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Viewing by month: November 2013
November 25, 2013 | Posted By Wayne Shelton, PhD

The political right in the U.S. has mounted a formidable effort from the outset to mischaracterize the aims of the Affordable Care Act (ACA) and to mislead voters about the need for fundamental reform in healthcare. I take it as a given that the opposition to the ACA has never been about its efficacy to promote certain goals to expand coverage for more Americans; even if the ACA accomplished its goals perfectly, those on the extreme political right would still oppose it. That is, the opposition from the political right is not about whether or not the ACA will work effectively but about ideology—they oppose the ACA as a matter of principle. They are committed to the view that government should not be involved in healthcare and fear, perhaps rightly, that if the ACA proves workable it would lead to a single payer system of universal coverage for all citizens. They apparently see healthcare services being like any other market service provided in a capitalistic society. But upon even a superficial analysis, this position is flawed.

It is basic to free markets that the ability of an individual to use a certain service or product is a function his or her ability to purchase it. One of the few services that is an exception in our current capitalistic society is healthcare, albeit only at the level of requiring services at an acute level. For example no matter how desperately I need transportation to go back and forth to work, I will not get a free car as a function of someone else’s obligation to provide it. This is not true of healthcare: even if I cannot pay for healthcare or I lack healthcare insurance, if I get sick enough and show up at an Emergency Room, I’ll not only be stabilized, I’ll be hospitalized and be given all I need to improve, or more fittingly, to be rescued from dying.

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 21, 2013 | Posted By Lisa Campo-Engelstein, PhD

As I’ve mentioned in a previous blogs, men only have 2 contraceptive options—male condom and vasectomy—and neither are long-acting reversible contraceptives. If more male contraceptives were developed, would men use them? Some empirical research shows many men would, especially young, urban, and educated men. Yet, skeptics say men don’t value pregnancy prevention to the same degree that women do so they won’t be motivated to use male contraception. Another common reason given for why men wouldn’t use male contraceptives is the fear that these contraceptives will emasculate them. Here I will discuss three social beliefs that contribute to this fear. 

First, many men believe that testosterone is a crucial factor in what makes them men. Though certain levels of testosterone in the body do result in what are usually classified as masculine characteristics, such as more body hair, more muscle tone, deeper voice, aggressive behavior, and stronger sex drive, the category ‘men’ is not just a biological one, it is also a social one. There are many cultural beliefs about what it means to belong to the category ‘men,’ one of which is that men have an uncontrollable libido. Most men want and feel pressured to adhere to these dominant conceptions of masculinity so that they are considered “real” men. 

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 19, 2013 | Posted By Jane Jankowski, LMSW, MS
Overshadowed by the brouhaha about the faulty Obamacare enrollment websites was an article that illustrated a far more egregious oversight in healthcare delivery priorities. A brief piece published in the New York Times noted that drug development priorities have continued to neglect diseases that primarily affect the world’s poorest. Though the supporting article published in The Lancet notes that drug development for such disease has not halted, vaccines and new treatments for conditions including malaria, worm and diarrheal disease, and tuberculosis are not being developed at a rate that reflects appropriate concern given the numbers of people afflicted by these conditions.

With just 4% of new drugs targeting what are considered neglected diseases, it seems reasonable to question the broader goals of those who conduct research and development endeavors. Historically, vaccination has been proven to be remarkably effective at preventing diseases that were once considered scourges, such as smallpox, polio, and diphtheria to give a very short list. The goals were simple – to halt the spread of disease through prevention. Grounded in the principle of beneficence, the research and development was aimed at reducing loss of life, suffering, and serving mankind. While I want to believe that medical research remains intent of the same principles, it is concerning that the world’s poorest are left behind when it comes to the scourges that still affect their regions.

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 14, 2013 | Posted By John Kaplan, PhD

I have written a few times in this blog about the stupidity of certain politicians in relation to their positions about science and the role of science in public policy. It is time for me to admit that, thankfully, many politicians are actually quite enlightened about the value of science. Today I will identify two such individuals, albeit not current politicians, who had a sophisticated appreciation of the relationship between scientific inquiry and the understanding of the world such inquiry produces to public policy, national security, and the underpinnings of democracy.

This year marks the one hundred fiftieth anniversary of the founding of the National Academy of Sciences. This national academy was founded in 1863 by Abraham Lincoln. He had a good deal going on that year, the Civil War and the Emancipation Proclamation among other things. But he still possessed and demonstrated the vision to create a body of distinguished scientists who would be available to provide scientific advice for the United States government.

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.

November 5, 2013 | Posted By Marleen Eijkholt, PhD

Last week, Dutch newspapers report about a Dutch physician who committed suicide after he had been suspended from his job, pending examination of his involvement in a Euthanasia case. The Dutch Inspection for Health Care (the Inspection or the IGZ), an institution that oversees quality in health care  with administrative powers or powers to bring cases to the Public Prosecution, had received reports about the physician’s inappropriate behaviour and the police had questioned him intensely. The reports awakened fear on Dutch soil, on both physicians and on the public’s side. It seemed hard to imagine that a Dutch physician would act inappropriately in the system that is firm from the inside, but so vulnerable for the outside. Why and how would someone pose a threat to the process?

Euthanasia and physician assisted suicide (PAS) legislation in the Netherlands or in Belgium regularly sparks controversial headlines in international newspapers: Headlines report on the increase in cases of Euthanasia or PAS: “Mobile death squads to kill sick and elderly in their own homes leads to surge in suicide rates in the Netherlands”, extension of grounds for requests: such as failed gender reassignment, and the possibilities of accessing euthanasia interventions. They seek to create fear about death squads and a vulnerable (elderly) population that is pressured into Euthanasia or that is euthanized involuntarily. Hardly any attention is paid to the process around Euthanasia.

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 4, 2013 | Posted By Zubin Master, PhD

This blog will be written in two parts. It discusses some interesting results produced by the publisher Science in regards to the quality of peer review of open access (OA) journals. In this first part, I will provide a brief explanation of OA journals and how peer review works and cover some of the shortcomings of peer review. In the second part of this blog post, I will discuss the specific experiment reported by Science and explain some of the limits of its design and end off with an interesting and novel model of the OA journal BioéthiqueOnline.

Part 1: The Open Access Movement and Limits of Traditional Peer Review

There has been a rise in OA journals, which are scholarly journals that are available online and are free to access or can be heavily subsidized. There is variation in how OA journals function e.g., authors may self-archive and upload a copy of the paper to an institutional or central repository (e.g., PubMed Central), journals may provide free access after an embargo period typically 6-12 months, or all journal articles may be made available online but authors pay a fee to publish. This last model is one we will pay attention to for the purposes of this blog.

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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