Do You Want the Police Snooping in Your DNA?
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...Bioethics Forum Essay
Migrants’ Lives, Immigration Policy, and Ethics Work
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...Bioethics Forum Essay
A Single-Payer Bubble?
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...Bioethics Forum Essay
What Are the Rules for Ethical Medication of Migrant Kids?
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...Read “What Are the Rules for Ethical Medication of Migrant Kids?”
Bioethics Forum Essay
Beyond Breaking News: Ways of Seeing Migrants and Their Children
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.Read “Beyond Breaking News: Ways of Seeing Migrants and Their Children”
Bioethics Forum Essay
Social Media, Privacy, and Research: A Muddled Landscape
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...Read “Social Media, Privacy, and Research: A Muddled Landscape”
Bioethics Forum Essay
Addyi Rises Again
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...Bioethics Forum Essay
Envisioning Civic Palliative Care
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...Bioethics Forum Essay
Jahi McMath, Race, and Bioethics
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...Bioethics Forum Essay
Newspaper Op-Eds Should Disclose Authors’ Industry Ties
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...Read “Newspaper Op-Eds Should Disclose Authors’ Industry Ties”
Bioethics Forum Essay
Inside a High School Bioethics Club
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...Bioethics Forum Essay
Immigrant Health and the Moral Scandal of the “Public Charge” Rule
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...Read “Immigrant Health and the Moral Scandal of the “Public Charge” Rule”
Bioethics Forum Essay
Avoiding Dementia, Causing Moral Distress
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...Bioethics Forum Essay
Ethical Perspectives on Advance Directives for Dementia
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...Read “Ethical Perspectives on Advance Directives for Dementia”
Bioethics Forum Essay
England’s Abortion Law Catches Up
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...Bioethics Forum Essay
Wrongful Death Suits for Frozen Embryos: A Bad Idea
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...Bioethics Forum Essay
Let the Sun Shine into the Medical Ivory Tower
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,...Bioethics Forum Essay
Doping, Corruption, and International Intrigue: Olympic Sport Confronts a Moral Crisis
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...Read “Doping, Corruption, and International Intrigue: Olympic Sport Confronts a Moral Crisis”
Bioethics Forum Essay
What I Practice: Democratic Medicine
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...Bioethics Forum Essay
Old Jews
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...Bioethics Forum Essay
Three Ethical Reasons for Vaccinating your Children
Across the country, billboards are popping up suggesting that vaccines can kill children, when the science behind vaccination is crystal clear – vaccinations are extremely safe. Researchers who study the beliefs of anti-vaxxers have found many...Bioethics Forum Essay
He Jiankui’s Genetic Misadventure: Why Him? Why China?
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...Read “He Jiankui’s Genetic Misadventure: Why Him? Why China?”
Bioethics Forum Essay
CRISPR in China: Why Did the Parents Give Consent?
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...Bioethics Forum Essay
He Jiankui: A Sorry Tale of High-Stakes Science
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...Bioethics Forum Essay
He Jiankui’s Genetic Misadventure, Part 2: How Different Are Chinese and Western Bioethics?
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...Read “He Jiankui’s Genetic Misadventure, Part 2: How Different Are Chinese and Western Bioethics?”
Bioethics Forum Essay
Staying in Their Lane: Health Professionals Must Address Gun Violence
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...Read “Staying in Their Lane: Health Professionals Must Address Gun Violence”
Bioethics Forum Essay
He Jiankui’s Genetic Misadventure, Part 3: What Are the Major Ethical Issues?
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...Read “He Jiankui’s Genetic Misadventure, Part 3: What Are the Major Ethical Issues?”
Bioethics Forum Essay
Prevention Optimism: Does It Raise Ethical Questions about PrEP for HIV?
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...Read “Prevention Optimism: Does It Raise Ethical Questions about PrEP for HIV?”
Bioethics Forum Essay
Scientists Disagree About the Ethics and Governance of Human Germline Editing
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...Read “Scientists Disagree About the Ethics and Governance of Human Germline Editing”
Bioethics Forum Essay
Chinese Bioethicists Respond to the Case of He Jiankui
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...Read “Chinese Bioethicists Respond to the Case of He Jiankui”
Bioethics Forum Essay
The Hastings Center at 50: Looking Back and Ahead
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...Bioethics Forum Essay
What Dr. Seuss Saw at the Golden Years Clinic
“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...Bioethics Forum Essay
#MeToo and Health Research Ethics
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...Bioethics Forum Essay
Moratorium on Human Genome Editing: Time to Get It Right
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.Read “Moratorium on Human Genome Editing: Time to Get It Right”
Bioethics Forum Essay
Why Avoid the “M-Word” in Human Genome Editing?
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.Bioethics Forum Essay
Rationality as Understood by a Neanderthal
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?Bioethics Forum Essay
What’s Wrong with a Fertility Doctor Using His Own Sperm?
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?Read “What’s Wrong with a Fertility Doctor Using His Own Sperm?”
Bioethics Forum Essay
Caster Semenya and the Challenges of Sports Brackets
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?Bioethics Forum Essay
We Should Be Concerned About Athletes Having to ‘Dope Down’
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.Read “We Should Be Concerned About Athletes Having to ‘Dope Down’”
Bioethics Forum Essay
Religion, Suffering, and the Physician’s Role
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."Bioethics Forum Essay
Forced from Home: Evicting Immigrants from Public Housing Harms Children’s Health
The federal government's proposed rule to disqualify families from public housing if any member is undocumented will harm children, families, and cities.Read “Forced from Home: Evicting Immigrants from Public Housing Harms Children’s Health”
Bioethics Forum Essay
Should Pandora’s Brain Be Regulated?
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?Bioethics Forum Essay
Pursue Public Engagement, but Don’t Expect ‘Broad Societal Consensus’
Read “Pursue Public Engagement, but Don’t Expect ‘Broad Societal Consensus’”
Bioethics Forum Essay
Is GINA Unjust?
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.Bioethics Forum Essay
Living with Pain and Opioid Addiction: Bioethics Narratives
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.Read “Living with Pain and Opioid Addiction: Bioethics Narratives”
Bioethics Forum Essay
From Outcry to Solidarity with Migrants: What Is the Good We Can Do?
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?Read “From Outcry to Solidarity with Migrants: What Is the Good We Can Do?”
Bioethics Forum Essay
Living Good and Healthy Lives on a Changing Earth: What Should Bioethics Do?
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.Read “Living Good and Healthy Lives on a Changing Earth: What Should Bioethics Do?”
Bioethics Forum Essay
It’s Unethical to Use Dental X-Rays to Send Migrant Children to Adult Detention Facilities
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.Read “It’s Unethical to Use Dental X-Rays to Send Migrant Children to Adult Detention Facilities”
Bioethics Forum Essay
The AMA’s Apology: What’s the Benefit?
Bioethics Forum Essay
Teaching Ethics to Adolescents
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.Bioethics Forum Essay
Daniel Callahan: In Memoriam
Bioethics Forum Essay
Daniel Callahan – A Remembrance
Bioethics Forum Essay
What I Learned from Dan Callahan About Bioethics, Writing, and Leadership
Read “What I Learned from Dan Callahan About Bioethics, Writing, and Leadership”
Bioethics Forum Essay
Dan Callahan’s Final Interview
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.Bioethics Forum Essay
Live-Tweeting About Dying: Last Lessons from Kathy Brandt
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.Read “Live-Tweeting About Dying: Last Lessons from Kathy Brandt”
Bioethics Forum Essay
Why Human Germline Editing Might Never Be Legal in the U.S.
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.Read “Why Human Germline Editing Might Never Be Legal in the U.S.”
Bioethics Forum Essay
The Public Charge Rule Is a Eugenic Policy
Bioethics Forum Essay
When Might Human Germline Editing Be Justified?
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.Bioethics Forum Essay
Justice for Survivors of Sexual Assault
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.Bioethics Forum Essay
Diving Deeper into Amazon Alexa’s HIPAA Compliance
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.Bioethics Forum Essay
Hannah Arendt in St. Peter’s Square
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?Bioethics Forum Essay
Citizen Science: Potential Benefits and Ethical Challenges
Read “Citizen Science: Potential Benefits and Ethical Challenges”
Bioethics Forum Essay
Immigrant DNA Collection: Fighting Crime or Moral Panic
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.Read “Immigrant DNA Collection: Fighting Crime or Moral Panic”
Bioethics Forum Essay
Not-So-Golden Years for NIH’s Retired Chimpanzees
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.Bioethics Forum Essay
What Is Ethical Eating in the Age of Climate Change?
Are we ethically obliged to eat less meat? Bioethicists consider that question, and their role in addressing it.Bioethics Forum Essay
Consider the Mouse
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.Bioethics Forum Essay
Quixote Reimagined: Magical Realism Meets the Opioid Epidemic
Read “Quixote Reimagined: Magical Realism Meets the Opioid Epidemic”
Bioethics Forum Essay
Chinese Bioethicists: He Jiankui’s Crime is More than Illegal Medical Practice
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.Read “Chinese Bioethicists: He Jiankui’s Crime is More than Illegal Medical Practice”
Bioethics Forum Essay
Transcending Borders in the Ethical Oversight of Human Genome Editing
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.Read “Transcending Borders in the Ethical Oversight of Human Genome Editing”
Bioethics Forum Essay
What’s Wrong with Virginity Testing?
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.Bioethics Forum Essay
To Restore Humanity in Health Care, Address Clinician Burnout
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.Read “To Restore Humanity in Health Care, Address Clinician Burnout”
Bioethics Forum Essay
An Incoherent Proposal to Revise the Uniform Determination of Death Act
Read “An Incoherent Proposal to Revise the Uniform Determination of Death Act”
Bioethics Forum Essay
A Responsible Death
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.Bioethics Forum Essay
Revising the Uniform Determination of Death Act: Response to Miller and Nair-Collins
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.Read “Revising the Uniform Determination of Death Act: Response to Miller and Nair-Collins”
Bioethics Forum Essay
Report from China: Ethical Questions on the Response to the Coronavirus
Hastings Center fellows in China discuss ethical questions about the response to the spreading coronavirus.Read “Report from China: Ethical Questions on the Response to the Coronavirus”
Bioethics Forum Essay
Why Health Care Organizations Need Technology Ethics Committees
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.Read “Why Health Care Organizations Need Technology Ethics Committees”
Bioethics Forum Essay
Deciding When Enough is Enough in Providing Life-Sustaining Treatment for a Child
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.Read “Deciding When Enough is Enough in Providing Life-Sustaining Treatment for a Child”
Bioethics Forum Essay
Chinese Bioethicists: Silencing Doctor Impeded Early Control of Coronavirus
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.Read “Chinese Bioethicists: Silencing Doctor Impeded Early Control of Coronavirus”
Bioethics Forum Essay
Globalized Science in a Deglobalizing World
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.Bioethics Forum Essay
Who Decides? Medical Intervention for Transgender and Intersex Children
Read “Who Decides? Medical Intervention for Transgender and Intersex Children”
Bioethics Forum Essay
Immigrant Health in the Public Charge Era: 15 Essential Articles
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.Read “Immigrant Health in the Public Charge Era: 15 Essential Articles”
Bioethics Forum Essay
Health Care for Obesity and Eating Disorders: What Needs to Change
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.Read “Health Care for Obesity and Eating Disorders: What Needs to Change”
Bioethics Forum Essay
When Endemic Disparities Catch the Pandemic Flu: Echoes of Kubler-Ross and Rawls
Read “When Endemic Disparities Catch the Pandemic Flu: Echoes of Kubler-Ross and Rawls”
Bioethics Forum Essay
Coronavirus Response Is Insufficient for Vulnerable New Yorkers
Read “Coronavirus Response Is Insufficient for Vulnerable New Yorkers”
Bioethics Forum Essay
Coronavirus and the Crisis of Trust
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.Bioethics Forum Essay
COVID: Collective of Voices in Distress
Bioethics Forum Essay
COVID-19 and the Global Ethics Freefall
Since the initial outbreak in Wuhan last December, the national and global responses to COVID-19 have been in ethics freefall.Bioethics Forum Essay
Flattening the Curve, Then What?
Bioethics Forum Essay
We Need International Medical Graduates to Help Fight Covid-19. Immigration Policies Keep Them Away
Bioethics Forum Essay
Crowdfunding for Covid-Related Needs: Unfair and Inadequate
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.Read “Crowdfunding for Covid-Related Needs: Unfair and Inadequate”
Bioethics Forum Essay
Disabusing the Disability Critique of the New York State Task Force Report on Ventilator Allocation
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.Bioethics Forum Essay
Do New York State’s Ventilator Allocation Guidelines Place Chronic Ventilator Users at Risk? Clarification Needed
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.Bioethics Forum Essay
The Price of Going Back to Work Too Soon
Bioethics Forum Essay
New York State Task Force on Life and the Law Ventilator Allocation Guidelines: How Our Views on Disability Evolved
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.Bioethics Forum Essay
Why I Support Age-Related Rationing of Ventilators for Covid-19 Patients
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.Read “Why I Support Age-Related Rationing of Ventilators for Covid-19 Patients”
Bioethics Forum Essay
When It Comes to Rationing, Disability Rights Law Prohibits More than Prejudice
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.Read “When It Comes to Rationing, Disability Rights Law Prohibits More than Prejudice”
Bioethics Forum Essay
On Being an Elder in a Pandemic
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.Bioethics Forum Essay
U.S. and Canada: Being Good Neighbors in the Pandemic
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.Read “U.S. and Canada: Being Good Neighbors in the Pandemic”
Bioethics Forum Essay
Ethics and Evidence in the Search for a Vaccine and Treatments for Covid-19
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.Read “Ethics and Evidence in the Search for a Vaccine and Treatments for Covid-19”
Bioethics Forum Essay
Please Don’t (Need to) Use My Work
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.Bioethics Forum Essay
Structural Racism, White Fragility, and Ventilator Rationing Policies
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.Read “Structural Racism, White Fragility, and Ventilator Rationing Policies”
Bioethics Forum Essay
Denying Ventilators to Covid-19 Patients with Prior DNR Orders is Unethical
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.Read “Denying Ventilators to Covid-19 Patients with Prior DNR Orders is Unethical”
Bioethics Forum Essay
The Covid Threat No One Is Talking About: Wearing Scrubs in Public
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.Read “The Covid Threat No One Is Talking About: Wearing Scrubs in Public”
Bioethics Forum Essay
Immigrants, Health Inequities, and Social Citizenship in Covid-19 Response and Recovery
Read “Immigrants, Health Inequities, and Social Citizenship in Covid-19 Response and Recovery”
Bioethics Forum Essay
Religion During the Coronavirus Pandemic: Islamic Bioethical Perspectives
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.Read “Religion During the Coronavirus Pandemic: Islamic Bioethical Perspectives”
Bioethics Forum Essay
When to Reopen the Nation is an Ethics Question—Not Only a Scientific One
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?Read “When to Reopen the Nation is an Ethics Question—Not Only a Scientific One”
Bioethics Forum Essay
Clinical Trials vs. Right to Try: Ethical Use of Chloroquine for Covid-19
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.Read “Clinical Trials vs. Right to Try: Ethical Use of Chloroquine for Covid-19”
Bioethics Forum Essay
Ethical Responsibility in Publishing Research Results on Covid-19 Treatments
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.Read “Ethical Responsibility in Publishing Research Results on Covid-19 Treatments”
Bioethics Forum Essay
Ethical Medicine Means Getting Political
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.Bioethics Forum Essay
Show Me Your Passport: Ethical Concerns About Covid-19 Antibody Testing as Key to Reopening Public Life
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. .Bioethics Forum Essay
Teaching Medical Ethics During the Pandemic
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.Bioethics Forum Essay
Sustaining Clinical Empathy During the Pandemic
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.Bioethics Forum Essay
Why Health Care Workers Should Receive Priority Care for Covid-19
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.Read “Why Health Care Workers Should Receive Priority Care for Covid-19”
Bioethics Forum Essay
Diversity and Solidarity in Response to Covid-19
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.Bioethics Forum Essay
A Covid-19 Side Effect: Virulent Resurgence of Ageism
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.Read “A Covid-19 Side Effect: Virulent Resurgence of Ageism”
Bioethics Forum Essay
#WeAreEssential: Why Disabled People Should Be Appointed to Hospital Triage Committees
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.Read “#WeAreEssential: Why Disabled People Should Be Appointed to Hospital Triage Committees”
Bioethics Forum Essay
Why I Don’t Support Age-Related Rationing During the Covid Pandemic
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.Read “Why I Don’t Support Age-Related Rationing During the Covid Pandemic”
Bioethics Forum Essay
Beyond the Covid Crisis—A New Social Contract with Public Health
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.Read “Beyond the Covid Crisis—A New Social Contract with Public Health”
Bioethics Forum Essay
Post-Covid Bioethics
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?Bioethics Forum Essay
Report from Sub-Saharan Africa: “When the Health Fundamentals Are Weak, Covid Will Expose You.”
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.Bioethics Forum Essay
Covid-19 Underscores Racial Disparity in Advance Directives
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.Read “Covid-19 Underscores Racial Disparity in Advance Directives”
Bioethics Forum Essay
Lessons from Covid-19: Why Treating Sick Patients is Bad Business for Hospitals
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.Read “Lessons from Covid-19: Why Treating Sick Patients is Bad Business for Hospitals”
Bioethics Forum Essay
Clinicians Have a Moral Duty to Care for All Patients–Including Lockdown Protesters
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.Read “Clinicians Have a Moral Duty to Care for All Patients–Including Lockdown Protesters”
Bioethics Forum Essay
Warp Speed Bioethics
It takes less time than ever to publish papers. But is quality sacrificed by doing bioethics at warp speed, especially during the Covid pandemic?Bioethics Forum Essay
Bioethics and Black Lives: A Call for Bioethics to Speak Against Racial Injustice
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.Read “Bioethics and Black Lives: A Call for Bioethics to Speak Against Racial Injustice”
Bioethics Forum Essay
Prioritize Health Care Workers for Ventilators? Not So Fast
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.Read “Prioritize Health Care Workers for Ventilators? Not So Fast”
Bioethics Forum Essay
Individual Freedom or Public Health? A False Choice in the Covid Era
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?Read “Individual Freedom or Public Health? A False Choice in the Covid Era”
Bioethics Forum Essay
Measure Twice and Cut Once: The Value of Health Care Ethicists in the Pandemic
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.Read “Measure Twice and Cut Once: The Value of Health Care Ethicists in the Pandemic”
Bioethics Forum Essay
Committing to Fight Racism
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.Bioethics Forum Essay
Human Challenge Studies for Covid-19 Vaccine: Questions about Benefits and Risks
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?Read “Human Challenge Studies for Covid-19 Vaccine: Questions about Benefits and Risks”
Bioethics Forum Essay
“You Can See Your Loved One Now.” Can Visitor Restrictions During Covid Unduly Influence End-of-Life Decisions?
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.Bioethics Forum Essay
After the Surge: Prioritizing the Backlog of Delayed Hospital Procedures
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?Read “After the Surge: Prioritizing the Backlog of Delayed Hospital Procedures”
Bioethics Forum Essay
Bringing Ethics into the Global Coronavirus Response
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.Bioethics Forum Essay
“If the virus doesn’t kill us, the stress and anxiety will.” Immigrants during Covid
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.Read ““If the virus doesn’t kill us, the stress and anxiety will.” Immigrants during Covid”
Bioethics Forum Essay
Cracks in the System: Lessons Learned from the Covid-19 Pandemic
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.Read “Cracks in the System: Lessons Learned from the Covid-19 Pandemic”
Bioethics Forum Essay
Accepting the Challenge: Covid Vaccine Challenge Trials Can Be Ethically Justified
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.Read “Accepting the Challenge: Covid Vaccine Challenge Trials Can Be Ethically Justified”
Bioethics Forum Essay
Social-Change Games Can Help Us Understand the Public Health Choices We Face
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.Read “Social-Change Games Can Help Us Understand the Public Health Choices We Face”
Bioethics Forum Essay
Using the Pandemic as an Excuse to Limit Abortion
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.Bioethics Forum Essay
Ethicists as a Force for Institutional Change and Policies to Promote Equality
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.Read “Ethicists as a Force for Institutional Change and Policies to Promote Equality”
Bioethics Forum Essay
Before We Turn to Digital Contact Tracing for Covid, Remember Surveillance in the Sixties
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.Read “Before We Turn to Digital Contact Tracing for Covid, Remember Surveillance in the Sixties”
Bioethics Forum Essay
Pandemic Language
Bioethics Forum Essay
On Being a Foster Parent During Covid
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.Bioethics Forum Essay
The Americans with Disabilities Act at 30: A Cause for Celebration During Covid-19?
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.Read “The Americans with Disabilities Act at 30: A Cause for Celebration During Covid-19?”
Bioethics Forum Essay
Lawsuits of Last Resort: Employees Fight for Safe Workplaces during Covid-19
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.Read “Lawsuits of Last Resort: Employees Fight for Safe Workplaces during Covid-19”
Bioethics Forum Essay
Against Personal Ventilator Reallocation
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.Bioethics Forum Essay
When Less-Lethal Weapons Are Lethal: Medicine’s Role in Police Brutality
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.Read “When Less-Lethal Weapons Are Lethal: Medicine’s Role in Police Brutality”
Bioethics Forum Essay
Black Bioethics and How the Failures of the Profession Paved the Way for Its Existence
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.Read “Black Bioethics and How the Failures of the Profession Paved the Way for Its Existence”
Bioethics Forum Essay
Is the Coronavirus Pandemic Accelerating Bioethics Nationalism?
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.Read “Is the Coronavirus Pandemic Accelerating Bioethics Nationalism?”
Bioethics Forum Essay
Hacking Ventilators in a Pandemic
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?Bioethics Forum Essay
Did Russia’s Most Influential Bioethicist Get a Coronavirus Vaccine?
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?Read “Did Russia’s Most Influential Bioethicist Get a Coronavirus Vaccine?”
Bioethics Forum Essay
Covid-19 and Deafness: Why the Protocols Fall Short
I am hard-of-hearing; I wear two hearing aids, and Covid-19 has made all forms of human interaction extraordinarily difficult.Bioethics Forum Essay
Are Physicians Hypocrites for Supporting Black Lives Matter Protests and Opposing Anti-Lockdown Protests? An Ethical Analysis
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?Bioethics Forum Essay
We Can’t Forget the Nation’s Other Epidemic
Covid isn’t merely overshadowing the drug overdose crisis—it’s directly worsening it.Bioethics Forum Essay
Fair Compensation for Rare Vaccine Harms
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.Bioethics Forum Essay
Living through the Pandemic in New Zealand
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.”Bioethics Forum Essay
Black Women Can’t Breathe
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.Bioethics Forum Essay
Volunteering for a Covid Vaccine Trial: Fulfilling Hindu Obligations or Fostering Pharmaceutical Company Profits?
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.COVID-19
Could the Common Cold Help Stop Covid-19? We Need to Know–Now.
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.Read “Could the Common Cold Help Stop Covid-19? We Need to Know–Now.”
Bioethics Forum Essay
Fox, Bosk, and Rothman: An Appreciation of Three Scholars of Medicine
Read “Fox, Bosk, and Rothman: An Appreciation of Three Scholars of Medicine”
Bioethics Forum Essay
Amid the Pandemic and Racial Injustice, Greater Empathy in Medical School
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.Read “Amid the Pandemic and Racial Injustice, Greater Empathy in Medical School”
Bioethics Forum Essay
Caring for My First Neo-Nazi Patient
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?Bioethics Forum Essay
Detention, Dignity, and a Call for Bioethics Advocacy
Read “Detention, Dignity, and a Call for Bioethics Advocacy”
Bioethics Forum Essay
A Historic Intersex Awareness Day
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.Bioethics Forum Essay
Ethics of Placebo Controls in Coronavirus Vaccine Trials
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?Read “Ethics of Placebo Controls in Coronavirus Vaccine Trials”
Bioethics Forum Essay
Ethics of Emergency Use Authorization During the Pandemic
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.Read “Ethics of Emergency Use Authorization During the Pandemic”
Bioethics Forum Essay
The Balloon, the Bicycle, and Al Jonsen
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.”Bioethics Forum Essay
The Ethics of Treating the President
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.Bioethics Forum Essay
Humanity on the Brink: Narratives of Caregiving and Dementia
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."Read “Humanity on the Brink: Narratives of Caregiving and Dementia”
Bioethics Forum Essay
Three Lessons from Leah
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.Bioethics Forum Essay
Human Plasma and Bioethics Nationalism
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.Bioethics Forum Essay
A Narrow Path for Optimism that Social Genomics Can Combat Inequality
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.Read “A Narrow Path for Optimism that Social Genomics Can Combat Inequality”
Bioethics Forum Essay
Resisting Public Health Measures, Then and Now
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?Bioethics Forum Essay
Bioethics, Nazi Analogies, and the Coronavirus Pandemic
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.”Read “Bioethics, Nazi Analogies, and the Coronavirus Pandemic”
Bioethics Forum Essay
Global Allocation of Coronavirus Vaccines
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.Bioethics Forum Essay
Prioritizing the “1a”: Ethically Allocating Scarce Covid Vaccines to Health Care Workers
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?Read “Prioritizing the “1a”: Ethically Allocating Scarce Covid Vaccines to Health Care Workers”
Bioethics Forum Essay
Tribute to Robert M. Veatch: Human Rights and Other Commitments
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.Read “Tribute to Robert M. Veatch: Human Rights and Other Commitments”
Bioethics Forum Essay
Coronavirus Mutation Panic
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?Bioethics Forum Essay
Ashamed to Be Vaccinated? The Ethics of Health Care Employees Forgoing Unfair Priority
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?Read “Ashamed to Be Vaccinated? The Ethics of Health Care Employees Forgoing Unfair Priority”
Bioethics Forum Essay
Masks Are Not Created Equal
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.Bioethics Forum Essay
The Bioethics of Built Health Care Spaces
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.Bioethics Forum Essay
Motivated Ignorance: A Challenge for Science Communication and Democracy
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.Read “Motivated Ignorance: A Challenge for Science Communication and Democracy”
Bioethics Forum Essay
Surprising Surge of Egg Freezing during the Pandemic Raises Ethical Questions
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.Read “Surprising Surge of Egg Freezing during the Pandemic Raises Ethical Questions”
Bioethics Forum Essay
Ethics Supports Seeking Population Immunity, Not Immunizing Priority Groups
Vaccine allocation guidelines that prioritize people at greatest risk of Covid-19 require considerable administrative work (sometimes taking weeks). This is creating a bottleneck that has resulted in doses stuck in freezers not in arms. There's a better, more ethical way to allocate vaccines.Read “Ethics Supports Seeking Population Immunity, Not Immunizing Priority Groups”
Bioethics Forum Essay
Efficacy is Relative in a Public Health Crisis: Evaluating the Next Wave of Covid-19 Vaccines
A third Covid vaccine candidate moving closer to potential FDA authorization is less effective than the two Covid vaccines already authorized in the United States. Is it ethical to offer a vaccine with lower efficacy? Is it ethical not to offer it in a public health emergency?Read “Efficacy is Relative in a Public Health Crisis: Evaluating the Next Wave of Covid-19 Vaccines”
Bioethics Forum Essay
Should Covid Vaccination Schedules Deviate from the Status Quo–as a Last Resort?
Last month, with concerns over the supply and coordinated administration of coronavirus vaccines escalating, the Centers for Disease Control and Prevention conceded that “any available mRNA COVID-19 vaccine” may be used to complete vaccination in “exceptional situations” preventing multi-dose manufacturer matching. While presented solely as a last resort, this guidance reflects a dilemma currently sweeping across the medical and health policy worlds: given limited supply, should vaccination efforts—still only authorized for emergency use in this country—deviate from evidence-driven, studied regimens to maximize individuals reached?Read “Should Covid Vaccination Schedules Deviate from the Status Quo–as a Last Resort?”
Bioethics Forum Essay
Islamic Ethics, Covid-19 Vaccination, and the Concept of Harm
Vaccine hesitancy is a concern around the world, but negative attitudes among Muslims in particular toward some coronavirus vaccines have been the focus of attention in the media. Some scholars in Asia recently issued fatwa against the Chinese Covid-19 vaccine. Media coverage has characterized the Muslim world as a hotspot for vaccine hesitancy, but experts point out biases in this coverage and explain the underlying reasons.Read “Islamic Ethics, Covid-19 Vaccination, and the Concept of Harm”
Bioethics Forum Essay
Deceptive Market Practices in the Marketplace of Ideas
Over the last four decades, conservative think tanks such as the Heritage Foundation, American Enterprise Institute, Cato Institute, Competitive Enterprise Institute, Hoover Institute, and Manhattan Institute have dominated the public...Read “Deceptive Market Practices in the Marketplace of Ideas”
Bioethics Forum Essay
Science in the Biden White House: Eric Lander, Alondra Nelson, and the Legacy of Lewis Thomas
Science has replaced populism in the White House. For the first time, the president's science advisor will be elevated to cabinet rank. There are other good omens, as well.Read “Science in the Biden White House: Eric Lander, Alondra Nelson, and the Legacy of Lewis Thomas”
Bioethics Forum Essay
Bruce Springsteen: The Latest Celebrity DWI
It was especially disappointing to read about Bruce Springsteen’s recent arrest for suspicion of driving while intoxicated (DWI). Here's hoping the famous rocker will use his arrest to refocus attention on a risky and dangerous behavior that is thoroughly preventable.Bioethics Forum Essay
TV Show Depicts Racism in Medicine
The television show The Good Doctor has always focused on issues of diversity and inclusion in medicine from its storylines to its casting. This week’s episode “Irresponsible Salad Bar Practices”...Bioethics Forum Essay
Vaccine Hesitancy Is No Excuse for Systemic Racism
Fewer vaccines are going to Black people. While it’s easy to fall back on vaccine hesitancy as an excuse, systemic racism is to blame.Bioethics Forum Essay
Regulation of Software as a Medical Device: Opportunity for Bioethics
In January, right before President Biden took office, the Food and Drug Administration proposed permanently exempting “software as a medical device” from regulatory review. The agency waived the approval process last year to streamline regulatory oversight during the Covid emergency. But the growing use of artificial intelligence programs and digital devices in health care raises safety and ethical concerns that require more attention. The Biden administration put the proposal on hold for now. Meanwhile, bioethicists should weigh in as the FDA reviews its action plan.Read “Regulation of Software as a Medical Device: Opportunity for Bioethics”
Bioethics Forum Essay
Why We Need a Covid-19 Commission
Congress recently announced plans for an independent commission to investigate the facts and causes of the January 6 insurrection at the U.S. Capitol. This 1/6 Commission is to be modelled after the 9/11 Commission. A national commission to investigate the disaster that the Covid-19 virus has caused in America must also be launched.Bioethics Forum Essay
Working Around the System: Vaccine Navigators and Vaccine Equity
Vaccine navigators have emerged as a response to the complexity of mass vaccination for Covid-19.Read “Working Around the System: Vaccine Navigators and Vaccine Equity”
Bioethics Forum Essay
Undocumented Immigrants and Covid-19 Vaccination
Willingness to be vaccinated is not the only factor that may reduce vaccination rates. Fear is a powerful deterrent for individuals in hidden populations, especially undocumented immigrants. Even if their work or other circumstances place them at high risk of infection, many would be unlikely to risk the consequences of coming forward to be vaccinated.Bioethics Forum Essay
Covid-19 Vaccination Certificates: Prospects and Problems
Now, with limited distribution of vaccines with varying degrees of efficacy there is renewed interest in immunity passports; more accurately described as vaccination certificates. What remains to be determined is who may use this documentation for what purpose.Read “Covid-19 Vaccination Certificates: Prospects and Problems”
Bioethics Forum Essay
How to Make It Right: Covid Reparations
Reparations in various forms of compensation to the American victims of preventable Covid, who may experience lifelong health effects, is obligatory.Bioethics Forum Essay
Making Vaccine Appointments Is Tearing Us Apart
The Covid-19 vaccine rollout is currently a hub of individual, sociopolitical, and ethical activity. As we watch the numbers of daily doses administered rising, we may feel engaged in a...Bioethics Forum Essay
Surrogate Decision-Making for Incarcerated Patients: A Pandemic-Inspired Call to Action
As Covid-19 continues to plague the United States, insufficient attention has been paid to the role that incarcerated persons play in the persistence of this pandemic and the work that...Read “Surrogate Decision-Making for Incarcerated Patients: A Pandemic-Inspired Call to Action”
Bioethics Forum Essay
Thinking Beyond “The Border”: American Bioethics and the Repair of U.S. Immigration Policy
How should the American bioethics community respond to the latest “crisis at the border,” focused on record numbers of unaccompanied minors – children and teenagers traveling from the Northern Triangle...Read “Thinking Beyond “The Border”: American Bioethics and the Repair of U.S. Immigration Policy”
Bioethics Forum Essay
A Doctor Confronts the Burden of Judgment during the Pandemic
Is it wrong for doctors to judge their patients’ choices? I have reflected on this question while being on the frontline of the Covid-19 pandemic in New York City. Health...Read “A Doctor Confronts the Burden of Judgment during the Pandemic”
Bioethics Forum Essay
Too Taboo to Contemplate? Refusing Covid Vaccination for Some People with Dementia
There are a whole lot of us who think that, if we had dementia and were unable to live independently, we would prefer death. The idea that someone suffering from dementia and confined to a nursing home might actually welcome death is apparently so taboo that it cannot be openly contemplated.Read “Too Taboo to Contemplate? Refusing Covid Vaccination for Some People with Dementia”
Bioethics Forum Essay
WHO-China Report on Covid: Important Step Forward, More to Be Done
The World Health Organization recently released a long-anticipated report on SARS-CoV-2 origins, based on 28 days of field research and site visits in China conducted jointly by 17 international and...Read “WHO-China Report on Covid: Important Step Forward, More to Be Done”
Bioethics Forum Essay
Beyond “Just Sign Here”–A New Model of Consent for Primary Care
The practice of informed consent in clinical medicine is broken. Globally, the process varies widely, and even in the United States informed consent looks little like the formal, legal, autonomy-based...Read “Beyond “Just Sign Here”–A New Model of Consent for Primary Care”
Bioethics Forum Essay
Vaccinated and Still Isolated: The Ethics of Overprotecting Nursing Home Residents
The pandemic is not over, but light is beginning to crest the horizon. Vaccination rates, especially among older adults and their caregivers, are rising. As we begin to relax physical...Read “Vaccinated and Still Isolated: The Ethics of Overprotecting Nursing Home Residents”
Bioethics Forum Essay
Exhortations to Trust Biomedical Experts: What’s Missing?
Disagreements among biomedical experts regarding whether the scientific evidence supports delaying the second shot of Covid-19 vaccines or pausing the AstraZeneca and Johnson & Johnson vaccines because of very rare side effects bring to the fore missing aspects in exhortations to trust biomedical experts.Read “Exhortations to Trust Biomedical Experts: What’s Missing?”
Bioethics Forum Essay
Covid-19 Vaccine Hesitancy in Rural Communities? Checking Our Assumptions
As access to vaccines increases, the popular press reports waning demand for vaccines in rural residents and points to vaccine hesitancy. But there may be other reasons why doses distributed to rural areas remain unclaimed.Read “Covid-19 Vaccine Hesitancy in Rural Communities? Checking Our Assumptions”
Bioethics Forum Essay
After the Anniversary of Covid, Reckoning with Many New Normals
Anniversaries are complicated. In rehabilitation psychology, the anniversary of an accident that caused a brain or spinal cord injury can be a time for profound gratitude and for grief. Now that we have passed the one-year anniversary of the Covid pandemic, each of us continues to deal with the repercussions and wondering what the "new normal" may look like.Read “After the Anniversary of Covid, Reckoning with Many New Normals”
Bioethics Forum Essay
Should We Enroll Our Child in a Covid-19 Vaccine Trial?
My partner and I are thinking a lot about this question. Moderna and Pfizer trials are running in our community–at the children’s hospital where I work as a clinical ethicist....Read “Should We Enroll Our Child in a Covid-19 Vaccine Trial?”
Bioethics Forum Essay
Ethical Challenges in Discharge Planning
Millions of patients are discharged from hospitals each year, but the individual and systemic forces that shape discharge planning and care transitions frequently lead to “failures that compromise patient health and well-being.”Bioethics Forum Essay
U.S. Organ Donation Needs Better Oversight, but New Rule Will Not Help
More than 100,000 people in this country are waiting for a life-saving transplant and on average 30 people die each day while waiting. The nonprofit organizations responsible for coordinating organ transplants between donors and recipient could be doing more to lower these numbers. A new government proposal designed to more closely regulate OPOs could, in some respects, actually make the situation worse.Read “U.S. Organ Donation Needs Better Oversight, but New Rule Will Not Help”
Bioethics Forum Essay
Nope. A Covid-19 Travel Pass isn’t Just like the Yellow Card.
Citing the Yellow Card as precedent for Covid-19 travel passes that exempt those with proof of vaccination from testing and quarantine mandates when crossing certain borders is an erroneous policy assumption that could prolong the pandemic and imperil global health.Read “Nope. A Covid-19 Travel Pass isn’t Just like the Yellow Card.”
Bioethics Forum Essay
C.D.C.’s Latest Mask Guidance: Science, Politics, and Public Health
The C.D.C.'s latest policy guidance that people who have been fully vaccinated against the coronavirus virus no longer need to wear face masks indoors gets the science right, but policymaking wrong.Read “C.D.C.’s Latest Mask Guidance: Science, Politics, and Public Health”
Bioethics Forum Essay
Covid-19 in Argentina and the Abuse of Bioethics
Many Latin American countries are being devastated by excessive loss of life from Covid-19, many sectors of society falling below the poverty line, and health systems being overwhelmed. As collateral damage, some countries in the region are witnessing an eruption of populism and autocratic trends and an increasing erosion of already weak and unstable democracies. Can bioethics be a useful tool for managing this crisis? Argentina provides a case study.Bioethics Forum Essay
Instead of Vaccine Passports, Let’s Push for Global Justice in Vaccine Access
In Costa Rica, where I live, only 24% of the population has received at least one vaccine dose because we have received very small amounts of vaccines. The Costa Rican president suggested that every person who can travel to the U.S. to get the jab, should do it. Vaccine tourism, then, seems to be another promising business opportunity for the powerful countries that have accumulated vaccines instead of redistributing them soon and fairly.Read “Instead of Vaccine Passports, Let’s Push for Global Justice in Vaccine Access”
Bioethics Forum Essay
With Legal Challenges to Abortion, Whither Prenatal Diagnosis?
Changes in abortion law threaten to undermine a major benefit of prenatal diagnosis, namely the ability of pregnant women to choose whether or not to continue their pregnancies upon learning of a serious fetal condition.Read “With Legal Challenges to Abortion, Whither Prenatal Diagnosis?”
Bioethics Forum Essay
Covid Vaccine Patent Waivers are for Health Sovereignty
The United States, Russia, and China support temporary patent waivers for Covid vaccines. The waivers, which need support from other countries, would likely save lives in low- and middle-income countries.Read “Covid Vaccine Patent Waivers are for Health Sovereignty”
Bioethics Forum Essay
Rugged American Individualism is a Myth, and It’s Killing Us
The American myth of rugged individualism, which often means “pulling yourself up by your own bootstraps,” is outdated, was never completely accurate. It is on full display during the coronavirus pandemic, contributing to cases and deaths.Read “Rugged American Individualism is a Myth, and It’s Killing Us”
Bioethics Forum Essay
Human Embryo Research Beyond 14 Days? International Perspectives
In late May, an international organization eliminated a 40-year prohibition against human embryo research beyond 14 days. The legal and scientific consequences will vary around the world.Read “Human Embryo Research Beyond 14 Days? International Perspectives”
Bioethics Forum Essay
What a Bad Day Science Had
June 7, 2021, was a bad day for science. That was the day Food and Drug Administration approved aducanumab for the treatment of Alzheimer’s disease, even though a committee of its own selected experts recommended strongly against approval.Bioethics Forum Essay
Would I Give Aducanumab to My Mother?
Aducanumab has just been approved by the Food and Drug Administration to slow the progress of Alzheimer’s disease. It is likely that many people who are candidates for the drug will no longer be competent to make their own health care decisions, and will be relying heavily on others to make the decision with them or for them. As a layperson, how would I evaluate the risks and benefits of this drug, were I acting as a health care proxy for someone with Alzheimer’s disease?Bioethics Forum Essay
Kidney Donors Should Be Treated Like Philanthropists, Not Like Vendors
Several years ago, one of us decided to donate a kidney to someone who needed one. She didn’t anticipate the difficulties that would arise from the process by which donors are evaluated.Read “Kidney Donors Should Be Treated Like Philanthropists, Not Like Vendors”
Bioethics Forum Essay
Revising the Legal Standard for Determining Death
In recent years, court cases and scholarly articles have increasingly highlighted discrepancies between the legal definition of death in the United States and the medical diagnostic standards for determining brain death. It has become clear to many that the 40-year-old Uniform Determination of Death Act, the legal standard, should be updated.Bioethics Forum Essay
Quality of Life? Suffering? Covid-19 Intensifies Challenges in Discussing Life-Sustaining Treatment
The pandemic magnified the inherent difficulty and stress of conversations involving life-sustaining treatment by forcing clinicians and patients to engage in life-altering discussions via telephone and video conference, restricting nonverbal communication and eye contact, and eliminating the benefit of simply having another person nearby in time of crisis.Bioethics Forum Essay
New Regulation for Organ Procurement Will Improve Equity and Save Lives
In the more than 35 years since federal legislation created organ procurement organizations (OPOs) to recover organs from deceased donors for transplantation, there has been a disparity in their performance,...Read “New Regulation for Organ Procurement Will Improve Equity and Save Lives”
Bioethics Forum Essay
Covid Doesn’t Justify Cutting Corners on Medical Interpretation
Many hospitals are providing incomplete or subpar professional medical interpretation to the patients who need it--many of whom are disproportionately affected by Covid.Read “Covid Doesn’t Justify Cutting Corners on Medical Interpretation”
Bioethics Forum Essay
The Great Leap Backward
The government and many residents of the state of Texas like to brag about their love of personal freedom and individual choice. That is why it is so strange and morally repugnant that the state has turned for guidance on how to manage reproductive decisions to the Chinese Communist Party of the Mao Zedong era.Bioethics Forum Essay
Bioethics Must Resist Attacks on Critical Race Theory
It would be easy for bioethicists, to ignore attacks on critical race theory—not in our wheelhouse, too politically charged, and so on. But the attacks on CRT are squarely relevant to our work.Read “Bioethics Must Resist Attacks on Critical Race Theory”
Bioethics Forum Essay
A Student’s Perspective: Universities Must Require Vaccination
Colleges and universities have an ethical obligation to mandate covid vaccines to protect the health and futures of both their students and the larger communities, in addition to promoting equality through education.Read “A Student’s Perspective: Universities Must Require Vaccination”
Bioethics Forum Essay
What Every Prospective Living Kidney Donor Should Know
There is a growing call for the lifetime risk of living kidney donation to be disclosed to prospective donors. This information is essential for informed consent.Read “What Every Prospective Living Kidney Donor Should Know”
Bioethics Forum Essay
Vaccine Mandates for Health Care Workers Raise Several Ethical Dilemmas
The moral justification for mandating covid vaccination for health care workers is clear. But what happens if some health care workers still refuse to be vaccinated, and there aren't enough vaccinated staff to care for all the patients in a hospital?Read “Vaccine Mandates for Health Care Workers Raise Several Ethical Dilemmas”
Bioethics Forum Essay
The FDA and the Moral Distinction Between Killing and Letting Die
Why is the FDA dragging its feet in approving Covid vaccines for children under 12? Justifications lack moral weight.Read “The FDA and the Moral Distinction Between Killing and Letting Die”
Bioethics Forum Essay
Parents, Covid, and Trauma-Informed Choices
As the parent of a child under 5 years old, I am worried about what lies ahead for kids and Covid-19. The more contagious Delta variant is widely circulating, infecting...Bioethics Forum Essay
Fear of Doing Too Much Too Soon or Too Little Too Late: Research on Covid-19
The Covid-19 pandemic has significantly affected the practice of clinical research. Researchers and IRBs have felt an urgency to respond more quickly than usual, aware that lives are at stake.Read “Fear of Doing Too Much Too Soon or Too Little Too Late: Research on Covid-19”
Bioethics Forum Essay
Should Covid Vaccination Status Be Used to Make Triage Decisions?
As the Covid-19 pandemic continues to strain health systems’ capacity to provide adequate care for critically ill patients, should patients’ vaccination status be considered in making triage decisions? This question sparked debate recently after the leak of an internal memo of the North Texas Mass Critical Care Guideline Task Force that proposed using patients’ Covid-19 vaccination status as a factor to assign intensive care beds.Read “Should Covid Vaccination Status Be Used to Make Triage Decisions?”
Bioethics Forum Essay
Love Thy Neighbor as Thyself: Building Community During Covid
The opposition to mask and vaccine mandates transcends the issue of individual liberty.Read “Love Thy Neighbor as Thyself: Building Community During Covid”
Bioethics Forum Essay
Public Reason, Public Schools, and Mask Mandates
In South Carolina, where I live, we are not just ignoring good arguments, but actually legislating on the basis of bad ones. The budget rule, Proviso 1.108, threatens the funding of schools that require masks.Bioethics Forum Essay
Capitalist Philanthropy and Vaccine Imperialism
The commitments made by the wealthiest countries to share Covid vaccines and funding for international cooperation mechanisms are crucial, but insufficient. They reflect the “securitization of health,” a 21st century phenomenon whereby states turn health issues into national security issues.Bioethics Forum Essay
The Elephant from Heaven and the Chicken from Hell–or: Colossal Fantasies
I have always wanted to see a woolly mammoth. From the time I first read about them up until, well, a few moments ago, I’ve fantasized about going back in time to see a herd shoving its way through an Ice Age snowstorm. Alas, it cannot be, even if George Church and a new company, Colossus, bend heaven and earth to make it happen.Read “The Elephant from Heaven and the Chicken from Hell–or: Colossal Fantasies”
Bioethics Forum Essay
An Evergreen Metaphor: Strachan Donnelley, Dan Callahan, and Environmental Ethics
The devastation of Hurricane Ida and the global threats of climate change are not on the fringe of bioethics. They call to mind the language of priority-setting typical of bioethics discourse. Who lives and who dies? What can be accomplished with prevention and more levees? And if more are built, how do we set priorities with limited resources?Read “An Evergreen Metaphor: Strachan Donnelley, Dan Callahan, and Environmental Ethics”
Bioethics Forum Essay
Who Will Be There to Care If There Are No More Nurses?
The pandemic has laid bare the significant shortcomings of a health system rooted in an unsustainable financial model that exploits the physical and emotional labor of its nurses.Read “Who Will Be There to Care If There Are No More Nurses?”
Bioethics Forum Essay
Contemporary Circus Draws on Ethics to Support Diversity
Even though the circus exists in the same world as theater and movies, it has been largely exempt from public criticism, apart from accusations of animal cruelty. But under the broad rubric of “contemporary circus,” this familiar entertainment genre is distancing itself from its past and creating a new and vibrant art form. And underlying this transformation is an ethical commitment to social justice, inclusion, and equity.Read “Contemporary Circus Draws on Ethics to Support Diversity”
Bioethics Forum Essay
What Warrants Religious Exemption from Covid Vaccine Mandates?
Faced with mandatory Covid vaccination, students and employees have appealed to religion as grounds for exemption. This latest conscience war within our culture wars presents a minefield of legal and philosophical complexities for states and health care systems.Read “What Warrants Religious Exemption from Covid Vaccine Mandates?”
Bioethics Forum Essay
Polygenic Embryo Screening: Ethical and Legal Considerations
Last month, Bloomberg reported on what seems to be the first child born following a new kind of genome-wide screening. Four embryos were screened, and the embryo selected for implantation was the one given the best genetic odds of avoiding heart disease, diabetes, cancer, and schizophrenia in adulthood. The news has been met with some concerns about the degree of control we may now have over future generations.Read “Polygenic Embryo Screening: Ethical and Legal Considerations”
Bioethics Forum Essay
Should Pro-Choice Advocates Compromise on Abortion?
I'd be happy to go along with a ban on elective abortion after 15 weeks if, but only if, certain conditions accompanied it.Bioethics Forum Essay
Individuals Declared Brain-Dead Remain Biologically Alive
A remarkable experiment raises anew questions about whether brain-death is really death.Read “Individuals Declared Brain-Dead Remain Biologically Alive”
Bioethics Forum Essay
Vaccine Mandates for Kids: It’s Not Whether, But When
States and school boards around the country are engaged in a debate about whether to require middle and high school students to be fully vaccinated against Covid-19. The debate is not so much about whether to mandate. It's when to do so.Read “Vaccine Mandates for Kids: It’s Not Whether, But When”
Bioethics Forum Essay
Is It Ethical to Prohibit Off-Label Use of Covid-19 Vaccines in Kids?
In a new essay in the Hastings Center Report, we argue it is not. Yet the practice is prohibited.Read “Is It Ethical to Prohibit Off-Label Use of Covid-19 Vaccines in Kids?”
Bioethics Forum Essay
Continuous Health Monitoring: Greater Self-Knowledge or TMI?
For millions of health-conscious Americans, digital technology has been a boon, providing increasingly sophisticated fitness trackers. Researchers speak excitedly about a new frontier of “continuous health monitoring,” with the potential to detect diseases and aliments in their incipient stages. It also raises a host of disturbing questions about health surveillance. Will these devices really empower us? Will they compromise us as autonomous individuals?Read “Continuous Health Monitoring: Greater Self-Knowledge or TMI?”
Bioethics Forum Essay
Pathogens and Humans
In a 1988 essay on pandemics, Nobel laureate Joshua Lederberg wrote, “We have no guarantee that the natural evolutionary competition of viruses with the human species will always find ourselves the winner.”Bioethics Forum Essay
Omicron, the Legacy of Renée Fox, and the Uncertain Practice of Medicine
Like the pandemic, uncertainty, growing confidence, and the return of doubt come in waves. The Omicron variant is just the latest twist in this plot.Read “Omicron, the Legacy of Renée Fox, and the Uncertain Practice of Medicine”
Bioethics Forum Essay
Studying Covid Vaccines in the Youngest Kids
Children have suffered both physical and mental illness during the pandemic. Nearly 200 children in the United States have died. Acute mental health crises increased during the pandemic. Getting children immunized is the best way to get back to normal. We suggest an option that would permit children under 5 to be vaccinated without waiting until traditional prospective randomized trials can be completed.Bioethics Forum Essay
Reckoning with Anti-Black Racism in Bioethics: Key Takeaways
The field of bioethics has a moral responsibility to respond to the continued racial and health inequities confronting Black, Indigenous, and other people of color. Along with several colleagues, we formed an antiracism task force to interrogate that moral responsibility. Here are key takeaways from a recent panel discussion that we organized.Read “Reckoning with Anti-Black Racism in Bioethics: Key Takeaways”
Bioethics Forum Essay
Vaccination Discrimination Goes Against Nursing Ethics
Some health care providers are prioritizing patients who are fully vaccinated against Covid-19 over those who are unvaccinated. This is unethical.Read “Vaccination Discrimination Goes Against Nursing Ethics”
Bioethics Forum Essay
Should Clinicians Ask Hospitalized Covid Patients Why They Aren’t Vaccinated?
The role of doctors, nurses and other clinicians is to treat patients without passing judgment and to fulfill their fiduciary duty. However, the Covid-19 pandemic has muddled these obligations.Read “Should Clinicians Ask Hospitalized Covid Patients Why They Aren’t Vaccinated?”
Bioethics Forum Essay
Bioethics in the Margins
Bioethics in the Margins is a new podcast that addresses fundamental moral issues facing society that don’t get the attention they deserve.Bioethics Forum Essay
With Pediatric Hospitalizations Rising, Reconsider Off-Label Covid Vaccination for Young Children
Pfizer recently announced that its trials in children 2 to 5 years old produced a weaker than expected antibody response and that it would hold off requesting authorization from the Food and Drug Administration. This news creates opportunities – and additional challenges – for off-label use of Covid-19 vaccines in children,Bioethics Forum Essay
Another Pragmatic Public Health Decision
There has been much criticism of the decision by the Centers for Disease Control and Prevention (CDC) to let Covid-infected people who are feeling better to stop quarantining after five days and simply wear a mask. But this sort of pragmatic decision has a long history in public health.Bioethics Forum Essay
Xenotransplantation: Three Areas of Concern
News of the first transplant of a pig’s heart into a human raises hope that the procedure could one day help alleviate the shortage of organs. But before we forge ahead with xenotransplantation trials, we should be concerned about several issues: the potential to spread pathogens, exploitation of human research participants, and animal welfare.Bioethics Forum Essay
The Death of Advance Care Planning is Greatly Exaggerated
Advance care planning has recently come under fire from physicians who say that it does not work and that there is too little evidence in favor of it. Giving up on advance care planning is not called for by the evidence and doing so would mean giving up significant benefits.Read “The Death of Advance Care Planning is Greatly Exaggerated”
Bioethics Forum Essay
Overcoming Covid Vaccine Hesitancy Among Minnesota’s Somali Muslims
When Covid-19 vaccines first became available last year, Somali Muslims in Minnesota--the largest Somali Muslim population in North America-- were fearful and, consequently, their vaccination rate was low and their Covid-19 rate was high. But health professionals and community representatives worked together to understand and overcome their vaccine hesitancy.Read “Overcoming Covid Vaccine Hesitancy Among Minnesota’s Somali Muslims”
Bioethics Forum Essay
Research Ethics Meets the New Marketplace
A bill for $476 for inquiring about participating in a medical research study? This is no joke.Bioethics Forum Essay
The Winter Olympics and the Doping Ecosystem
Here is what I find particularly sad about this Winter Olympics. Kamila Valieva is 15 years old. Her Russian coach is notorious for employing ethically dubious training techniques. Who should be punished?Bioethics Forum Essay
Proposal for Revising the Uniform Determination of Death Act
We believe that the concept of brain death, though flawed in its present application, can be preserved and promoted as a pathway to organ donation, but only after particular changes are made in the medical criteria for its diagnosis.Read “Proposal for Revising the Uniform Determination of Death Act”
Bioethics Forum Essay
Global Health Justice: Now Is the Time
The recognition of the social injustices surrounding the pandemic is an important opportunity to understand the longstanding links between health and social and global justice.Bioethics Forum Essay
Housing an Aging Society: Five Priorities
While home and neighborhood environments matter to all people, older age brings particular considerations related to housing cost, safety and accessibility, neighborhood livability, links between the home and supportive services,...Bioethics Forum Essay
I Was Never “Just” a Visitor
Caregivers are not visitors. Hospital policies that restrict visits from family caregivers can harm patients.Bioethics Forum Essay
Child Abuse in Texas
Medical care that is widely considered beneficial for transgender teenagers has been identified as child abuse in Texas. The state attorney general issued a decision that gender-affirming medical treatments such...Bioethics Forum Essay
Bioethics in the Second Cold War
Bioethics is an integral part of the liberal international order intentionally developed after World War II. Following the Russian war on Ukraine there is every reason to believe that the set of norms and institutions that preserved peace in Europe through the first Cold War will be revised according to new assumptions that will structure international relations in a second Cold War.Bioethics Forum Essay
Resilience and the Twin Medical Catastrophes of War and Pandemic
As I sit here in my office at the Slovak Medical University in Bratislava, my colleagues are experiencing great moral anguish because of Russia’s invasion of neighboring Ukraine. Simultaneously, we are also confronting the Omicron wave of the Covid-19 pandemic. The war complicates and burdens health care here and in other border nations exponentially, and especially so in combination with the pandemic.Read “Resilience and the Twin Medical Catastrophes of War and Pandemic”
Bioethics Forum Essay
Masks, Values, and a Lesson for Democracy?
As mask mandates are rolled back and friends and neighbors debate the risks and benefits of masks and the merits or permissibility of mandating their use, we can catch a glimpse of the considerable extent to which values depend heavily on something other than pure reason. It’s a bit disappointing, perhaps. But it might be a useful lesson for democracy.Bioethics Forum Essay
Ethical Placemaking for Refugees
More than 4 million people have fled from war and terror in Ukraine. They are among the 70 million forcibly displaced people worldwide. What is brazenly clear is not only the impotence of the existing international apparatus designed to protect them, but also its asymmetries.Bioethics Forum Essay
Looking Back 10 Years: How Far Have We Come in Mental Health Care?
The most recent issue of Narrative Inquiry in Bioethics, “Living with Mental Health Challenges: Stories of Recovery from Across the Globe,” revisits a topic discussed a decade ago. For many authors, the answer to the question, “How far have we come in mental health care?” may be: not far enough.Read “Looking Back 10 Years: How Far Have We Come in Mental Health Care?”
Bioethics Forum Essay
Aphasia, Communication, and Caregiving
What “recovery” really means in aphasia is left unsaid in this novel.Bioethics Forum Essay
Leaked Supreme Court Opinion, Structural Sexism, and Our Moral Imagination
The leaked draft of the Supreme Court’s majority opinion to overturn Roe v. Wade has sent shockwaves throughout the world. Over the last decade, during which we came into adulthood,...Read “Leaked Supreme Court Opinion, Structural Sexism, and Our Moral Imagination”
Bioethics Forum Essay
Bioethics Without Roe
The Supreme Court decision in Roe v. Wade has played a subtle but critical role in the history of bioethics in America. Would American bioethics discourse be changed with the end of a constitutionally protected right to abortion?Bioethics Forum Essay
California U-Turn on Vaccine Mandates for Schoolchildren
The California legislature appears to have caved to pressure from opponents of a Covid vaccine mandate for schoolkids. I’d prefer to think of it as a wise and strategic retreat from a battle that mandate advocates could not win.Read “California U-Turn on Vaccine Mandates for Schoolchildren”
Bioethics Forum Essay
Treating Gun Violence as a Public Health Threat: Not Exactly What We Meant
This week, the United States saw two momentous public health events: one million deaths attributed to Covid and the 198th mass shooting of the year. Both the pandemic and gun shootings are threats to public health that are not being adequately addressed.Read “Treating Gun Violence as a Public Health Threat: Not Exactly What We Meant”
Bioethics Forum Essay
Oncology, Bioethics, and War
Like many other Ukrainians, I woke up on February 24 from the sounds of explosions. I had some difficult decisions to make. I treat cancer patients.Bioethics Forum Essay
DACA at 10: More, Please
DACA, the Deferred Action for Childhood Arrivals program, has been with us for 10 years. Granting a work permit and a renewable two-year stay of deportation to undocumented youth who have grown up in the United States turned out to have enormous benefits for them and for our nation.Bioethics Forum Essay
Veterinarians Often Provide Futile Care. Doing So Comes at a Cost
Like medical doctors and nurses, veterinarians experience moral distress and burnout because of the ethical conflicts they face on the job.Read “Veterinarians Often Provide Futile Care. Doing So Comes at a Cost”
Bioethics Forum Essay
The End of Roe v. Wade Will Be a Nightmare for Disabled Americans
The end of federal abortion rights is a disability justice issue—but not in the way you might think.Read “The End of Roe v. Wade Will Be a Nightmare for Disabled Americans”
Bioethics Forum Essay
After Roe, What’s Next for End-of-Life Care?
The reversal of Roe may be the beginning of an onslaught on our freedoms. I want to add one more worry to the list and point to self-determination at life's end. Here we have Justice Neil Gorsuch to worry about.Bioethics Forum Essay
Experiencing Racism: Health Care Professionals Speak Out
“My emotions and insecurities were at an all-time high, so much so that I was no longer comfortable coming into work. Do my coworkers also joke about my culture, my skin tone? Do my patients and families feel uncomfortable with me being their nurse? These were the questions I frequently asked myself as I anxiously braced myself for my next shift. I could no longer walk the streets, sidewalks, or even the hospital lobby without believing someone was looking at me because of the color of my skin.” ¬ This quote from Cecilia Igwe-Kalu describes her experience as a nurse confronting racism in health care.Read “Experiencing Racism: Health Care Professionals Speak Out”
Bioethics Forum Essay
Primates in Medical Research: A Matter of Convenience, not Sound Science
What are the current and future potential uses of nonhuman primates in research? The National Academies of Sciences, Engineering, and Medicine is examining this question.Read “Primates in Medical Research: A Matter of Convenience, not Sound Science”
Bioethics Forum Essay
Abortion Law—Lessons from Medical Aid-in-Dying?
Health care and society will strive to find ways to undercut crude bans inconsistent with perceived medical need and professional duty.Bioethics Forum Essay
Public Health Officials and Gun Rights Advocates Must Work Together
In rural Virginia, where I live, there is strong support for the right to own and carry guns. For more than a decade, I have shared public health, mental health, and other scientific findings with the leadership of a statewide Second Amendment rights advocacy group, especially regarding the leading number of deaths by firearms: suicide. We do not agree on what firearms laws and policies might be or do to prevent suicides, but we have sustained our conversations and respectfully learned from each other’s point of view. Such conversations are hard to have.Read “Public Health Officials and Gun Rights Advocates Must Work Together”
Bioethics Forum Essay
From Gene-Edited Embryos to Covid: China Faces Regulatory and Ethical Challenges
Over the last two years, China has updated some regulations on human genetic engineering and assisted reproduction and established a national committee to guide and supervise bioethics nationwide. But there are legal gaps in some of the regulations and tension between competing values: the desire to encourage new research and to potentially inhibit it by imposing stricter ethics regulations.Read “From Gene-Edited Embryos to Covid: China Faces Regulatory and Ethical Challenges”
Bioethics Forum Essay
Mark Cuban’s Innovative Pharmacy: A Band-Aid on Drug Prices
Billionaire Mark Cuban and physician Alex Oshmyansky recently launched the Mark Cuban Cost Plus Drug Company (MCCPDC), an online pharmacy that sells generic prescription medicines at significantly lower prices than other sources. But the acclaim for the pharmacy may eclipse attention to the longstanding structural problems of the pharmaceutical industry and MCCPDC’s role in it.Read “Mark Cuban’s Innovative Pharmacy: A Band-Aid on Drug Prices”
Bioethics Forum Essay
Dusting Off Double Effect for the Post-Dobbs Era
What constitutes a medical emergency for a pregnant patient? ER clinicians in states with abortion bans need to know.Bioethics Forum Essay
Back to School: The Covid Vaccination Choice
It’s back-to-school season in the United States, the third one during the Covid pandemic, but the first in which all schoolchildren are eligible for Covid vaccines. Yet fewer than a third of children ages 5 to 11 are fully vaccinated, while the percentage of those under 5 who have started–let alone completed–vaccination is in the low single digits. Why? The answers are complicated.Bioethics Forum Essay
Requests for Sterilization, Abortion Bans, and Reproductive Justice
In the nearly three months since the United States Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision eliminated the constitutional right to an abortion, doctors have reported increased in...Read “Requests for Sterilization, Abortion Bans, and Reproductive Justice”
Bioethics Forum Essay
Philanthropy is Not Enough: Oil and Gas Giants Must Consider Medical Ethics
Given the well-known environmental and health risks of oil and gas drilling, oil and gas giants that enter developing nations routinely offset these risks with charitable investments. Are these investments sufficient? Do the funds go where they are needed? Answering this question raises ethical issues that need greater attention.Read “Philanthropy is Not Enough: Oil and Gas Giants Must Consider Medical Ethics”
Bioethics Forum Essay
Could Alarm Over Genetic Manipulation Get in the Way of Environmental Conservation?
The American chestnut is basically defunct, unless science can rescue it. Genetic manipulation may be the answer.Read “Could Alarm Over Genetic Manipulation Get in the Way of Environmental Conservation?”
Bioethics Forum Essay
The Place in “Aging in Place”: Housing Equity in Late Life
Most older Americans want to age “in place” – in the community, not an institution. But there's a poor fit between our nation’s housing stock and our aging demographics.Read “The Place in “Aging in Place”: Housing Equity in Late Life”
Bioethics Forum Essay
How Many Covid-19 Deaths Should We Accept?
President Biden recently declared that the Covid-19 “pandemic is over.” Some public health experts agreed with this assessment; others disagreed. What cannot be disputed is that nearly 12,000 Americans have...Bioethics Forum Essay
Clicking ‘Accept’ Is Not Informed Consent
A recent Science article published the results of an experiment conducted on 20 million LinkedIn users over five years involving the “People You May Know” algorithm. None of these people knew they were part of an experiment, nor did they consent to participate.Bioethics Forum Essay
The CDC’s Misguided Medical Masking Policy
The Center for Disease Control and Prevention’s revised guidelines have done away with universal masking at health care facilities, making masking optional if community Covid transmission isn’t high. It’s the latest attempt of public health officials to adapt their guidance to meet the country’s fatigued sensibilities. Some patients will be at risk.Bioethics Forum Essay
Well, There’s Always the Zoo
Our patient, weighing over 600 lbs., was above the weight limit of our hospital system’s scanner tables and those of all the other major medical centers that we called in our large city. What to do next? Our radiology department’s answer was, “Well, there’s always the zoo.”Bioethics Forum Essay
Should Ethicists Be at the Table in Public Health Policy Deliberations?
In a recent article in The New England Journal of Medicine, Ezekiel Emanuel and colleagues clearly illustrate the relevance of ethical considerations to policy deliberations concerning public health emergencies. But do ethicists belong at the table?Read “Should Ethicists Be at the Table in Public Health Policy Deliberations?”
Bioethics Forum Essay
Popular Culture and Bioethics: Severance
Severance, a popular Emmy Award-winning show streaming on Apple TV+, is a rich cultural artifact. It concerns a team of office workers at a morally questionable company that performs brain surgery on employees to sever the consciousness of their work and personal lives. The four of us were so taken by the show that we wrote these reflections on its important ethical themes.Bioethics Forum Essay
Moving On from Covid? Immunocompromised People Can’t
The best case scenario for immunocompromised people like me would be universal masking in all public spaces. But I am willing to compromise.Bioethics Forum Essay
The Cure for Politicized Pediatric Gender Care
Children and adolescents diagnosed with gender dysphoria receive radically different treatments depending on where they live. With intense politicization of pediatric gender medicine, the U.S. needs a systematic review of the evidence for different care options.Page
Writers’ Guidelines for Clinical Ethics Cases for Hastings Bioethics Forum
The purpose of this series is to illustrate how clinical ethicists analyze, process, and address complex cases. The primary author of each essay should be a clinical ethicist (individual, team,...Read “Writers’ Guidelines for Clinical Ethics Cases for Hastings Bioethics Forum”
Hastings Center News
Introducing Clinical Ethics Case Studies in Hastings Bioethics Forum
Each year, tens of thousands of clinical ethics case consultations are performed in hospitals around the country. These consultations respond to fraught, complex questions from patients, families, health care professionals,...Read “Introducing Clinical Ethics Case Studies in Hastings Bioethics Forum”
Bioethics Forum Essay
Pediatric Gender Care: Absence of Evidence Is Not Absence of Efficacy
In “The Cure for Politicized Pediatric Gender Care,” Moti Gorin argues that a U.S.-based systematic review, conducted by a trusted major medical organization such as the National Institutes of Health or the National Academy of Medicine, is needed to develop consistent standards for pediatric gender care. While the intent behind his call is well-intended, it is based on a flawed premise.Read “Pediatric Gender Care: Absence of Evidence Is Not Absence of Efficacy”
Bioethics Forum Essay
Should He Have Brain Surgery?
J is a 21-year-old male with multiple disabilities. He has a brain tumor. Would he benefit enough from brain surgery?Bioethics Forum Essay
Grateful Patient Fundraising: Ethically Problematic or Altruistic?
Nonprofit hospitals increasingly rely on philanthropy to supplement decreasing clinical revenues and a decline in the growth of government research funding. Grateful patient fundraising programs, as they are known, employ a strategy in which hospitals seek donations from satisfied patients, often using public data to identify those who are wealthy and requiring their physicians to discuss giving opportunities with them. In a recent issue of Narrative Inquiry in Bioethics, 12 physicians discuss their experiences with grateful patient fundraising and take up legal and ethical issues.Read “Grateful Patient Fundraising: Ethically Problematic or Altruistic?”
Bioethics Forum Essay
A Warning from China: After the Zero Covid Policy
A massive wave of Covid infections has begun now that China has ended much of its zero Covid policy. Three steps ought to be taken.Bioethics Forum Essay
Advancing Maternal Health Equity with Data Transparency: The Case of Texas
Texas has delayed the release of the full report of the most up-to-date data on maternal health, further threatening the health of marginalized women, children, and families.Read “Advancing Maternal Health Equity with Data Transparency: The Case of Texas”
Bioethics Forum Essay
New York City’s Involuntary Commitment Plan: Fulfilling a Moral Obligation?
After a string of violent crimes involving mentally ill people who are homeless, New York City Mayor Eric Adams announced a plan for police and emergency medical workers to involuntarily remove people with severe mental illness from the streets and bring them to hospitals for psychiatric evaluation. Mayor Adams said we have a “moral obligation” to help people who are mentally ill. But is this plan moral?Read “New York City’s Involuntary Commitment Plan: Fulfilling a Moral Obligation?”
Bioethics Forum Essay
Will Gaylin’s Wit, Wisdom, and Kindness
I’ve had the privilege of knowing more than a few extraordinarily brilliant people from whose mouths seemed to spill spontaneous gems of polished prose. None surpassed Will. For those of us who must struggle in our writing to convey with clarity the complicated ideas we are driven to share, Will’s gift for off-the-cuff eloquence was awe-inspiring.Bioethics Forum Essay
Medical Aid in Dying and Organ Donation: Canada’s Autonomy Gap
One of the most important aspects of the Canada's medical aid-in-dying process is the respect given for the patients’ wishes concerning organ donation. People dying of other causes should be shown the same respect.Read “Medical Aid in Dying and Organ Donation: Canada’s Autonomy Gap”
Bioethics Forum Essay
Quiet Quitting Undermines Human Flourishing
Quiet quitting, the trend in which people do only the minimum in their jobs, has captured attention in the news and on social media. More than half of U.S. workers are quiet quitting, according to a recent Gallup poll, and most of them are in their 20s and 30s. I was discussing this trend with my bioethics colleagues, and we considered the ethical implications for people’s well-being.Bioethics Forum Essay
Is It Ethical to Reduce Prison Sentences in Exchange for Organ Donation?
A bill filed in the Massachusetts House of Representatives would allow prisoners who choose to donate organs or bone marrow for transplantation to be eligible for reduced sentences. Is such a policy ethical?Read “Is It Ethical to Reduce Prison Sentences in Exchange for Organ Donation?”
Bioethics Forum Essay
Is Chinese Bioethics Ready to Move Forward from the CRISPR Baby Scandal?
The Third International Summit on Human Genome Editing is being held in London this week. Chinese biophysicist He Jiankui’s illegal experimentation with heritable human genome editing, announced at the Second International Summit in Hong Kong four years ago, will haunt some of the discussions. To what extent has the Chinese bioethics community addressed gaps exposed by the Crispr Baby scandal and prepared to prevent similar future scenarios?Read “Is Chinese Bioethics Ready to Move Forward from the CRISPR Baby Scandal?”
Bioethics Forum Essay
ChatGPT in the Clinic? Medical AI Needs Ethicists
There's a lot of excitement about the possibilities of sophisticated, conversational AI in medicine, but we are already seeing problematic examples of its use. The insight of ethicists is sorely needed.Bioethics Forum Essay
Should An Unrepresented, Incapacitated Patient Be Treated Over Her Objection?
This is the second clinical ethics case study in our series. It concerns a patient with delusions and no surrogate decision-maker who refuses all treatment, even after a game-changing finding.Read “Should An Unrepresented, Incapacitated Patient Be Treated Over Her Objection?”
Bioethics Forum Essay
My Friend ChatGPT: Fun to Talk With, Not Yet to Be Trusted
How long does it take to trust someone? Think twice before getting too close to your chatty friend ChatGPT.Read “My Friend ChatGPT: Fun to Talk With, Not Yet to Be Trusted”
Bioethics Forum Essay
Where is Clinical Ethics in the Revised Hospital Accreditation Standards?
The Joint Commission, which accredits our nation's hospitals, eliminated the sole element of performance that governed clinical ethics services. This decision impedes equity and undercuts progress toward fostering ethical practice in health care.Read “Where is Clinical Ethics in the Revised Hospital Accreditation Standards?”
Bioethics Forum Essay
Health Equity Without Ethics Perpetuates Marginalization
To eliminate a quality metric for clinical ethics is at odds with good clinical practice and it reinforces structural inequality.Read “Health Equity Without Ethics Perpetuates Marginalization”
Bioethics Forum Essay
AI Meets Bioethics Literature: How Did It Do?
How accurately could AI translate complex medical information for lay persons? How well could it identify and distill the ethical dilemmas posed by research findings? What safeguards could be used to prevent the use of AI for misinformation and disinformation? We performed a small nonscientific experiment.Bioethics Forum Essay
ChatGPT Just Makes Stuff Up: A Conversation on a Controversial Topic
I am currently writing up the results of a retrospective chart review of patients’ consent or refusal for medical students to perform pelvic exams on them when they’re under anesthesia and sedated. I asked ChatGPT to summarize the ethical issues and tell me what sources it used to generate its response.Read “ChatGPT Just Makes Stuff Up: A Conversation on a Controversial Topic”
Bioethics Forum Essay
Confusing Equity for Ethics Standards: Where Do We Go from Here?
The country’s leading hospital accreditation body recently eliminated the only performance standard that governed clinical ethics services. We argue the removal of the ethics standard requires additional review, and we have three recommendations.Read “Confusing Equity for Ethics Standards: Where Do We Go from Here?”
Bioethics Forum Essay
In Search of an Ethical Constraint on Hospital Revenue
Hospitals' tactics for maximizing revenue may be legal, but they raise ethical concerns.Read “In Search of an Ethical Constraint on Hospital Revenue”
Bioethics Forum Essay
Theocracy Is Closer Than It Appears
On a cloudy April afternoon, in my home in western Pennsylvania, a headline catches my eye: A federal judge in Texas suspended FDA approval of mifepristone. This abortion-inducing drug has been on the market for more than 20 years. Although the decision is presented with a secular and legal façade, like other recent antiabortion court rulings and legislation, a solid religious motive is at play.Bioethics Forum Essay
What Happened to Concerns About Human Enhancement?
Prominent science policy reports that set the stage for the recent Third International Summit on Human Genome Editing all raise questions about human enhancement. Enhancement concerns also consistently loom large...Bioethics Forum Essay
Remembering James F. Drane
James F. Drane, a member of the founding generation of bioethicists, passed away on April 17 in Edinboro, Pennsylvania at the age of 93. He was a prolific writer, internationally recognized scholar, and trusted friend.Bioethics Forum Essay
For Ethical Use of AI in Medicine, Don’t Overlook Maintenance and Repair
AI systems are susceptible to bias; maintenance and repair are essential to detecting and eliminating it.Read “For Ethical Use of AI in Medicine, Don’t Overlook Maintenance and Repair”
Bioethics Forum Essay
Legalized Medical Discrimination Violates Medical Ethics
Florida Governor Ron DeSantis recently signed SB 1580, a bill that that shields health care providers, institutions, and insurers who decline to treat patients or refuse to pay for care...Read “Legalized Medical Discrimination Violates Medical Ethics”
Bioethics Forum Essay
Medical Interpretation in the U.S. is Inadequate and Harming Patients
Over the past few decades, many major cities in the United States have become more diverse and gained more residents with limited English proficiency. Health care systems have attempted to accommodate these residents, but their medical interpreter services are inadequate and inefficient. The results can be delayed emergency care for children, an increase in medical errors and health care costs, and a decrease in care quality and patient satisfaction.Read “Medical Interpretation in the U.S. is Inadequate and Harming Patients”
Bioethics Forum Essay
Bioethicists and Health Care Institutions Must Act Against Florida’s Anti-Immigrant Law
Florida’s new anti-immigrant law, SB 1718, has escaped widespread notice, despite the way it will undermine the mission—and core identity--of not-for-profit hospitals as caring institutions that promote the health of the community. Bioethics and health care institutions must take action.Read “Bioethicists and Health Care Institutions Must Act Against Florida’s Anti-Immigrant Law”
Bioethics Forum Essay
We Have Met the Enemy and It Is Us
In its early days, bioethics emphasized patient autonomy in the doctor-patient relationship. But patient autonomy is not the be-all and end-all principle to follow in all health care settings. Especially in lethal, airborne infectious disease pandemics.Bioethics Forum Essay
A Model of Conscientious Objection to Abortion Bans
Many clinicians have followed their conscience to find ways to provide good care within the confines of abortion bans. Henry Morgentaler was a model.Bioethics Forum Essay
Hospice and Medical Aid-in-Dying: Addressing an Unethical Disconnect
Most patients who die with medical aid in states where the practice is legal are enrolled in hospice, but coordination between those providing hospice care and those providing medical aid-in-dying (MAiD) is woefully inadequate. Many hospice facilities have policies against supporting patients who request MAiD and do not disclose these policies to prospective patients, even in states where disclosure is required.Read “Hospice and Medical Aid-in-Dying: Addressing an Unethical Disconnect”
Bioethics Forum Essay
Keep Politics Out of State Medical Policy
State medical boards and other government-appointed health officials have an obligation to follow evidence-based medicine to frame their opinions and regulations. However, there is disturbing evidence that, in some cases, political ideology is guiding health policy.Bioethics Forum Essay
The Next President’s Council on Bioethics: Who Cares What It Does?
President Obama’s announcement that he will replace the members of the President’s Council on Bioethics has led to speculation about appointments and the issues a reconstituted commission might address. White...Read “The Next President’s Council on Bioethics: Who Cares What It Does?”
Bioethics Forum Essay
The Drama of Medical Ethics: A New Play
“The Doctor,” a new play by Robert Icke, powerfully dramatizes many controversial issues of medical ethics, along with identity politics.Bioethics Forum Essay
Oppenheimer’s Nuclear Value Judgment Wasn’t the First
Christopher Nolan’s film, “Oppenheimer,” which opens in theaters on July 21, highlights a value judgment that the Manhattan Project scientists had to make before Trinity, the test of the first atomic bomb.Read “Oppenheimer’s Nuclear Value Judgment Wasn’t the First”
Bioethics Forum Essay
New York’s Involuntary Psychiatric Treatment Initiative: Positive Signs and a Path Forward
Recent policies by New York State Governor Kathy Hochul and New York City Mayor Eric Adams to identify homeless mentally ill people and remove them from the streets for involuntary...Read “New York’s Involuntary Psychiatric Treatment Initiative: Positive Signs and a Path Forward”
Bioethics Forum Essay
Bartering Your Eggs: A Rotten Deal
There is significant reproductive injustice and lack of access to fertility treatments by diverse populations. Nowhere is this more obvious than with egg freezing.Bioethics Forum Essay
Involuntary Withdrawal: A Bridge Too Far?
Despite its intended use as a treatment of last resort, some patients can remain on ECMO for weeks or months. And some are awake, alert, and capable of medical decision-making. RD was one such patient.Bioethics Forum Essay
The Retrievals: Women’s Vulnerability to Injury, Violence, and Pain in Health Care
What happens when a health care provider decides that the patient is not a reliable narrator of their own pain? The Retrievals, a recent documentary podcast, explores this question and the excruciating pain that 12 women endured while receiving fertility treatments.Read “The Retrievals: Women’s Vulnerability to Injury, Violence, and Pain in Health Care”
Bioethics Forum Essay
Covid is Surging. Most Young Children Are Still Unvaccinated
Children are returning to classrooms amid another wave of Covid cases, but some public health leaders have leaned into the message that “most of us” can ignore the continued presence of Covid by taking just “a few basic steps,” such as staying up to date with vaccinations. “Most of us,” however, does not include families with young babies, among other groups for whom these steps are unavailable or insufficient.Read “Covid is Surging. Most Young Children Are Still Unvaccinated”
Bioethics Forum Essay
Beyond the Gift of Life: What Else to Expect from an Organ Transplant
“Between the time of my heart transplant and the moment my hair began to fall out, I arguably had suffered enough,” writes Leilani R. Graham. “Transplant brought four open-heart surgeries, ten days on ECMO, an intra-aortic balloon pump, delirium, necrotizing pneumonia, and so much muscular atrophy that I had to re-learn how to walk. [Transplant] was not the miracle I was hoping for.”Read “Beyond the Gift of Life: What Else to Expect from an Organ Transplant”
Bioethics Forum Essay
To Reduce Maternal Health Disparities, Expand Medicaid
Black women are three times as likely to die from preventable pregnancy-related complications as white women in the United States. There are many reasons for this, but one of them is that Black women have lower rates of health insurance. Without insurance, they cannot afford the pre-pregnancy and prenatal care they need to reduce their maternal mortality rate. A fundamental way to address this problem is to expand Medicaid.Read “To Reduce Maternal Health Disparities, Expand Medicaid ”
Bioethics Forum Essay
Myopic View of Xenotransplantation
. A report last week in the New York Times of a pig heart transplant performed at the University of Maryland Medical Center exemplifies a common myopic view of xenotransplantation research.Bioethics Forum Essay
Our System for Reporting Child Abuse is Unethical
The system of mandatory reporting of child abuse is rife with ethical problems and can lead to unjustified custody loss.Bioethics Forum Essay
Improving Linguistic Justice and Accessibility in Bioethics Work
Bioethicists should practice linguistic justice, making our work accessible to people by using relatable language. It's key to improving health justice.Read “Improving Linguistic Justice and Accessibility in Bioethics Work”
Bioethics Forum Essay
My Mom’s Myeloma and the Fire-Breathing Chimaera
Just one month ago, my mom received an intravenous infusion of CAR T-cells, which have become mythical creatures in my imagination.Bioethics Forum Essay
Chemical Weapons Convention Reaches Milestone
Many post-World War II international structures are what might be called bioethics adjacent: They are not strictly part of the set of widely recognized global bioethics standards and instruments, like the Declaration of Helsinki, but they overlap with concerns routinely expressed in bioethics. One of these is the Chemical Weapons Convention, which celebrated its 30th anniversary this year with the destruction by all States Parties of their declared stockpiles of chemical weapons and dual-use chemicals.Bioethics Forum Essay
Don’t Give Symptom-Free People Alzheimer’s Drugs
Some people advocate giving Alzheimer's disease drugs to people with normal cognitive function who have elevated amyloid levels in their brains. This is not only wrong, but dangerous.Bioethics Forum Essay
Race, Research, and Bioethics: The Chapatis Studies
New inquiry examines ethics of 1960's experiments involving Punjabi immigrants in the United Kingdom and radioactive chapatis.Bioethics Forum Essay
Should Your Wedding Plans Include Plasma Donation?
When I said “yes!” to my partner’s proposal last spring and changed my Facebook relationship status to engaged, I expected targeted advertisements for wedding dresses, flowers, and photographers. What I did not expect were ads to donate my plasma to help pay for my wedding.Bioethics Forum Essay
The Genetics of Obesity: A New Narrative or the Same Old Story?
It seems to me a kind of magical thinking to assume that explaining the genetic causes of obesity will reduce stigma when that new explanation is lodged firmly within a broader project of treating, preventing, or curing fatness. Today, drugs like Ozempic, Wegovy, and now Zepbound are the favored medical solution.Read “The Genetics of Obesity: A New Narrative or the Same Old Story?”
Bioethics Forum Essay
Conscientious Objection and Abortion: Medical Students’ Perspective
Despite the medical necessity of the abortion, it was delayed and rescheduled twice that day because individual anesthesiologists, technicians, and nurses did not want to be involved in, what several called, “this kind of procedure.”Read “Conscientious Objection and Abortion: Medical Students’ Perspective”
Bioethics Forum Essay
Newly Released Documents from Untreated Syphilis Study: Ethical, Just, and Respectful Use of Archival Materials
To mark the 50th anniversary of the end of the United States Public Health Service’s Syphilis Study, the National Library of Medicine recently digitized and released reams of historical documents on the “origin and development of the Tuskegee syphilis study.” The release of these documents is a poignant occasion to consider what qualifies as ethical, just, and respectful use of archival materials.Bioethics Forum Essay
Involuntary Donation: Animal Welfare and Xenotransplantation
The realized promise of xenotransplantation seems to be quickly approaching, following the medical breakthrough of a pig kidney functioning for a record two months in a deceased human body. This milestone has received overwhelmingly positive media attention. Ethicists, physicians, and transplantation specialists have shared their apprehensions about the risks of implanting animal-grown organs into humans. However, conspicuously absent from these discussions is a major stakeholder: the animals.Read “Involuntary Donation: Animal Welfare and Xenotransplantation”
Bioethics Forum Essay
Texas Supreme Court Offers Roadmap for Legal Abortion
A recent Texas Supreme Court decision with implications for post-Dobbs jurisprudence on abortion seems to have been a victory for those who oppose the practice. It was widely read as upholding Texas’s very strict anti-abortion legislation. I suggest another possible reading of that decision.Read “Texas Supreme Court Offers Roadmap for Legal Abortion”
Bioethics Forum Essay
This Wasn’t the Plan: A Family Caregiver’s Recommended Readings from 2023
Work and life overlapped significantly for me in 2023. The timeframe for the latest project in the Bioethics for Aging Societies portfolio—a Greenwall Foundation-funded analysis of ways to support aging...Read “This Wasn’t the Plan: A Family Caregiver’s Recommended Readings from 2023”
Bioethics Forum Essay
Cold Comfort for Texas Obstetricians
What is a "reasonable medical judgement" that a patient would be harmed before an abortion is permissible?Bioethics Forum Essay
Balancing a Patient’s Autonomy Against Misinformation
With ventilator support, Ms. J would have a 50% chance of making a full recovery. Without it she would almost certainly die. That notwithstanding, Ms. J declined to consent to the ventilator.Read “Balancing a Patient’s Autonomy Against Misinformation”
Bioethics Forum Essay
Unresolved Grief is Eating Away at Us
In most ways, 2023 was a return to normal. Schools were fully back in person; hybrid work was old hat; travel rebounded. But people are easily agitated. I think in our desire to regain a sense of normalcy we have not grieved properly for the losses and hardships of the past four years.Bioethics Forum Essay
Considering the Duality of Nitrogen
Nitrogen gas was just used for the first time to execute a prisoner on death row. The execution of Kenneth Smith does not answer the many questions raised by this new means of capital punishment. Is it “perhaps the most humane method” of execution,” as the Alabama attorney general has claimed? Or is it cruel and unusual punishment, as Smith’s attorneys and others have argued? Answering these questions is of vital importance, since nitrogen gas has been approved by three states for capital punishment.Bioethics Forum Essay
SpongeBob, Slime, and Brain Injuries: A Dangerous Combination for Kids
For the first time, this year’s Super Bowl will have an alternate telecast for children featuring beloved cartoon characters. But as public health researchers, we are alarmed by efforts to promote the full-body collisions of tackle football to young children with animated mascots, enhanced augmented reality, bright colors, 3D iconography, and other child-friendly symbols.Read “SpongeBob, Slime, and Brain Injuries: A Dangerous Combination for Kids”
Bioethics Forum Essay
The Neuralink Patient Behind the Musk
The sole virtue of Elon Musk’s report on X, formerly known as Twitter, of the first in-human brain implant by his company, Neuralink, is its brevity: “The first human received...Bioethics Forum Essay
Fetal Personhood, IVF, and the Negligent Loss of Embryos
How can the legitimate concerns of fertility patients whose embryos are negligently lost be addressed without threatening the very existence of IVF?Read “Fetal Personhood, IVF, and the Negligent Loss of Embryos”
Bioethics Forum Essay
A Thousand Double Binds: Alabama, Reproductive Freedom, and Child Health
As two people who have ties to Alabama and grew up in the Deep South, we are frustrated by the state’s ceaseless assault on reproductive freedom, while its politicians continue to ignore child health. Because Alabama lawmakers and its Supreme Court justices profess to care about children–and use this as a reason to restrict reproductive freedom–we believe there is a strong responsibility to aid kids who do not have consistent access to groceries or health care.Read “A Thousand Double Binds: Alabama, Reproductive Freedom, and Child Health”
Bioethics Forum Essay
Today’s Politics Threatens Tomorrow’s Reproductive Technologies
With a new technology called in vitro gametogenesis (IVG), scientists produced an egg from a male mouse, leading to two male mice having offspring. In mice. IVG could be a game changer for women and men dealing with infertility, women of advanced maternal age, and same-sex couples.Read “Today’s Politics Threatens Tomorrow’s Reproductive Technologies”
Bioethics Forum Essay
Financing Reforms to Meet a Pivotal Moment in Global Health
This year will be the most important moment for global health since WHO’s founding in 1948, but only if states give major reforms their full political and financial backing.Read “Financing Reforms to Meet a Pivotal Moment in Global Health”
Bioethics Forum Essay
Emerging from the Cacophony of Clinical Ethics Consultation
I had underestimated the challenges I would face as an ESL speaker when immersed as a clinical ethicist in the dynamic space of the hospital. This was like learning a third language.Read “Emerging from the Cacophony of Clinical Ethics Consultation”
Bioethics Forum Essay
In the Shadow of War: Health Conditions in the Za’atari Refugee Camp
While working as a medical volunteer in the clinic at the edge of the refugee camp, I quickly realized I was in a clinical environment I had never seen before. I was unprepared for the sheer scale of medical needs among the refugees I was there to serve, and for what resource scarcity meant under these conditions.Read “In the Shadow of War: Health Conditions in the Za’atari Refugee Camp”
Bioethics Forum Essay
How to Avoid a Genetic Arms Race
Breakthroughs in our ability to change the genes of organisms are generating novel capabilities for biological weapons, a form of warfare that has been largely abandoned for decades. Guidance from scientists and bioethicists is needed to avert the threat.