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Viewing by month: December 2013
December 5, 2013 | Posted By Marleen Eijkholt, PhD

Early November 2013: TB, a 32 year old deer hunter from Indiana, falls 16 feet from a tree while on a hunting trip and crushes his spinal cord. He injures his C3,4 and 5 vertebrae, but does not suffer any brain damage. TB’s prognosis includes paralysis from the shoulders down and potentially life-long dependence on a ventilator. His family asks the physicians if they can get him out of sedation and remove his ventilator, so that he can decide about how to proceed with his treatment. Once awake, TB hears his prognosis and asks to stop treatment. He dies one day after incurring his injury.

Several factors seem to have sparked the headlines and stir controversy, and I would like to focus on one of these. I question whether TB’s decision was and could be informed. Using this case, I propose that TB’s decision was perhaps a shot in the dark. I raise some of the pressing questions about informed consent in the clinical ethics context. I ask how we should ensure informed decision making, what we should do to enlighten patient’s perspectives and what we should do if patients refuse information that we consider material in the decision making process? 

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 3, 2013 | Posted By Zubin Master, PhD

This is part 2 of a blog written last month. In Part 1, I explained how open access (OA) journals work and some of the shortcomings of peer review. This was done to provide a background on a recently published study by staff at the leading journal Science. In this part, I will cover the specific experiment reported by Science and explain some of the limits of its design followed by an interesting and novel model of the non-profit OA journal BioéthiqueOnline.

Part 2: Open Access Journals, Peer Review, and Conflicts of Interest

Do OA Journals Perform Rigorous Peer Review?

Recently, John Bohannon of the Science group conducted an investigation where he submitted scientifically flawed papers using fake names and provided the names of research or academic institutions that didn’t exist to 304 OA journals (Science 342: 60-65, 2013). The idea was to create a scientific paper with major errors, so that “[a]ny reviewer with more than a high-school knowledge of chemistry and the ability to understand a basic data plot should have spotted the paper’s shortcomings immediately.” Bohannon created a database of molecules, lichens and cancer cell lines and ran them through a computer program to generate unique papers, but with a standard structure: “molecule X from lichen species Y inhibits the growth of cancer cell Z.” He also created fake authors from fictitious African institutions with the hope that using developing world authors would lessen suspicion by journal editors. The main flawed graph showed a dose-dependent decrease in cell growth yet despite rising concentrations, the effects on cells were modest. In addition, the anti-proliferative molecule was dissolved in a large amount of ethanol and because the control group was not treated with the same solution buffer, the anti-proliferative effects seen could simply be due to the cytotoxic effects of ethanol. In a second experiment, Bohannon attempted to show an “interactive effect” by adding the molecule with radiation, but the control cells were not exposed to any radiation. As the experiments had a tragically flawed design, the idea was that any peer reviewer should pick them up and the article should be rejected.

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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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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