Forum Posts by
Joseph J. Fins
- The Americans with Disabilities Act at 30: A Cause for Celebration During Covid-19?
Posted on July 27, 2020
A central mandate of the ADA is to make the goods of society accessible to people with disabilities and overcome their segregation in civil society through reasonable accommodation that allows them to go to work, live with their neighbors, and avoid institutionalization. But let’s not delude ourselves with historic sentimentality as disability law is placed under tremendous stress by the pandemic.
- Covid-19 Makes Clear that Bioethics Must Confront Health Disparities
Posted on July 9, 2020
With some reluctance, I’ve come to the sad realization the COVID-19 pandemic has been a stress test for bioethics, a field of study that intersects medicine, law, the humanities and the social sciences. As both a physician and medical ethicist, I arrived at this conclusion after spending months at what was once the epicenter of the pandemic: New York City. I was overseeing a 24/7 bioethics consultation service.
- New York State Task Force on Life and the Law Ventilator Allocation Guidelines: How Our Views on Disability Evolved
Posted on April 7, 2020
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.
- Disabusing the Disability Critique of the New York State Task Force Report on Ventilator Allocation
Posted on April 1, 2020
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.
- Hannah Arendt in St. Peter’s Square
Posted on October 14, 2019
Neither one of us expected to be talking about Hannah Arendt at the Vatican. We had been invited to give talks at the Pontifical Academy of Sciences on the scientific and ethical challenges posed by personalized medicine. Walking across the cobblestones of St. Peter’s Square we began to discuss how society regulates biomedical research. Are institutional review boards capable of dealing with innovations like personalized medicine? Are they too bound by regulations? Can they ask larger questions of meaning when simply following the rules won’t suffice? And most worrisome, has their bureaucratic function caused them to mistake regulatory compliance for ethical reflection?
- When Pat and Bob Nearly Saved Health Care Reform: A Lesson in Senatorial Bedside Manner
Posted on July 28, 2017
With Senator John McCain’s heroic return and Vice President Mike Pence’s tie-breaking vote on a health care bill July 25, Senate Republicans managed to cobble together 51 votes simply to agree to debate health care reform. This razor’s edge victory is diagnostic. Hyperpartisan debate is convulsive. It endangers the body politic and needs to give way to more… Read more
- Who “Persists” in Opposing DNR Orders? Demographics Matter
Posted on May 18, 2017
Reading “After DNR: Surrogates who persist in requesting cardiopulmonary resuscitation” in the Hastings Center Report, I was reminded of Senate Majority Leader Mitch McConnell’s chastisement of Senator Elizabeth Warren’s opposition to Jeff Sessions’ nomination as Attorney General. McConnell called for Warren’s censure by the Senate because she quoted a 1986 letter by Coretta Scott King… Read more
- Lincoln’s Promise: Congress, Veterans, and Traumatic Brain Injury
Posted on June 21, 2016
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 Affairs (VA) shortfalls for TBI – the “signature injury” of the… Read more
- Responding to Ebola: Questions about Resuscitation
Posted on October 10, 2014
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 orders are justified in this discrete clinical circumstance. To… Read more
- Orphans to History: A Response to the Bucharest Early Intervention Project Investigators
Posted on January 29, 2014
I appreciate the thoughtful responses to my essay on the ethics of the Bucharest Early Intervention Project (BEIP), from its investigators, Drs. Fox, Zeanah and Nelson and from Dr. Millum, one of the bioethicists who had defended their study design. Let me begin by considering how Zeanah, Koga, Simion, Stanescu, Tabacaru and Nelson for the BEIP Core Group responded , in… Read more
- Romanian Orphans: A Reconsideration of the Ethics of the Bucharest Early Intervention Project
Posted on October 15, 2013
Recently I had a Susan Reverby moment. Reverby is the Wellesley historian best known for unearthing the revelations of the Guatemalan syphilis and gonorrhea studies conducted by the United States Public Health Service and the Pan American Health Organization in the late 1940s. As the now famous story goes, Reverby was doing archival work on the Tuskegee… Read more
- Givers Beware: Medical Charities and Deceptive Fundraising
Posted on December 10, 2012
On a bright Sunday morning in New York’s Central Park, as October leaves bid a variegated farewell to green, nascent golds and auburns yielded for a few short hours to vibrant pink, the American Cancer Society held a fundraising walk for breast cancer. The local TV news anchors were outfitted in matching pink for the… Read more
- When Endemic Disparities Catch the Pandemic Flu: Echoes of Kubler-Ross and Rawls
Posted on April 30, 2009
Over the past several years, I have served on a couple of panels considering the clinical and ethical challenges posed by pandemic flu. Our concern was the threat posed by the avian variety brewing in China; not once did we discuss an alternative viral vector. Nonetheless, in light of the current fears that pandemic swine… Read more