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Health and Health Care

This description is editable from the Categories section under Posts

  • Bioethics Forum Essay

    Beyond “Just Sign Here”–A New Model of Consent for Primary Care

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    Bioethics Forum Essay
    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 process presented in textbooks, journal articles, and academic lectures.
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  • Advancing Social Justice, Health Equity, and Community

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    TRANSCRIPT: February 9, 2021
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  • Bioethics Forum Essay

    The Bioethics of Built Health Care Spaces

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    The Ethics of Treating the President

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    Hastings Center Scholar on How Some Countries Control Health Spending

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    Hastings Center News
    Although the U.S. has the highest health care prices in the world, the specific mechanisms commonly used by other countries to set and update prices are often overlooked, with a tendency to favor strategies such as reducing the use of fee-for-service reimbursement. Many U.S. health policymakers reco...
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  • Hastings Center News

    Can AI Reduce Inequity and Improve Empathy in Medicine? A Conversation Between Eric Topol and Mildred Solomon

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

    Ethics of Emergency Use Authorization During the Pandemic

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    New Project: Building an Ethics Framework for Big Data in Health Care

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

    A Historic Intersex Awareness Day

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    Bioethics Forum Essay
    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.
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  • Building an Ethics Framework for Biomedical Data Modeling

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    Principal investigator: Diane M. KorngiebelFunder: National Institutes of Health/National Human Genome Research Institute; National Institutes of Health/Office of the Director
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  • Bioethics Forum Essay

    Caring for My First Neo-Nazi Patient

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    Bioethics Forum Essay
    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?
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  • Bioethics Forum Essay

    Fox, Bosk, and Rothman: An Appreciation of Three Scholars of Medicine

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

    Black Women Can’t Breathe

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Fair Compensation for Rare Vaccine Harms

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    We Can’t Forget the Nation’s Other Epidemic

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

    Ethicists as a Force for Institutional Change and Policies to Promote Equality

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Cracks in the System: Lessons Learned from the Covid-19 Pandemic

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    After the Surge: Prioritizing the Backlog of Delayed Hospital Procedures

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    Bioethics Forum Essay
    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?
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  • Bioethics Forum Essay

    Lessons from Covid-19: Why Treating Sick Patients is Bad Business for Hospitals

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Why Health Care Workers Should Receive Priority Care for Covid-19

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Sustaining Clinical Empathy During the Pandemic

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    The Covid Threat No One Is Talking About: Wearing Scrubs in Public

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Denying Ventilators to Covid-19 Patients with Prior DNR Orders is Unethical

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    When It Comes to Rationing, Disability Rights Law Prohibits More than Prejudice

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Why I Support Age-Related Rationing of Ventilators for Covid-19 Patients

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    New York State Task Force on Life and the Law Ventilator Allocation Guidelines: How Our Views on Disability Evolved

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Do New York State’s Ventilator Allocation Guidelines Place Chronic Ventilator Users at Risk? Clarification Needed

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Disabusing the Disability Critique of the New York State Task Force Report on Ventilator Allocation

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Crowdfunding for Covid-Related Needs: Unfair and Inadequate

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    We Need International Medical Graduates to Help Fight Covid-19. Immigration Policies Keep Them Away

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

    America’s Bioethicists and Health Care Leaders: Government Must Use Federal Powers To Fight COVID-19

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

    The Hastings Center Produces Guidance for Ethical Practice in Responding to COVID-19

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    Hastings Center News
    The Hastings Center has developed a resource for health care institutions and institutional ethics services to support leadership and practice during the novel coronavirus public health emergency and in the care of patients with COVID-19.The Hastings Center convened an expert advisory group to meet the need for a practical resource to support institutional preparedness and supplement public health and clinical practice guidance on COVID-19.
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  • Bioethics Forum Essay

    Coronavirus Response Is Insufficient for Vulnerable New Yorkers

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

    Health Care for Obesity and Eating Disorders: What Needs to Change

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Deciding When Enough is Enough in Providing Life-Sustaining Treatment for a Child

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Why Health Care Organizations Need Technology Ethics Committees

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    Hastings Rice Family Fellow Founds New Journal on Disability

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    Hastings Center News
    Joel Michael Reynolds, The Hastings Center’s Rice Family Fellow in Bioethics and Humanities and an assistant professor of philosophy at the University of Massachusetts Lowell, is launching a new journal: The Journal of Philosophy of Disability.
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  • Bioethics Forum Essay

    To Restore Humanity in Health Care, Address Clinician Burnout

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    Expert in Artificial Intelligence Named Hastings Center Senior Advisor

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

    Hastings Center Scholars Respond to Prison Sentence of Researcher Who Created First Gene-Edited Babies

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

    Helping Seriously Ill Patients Access “Last Resort” Medicines

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

    What Is Ethical Eating in the Age of Climate Change?

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    Bioethics Forum Essay
    Are we ethically obliged to eat less meat? Bioethicists consider that question, and their role in addressing it.
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  • Hastings Center News

    What’s Next for an Aging America: Palliative Care Leaders Assess the Future

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    Hastings Center News
    The Collaborative for Palliative Care, in partnership with The Hastings Center, University of Rochester Finger Lakes Geriatrics Education Center (FLGEC), and Calvary Hospital, will host its annual conference this December 11th at Iona College, New Rochelle, N.Y., titled The Next Generation of Palliative Care: Integrating Palliative and Social Ethics of Care.”
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  • Hastings Center News

    Addressing Structural Injustice: A Call to Action for Bioethics

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    Hastings Center News
    Tremendous wealth beside abject poverty, a widening income gap, the vast disparity between the life prospects of a black child and a white child -- structural injustices are pervasive in our country and many places in the world. What does bioethics have to say about these problems? The Hastings Center has committed to intensifying it efforts to address structural injustices. Ideas for doing so emerged in a plenary session organized by Hastings at the annual meeting of the American Society for Bioethics and Humanities.
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  • Hastings Center News

    New Project Seeks to Build Diverse Participation in Precision Medicine Research

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    Hastings Center News
    The Hastings Center is co-leading a new project to examine recruitment and retention of participants the National Institutes of Health’s All of Us Research Program, an unprecedented initiative to collect genetic and other health-related data from at least one million people living in the United States. This project will focus on a research site that is a health center that serves primarily Latino and African American patients -- groups historically underrepresented in research – to identify strategies to build engagement.
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  • Hastings Center News

    Award-Winning Essay: How Can Mobile Apps Improve Clinical Trials and Safeguard Participants?

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    Hastings Center News
    The Hastings Center is pleased to announce the winner of the inaugural David Roscoe Award for an Early-Career Essay on Science, Ethics, and Society.
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  • Bioethics Forum Essay

    Diving Deeper into Amazon Alexa’s HIPAA Compliance

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    Justice for Survivors of Sexual Assault

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    Hastings Center’s Rosemary Gibson Honored for Enhancing Health Care Quality

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    Hastings Center News
    The American Pharmacists Association Foundation recognized Hastings Center’s Rosemary Gibson with a 2019 Pinnacle Award for career achievement on Monday, September 16. 
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  • Bioethics Forum Essay

    The Public Charge Rule Is a Eugenic Policy

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

    Does Genetic Testing Pose Psychosocial Risks?

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    Hastings Center News
    For the last quarter century, researchers have been asking whether genetic information might have negative psychosocial effects. Anxiety, depression, disrupted relationships, and heightened stigmatization have all been posited as possible outcomes—but not consistently found. What accounts for the ...
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  • Bioethics Forum Essay

    It’s Unethical to Use Dental X-Rays to Send Migrant Children to Adult Detention Facilities

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    Hastings President Addresses the Question: Is Ethical AI an Oxymoron?

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

    Living with Pain and Opioid Addiction: Bioethics Narratives

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    Bioethics Forum Essay
    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.
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  • Hastings Center News

    Dementia and the Ethics of Choosing When to Die

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    Hastings Center News
    As the American population ages and dementia is on the rise, The Hastings Center is embarking on pathbreaking research to explore foundational questions associated with the dementia trajectory and the concerns of persons facing this terminal condition. This new research is made possible by a major g...
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  • Bioethics Forum Essay

    Religion, Suffering, and the Physician’s Role

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    Bioethics Forum Essay
    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."
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  • Hastings Center News

    New York City Initiative to Cover the Uninsured Reflects Hastings Research, Recommendations

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    Hastings Center News
    On May 7, New York City officials unveiled details of NYC Care, a new  program in the nation’s largest public health system that aims to improve health care access for about 300,000 low-income New Yorkers who are ineligible for insurance because of their immigration status. The initiative, ann...
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  • Hastings Center News

    Genomics Enters the Clinic: What Should Savvy Consumers Know?

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    Hastings Center News
    Genetics is finally being integrated into the clinic: cancer patients are having their cancer’s genome sequenced, fertility patients are having their embryos tested, and parents are being offered sequencing of their newborn babies.
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  • Hastings Center News

    Should Patients Be Considered Consumers? Hastings Scholars Say, No.

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    Hastings Center News
    There is broad support for building health care systems that are patient centered, seen as a means of improving health outcomes and as morally worthy in itself. But the concept of patient-centered care has increasingly merged with the concept of patients as consumers, which “is conceptually confuse...
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  • Bioethics Forum Essay

    What Dr. Seuss Saw at the Golden Years Clinic

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    Bioethics Forum Essay
    “Improving patient experience” has become the mantra of many health care facilities in a highly competitive and regulated environment. But just what is it about the patient experience that needs to be improved?  Will better food and gift bags do the trick? Or are more basic changes required?
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  • Bioethics Forum Essay

    Prevention Optimism: Does It Raise Ethical Questions about PrEP for HIV?

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    Bioethics Forum Essay
    The introduction of pre-exposure prophylaxis (PrEP) as a means of preventing HIV infections in those at high risk marked a significant step in the fight against the virus. PrEP involves taking the HIV medicine Truvada or a generic version daily. It is now gradually becoming available across the world...
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  • Bioethics Forum Essay

    Staying in Their Lane: Health Professionals Must Address Gun Violence

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    Bioethics Forum Essay
    In the wake of the recent Twitter fight between the National Rifle Association and U.S. physician groups over whether doctors should speak out about firearm policy issues, we argue that professionalism actually requires that doctors take a leadership role in gun policy debates, even if (in fact, espe...
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  • Hastings Center News

    The Hastings Center Celebrates Outstanding Journalists

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    Hastings Center News
    Three journalists received The Hastings Center Awards for Excellence in Journalism on Ethics and Reprogenetics. The awards were presented at an event in New York City on December 6 that celebrated the role of journalists in helping the public understand the science of heredity and the power of geneti...
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  • Bioethics Forum Essay

    Should We Edit the Human Germline? Is Consensus Possible or Even Desirable?

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    Bioethics Forum Essay
    I started writing this on my way back to New York from the Second International Summit on Human Genome Editing, held in Hong Kong November 27 to 29, where the breaking news of the alleged world’s first birth of genetically edited babies loomed large. The surprising news both reinforced and undercut...
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  • Bioethics Forum Essay

    Three Ethical Reasons for Vaccinating your Children

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    What I Practice: Democratic Medicine

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    Bioethics Forum Essay
    When people ask me what kind of medicine I practice, I most often say family medicine. Now, however, I am also apt to say I practice “democratic medicine.” What is democratic medicine? Less a style than a way of being, it embodies five principles born of democratic values related to history, duty...
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  • Hastings Center News

    Debating Modern Medical Technologies: The Politics of Safety, Effectiveness, and Patient Access

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    Hastings Center News
    Does a new medicine or diagnostic test work? Is it safe? Should the government approve it and insurers pay for it? The answers are not as straightforward as they may seem – and the reasons are the subject of a new book by Karen J. Maschke, a research scholar at The Hastings Center, and Michael K. G...
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  • Bioethics Forum Essay

    Let the Sun Shine into the Medical Ivory Tower

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    Bioethics Forum Essay
    In 2012, I coauthored a case report about the successful use of dietary supplements in treating a case of male infertility in the American Family Physician. Before it was published, I was surprised to receive a communication asking me to disclose the fact that I had written a textbook on dietary supp...
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    New Project: Countering the Rising Threats to Immigrant Health

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    Hastings Center News
    Immigrants and their families in the United States and migrants who seek asylum in this country face accelerating threats and harms to their health because of the Trump administration’s immigration priorities. A new Hastings Center project, supported by the Open Society Foundations Public Health ...
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  • Bioethics Forum Essay

    Wrongful Death Suits for Frozen Embryos: A Bad Idea

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    Bioethics Forum Essay
    Last March, 4,000 frozen eggs and embryos were lost at University Hospitals Fertility Center in Cleveland when the temperature in cryogenic tanks spiked due to human error. Officials at University Hospitals have apologized repeatedly to the affected patients, and say that they are working to provide ...
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  • Bioethics Forum Essay

    England’s Abortion Law Catches Up

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    Bioethics Forum Essay
    Last month, England announced that it would allow women to take the second pill required for a medical abortion–misoprostol–at home, rather than requiring them to travel to a clinic. The policy brings England in line with Scotland and Wales, as well as many other countries, and it elimina...
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  • Bioethics Forum Essay

    Immigrant Health and the Moral Scandal of the “Public Charge” Rule

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    Bioethics Forum Essay
    A long-anticipated policy change proposed by the Trump administration that would count the use of many federally-subsidized programs against immigrants currently eligible to use them threatens public health and would undermine ethical practice in health professions and systems.
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    Hastings Scholar on Ensuring Evidence-based Prescribing of Off-Label Drugs

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    Hastings Center News
    It is legal and common for physicians to prescribe drugs for uses other than those for which they are approved by the Food and Drug Administration. But in a letter in JAMA: The Journal of the American Medical Association, Hastings Center research scholar Karen J. Maschke points to the important role ...
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  • Bioethics Forum Essay

    Newspaper Op-Eds Should Disclose Authors’ Industry Ties

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    Bioethics Forum Essay
    Earlier this month, The Seattle Times published an op-ed by Samuel Browd, medical director of Seattle Children’s Sport Concussion Program, on the risks of brain injury in youth sports. Dr. Browd acknowledged troubling research on the dangers of repetitive brain trauma, but also emphasized that mil...
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  • Bioethics Forum Essay

    Jahi McMath, Race, and Bioethics

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    Bioethics Forum Essay
    Twice upon a time, there was a girl who died. The death certificate that New Jersey issued to 17-year-old Jahi McMath on June 22 was the second one issued for her. California issued McMath’s first death certificate in December 2013.  McMath had been admitted to Children’s Hospital Oakland on...
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  • Bioethics Forum Essay

    Addyi Rises Again

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    Bioethics Forum Essay
    Addyi, a drug that made a splash when it was approved in the summer of 2015 as the first “female Viagra,” is back. Its rise, fall, and rise again is an example of shrewd pharmaceutical marketing and the potential dangers it can pose to patients.
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  • Bioethics Forum Essay

    What Are the Rules for Ethical Medication of Migrant Kids?

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    Bioethics Forum Essay
    Reports that migrant children held by the Office of Refugee Resettlement are being drugged require an immediate and unambiguous response by the Trump administration. According to court filings, the drugs that are alleged to be among those given to children without their parents’ consent include cl...
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  • Hastings Center News

    Scanning the Landscape of Physician-Assisted Death

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    Hastings Center News
    The National Academies of Science, Engineering, and Medicine released Physician- Assisted Death: Scanning the Landscape, proceedings from a two-day workshop convened by the National Academies in February to take a comprehensive look at the current landscape of physician-assisted death in the United S...
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  • Bioethics Forum Essay

    Love and Boundaries in Medicine

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    Bioethics Forum Essay
    It’s a little-known and rarely discussed fact of medical practice that doctors value the ability to love our patients. If the thought of doctors loving patients makes you queasy, be reassured. I’m not talking about romantic love but the visceral sense of goodwill and impulse to service that draws...
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  • Bioethics Forum Essay

    Shocking the Conscience: Justice Department versus the Health of Immigrant Women and Children

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    Bioethics Forum Essay
    In April, the U.S. Justice Department announced that it would criminally prosecute migrants who had been apprehended after crossing the U.S.-Mexico. border. An immediate consequence of this announcement, explained in detail here, is the separation of children from their parents.
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  • Bioethics Forum Essay

    The Only PhD Scientist in Congress Speaks About Truth, Politics, and Human Flourishing

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    Bioethics Forum Essay
    At a time when facts are distorted, disregarded, and ignored in policy making and political discourse, the need in Washington for seekers and defenders of truth has perhaps never been greater. I discussed the state of affairs with Representative Bill Foster, a Democrat from Illinois who prides himsel...
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  • Bioethics Forum Essay

    Trumping Drug Costs

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    Bioethics Forum Essay
    I usually have trouble finding a good word to say for President Trump’s policy ventures, but his aim to better control out-of-pocket drug costs is worth support. Distressingly, but unsurprisingly, it does not include giving government the needed power to bargain with industry for what it will pay f...
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  • Bioethics Forum Essay

    Addressing Questions About DTC Genetic Tests and Privacy

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    Bioethics Forum Essay
    The process is fairly simple. You select one of the companies that offer direct-to-consumer genetic tests; pay online; receive a neatly packed kit that contains a tube designed to collect your spit; return the package using prepaid postage; and wait for the results that will unravel the mysteries of ...
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    Hastings Center President Calls for “Moral Leadership” to Improve End-of-Life Care

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    Hastings Center News
    Are you, as caregivers in a twenty-first century health system, helping your patients and families to make fully informed decisions about the treatments they want and that are likely to be in their best interest?  Or, like so many clinicians working in modern health care systems today, are your pati...
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  • Bioethics Forum Essay

    Is it Time to Regulate the Sale of Sugar to Minors?

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    Bioethics Forum Essay
    In “Tackling Obesity and Disease: The Culprit Is Sugar; the Response is Legal Regulation,” published in the Hastings Center Report, Lawrence O. Gostin describes four coordinated interventions that have been effective at controlling peoples’ tobacco consumption and which can serve as a “powerf...
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  • Bioethics Forum Essay

    Should Doctors Treat Family Members?

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    Bioethics Forum Essay
    Many privileges come with having a doctor in the family: appointments squeezed into busy schedules as personal favors, a conspicuous lack of financial strain, an ability to comprehend both treatment plans and health care systems. But familial and professional roles often clash in a health crisis.
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  • Bioethics Forum Essay

    Palliative Care vs. Cancer Research

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    Bioethics Forum Essay
    The death of former first lady Barbara Bush at age 92 was noteworthy in many ways. She was by all accounts smart, sharp and funny, and a fine, helpful wife to one president and mother to another. Her death last week after a long illness, with her husband at her side, was a model of palliative care su...
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    Hastings Scholar and Pulitzer Prize-Winning Journalist on Conscientious Objection

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    When is it acceptable for health care professionals to refuse to provide a treatment because it violates their conscience? The implications of recent developments in federal and state governments that increase protections for conscientious objection were the focus of a panel discussion in New York Ci...
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  • Bioethics Forum Essay

    Evaluating Recommendations to Increase Organ Donation

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    Bioethics Forum Essay
    While the U.S. system of organ donation and transplantation is in a state of growth for the fifth year in a row, the call for new strategies to accelerate that progress has never been more robust as the critical need for transplantable organs continues to far exceed the supply. In an article in the M...
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  • Bioethics Forum Essay

    Fentanyl at Your Door: Who are Pain Groups Advocating For?

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    Bioethics Forum Essay
    In February, Senator Claire McCaskill (D-Missouri) published a report that revealed the unsettling relationship between opioid manufacturers and pain advocacy groups. Focusing on five opioid manufacturers, Purdue, Janssen, Depomed, Insys, and Mylan, the report found that manufacturers contributed $9 ...
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  • Bioethics Forum Essay

    Organ Donation and Transplantation in the U.S.: 50 Years of Success, Strategies for Improvement

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    Bioethics Forum Essay
    The Uniform Anatomical Gift Act, a landmark law adopted 50 years ago this summer, has provided a sound and stable legal platform on which to base an effective nationwide organ donation and transplantation system, as we discuss in our article in the current issue of the Hastings Center Report. We work...
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  • Bioethics Forum Essay

    “No one was listening to us.” Lessons from the Jahi McMath Case

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    Bioethics Forum Essay
    “It was like he thought we were dirt.”
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    Documentary Series Premiere on Genetic Medicine Features Hastings Scholars

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    Hastings Center News
    Hastings Center president Mildred Z. Solomon and director of research Josephine Johnston were featured speakers at the premiere screening of The Code, a series of three documentaries on the origins of genetic medicine and what its successes and failures mean for the future. The series was produced by...
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  • Bioethics Forum Essay

    Being Poor Is a Full-Time Job

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    Bioethics Forum Essay
    An article in the Hastings Center Report asks whether it is ethical to ration health care by inconvenience and red tape. In other words, given that all societies must ration health care in one way or another, is it ever ethical to push people away from an unpreferred health care option by making it m...
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    Lena Dunham’s Lesson for Doctors

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    Bioethics Forum Essay
    In a recent essay in Vogue the actress, writer, and director Lena Dunham described her decision to have a hysterectomy at age 31 after a decade of unsuccessful attempts to control increasingly excruciating pain from endometriosis. The decision was difficult because it meant that she would never be ab...
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  • Bioethics Forum Essay

    Reproductive Freedom: The More Things Change . . .

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

    Breastfeeding and Transgender Women

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    Bioethics Forum Essay
    A transgender woman has successfully breastfed a baby. This case has been hailed as a “breakthrough” for transgender families. I will argue that being transgender is only peripherally relevant, and the potential risks to infants are unjustified.
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  • Bioethics Forum Essay

    Natural, Medical, Political Childbirth

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    Bioethics Forum Essay
    “It felt selfish to put my baby at serious risk by pursuing a vaginal birth,” writes Kristen Terlizzi in a collection of essays published recently in Narrative Inquiry in Bioethics. You can read Terlizzi’s full story here.
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  • Hastings Center News

    Questions About Conscientious Objection in Health Care

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    Hastings Center News
    In January the Department of Health and Human Services acted to increase enforcement of laws that permit doctors and other health care workers to refuse to provide services such as abortion because of moral or religious objections. A new Conscience and Religious Freedom Division in the department’s...
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  • Bioethics Forum Essay

    After Hurricane Harvey, Injustice in Houston

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    Bioethics Forum Essay
    Hurricane Harvey dissipated in September, but much of the destruction that it wreaked on Texas and Louisiana remains. When addressing residential concerns, disaster relief officials prioritize the newly homeless over the chronically homeless, choosing to protect the previously privileged over the unp...
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  • Bioethics Forum Essay

    Improving Ethics at the Bedside

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    Bioethics Forum Essay
    It’s one o’clock in the morning in the pediatric intensive care unit.  A 16-year-old patient tells his nurse that he disagrees with the medical treatment plan that was agreed to by his parents. While he is legally a minor, he may have the capacity to make his own medical decisions. He is...
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  • Hastings Center News

    Hastings Center Scholar Addresses Implications of CDC Avoiding Seven Words

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    Hastings Center News
    Vulnerable. Entitlement. Diversity. Transgender. Fetus. Evidence-based. Science-based. Last week, news outlets reported that the Centers for Disease Control and Prevention had been advised to avoid using these seven words in budget documents. In an interview with Medscape Hastings Center research sc...
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  • Bioethics Forum Essay

    Cancer and Fertility: Learning from Survivors

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    Bioethics Forum Essay
    As modern medicine improves survival odds, many young cancer patients are living long lives that bear the markings of the disease and its treatment. The side effects of chemotherapy, radiation, and surgery often include damage to fertility, such as early menopause or the loss of viable sperm. A recen...
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  • Hastings Center News

    Deadline Extended: Help Us Recognize Physicians for Outstanding End-of-Life Care

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    Hastings Center News
    Nominations have been extended to January 22, 2018 for The Hastings Center Cunniff-Dixon Physician Awards, which recognize physicians in the United States who give exemplary care to patients nearing the end of life. The awards commend doctors  who provide outstanding care at the bedside, serve as mo...
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  • Bioethics Forum Essay

    Medicine, Morals, and Female Genital Cutting

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    Bioethics Forum Essay
    The arrest of Jumana Nagarwala and her colleagues, in what has become the first case to be tried under the federal law prohibiting female genital mutilation, has brought female genital cutting practices into public conversation once again. Dr. Nagarwala, an emergency medicine physician from a small S...
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  • Hastings Center News

    How Much Control Should You Have Over Your Biological Data?

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    Hastings Center News
    When you donate a sample of blood or saliva for research purposes, is it your property? What about the genetic and other data it contains? Should you be allowed to specify the type of research it is used for? These and other ethical questions are at the heart of a new book, Specimen Science: Ethics a...
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  • Bioethics Forum Essay

    When Are Organ Recipients Human Research Subjects?

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    Bioethics Forum Essay
    Do the recipients of organ transplants have a right to know if the organs they are about to receive were part of a research study? If so, are the recipients themselves research subjects? A recent article in the Hastings Center Report maintains that the recipients do have a right to know, but that the...
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  • Bioethics Forum Essay

    A Call for Medical Students to Learn the Full Story about the “Father of Gynecology”

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    Bioethics Forum Essay
    Along with the recent public debates over  Confederate memorials, there have been calls to remove or modify the statue of Dr. J. Marion Sims, called the father of gynecology in medical histories, who conducted horrific experiments on enslaved black woman.   Removal of the structures alone will not...
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    Breakthrough Cancer Treatment: Hastings Scholars Discuss Hope and Challenges in Health Affairs

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    Hastings Center News
    The first gene therapy for cancer, approved by the Food Drug Administration in August, will transform the treatment of a particular kind of cancer in children and young adults.  It’s transformative because it uses a patient’s own immune cells to attack the cancer cells. The hope is that this is ...
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  • Bioethics Forum Essay

    Being a Good Doctor When Patients Fear Deportation: Lessons for Future Physicians

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    Bioethics Forum Essay
    An  article in the New England Journal of Medicine last March warned of the “chilling effect” of recent federal immigration policy changes on health care access for undocumented immigrants. The Trump administration’s expanded immigration enforcement has seen an increased number of arrests at m...
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  • Bioethics Forum Essay

    On Sims’s Legacy: Work for Bioethics

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    Bioethics Forum Essay
    My  colleague Susan Reverby surely got this right: It is time to consider anew what to do about Dr. J. Marion Sims, that is, what to do about the New York City statue that commemorates him, and accordingly, about the medicine, history, and bioethics that have remembered and/or revered him. The works...
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  • Bioethics Forum Essay

    Removing the Stigma from “Stigmatopin” to Help Curb Opioid Dependence

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    Bioethics Forum Essay
    The magnitude of the opioid epidemic is increasing across North America, stretching its harmful reach across socioeconomic borders. Drug overdoses are currently the number one killer of Americans under the age of 50. Reports suggest that in the next decade the opioid epidemic could kill more people t...
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  • Bioethics Forum Essay

    Charlie Gard, Compassionate Use, and Single-Payer Health Care

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    Bioethics Forum Essay
    The case of Charlie Gard continued to unfold this week as Charlie’s parents, Connie Yates and Chris Gard, withdrew their appeal for permission to bring him to the United States for experimental treatment. The move came after tests showed that Charlie had sustained irreversible muscle damage, making...
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  • Bioethics Forum Essay

    Masked Marketing: Pharmaceutical Company Funding of ADHD Patient Advocacy Groups

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    Bioethics Forum Essay
    In 1971, the United Nations passed a resolution prohibiting its member nations from advertising psychotropic drugs to the general public. More than 40 years later, this resolution has done little to halt pharmaceutical companies from marketing stimulants as treatments for attention deficit-hyperactiv...
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  • Bioethics Forum Essay

    The Score is Even

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    Bioethics Forum Essay
    Three years ago, a small pharmaceutical company with a big agenda created a fake feminist group so that they could get a bad drug approved by the Food and Drug Administration. The story of how this happened is a case study in how industry affects medical discourse, the subject of a PharmedOut confere...
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  • Hastings Center News

    Helping Transgender Adolescents Make Informed Decisions About Their Reproductive Care

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    Hastings Center News
    Danielle is a 15-year-old transgender female who is about to begin hormone therapy. Her parents would like her to explore gamete cryopreservation – sperm freezing – as a means of preserving her fertility, which could be impaired by the hormone treatments. Danielle would prefer not to, remarking, ...
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  • Hastings Center News

    Governance of Emerging Technology Conference Features Hastings Center Experts

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    Hastings Center News
    Artificial intelligence, gene editing, synthetic biology – these are among the new technologies discussed at Governance of Emerging Technology 2017, organized by Arizona State University College of Law and cosponsored by The Hastings Center, which took place in Phoenix on May 17 – 19. Hastings Ce...
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  • Hastings Center News

    Robert Wilson Charitable Trust Enables The Hastings Center to Set Priorities for Future Work on Aging

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    Hastings Center News
    It’s unusual for a funder to recognize that large societal problems are best addressed after deep reflection and a deliberate and inclusive process of consultation and priority-setting.  “But then,” says Mildred Z. Solomon, president of The Hastings Center, “The Robert Wilson Charitable Trus...
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  • Bioethics Forum Essay

    Health Reform and Competing Visions of Justice

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    Bioethics Forum Essay
    On May 4, 2017, just over one month after abandoning a previous version of the bill, the U.S. House of Representatives voted by a 217-213 margin (with one abstention) to adopt the American Health Care Act (AHCA). During the coming weeks and months, most of the political commentary will focus on the s...
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  • Hastings Center News

    Association of Health Care Journalists Meeting Features Hastings Center Experts

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    Hastings Center News
    The Hastings Center teamed up with the Association of Health Care Journalists (AHCJ) to create three sessions on gene editing for its annual meeting in Orlando on April 20. In addition, Hastings Center research scholar Nancy Berlinger was a panelist on a session concerning health care for refugees an...
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  • Bioethics Forum Essay

    OrthoKantics

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    Bioethics Forum Essay
    In 2008, The President’s Council on Bioethics turned to Immanuel Kant and his deontological philosophy as a resource for deliberations on contemporary bioethical issues.  The report focused on Kant’s understanding of human dignity, and his deduction that the value of a human is intrinsic.  The ...
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  • Hastings Center News

    For Medicare Coverage, What Outcomes Should Count and What Evidence Is Needed?

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    Hastings Center News
    Why doesn’t Medicare pay unconditionally for amyloid PET imaging, a brain scan that identifies whether patients have beta amyloid plaque in their brain tissue, which may be a contributing factor for Alzheimer’s disease? This question is at the heart of current disputes about health technology ass...
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  • Bioethics Forum Essay

    How “America First” Undermines Our Health

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    Bioethics Forum Essay
    People value their health. It allows them to pursue their aims and enjoy their lives, and it contributes to their well-being. But health is not only good for particular healthy individuals. It is also good for their families, communities, nations, and in a world in which people flows are global, heal...
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  • Bioethics Forum Essay

    Neil Gorsuch, Aid in Dying, and Roe v. Wade

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

    A Doctor’s Dilemma: A Case of Two “Right” Answers

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    Bioethics Forum Essay
    Imagine you are a doctor running a clinic in a primarily lower-income neighborhood, where many of your patients are recent immigrants from different parts of the world. You are granted a fixed annual budget of $100,000 through your local public health department, and it is unlikely that you can obtai...
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  • Bioethics Forum Essay

    New Homeland Security Rules and Health Care Access for Undocumented Immigrants

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    Bioethics Forum Essay
    On February 21, the Department of Homeland Security released new policies prioritizing deportation of undocumented immigrants. Will this policy shift affect health care access for this population of 11 million? Two public health studies from Arizona suggest that immigration crackdowns change health-s...
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  • Hastings Center News

    What Happens When Undocumented Immigrants Are Seriously Ill?

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    Hastings Center News
    How do state and local health care systems care for seriously ill undocumented immigrants? This question is the focus of a collection of articles in JAMA Internal Medicine. Nancy Berlinger, a Hastings Center research scholar and coauthor of one of the articles, “The Illness Experience of Undocument...
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  • Bioethics Forum Essay

    The 21st Century Cures Act Sparks Values Debate

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    Bioethics Forum Essay
    On December 13th, President Obama signed the 21st Century Cures Act, a bipartisan, multidimensional health research and development bill.  The act allocates $4.8 billion to the National Institutes of Health and $500 million to the Food and Drug Administration over the next 10 years for research and ...
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  • Bioethics Forum Essay

    Health Care Access for Undocumented Immigrants under the Trump Administration

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    Bioethics Forum Essay
    Health care access is local; creating, financing, expanding, or restricting health care access for a low-income population involves local, state, and federal policies. During the Obama administration, health insurance for the estimated 11 million undocumented immigrants in the United States remained...
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  • Bioethics Forum Essay

    Public Health under the Trump Administration

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    Bioethics Forum Essay
    The recent report by the National Center for Health Statistics showing a decline in life expectancy in the U.S. in 2015 highlights a point largely overlooked in post-election discussions about health policy under the Trump Administration. The significant increases in health insurance coverage under t...
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  • Bioethics Forum Essay

    After the Election Bioethics Faces a Rocky Road

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    Bioethics Forum Essay
    Academic bioethics has never been popular with Republicans. Libertarians dislike academic bioethics because it seems too elitist and anti-free market.  Religious thinkers worry it is technocratic, soulless and crassly utilitarian. Now with Trumpism add a populist disdain for expertise, experts and t...
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  • Hastings Center News

    Transgender Medicine Focus of New Publication

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    Hastings Center News
    The November issue of the AMA Journal of Ethics is devoted to transgender health and medicine. Contributors include Elizabeth Dietz, a project manager and research assistant at The Hastings Center, who is co-author of “How Should Physicians Refer When Referral Options Are Limited for Transgender Pa...
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  • Hastings Center News

    Mildred Solomon on Controversial Duchenne Drug Approval

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    Hastings Center News
    Writing in the Health Affairs Blog, Hastings Center president Mildred Solomon says that the Food and Drug Administration’s controversial decision to approve the first drug for Duchenne muscular dystrophy is defensible, but only if there is adequate follow through. Read the post here.
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  • Bioethics Forum Essay

    Telemedicine Needs Ethical Guidelines

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    Bioethics Forum Essay
    Telemedicine is becoming more widespread. This is care at a distance, where patient and clinician are connected by information technology that may include video, audio, and monitoring equipment linked by computer. Telemedicine has many advantages. It can bring expert care and support to people in rem...
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  • Bioethics Forum Essay

    EpiPens and the Sale of Fear

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    Bioethics Forum Essay
    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.
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  • Bioethics Forum Essay

    The Challenge of High Drug Prices in the U.S.

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    Bioethics Forum Essay
    Drug spending in the United States increased more than 12 percent in 2014 and is projected to rise faster than overall health care spending over the next 10 years. Between 2007 and 2016, the price of a pair of epinephrine autoinjector EpiPens, used to counter life-threatening allergic reactions, rose...
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  • Bioethics Forum Essay

    Why EpiPen Prices Are No Shock

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    Bioethics Forum Essay
    High drug prices are a fact of modern American life. They are not, however, equally high for all Americans. Their magnitude depends on whether you are un-, under-, or adequately insured, and also whether or not you are an insurance company. Insurance companies routinely negotiate for lower-than-list ...
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  • Hastings Center News

    Nancy Berlinger Co-Authors Palliative Care Recommendations

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    Hastings Center News
    Hastings Center research scholar Nancy Berlinger is an author of a new policy statement on palliative care issued by the American Heart Association/American Stroke Association. The statement makes recommendations on how to reduce barriers that prevent many patients with heart disease and stroke from ...
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  • Bioethics Forum Essay

    Lincoln’s Promise: Congress, Veterans, and Traumatic Brain Injury

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    Bioethics Forum Essay
    Perhaps we were naïve. Our plan was relatively simple: we would chart the legislative evolution of programs for veterans with traumatic brain injuries (TBI) to identify policy gaps for this underserved and vulnerable population. With recent media attention highlighting the U.S. Department of Veteran...
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  • Bioethics Forum Essay

    Reframing Conscientious Care: Q&A with Mara Buchbinder

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    Bioethics Forum Essay
    Much of the conversation about conscience in health care has focused on the ethics of physician refusal to perform procedures that they object to. However, this framework seems insufficient for thinking about contemporary abortion provision, where new legislation is routinely passed to restrict the a...
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    U.S. Military Medical Ethics Guidelines in Limbo

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    Bioethics Forum Essay
    As President Barack Obama’s term comes to a conclusion, various initiatives started under his administration remain unfinished.  One of these, the adoption of the recommendations of the Defense Health Board (DHB), “Ethical Guidelines and Practices for U.S. Military Medical Professionals,”  is...
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    Do Documentaries Have to Tell the Truth?

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    Bioethics Forum Essay
    When the Tribeca Film Festival canceled its controversial screening of Vaxxed, a “documentary” (with scare-quotes) alleging a Centers for Disease Control cover-up of the debunked vaccine-autism link, it vindicated what scientists have collectively been saying for years: There’s nothing t...
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  • Bioethics Forum Essay

    On Living to 100 or More

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    Bioethics Forum Essay
    Sometime around my mid-50’s I began to ask myself a question: how long should I want to live? My father had died at 64, my mother at 85, my various uncles and aunts in their 60s and 70s. Occasional news stories, always with a picture, reported on those few people who made it to 100. I am now 85 an...
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    Canada Marches toward Expansive Aid in Dying

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    Bioethics Forum Essay
    Canada is on track to enact one of the most permissive assisted dying legislations in the world, comparable with laws in the Netherlands and Belgium.
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    The Case for Expanding Physician-Assisted Death to Psychiatric Conditions

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    Bioethics Forum Essay
    Should people suffering from psychiatric conditions, such as severe, prolonged depression, that have not responded to treatment, be eligible for physician-assisted death? Most jurisdictions that allow PAD do not permit it for psychiatric conditions. However, though rare, it is allowed in Belgium and ...
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  • Bioethics Forum Essay

    A Body With Bullet Holes and the Right to Arm Ourselves

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    Bioethics Forum Essay
    At the end of an otherwise quiet night, we were paged to the emergency department for a stat trauma. A man with multiple gunshot wounds was wheeled by paramedics into the trauma bay, his blood pressure perilously low. The surgeons searched his body for blood. They cut off his clothes and rolled his ...
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  • Bioethics Forum Essay

    Making an Example of Martin Shkreli

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    Bioethics Forum Essay
    Last month, the New York Times reported that the price of a 62-year old little-known drug, Daraprim (pyrimethamine), rose overnight from $18 to $750 a pill. About 100 pills are needed to treat toxoplasmosis, a disease caused by a parasite that lives inside a third of humans but can cause life-thre...
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  • Bioethics Forum Essay

    From Jackie and Me: A Plea for Opt-Out Organ Donation

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    Bioethics Forum Essay
    Three weeks ago, my dear friend Jackie, a internationally recognized bioethicist in her fifties who lives in Newcastle-Upon-Tyne, went to bed with what she thought was a bad case of flu. A few days later she was really ill, and her partner and another dear friend persuaded her to go to an emergency c...
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  • Bioethics Forum Essay

    California’s Strides in Providing Health Care for Undocumented Immigrants

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    Bioethics Forum Essay
    I had just turned 5 in November 1994 when my fellow Californians voted to pass Proposition 187 in a draconian attempt to restrict undocumented immigrants from receiving health care, education, and other services, as well as to require doctors, teachers, and others to report those suspected of viola...
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  • Bioethics Forum Essay

    Supreme Court Decision in King v Burwell: Backstory and Next Steps

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    Bioethics Forum Essay
    The Patient Protection and Affordable Care Act (ACA) relies on three primary strategies for expanding health insurance coverage. First, it regulates the insurance market to prevent practices that made it difficult or impossible for sick people to purchase insurance. Second, it expands Medicaid dram...
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  • Bioethics Forum Essay

    Rats Have Empathy, But What About the Scientists Who Experiment on Them?

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    Bioethics Forum Essay
    Decades of experiments have shown that rats are smart individuals that feel pain and pleasure, care about one another, can read others’ emotions, and will help unfamiliar rats even at a cost to themselves. It’s time to apply what we’ve learned from these animals and stop conductin...
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    When Words Matter: Medical Education and the Care of Transgender Patients

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    Bioethics Forum Essay
    I was only there to learn how to place IV lines. But as my anesthesia attending and I gathered our needles, tourniquet, and gauze, I noticed that our patient, whom I’ll call Jamie, didn’t appear to fit into a narrowly defined version of gender. I wasn’t sure whether to refer to Jamie as she, he...
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    Suing for Justice? More on the U.S. STD Studies in Guatemala

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    Bioethics Forum Essay
    On April 1, a $1 billion lawsuit was filed by three law firms based in the United States and Venezuela against Johns Hopkins University, the Rockefeller Foundation, and Bristol-Myers Squibb on behalf of more than 750 Guatemalans alleged to have been harmed when the U.S. Public Health Service and the...
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    The Drug that Cried “Feminism”

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    Bioethics Forum Essay
    Branded as “The Little Pink Pill” and “Female Viagra,” flibanserin, Sprout Pharmaceuticals’ only drug, was recently resubmitted to the Food and Drug Administration for approval for hypoactive sexual desire disorder (HSDD), a questionable condition promoted by pharmaceutical companies to sel...
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    New York City’s Compromise on Dangerous Circumcision Practice Leaves Infants at Risk

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    Bioethics Forum Essay
    I would guess that most Americans, even Jewish Americans, had never heard of metzitzah b’peh until the recent controversy between ultra-Orthodox Jews and the New York City Department of Health. This phrase, translatable as suction by mouth, refers to a custom performed after a circumcision in which...
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    Lessons from Ebola: Presidential Bioethics Commission Releases Recommendations on Preparedness for Public Health Emergencies

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    Bioethics Forum Essay
    This week the Presidential Commission for the Study of Bioethical Issues released a brief, Ethics and Ebola: Public Health Planning and Response,to the administration and the public on ethical preparedness for public health emergency response, with a focus on the U.S. response to the current Ebola e...
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    Measles, Vaccination, and the Tragedy of the Commons

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    Bioethics Forum Essay
    After having been virtually eliminated in the United States in the year 2000, measles have made a comeback, with nearly 150 cases in 17 states and nearly 30 confirmed cases of the illness in the Canadian provinces of Ontario, Quebec, and Manitoba.
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  • Bioethics Forum Essay

    Vaccine Exemptions and the Church-State Problem

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    Bioethics Forum Essay
    The current measles outbreak has brought public attention to the ease with which vaccine exemptions are available. As the media continually inform us, 48 states allow for religious exemptions, while 19 states also offer exemptions based on some sort of personal philosophy. The New York Times feature...
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    Have a Miscarriage and Go to Jail? Potential Consequences of Personhood Amendments

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    Bioethics Forum Essay
    When she was 18, Carmen Guadalupe Vasquez Aldana was sentenced to 30 years in jail. Her crime was delivering a stillborn baby. She was suspected of having had an abortion. While her  sentence was overturned on January 21,  her original conviction of homicide was the result of Article 1 of El Salv...
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    Don’t Categorically Refuse CPR to Ebola Patients

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    Bioethics Forum Essay
    Recently it has been argued that cardiopulmonary resuscitation (CPR) should, as a matter of policy, not be offered to persons with Ebola disease. Such a categorical restriction of CPR based solely on a patient’s diagnosis rather than his prognosis would be unique in modern medical practice. Beyond ...
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  • Bioethics Forum Essay

    Two Cheers for Choosing Wisely

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    Bioethics Forum Essay
    The Choosing Wisely campaign is one of the most exciting experiments in health care in quite a while. If it lives up to its potential, Choosing Wisely could prevent some of the harm caused by unnecessary tests and treatments, while helping to bring down medical costs. But the real challenge to the ...
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    Trapper’s Care in the Animal ER and Frank Talk about Costs

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    Bioethics Forum Essay
    “The capacity for suffering and enjoying things is a prerequisite for having interests at all, a condition that must be satisfied before we can speak of interests in any meaningful way,” –Peter Singer
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    Responding to Ebola: Health Care Professionals’ Obligations to Provide Care

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    Bioethics Forum Essay
    As health care institutions in the United States prepare for Ebola patients, many have adopted the policy that those providing hands-on care should come from a pool of volunteers. Given the mixed history of health care providers’ willingness to care for patients during epidemics and pandemics, an...
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    Responding to Ebola: Questions about Resuscitation

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    Bioethics Forum Essay
    While details of the deaths of patients in Dallas and Madrid from Ebola are not public, their passing prompts questions about resuscitation in individuals infected with the virus. To date, this question has not been raised in clinical ethics. We must now consider whether unilateral do-not-resuscitate...
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    The VA Crisis is Fundamentally an Ethics Crisis

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    Bioethics Forum Essay
    The crisis and failure of caregiving that have engulfed the Veterans Health Administration cannot be solved with increased resources or even by hiring more doctors and nurses. Additional resources are critical and necessary—but they are not a sufficient long-term and comprehensive solution to a pro...
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  • Bioethics Forum Essay

    Hobby Lobby Decision Likely to Increase Health Care Inequity

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    Bioethics Forum Essay
    The Supreme Court’s ruling in Burwell, Secretary of Health and Human Services, et al. v. Hobby Lobby Stores, Inc., et al., could undermine a central goal of the Patient Protection and Affordable Care Act (ACA): to expand access to health care by creating a system in which access to health care is ...
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    Chronicling the Tuskegee Syphilis Study Through Art

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    Bioethics Forum Essay
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    How I Learned Bioethics in Medical School

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    Bioethics Forum Essay
    The director of the medical intensive care unit did not like the idea of having a bioethicist around. But she agreed to the request, and there he was on rounds, most mornings for several months. The year was 1986.
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    LEGGO the Logo? Why Pharma Logos Belong on CME

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    Bioethics Forum Essay
    Several weeks ago, the Accreditation Council for Continuing Medical Education (ACCME) announced a new rule banning corporate logos from accredited educational materials for physicians. The ACCME sets standards for the continuing medical education (CME) that most practicing physicians must obtain in o...
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  • Bioethics Forum Essay

    The Latest Challenge to Health Privacy: Health Care Consolidation

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    Bioethics Forum Essay
    The American health care industry is undergoing a transformation in several respects, including the substantial integration and consolidation of health care providers. Three of the leading ways in which this is taking place are through mergers of hospitals and health systems, development of accountab...
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    Despite the Risks, and Because of Them, the FDA Should Permit Recycling Medical Implants

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    Bioethics Forum Essay
    It is hard to quibble with the fact that Dr. Daniel Mascarenhas is breaking the law. It is also hard to quibble with the fact that he is a hero.
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  • Bioethics Forum Essay

    What Role Should Bioethics Play in Global Health?

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    Bioethics Forum Essay
    I appreciate Dr. Benatar’s essay on the role of bioethics in confronting the challenges of global health inequities. His article aptly catalogues the contributing factors–both specific to health and otherwise–that weigh heavily on our unequal world. More importantly, Dr. Benatar’s focus on ...
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  • Bioethics Forum Essay

    Truvada: No Substitute for Responsible Sex

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    Bioethics Forum Essay
    A new debate is surging through the gay male population in the United States: should gay men take a drug that can reduce their risk of contracting HIV? The drug in question is Truvada, a combination antiretroviral commonly used to treat HIV infection. In 2012, Truvada was approved by the U.S. Food a...
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  • Bioethics Forum Essay

    Bioethics and the Dogma of “Brain Death”

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    Bioethics Forum Essay
    Two cases involving “brain death” have received considerable public attention, including commentary by several well-known bioethicists. In commenting on these cases the bioethicists have stated, in no uncertain terms, that an individual correctly diagnosed as “brain dead” is dead, pure and si...
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  • Bioethics Forum Essay

    “Health Care as Hospitality”: Organizational Ethics in a Migrant Health Clinic

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    Bioethics Forum Essay
    Geylang is the red-light district of Singapore, east of the city center. It would be easy, and wrong, to describe Geylang as a different world from the skyscrapers and malls of the contemporary, booming city. Its restaurants and its vernacular “shophouse” architecture link its street culture to o...
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  • Bioethics Forum Essay

    Genetic Information Is Not Always Benign

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    Bioethics Forum Essay
    Ethicists and others have been concerned that the disclosure of genetic information to patients might have negative consequences. The suspicion has been that negative effects, say, becoming depressed, are particularly likely when people are being informed about predispositions to diseases that are no...
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  • Bioethics Forum Essay

    New Recommendations for Research with Human Subjects Who Lack Consent Capacity

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    Bioethics Forum Essay
    The New York State Task Force on Life and the Law released its Report and Recommendations for Research with Human Subjects Who Lack Consent Capacity today, which analyzes the ethical and legal implications of involving cognitively impaired adults to participate in human subjects research (HSR). Th...
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  • Bioethics Forum Essay

    Bloomberg’s Health Legacy: What Inflames Consumer Passions in the Food Wars?

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    Bioethics Forum Essay
    After the Hastings Center Report published my essay on Mayor Bloomberg’s health legacy­ — with its key ideas spread through the popular media (here and here) — vitriolic messages streamed into my inbox. The messages were not intellectual arguments supporting free enterprise or limited governme...
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    Canada Confronts its Own “Tuskegee” Studies

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    Bioethics Forum Essay
    Last summer’s revelations that malnourished Aboriginals in Canada served as unwitting and unprotected subjects in nutritional experiments in the 1940s and 1950s brought a sharp reaction–though the research took place decades ago, the pain in Canada’s First Nations communities was fresh. First N...
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  • Bioethics Forum Essay

    In Search of Sterility

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    Bioethics Forum Essay
    In the November-December issue of the Hastings Center Report I wrote about voluntary sterilization for childfree women. The article came about through my inability to get sterilized as a childfree woman. I had never wanted children. In college I met a man who felt the same way. We fell in love a...
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  • Bioethics Forum Essay

    Doctors Googling Patients

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    Bioethics Forum Essay
    In the current issue of the Hastings Center Report, two teams of physicians and ethicists at Penn State consider the ethics of using online research and social networking tools to learn more about a patient who came to them with a request for a prophylactic bilateral mastectomy. The patient’s s...
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  • Bioethics Forum Essay

    Charging Smokers Higher Health Insurance Rates: Is it Ethical?

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    Bioethics Forum Essay
    Smoking-related illnesses cost the United States hundreds of billions of dollars a year in health care expenditures and lost productivity, and claim hundreds of thousands of lives.” Given the enormous medical and economic toll of smoking, it is not surprising that 58 percent of Americans favor ch...
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  • Bioethics Forum Essay

    The Supreme Court and the Fight Against AIDS

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    Bioethics Forum Essay
    The salience of the Constitution’s spending clause to the public’s health is not often appreciated–empowering the federal government to “provide for the common Defense and general Welfare.” But the power to spend–along with the equally vital power to tax–provides government with authori...
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    “Undocumented Doctors” and the Health of the Dreamers

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    Bioethics Forum Essay
    Loyola University Chicago Stritch School of Medicine’s recent announcement that it would accept applications from Dreamers – young undocumented immigrants eligible for Deferred Action on Childhood Arrivals (DACA)status – is an innovative and welcome response to the promise implicit in DACA....
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  • Bioethics Forum Essay

    Sports Concussions and Sandbagging

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    Bioethics Forum Essay
    Sport-related concussions are a significant public health problem, and concussion management is one of the most controversial issues in sports medicine. The latest international consensus statement on concussion in sport advises that players not return to play on the same day they were injured a...
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  • Bioethics Forum Essay

    Touching History

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    Bioethics Forum Essay
    AIDS in New York: The First Five Years is an exhibit running this summer at The New-York Historical Society, an organization so venerable that its name reflects how the city’s name was originally spelled.  The exhibit works on several levels: historically, as a story about how one city and region...
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  • Bioethics Forum Essay

    Learning to Talk Like a Doctor

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    Bioethics Forum Essay
    Three years before beginning medical school, I got off a bus in Granada, Spain and met the family I would be living with for four months. My host parents, Carmen and Monolo, introduced themselves and asked how old I was, where I was from, and how many sisters and brothers I had.  Within a few minute...
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  • Bioethics Forum Essay

    Why Target National Obesity Rates?

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    Bioethics Forum Essay
    In a recent article in the Hastings Center Report, Daniel Callahan argues that obesity is a serious public health problem facing the U.S. and suggests a variety of strategies for combating this problem. The article has provoked a great deal of public attention on blogs and web news sites since its...
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  • Bioethics Forum Essay

    Why Target National Obesity Rates?

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    Bioethics Forum Essay
    In a recent article in the Hastings Center Report, Daniel Callahan argues that obesity is a serious public health problem facing the U.S. and suggests a variety of strategies for combating this problem. The article has provoked a great deal of public attention on blogs and web news sites since ...
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  • Bioethics Forum Essay

    A More Ethical Strategy Against Obesity: Changing the Built Environment

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    Bioethics Forum Essay
    Since the 1960s, obesity has become one of the most significant health problems in industrialized nations. In the U.S., the percentage of obese adults increased from 13 percent in the 1960s to 32 percent in 2004. According to some estimates, 41 percent of U.S. adults will be obese by 2015 and 75 p...
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  • Bioethics Forum Essay

    Obesity and Public Health: No Place for Shame

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    Bioethics Forum Essay
    In his article, “Obesity: Chasing an Elusive Epidemic,” published in the Hastings Center Report, Daniel Callahan posits that obesity is so widespread and embedded in our culture that most if not all efforts to combat it have failed, and failed miserably. Change, in a large and most revolutionary...
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  • Bioethics Forum Essay

    Controversy in the Hastings Center Report: Responding to an Article on Obesity

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    Bioethics Forum Essay
    Nearly everyone agrees that obesity is a significant public health problem in the United States, and nearly everyone agrees that the public health responses to it so far have been disappointing.  So what should be done about it? In the January-February issue of the Hastings Center Report, an arti...
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  • Bioethics Forum Essay

    Rites and Wrongs: Changing a Ritual from Within

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    Bioethics Forum Essay
    The previously obscure ultra-Orthodox Jewish rite of metzitzah b’peh (oral suction) has burst into the news lately and raised critical questions about genital surgery, consent, First Amendment rights, tradition, and the representation of Jews. I would guess that most Americans, even Jewish-Amer...
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    TEDMED 2012: Great Expectations

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    Bioethics Forum Essay
    TEDMED, which took place in Washington last week, was a beehive of doctors, nurses, medical students, leaders of medical institutions and government health agencies, entrepreneurs, engineers, patients, patient advocates, athletes, musicians, artists, poets, and, yes, bioethicists — a diverse...
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    What is an Ounce of Prevention Really Worth?

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    Bioethics Forum Essay
    Is there an ethical case to be made for questioning the homespun wisdom, “An ounce of prevention is worth a pound of cure?” An argument along those lines caught a lot of attention when it was made in the Hastings Center Report 35 years ago by philosopher Benjamin Freedman. Now, on the 15thanni...
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    Why Shame Won’t Stop Obesity

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    Bioethics Forum Essay
    I am still in medical school, but today I sigh the frustrated, disapproving sigh of a fully trained doctor. “You know,” I scold the middle-aged man in front of me, “you really should start eating better.”
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    New Hope for Detecting Consciousness in Vegetative Patients: Ethical Implications

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    Bioethics Forum Essay
    Patients diagnosed as being in a persistent vegetative state have figured prominently in the law and medical ethics relating to end-of-life decisions since the case of Karen Quinlan in 1976. These patients have profound brain injuries that leave them in the seemingly anomalous condition of being awak...
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    Administration Reveals Lack of CLASS

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    Bioethics Forum Essay
    The demise of the CLASS (Community Living Assistance Services and Support) Act is the calamitous result of ideological warfare and political cowardice. It would have provided a modest benefit – a basic guaranteed lifetime benefit of at least $50 a day in the event of illness or disability to be use...
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    “M,” Polly, and the Right to Die

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    Bioethics Forum Essay
    Another landmark right-to-die case hit the U.K. headlines last week. A High Court judge ruled, in W v M & Ors [2011] EWHC 2443 (Fam), that a 52-year- old woman in a minimally conscious state (after contracting viral encephalitis nearly 10 years ago) cannot be allowed to die (by having artificial ...
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    Blotto, Not Beautiful, Medicine

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    Bioethics Forum Essay
    Reading Frank Bruni’s recent review in the New York Times of Provocateur, a chic bar in the meatpacking district, got me thinking about an argument I’d had recently with a family practice doctor. It’s true the argument had driven me to drink, but that wasn’t the essence of the connection betw...
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    Dying for Some Standards: Broken Medical Systems as Revealed by a New FDA Warning

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    Bioethics Forum Essay
    I’d like to say I was shocked when a colleague sent me the warning letter from Eli Lilly relaying results of a French study that indicate a 30 percent increased risk of death among children treated with recombinant human growth hormone (rhGH) in attempts to make them taller.
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    The Tale of Tea with Jim the Third

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    Bioethics Forum Essay
    It was one of those messages I get occasionally, this time from a man who had suddenly realized we were just a few blocks away from each other. The writer’s father was at a nearby Northwestern hospital, suffering from a terminal cancer.
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    Pink Boys with Puppy Dog Tails

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    Bioethics Forum Essay
    In my e-mail in-box a few weeks ago, I received a polite message from a woman named Sarah Hoffman who was writing to ask why I was being such a gender conservative. Sarah didn’t quite put it that way, but that was the gist of her message, and given that I’m usually accused of being a gender ra...
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    Attenuated Thoughts

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    Bioethics Forum Essay
    I was invited to join the Seattle Growth Attenuation and Ethics Working Group — collective author of the lead article in the current issue of the Hastings Center Report — but I begged off, claiming I had too many other things on my plate. True, but the bigger reason for avoiding the proj...
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    Bad Vibrations

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    Bioethics Forum Essay
    In “The Rhetoric of Dehumanization: An Analysis of Medical Reports of the Tuskegee Syphilis Project,” Martha Solomon brilliantly demonstrates how the project’s researchers hid their work in plain sight. Specifically, Solomon used the published reports of the Tuskegee syphilis study – which in...
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    Intersex and Sports: Back to the Same Old Game

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    Bioethics Forum Essay
    If you’re trying to make sense of the “decisions” just made in Miami about sex-typing in sports, and you’re struggling, join the club.
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    Medicine Needs a Declaration of Independence from Cosmetic Procedures

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    Bioethics Forum Essay
    What is medicine for? I found this question on my mind recently, not only because I had been discussing it with a group of thoughtful medical students to whom I was teaching the history of medicine, but also because I was shopping for a bra at Bloomingdale’s.
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    How and Why to Take “Gender Identity Disorder” Out of the DSM

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    Bioethics Forum Essay
    As a wizened gender rights advocate, I know better than to assume the activists making the most noise are actually representative of “the community” they insist they represent. So, while American transgender activists have lately been fairly unified and very vocal about the need to remove “Gend...
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    The AMA’s Apology: What’s the Benefit?

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

    Lavish Dwarf Entertainment

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    Bioethics Forum Essay
    A dwarf walks into a bar.
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  • Bioethics Forum Essay

    Selective Parenting

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    Bioethics Forum Essay
    For years, the abortion of fetuses likely to have disabilities has been called “selective abortion,” but, for reasons made clear in Hilde Lindemann’s thoughtful Bioethics Forumreflection on the matter, the practice might better be called “selective parenting.” It fundamentally reflects, aft...
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  • Bioethics Forum Essay

    Products of Conception

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    Bioethics Forum Essay
    Deborah Costandine and I met in June of 2004, but she didn’t send me the autopsy report of her baby for another year and a half. So I didn’t start looking for more information about what had happened to her until January of 2006. That’s when Deb wrote to say she was wanted some help, so that’...
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  • Bioethics Forum Essay

    Ashley and the Dangerous Myth of the Selfless Parent

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    Bioethics Forum Essay
    Because I’ve acted as a professional advocate for people born with norm-challenging bodies, quite a number of strangers and familiars have been writing to ask me what I think of the “Ashley Treatment.” Nine-year-old Ashley’s parents decided to remove their severely cognitively-impaired daught...
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  • Bioethics Forum Essay

    Really Changing Sex

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    Bioethics Forum Essay
    On Tuesday, the New York Times reported that New York City “is moving forward with a plan to let people alter the sex on their birth certificates even if they have not had sex-change surgery.” Under the new plan “being considered by the city’s Board of Health… people born in the city would...
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  • Bioethics Forum Essay

    Explaining More, Doing Less

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    Bioethics Forum Essay
    As if we didn’t have enough reasons to wish for better informed consent practices in the United States, here’s another: evidence that, if physicians spent more time seeking truly informed consent – telling patients what the best available studies show about their options – their patients migh...
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  • Bioethics Forum Essay

    Taking People at Their Word

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    Bioethics Forum Essay
    When I was a student, I loved to read Freud and Nietzsche and Marx. I was into what the great French philosopher Paul Ricoeur called “the hermeneutics of suspicion.” Sex, power, and money were at work everywhere. So were the psychological and social mechanisms that kept everybody else fro...
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  • Bioethics Forum Essay

    Proof that I Like Penises

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    Bioethics Forum Essay
    So, a new randomized control trial comes out showing that circumcision in adult males can dramatically reduce HIV infection rates, and all my friends who opted for circumcising their baby boys are holding up the dozens of national news accounts of this saying to me, “See?! See?!” Like I j...
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