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February 11, 2015 | Posted By Jane Jankowski, DPS, LMSW

It’s a challenging time of year for those of us living in the snowbound regions of North America. Cold temperatures limit outdoor activity to quick spurts broken up by the need to get warm and sunshine can be hard to come by. Ground hogs are disrupted from their morning naps every Feb. 2 to see if warmer days will be welcomed back sooner rather than later. We yearn for the return of leafy trees, green grass, and less slippery walkways. Science has taken an interest in just what we gain from exposure to nature, and it seems there is more to it than simply wishing winter a glad farewell.  Though we may consider it common sense that people feel better when they get outdoors, breathe fresh air, and spend time in green spaces filled with grass and trees, there is a growing body of literature to back it up.

According to the NYS Department of Environmental Conservation spending time in forests makes us healthier.  The noted benefits include: boosts immunity, reduces stress, lowers blood pressure and improves mood, helps with focus and concentration, increases energy, and improves sleep. “Recognizing those benefits, in 1982, the Japanese Ministry of Agriculture, Forestry and Fisheries even coined a term for it: shinrin-yoku. It means taking in the forest atmosphere or "forest bathing," and the ministry encourages people to visit forests to relieve stress and improve health”. It seems they are onto something important here. Rx: Forest time.

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 3, 2015 | Posted By John Kaplan, PhD

I knew that I was going to write this blog post about the news concerning the resurgence of measles and its relationship to the dangerous and misguided anti-vaccination movement. The difficulty was with all the lunacy out there I did not quite know where to start. I grew up in the era prior to vaccination against childhood diseases. I had measles, mumps, rubella and chicken pox. I remember the fear people had of these infectious diseases and even as a child I was aware of how welcome these immunizations were when they became available. It seems absolutely inconceivable that decades later people are advocating against vaccines and placing their children and others at risk of infection with potentially devastating diseases.

There now seems to be a perfect storm of parents making poor choices for their children, a few vocal physicians giving bad advice, a staggering number of ill-informed celebrities saying truly stupid things, and political cowardice and hypocrisy failing to react appropriately. Let’s talk about the history leading to this unfortunate circumstance. Keep in mind that in the year 2000 measles was considered to have been vanquished in the US. There were a few dozen cases all contracted by people who had travelled overseas. However, these few cases were not transmitted to others because the rate of immunization was so high, despite the high level of contagiousness. This circumstance has now changed with people forgoing the vaccinations and like-minded people creating communities with high levels of the unvaccinated.

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. 

January 27, 2015 | Posted By Zubin Master, PhD

Academic journal publishing is big business. More journals are popping up in almost every field especially with the open access movement dominating academic publishing. While editors of some high impact journals might reject papers outright, editors of most journals, especially open access journals, might be willing to send the paper out for peer review so long as it isn’t methodologically flawed (Arns, 2014). Some predatory open access journals likely provide far less scrutiny and may send seriously flawed or poorly written papers to reviewers – I can personally vouch for this happening for one open access journal in my field. With the rise of journals and the increased pressure for scientists to publish, the demand and strain on peer reviewers and the peer review system is growing.

There are certainly signs that peer review is placing demands on researchers. For example, my previous supervisor who is an expert in bioethics and health law once told me he receives a request to peer review an article every couple of days. Another researcher at Mt. Sinai Hospital at the University of Toronto in Canada mentioned that he receives 300 requests to review papers a year, each of which takes him 3-4 hours to complete (Diamandis, 2015). Many of my colleagues who are prolific researchers turn down peer reviews, trying to do only a few a year or pass it off to junior researchers. In a recent column of the journal Nature, Martijn Arns explains that the increased pressure to review and the reluctance of researchers to undertake peer review might mean that editors will assign papers to reviewers who might not have the appropriate expertise in a particular area. Peer reviewers who are not experts on the topic should not accept articles to review, or declare to editors what areas they can appropriately review. Certainly junior researchers or doctoral students may not be international experts on a topic, but junior researchers might do a better job of reviewing manuscripts by investing more time and giving fair consideration to an article. However, given the time involved and the sense of obligation to conduct peer review, some reviewers might cut corners and perform mediocre reviews.

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. 

January 23, 2015 | Posted By Lisa Campo-Engelstein, PhD

Although life-saving, cancer treatments (e.g. radiation, chemotherapy, and surgery) can also lead to infertility in both women and men. Established reproductive technologies for women and men like gamete freezing and embryo freezing allow cancer patients to preserve their fertility in case they want to become biological parents in the future. 

Unfortunately, patients are frequently not adequately informed and sometimes not informed at all about fertility preservation. Some oncologists don’t consider fertility preservation to be an important issue, as they are more focused on saving the patients’ lives and see fertility preservation as a secondary consideration. Research has shown that even when oncologists refer their patients for fertility preservation they often do so based on social factors (they are more likely to refer wealthy, white, heterosexual, married patients) rather than purely on medical indications. Even when health care providers discuss fertility preservation with patients, many patients say that once they heard the word “cancer” as a diagnosis, they didn’t absorb much else from their initial conversation with their provider. 

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. 

January 19, 2015 | Posted By Wayne Shelton, PhD

Let’s say you are looking to buy a car. You think you might want to buy a Volvo so you go down to the Volvo dealer and check out the new models. But you are shocked by what you see. You realize that you really don’t need to spend $35 to $40,000, or more, on a new car, so you decide to visit the Subaru dealer. There you find very nice alternative models for thousands of dollars less. You are delighted to have a new Outback for about $27,000.

The above story is how private markets and market choices work for the vast majority of items that we purchase to meet most of our needs as human beings. However, it has become painfully obvious that healthcare is an area where the normal model of markets and market choices do not apply. I’ll use a personal example.

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. 

January 16, 2015 | Posted By Jane Jankowski, DPS, LMSW

The release of Cuban spy Gerardo Hernandez as part of a prisoner swap made headlines last month not only for the diplomatic implications for Cuba-US relations, but also for the questions surrounding assisted reproductive services for incarcerated persons. According to a brief report from NPR, Hernandez’s spouse wanted to have a child with her incarcerated husband and sought support from a sympathetic US senator to facilitate this expression of reproductive liberty. While this case includes an added layer of intrigue because of the impressive barriers that were overcome to secure the means and support for artificial insemination, the question of how we ought to consider the use of assisted reproductive technology for couples who wish to bear children despite one parent serving a life sentence.

While some children may be conceived where prisoners are permitted conjugal visits, Mr. Hernandez was in a federal prison where it is reported that such visits are not allowed. The only means for reproduction would be via assisted technology such as artificial insemination, a now basic intervention. What about other families who wish to raise children but without the connections or possibility for release? Is it ethical to support such endeavors when one parent will be able to contribute gametes and an occasional visit in a prison setting without freedom to participate in rearing the child? This is not such an easily answered question.

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. 

January 12, 2015 | Posted By John Kaplan, PhD

Late in 2013 I posted an entry to this blog which described PubPeer, the newly implemented system for post publication peer review. In that blog I raised the question whether this is a good idea compared to other opportunities for post publication commentary such as letters to the editor or even new publications which would either support or challenge previously published research. The system has been going for a bit over a year now and I thought it would be appropriate to revisit the question of promise or chaos.

One of my principal concerns related to the ability of anyone who met the qualifications to comment to jump in and comment. The necessary qualifications are quite easy to meet and quite arbitrary. Anyone who has been funded to do research by the National Institutes of Health (US) or the Wellcome Trust (UK) is considered qualified. I have no idea why someone funded by the National Science Foundation (US) or the National Research Council (Canada) is not qualified.  

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. 

January 8, 2015 | Posted By Bruce White, DO, JD

On December 22, 2014, JAMA Internal Medicine published an article online titled “Mortality and Treatment Patterns Among Patients Hospitalized With Acute Cardiovascular Conditions During Dates of National Cardiology Meetings.” A note by the journal’s editor Rita F. Redberg, MD, MSc, a cardiologist, titled “Cardiac Patient Outcomes During National Cardiology Meetings” appeared the same day. [JAMA Intern Med. Published online December 22, 2014. doi:10.1001/jamainternmed.2014.6801] Also, the same day press reports appeared – among other news outlets – in The New York TimesLos Angeles Times, and on the Web pages of the Harvard Medical School commenting on these articles. The newspaper articles and press release titles are more tantalizing: “Do Heart Patients Fare Better When Doctors Away?”; “Some Heart Patients Do Better When the Cardiologist Is Away”; and “Startling Benefit of Cardiology Meetings.”

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. 


January 6, 2015 | Posted By Lisa Campo-Engelstein, PhD

Many professions require state or federal licensure, including hairdressers, teachers, accountants, and physicians. The main reason we have professional licensure is to protect the clients who seek out the services of these professionals. Licenses require that professionals meet a minimum standard of knowledge and skills to certify competence in their field. Even some leisure activities require licensure, especially those that are considered potentially dangerous, such as scuba diving and hunting. 

Some have suggested that parents should also be licensed as a way of protecting their children by ensuring that have a base minimum skill set and knowledge about good parenting. The typical response to this suggestion is an emphatic no. Why is our knee jerk reaction to the idea of licensing parents to be horrified when we aren't bothered by licenses for professional and leisure activities, some of which also involve placing the lives of others in their hands (e.g. a physician) or require developing a deeper connection between people (e.g. a teacher)? How and why is parenthood different from these other activities? 

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 22, 2014 | Posted By Zubin Master, PhD

Recently Dr. Christopher Thomas Scott of Stanford University wrote a great paper titled “The Case of Stem Cell Counselors” in Stem Cell Reports which draws parallels from the field of genetic counseling arguing for the need for stem cell counsellors (1). Scott outlines that due to increases in the number of stem cell trials combined with fraudulent therapies being offered around the world, the time is ripe for having counsellors help patients navigate the clinical stem cell research/therapy landscape. These experts can help patients identify and distinguish legitimate trials from unproven interventions, explain the risks, benefits and therapeutic options, and serve as a resource to provide them with educational information.

On a related topic, my colleagues and I at AMBI were going to write a paper arguing that clinical ethics consultants should be involved in countering the impact of stem cell tourism and serve as a resource for patients who are contemplating undertaking an unproven stem cell based intervention (SCBI). We thought that clinical ethics consultants are in a unique position to offer advice and counselling to patients seeking unproven SCBIs for a few reasons.

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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