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Topic: Bioethics in the Media
May 2, 2012 | Posted By Michael Brannigan, PhD

The year is 2029. After discussing schedules, I've picked early afternoon April 28 as my day. That works for most of us. My wife will have returned from her conference. My sisters can fly in after their dance recital. My brother rescheduled his interviews.

Cousins can drive in from the coast. Some nieces and nephews can't make it, but that's all right. They're busy. Dr. Landis assured us it would be brief. I'll just take the pill the good doc gives me and fall quickly asleep, peacefully, forever. No pain. I'm doing what's right. It is better for all of us.

As we face dying's three dreads — pain, abandonment, helplessness — what is the practical allure of physician-assisted suicide?

April 30, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

“A call to arms” may be a bit martial for many bioethicists, but we live in perilous times. Meaningful action is needed across the board with respect to the functioning of government, whether federal, state, or local. We are confronted with the effects of benighted policies (or lack of policies and lack of regulations) that threaten to destroy our national (and global) financial system, our national health care “system” (really a default hodgepodge of buyers, sellers, and canny middlemen), and our global ecosystem. Standards of living continue to erode in the U.S. and Europe. Unemployment persists at high levels. In the United States, at least, educational achievement is in free fall. We live in a national culture that has degraded to the narrow perspective of me and mine. It is not an exaggeration to assert that many Americans have lost their moral compass, if indeed they ever had one. For the rest of us, those who recall what it means to be blessed with the right to life, liberty, and the pursuit of happiness, it is long past time to do what anchorman  Howard Beale did in Network: throw open the windows to the street, lean our heads out, and shout I’m mad as hell and I’m not going to take this anymore!

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

April 24, 2012 | Posted By Ricki Lewis, PhD

In Fasil Tekola Ayele’s native Ethiopia, the people call it “mossy foot.” Medical textbooks call it podoconiosis, non-filarial elephantiasis, or simply “podo.”

The hideously deformed feet of podo result not from mosquito-borne parasitic worms, as does filarial elephantiasis, nor from bacteria, like leprosy. Instead, podo arises from an immune response to microscopic slivers of mineral that penetrate the skin of people walking barefoot on the damp red soil that tops volcanic rock. Podoconiosis means “foot” and “dust” in Greek.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

 

April 19, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

Something remarkable is happening in the world of medicine (the field is often considered a monolithic special interest group). On April 4, 2012, nine medical specialty societies released lists of the "Top Five" services that are the most expensive and "have been shown not to provide any meaningful benefit to at least some major categories of patients". These nine lists are the first results of the "Choosing Wisely" campaign, launched by the American Board of Internal Medicine in response to a 2010 article in the New England Journal of Medicine.

That article challenged physicians to take the lead in health care reform. Rather than waiting for the government to impose new standards and regulations, the article encouraged physicians and professional medical societies to identify wasteful services and procedures that could be readily eliminated.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

April 5, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

Last week's historic three days of arguments before the Supreme Court on the merits of the Affordable Care Act provided many head-scratching moments. Those naive enough to believe that the case was actually going to be considered on constitutional grounds (this being the Supreme Court, after all) were rudely awakened to an apparent actual agenda of partisan politics and corporate interests.

Broccoli was a key theme, startling the 50 million Americans who may be able to purchase green vegetables at the local market but are unable to purchase badly needed health insurance. The welfare of health insurers was a second prominent theme, providing concrete evidence to those who posit that our nation is no longer a government of the people, but rather a "government of the corporation".

The outrage has been profound, including Op-Ed pieces in The New York Times, featured articles in The New Yorker, and commentary in the New England Journal of Medicine.

First, the produce. During the second day of arguments, Justice Scalia attempted to define the market for health care. He said ". . . you define the market as food, therefore everybody is in the market; therefore, you can make people buy broccoli." Chief Justice Roberts picked up the theme as easily as if he were choosing a ripe cantaloupe at his local farm stand. Roberts informed us that "a car or broccoli aren't purchased for their own sake, either." Broccoli is purchased to cover the need for food, we were sagely advised.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

March 30, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

It has been a very busy week at the Supreme Court. Three days of arguments on the various challenges to the Patient Protection and Affordable Care Act each merited front-page coverage in The New York TimesSCOTUSblog, the blog of the Supreme Court, received more than 800,000 hits in three days, which was more than the site has received in its first 4 years of existence. Regardless of the court's final ruling (expected on June 28th), the active engagement in our robust democratic politics of so many Americans and interested parties worldwide bodes well for the future of our way of life. Separation of powers, first described and promulgated by John Adams (second president of the United States) in his treatise, Thoughts on Government, Applicable to the Present State of the American Colonies, is alive and well.

It's easy to experience the ebbing of America's power. Our national political scene is a toxic partisan shambles. We have been severely depleted — our blood and treasure have been unthinkingly squandered in 10 years of geopolitically useless war in Iraq and Afghanistan. We are beset by real threats to our welfare and continued existence . . .

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

March 25, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

On Monday, March 26th, 2012, the Supreme Court will begin hearing arguments on National Federation of Independent Business v. Sebelius and two linked cases, the lawsuits against the Patient Protection and Affordable Care Act (ACA; signed into law by President Obama on 3/23/2010). The court announced on February 21st that it would hear 6 hours of arguments over 3 days, an historic and unprecedented amount of time. The last time the Supreme Court heard more than 2 hours of arguments was when it considered the McCain-Feingold campaign finance law in 2003.

At issue in the cases before the Supreme Court is the constitutionality of federal involvement, interference, or interposition (depending on who's doing the interpreting) regarding activities of private citizens and activities of the states. The question of constitutionality of the ACA relates specifically to the Commerce Clause (U.S. Constitution Article 1, Section 8, Clause 3). The Commerce Clause states "Congress shall have power to regulate commerce with foreign nations, and among the several states, and with the Indian tribes". As with all clauses of the Constitution, the Commerce Clause must be interpreted and applied. The Supreme Court is the final arbiter and interpreter of all such applications, declaring the constitutionality (or lack thereof) of congressional and state legislation.

The challenges to the ACA state that the federal government has exceeded its constitutionally enumerated powers. The Tenth Amendment states "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." The challenges suggest that the ACA attempts to wield a federal power that does not exist under the Constitution and attempts to interfere with powers appropriately "reserved" to the states and to "the people". The challenges assert that it is the right of a citizen, rather than a prerogative of the federal government, to determine whether she will purchase health insurance. The challenges also assert that the federal government cannot dictate how a state conducts its Medicaid program.

 

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

March 17, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

We need less medical care, not more. We need more preventive services and more patient education, not more high-technology crisis care. Specifically, we need more primary care physicians.

Most informed citizens are aware that in the U.S., per capita expenditures on health care are the highest in the world. Each American spends an average of $8100 per year, representing a substantial proportion of annual income. The total U.S. health care burden of $2.5 trillion (in 2009) is 17.6% of our gross domestic product.

These numbers need to come down, but costs continue to rise. A long-term solution is available, one that doesn't involve structural changes in how health care services are bought and paid for. [Such structural change is critically important, but vested interests continue to severely dominate the U.S. political landscape.] The specific long-term solution involves focusing on primary care.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

March 9, 2012 | Posted By Posted By David Lemberg, M.S., D.C.

For 500 years science has built an ever-increasing knowledge base, proceeding in fits and starts and yet moving inexorably toward improved explanations of the universe in which we live. But science has reached a crossroads. Thus society, too, is similarly positioned.

Years ago, during the Enlightenment and the subsequent Industrial Revolution, Nature as such was vast and apparently infinitely replenishable. It was inconceivable that harm was being done to the environment on a large scale.

But as Inigo Montoya remarks to Vizzini in The Princess Bride, "You keep using that word [inconceivable]. I do not think it means what you think it means."

What was inconceivable then is now, appallingly, very conceivable. The outcomes of many scientific fields of inquiry have the potential to destroy the biosphere.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

March 2, 2012 | Posted By Posted By David Lemberg, M.S., D.C.
Dr. Ricki Lewis The Forever Fix
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Dr. Ricki Lewis is a science writer with a Ph.D. in genetics. Her newest book, The Forever Fix: Gene Therapy and the Boy Who Saved It, a narrative nonfiction book from St. Martin’s Press, is arriving in stores on March 13.

In our wide-ranging interview, Dr. Lewis discusses

  • How gene therapy can extend a child’s life, in some cases by years
  • Issues encountered in deciding whether a child should enroll in a gene therapy trial
  • How participants should be chosen for clinical trials
  • How problems with the informed consent process initially derailed gene therapy
  • "Therapeutic misconception"
  • How gene therapy may benefit patients with Parkinson's disease and macular degeneration

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

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ABOUT BIOETHICS TODAY
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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