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Topic: Bias
October 13, 2014 | Posted By Wayne Shelton, PhD

As I have been saying in recent blogs, most of what we do in clinical ethics, but also in most areas of bioethics, is procedural ethics. That is when we are faced with an ethical dilemma, our approach, whether consciously or unconsciously is usually to try to reach a reasonable compromise or consensus among the key participants that are in conflict consistent with well-established values and principles. This tendency reflects an obvious reality about the nature of contemporary ethics that we often ignore: in the current Western moral setting, our only viable methodology for resolving value laden disputes, whether at the micro level in clinical ethics or macro level in healthcare policy, is to attempt to craft an agreement or consensus among those with a say. Whether we are dealing with patients and families at odds with their physician on how to define the goals of care in the hospital setting or trying to build a consensus of opinion among voters in the political arena, we assume there are no final, authoritative moral answers that avail themselves to us. Whether we like it or not, we humans must figure out ethical dilemmas for ourselves and learn to get along.

Yet the idea of procedural ethics remains very worrisome for many people, including such bioethicists and Tristram Engelhardt, Jr. He believes that procedural ethics, such much of what we do in clinical ethics, is not really ethics in because it is based on convention and legalistic type standards. For him ethics worthy of the name must flow from a content-rich, canonical moral tradition that provides moral authority to our everyday ethical and moral judgments. The prototype ethical tradition was the medieval Christian Natural Law perspective grounded in Aristotelian philosophy. Aristotle assumed the inherent order and intelligibility of the cosmos, which also permeated his understanding of ethics. Humans, like all natural things, had a natural function, which was to be rational. But rational did not mean to that ethics was about finding intellectual or theoretical basis for right action according to rational rules in order to know and perform one’s duty—this was Kant’s (1724-1804) ethics during the 18th century following the rise of modern science. For Aristotle, the question was, how can one live and embody the good life; so rationality in this sense meant internal harmony between emotions and decision-making that resulted in well-established habits or states of character. This means finding in all of one’s activities the balance between excess and deficiency, or what he called the “mean”. Over time, forming the right habits according to the mean in all areas of life lead to excellence and happiness or what he called the good life. This was the natural fulfillment of the human function in practical terms consistent with the ancient Aristotelian.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website

June 3, 2014 | Posted By John Kaplan, PhD

The essence of responsible conduct of research is to assure that science concerns itself with the identification and clarification of objective truth.  I have spent some time this past week trying to read a recent study by Fanelli and Ioannidis entitled “US studies may overestimate effect sizes in softer research” published in the Proceedings of the National Academy of Science

 This is a statistical paper, written densely, but still mostly understandable even to a mere scientist such as myself. Many of you have probably heard of John Ioannidis. He has gained prominence by doing theoretical analysis of the studies of others and using his results to conclude that most biomedical research is wrong or at least biased. I may be wrong, or at least biased, but I have come to believe upon reading this work that Dr. Ioannidis is wrong and maybe biased as well.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website

May 16, 2014 | Posted By Zubin Master, PhD

Last month, I discussed bias in academia and more specifically in the workplace. Just to recap, there are several studies that show bias in peer review and bias or favoritism in the workplace. Much of the bias may be unconscious or what is considered “hidden bias” and is not shown overtly. In this month’s blog, I propose three steps to reduce bias in the workplace.

The solutions proposed here are geared towards academic work environments at the departmental level in one of the three settings: 1) professors or research scientists running a lab or a research group who supervise research assistants, students, fellows and staff; 2) department directors/heads; and 3) members and chairs of committees charged with the selection of candidates for awards, prizes, and positions. While I am not applying these steps to the peer review of grants or publications, some of the points may be helpful to reduce bias in peer review processes.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

May 12, 2014 | Posted By Wayne Shelton, PhD

Recently, the Governor of Tennessee signed into law a bill, SB 1391, which criminalizes a woman who has had a baby with drug-related complications.  As a result babies born with addictions due to drug use by the mother during pregnancy will be grounds for the mother being charged with aggravated assault, which could result in sentence of up to 15 years in prison for the mother. The concerns of the state legislators who promoted and passed this bill were over a condition in newborns called neonatal abstinence syndrome (NAS).  This condition results from exposure to addictive drugs while in the mother’s womb. In 2013 the Tennessee state Health Department reported 921 babies born with NAS and 278 cases so far in the past four months. The stated goal of the law was to reduce the number of babies born with this condition. But is criminalizing drug use during pregnancy, in this first of its kind state law, the most effective way of accomplishing this goal?

It is important to note that the bill was passed against the strong objections of women’s rights groups as well as health care and addiction specialty groups. First of all these experts agree that cause more harm to babies as pregnant women will be afraid to seek medical care.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

April 17, 2014 | Posted By Zubin Master, PhD

One of my areas of research focus in bioethics is known as the responsible conduct of research (RCR) (a.k.a. research integrity). Research on research integrity covers a range of different norms and practices including authorship and publication ethics, research misconduct (fabrication, falsification and plagiarism), responsible mentorship, peer review, and RCR education among others. I have written on several of these topics in our AMBI blogs.

One of the topics I am interested in chatting about today is bias in the academic setting, but even more generally in the workplace. Much about research methodology aims to reduce or eliminate bias. For example, the experimental scientific method attempts to reduce bias by having proper controls, blinding researchers, and employing statistics so that we don’t over interpret our findings. Sociologists and other qualitative researchers may declare their biases when reporting research so the reader knows where the researcher is coming from. The entire concept of declaring conflicts of interest also aim to permit others to know what potential interest(s) the researcher may have which could bias their results. Moreover, the peer review process, which academia heavily relies on, aims to reduce bias in research. Peer review is not only used in the context of evaluating research, it also evaluates academic scholars for jobs, committee memberships, awards and scholarships, and other entitlements. One recent studydone by Drs. Daniele Fanelli and John Ioannidis showed the overestimation of effect sizes in behavioral research. Here the researchers performed a meta-analysis of meta-analyses (cleverly called meta meta-analysis) and found that researchers working in the behavioral, but not biomedical, sciences tended to exaggerate effects that were not supported by the data. Most interestingly, this exaggerated effect was heightened if the research had one or more US authors. While this sort of bias in the reporting of research may at first glance seem relatively benign, it actually has significant consequences because other researchers build on the results of previously published work and accumulatively, our social policies and clinical practices are based on evidence collected from such studies. Yet bias can come in all sorts of shapes and sizes in the academic and research context, some of which I think hits more personally to individual researchers.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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