Topic: Bioethics and the Law
May 23, 2016 | Posted By Claire Horner, JD, MA and Paul Burcher, MD, PhD

Earlier this year, Utah passed a fetal pain bill that requires the use of general anesthesia on women seeking abortions at 20 weeks gestation or later.  This bill, which relies on a controversial claim that fetuses may feel pain as early as 20 weeks, has been heavily criticized as an attempt to abrogate abortion rights rather than serving a legitimate protective purpose. 

The issue of fetal pain has long been a source of contention in the scientific community, and the dispute has led to several states restricting or prohibiting abortions 20 weeks or later on the basis of potential fetal pain.  While many argue that this law is just one of many across the country aimed not at protecting health, but at restricting or eliminating abortion rights, this law, in fact, seems to be justified in its goal of minimizing the possible experience of suffering by the fetus. 

While studies have not proven that a fetus can feel pain prior to the third trimester, reasonable doubt about the possibility of fetal experience of pain exists.  As E. Christian Brugger argues in his article entitled “The Problem of Fetal Pain and Abortion: Toward an Ethical Consensus for Appropriate Behavior,” there is no moral certitude that fetuses do not feel pain after 20 weeks, and “a preponderance of evidence supports the conclusion that fetal-pain experience beginning in the second trimester of pregnancy is a real possibility.”  Brugger makes the argument, drawing from several researchers of fetal neuroanatomy that all the neural structures for both pain perception and consciousness are in place by 18-20 weeks.  Furthermore, he argues that those who deny fetal consciousness until much later in pregnancy may be relying on outdated assumptions which place the seat of consciousness in the cerebral cortex, despite growing evidence that the upper brainstem and subcortical tissues may actually play a greater role.

 

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.

December 29, 2015 | Posted By Claire Horner, JD, MA

“It is a disturbing consequence of modern biological technology that the fate of the nascent human life, which the Embryos in this case represent, must be determined in a court by reference to cold legal principles.”  Findley v. Lee, No. FDI-13-780539, 4 (Cal. Tentative Ruling Filed Nov. 18, 2015).

On November 18, 2015, the Superior Court of California issued a Tentative Decision and Proposed Statement of Decision holding that five embryos that were created and cryopreserved by a husband and wife, now divorced, must be destroyed in accordance with the agreement signed by the parties prior to beginning IVF.  According to the Court, the agreement contained, among others, a provision determining in advance the agreed-upon disposition of any remaining embryos in the event of divorce.  For this provision, both spouses initialed “thaw and discard.”  This “contractual approach” has been adopted by several jurisdictions that have had occasion to determine disposition of embryos in divorce.  In this analysis, courts will enforce an agreement signed by the parties prior to IVF as evidence of their intentions at the outset of the process.  

Courts in some states have decided such cases using different approaches.  The Constitutional rights approach (or balancing approach) looks at the interests of the parties, evaluating and balancing their respective rights, which seems to result in a comparison of the right to procreate and the right to avoid procreation.  This paradigm, in practice, has led courts to conclude that the right to avoid procreation typically prevails.  The contemporaneous mutual consent approach, on the other hand, attempts to reconcile the contractual approach with the current wishes of the parties by holding that pre-IVF agreements are valid and enforceable unless and until one of the parties changes his or her mind.  While this approach appears to recognize contracts, in practice a contract is disregarded where there is disagreement, and the embryos remain frozen until a mutual decision can be reached.

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 16, 2015 | Posted By Maggie Kirby

We are always pleased to support the activities of young scholars who are interested in bioethics. This link is a timeline of the Supreme Court case Gonzales vs. Oregon. It was prepared by Ms. Maggie Kirby who attends high school at U-32 in Vermont. It does a terrific job of documenting this important bioethics case and binging awareness to the ongoing debate about physician-assisted suicide. Great work Maggie! 

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 7, 2015 | Posted By Bruce D. White, DO, JD

On March 30, 2015, the American Pharmacists Association (APhA) House of Delegates – the group’s representative assembly – adopted a policy discouraging pharmacists from participating in executions. The APhA policy is only one sentence long: “The American Pharmacists Association discourages pharmacist participation in executions on the basis that such activities are fundamentally contrary to the role of pharmacists as providers of health care.”

In defending the new policy, APhA Executive Vice President and CEO, Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, stated, “Pharmacists are health care providers and pharmacist participation in executions conflicts with the profession’s role on the patient health care team. This new policy aligns the APhA with the execution policies of other major health care associations including the American Medical Association, the American Nurses Association, and the American Board of Anesthesiology.”

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. 

July 14, 2014 | Posted By Bruce D. White, DO, JD

On the very last day of the 2014 legislative session, the New York Senate passed “The Compassionate Care Act” (S.1682-A, Savino) approving the legalization of medical marijuana.  The Assembly had previously passed a companion bill (A.6357-A, Gottfried). The Senate bill has been sent to Governor Cuomo for his signature. The governor endorsed the bill in the legislature, but as of July 4, 2014, has yet to sign it.

New York medical marijuana proponents have been advocating for the availability of cannabis for several years. Neighboring states Connecticut, New Jersey, and Vermont, and 18 other states and the District of Columbia currently allow medical marijuana. However, last minute compromise changes to the New York law will severely restrict access to medical cannabis. In fact, the limitations are so rigid that some might say the bill is a hallow shell, a sham, one designed to appear to allow medical marijuana yet really not. Regardless of how one feels about medical cannabis, to hype the public into believing that marijuana will be available for medical purposes and then establishing barriers to its accessibility that is a fraud. It would be unconscionable to raise the hopes of distressed patients, many suffering with chronic and painful conditions, only to see those hopes dashed.

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 6, 2014 | Posted By Bruce D. White, DO, JD

The ongoing VA scandal is indeed unfortunate and sad. In a speech on May 30, 2014, in Washington, DC, Eric K. Shinseki apologized for the “systemic, totally unacceptable lack of integrity” shown by some administrators in managing the Veterans Administration health care system hospitals and clinics. Within hours of the apology, Secretary Shinseki resigned.

It is clear that the trouble within the VA has been brewing for some time. The fuse that set off this latest explosion may have been whistleblower claims that managers at the Phoenix VA Medical Center were keeping two sets of books which logged wait times for veterans seeking primary care appointments. There are allegations that some of the delays resulted in veteran deaths. Acting VA Inspector General Richard J. Griffin issued a preliminary report confirming that Phoenix VA administrators had manipulated wait times possibly to assure more favorable annual performance reviews and higher bonuses and compensation for staff.  The unethical behavior by those entrusted with the care of our veterans is inexcusable.

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.

February 17, 2014 | Posted By Bruce White, DO, JD

Last month, a New Mexico trial court judge ruled that a terminally ill patient had a constitutionally protected right to aid in dying from a physician without risking criminal prosecution for assisted suicide. Judge Nan G. Nash of the Second District Court in Albuquerque based her opinion in the New Mexico Constitution: “This court cannot envision a right more fundamental, more private or more integral to the liberty, safety and happiness of a New Mexican than the right of a competent, terminally ill patient to choose aid in dying.” Thus, the state became the fifth to permit physician-assisted suicide, following Oregon (1997, approved by voter referendum), Washington (2006, approved by voter referendum), Montana (2009, allowed by state supreme court opinion), and Vermont (2013, enacted by the state legislature).

The case was brought by two oncologists (Drs. Katherine Morris and Aroop Mangalik) who asked the court to clarify the state’s assisted suicide law and allow them write a lethal dose of a drug for a 49-year-old patient (Aja Riggs) with advanced uterine cancer. Critical to the case may have been the December trial testimony from the patient: “I don’t want to suffer needlessly at the end.”

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.

November 12, 2013 | Posted By Bruce White, DO, JD

With the endorsement of the American Society for Bioethics and Humanities (ASBH) Board of Directors, and the publication of a process to confer eventually a “quality attestation” credential on successful candidates, the ASBH Quality Attestation Presidential Task Force (QAPTF) has begun apilot procedure to assess those involved in providing clinical ethics consultation services. Importantly, it’s unclear at this point if the Task Force will be looking at those who provide consultation as an individual, or as a member of a small group of consultants or as a member of a larger ethics committee.

As part of the pilot to refine the process, the QAPTF has asked those interested to submit a letter of intent. (It is not a requirement that one be an ASBH member to submit a letter of intent.) The Task Force will review the submitted letters and select a representative sample (“a cross-section of eligible candidates whose professions represent the distribution of professions among Clinical Ethics Consultants”). 

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.

July 25, 2013 | Posted By Benita Zahn, MS

The law in the United States is clear that once a person has completed their prison sentence and parole they are free to go on and live their lives. The state does not have continued control over them. While some might argue that for sex offenders and regulations regarding where they may live impinges on this, that narrow issue is not the focus of this paper. I will argue that castration, chemical or physical, is antithetical to our society. 

The eighth amendment prohibits cruel and unusual punishment. Mutilation would be considered cruel and unusual punishment and castration clearly falls under that banner. It involves a surgical procedure to remove the testicles or in women, the removal of their ovaries. One need to look no further than to realize physical castration to control sexual predators should not be permitted.    

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 13, 2013 | Posted By Ricki Lewis, PhD

Earlier today, my “in” box began to fill with info from everyone I’ve ever met letting me know that the Supreme Court had ruled on the Myriad case about patenting the breast cancer genes BRCA1 and BRCA2. I also received a dozen pitches from PR people offering me all manner of instant interviews with lawyers, doctors, bioethicists, and health care analysts.

No one offered me an interview with a geneticist – a person who knows something about DNA. So being such a person myself, I decided to take a look at the decision. And I found errors – starting right smack in the opening paragraph.

“Scientists can extract DNA from cells to isolate specific segments for study. They can also synthetically create exons-only strands of nucleotides known as composite DNA (cDNA). cDNA contains only the exons that occur in DNA, omitting the intervening exons.”

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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