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December 15, 2014 | Posted By Wayne Shelton, PhD

The vast majority of developed nations in the world provide universal healthcare coverage for its citizens. The only developed nations that do not are “…a few still-troubled Balkan states, the Soviet-style autocracy of Belarus, and the U.S. of A., the richest nation in the world.” 

Yet the United States (US) has the most expensive healthcare system in the world, by far—there really isn’t a close second—spending just under 18% of GPD and around $8,500.00 per person on healthcare. One might assume that given that type of expense, we would be getting a lot more than other countries in return for our investment. According to the research provided by Mirror, Mirror, from the Commonwealth Fund, the US sadly underperforms and often fails relative to other developed countries on major measures of performance. 

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 11, 2014 | Posted By Dan Thompson, MD

The title of the article in the Journal of Medical Ethics asks this question.[1]  The authors from the University of Montreal consider this subject while the topic of “illegal aliens” or foreign nationals (FN’s) has been a hot topic in the United States.  They however attempt to answer the problem from an international perspective.  The FN that we hear about is usually in the country illegally, but may be in the country as a legal non-citizen, visitor, non-permeant resident, refuge claimant, resettled refugee and in rare cases a person detained by the government.

A patient who arrives at the emergency room requiring hemodialysis would likely rapidly be started on renal replacement therapy.  This is an emergency and since this is considered, an emergency there would likely not be a question about the provision of such therapy. What then about transplantation of a kidney?  Is renal transplantation an emergency treatment?  We usually consider transplantation to be a more economical form of treatment of the acute renal failure in the end, but the lack of long term funding for medical care of the FN puts a different spin on the subject. It is not just the procurement of the organ and the surgery but also provision of and management of the immunotherapy necessary to prevent rejection of the kidney and the technology to manage the therapy.   A foreign national that returns to their home country where there is not an infrastructure that can provide the drug therapy or monitoring will reject the kidney. There is a national issue of financing the care and the ethical and national issues of obtaining the organ.

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 9, 2014 | Posted By Bruce White, DO, JD

On November 28, 2014, The New York Times broke another story about Big Pharma marketing extremes. Reported by Katie Thomas and titled “Using Doctors With Troubled Pasts to Market a Painkiller, the article reveals that one drug manufacturer is taking usual and customary sales strategies beyond the reasonable.

It is independently reported that pharmaceutical manufacturers spent as much as $27 billion in 2012 to promote their products.  (Curiously during the same year, Big Pharma itself reported spending about $48 billion on the research and development of new drugs.  However, some believe the research and development costs are overstated because government grant support and marketing and other expenses are included in the totals.)

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 4, 2014 | Posted By John Kaplan, PhD

You may remember a movie, now twenty five years old in which two apparently unintelligent teens (Ted and Bill) use a time machine to prepare a history assignment. In this movie it appears that things may not turn out so well but a being from the future comes to help them out and save the world. The movie is, of course, fiction and a farce. It very much appears that we are, in a sense, reliving this sort of excellent adventure with an important difference. It appears to be a farce but unfortunately it is not fiction. It is also not likely to be excellent.

In January the 113th Congress of the United States of America will be convened with Republican majorities in both the Senate and House of Representatives. In this new congress Senator James Mountain Inhofe, Republican from Oklahoma will almost certainly become Chair of the Senate Environment and Public Works Committee. The Senate Environment and Public Works Committeehas oversight of pollution and those environmental issues which impact public works including highways and power plants. 

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 26, 2014 | Posted By John Kaplan, PhD

When I was a young scientist (quite some time ago) there was a joke that seemed to be circulating about how our older established colleagues conducted science. This was a somewhat cynical exercise motivated, at least in part, by professional jealousy. The joke went on to say that one could establish a fact by writing two papers. In the first paper the author speculates that something might be true. In the second paper the author says that the previously speculated thing is true, and references the paper containing the original speculation. In fact I have rarely seen this actually done. But as I write blog I have an example sitting in front of me on my desk. It is especially intriguing that this paper was written by an individual who maintains that “most published research findings are false”.

The paper in question was published just last month with the rather presumptuous title: “How to make more published research true”.  This, of course, is a statement predicated on the presumption that much published research is false. Indeed the author says in the first paragraph, referring to scientific research, that “Many new proposed associations and/or effects are false or grossly exaggerated” and refers to two previously published papers both single author papers by him.

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 24, 2014 | Posted By Zubin Master, PhD

Paolo Bianco and colleague Douglas Sipp wrote a very provocative and interesting piece recently published in the journalNature (http://www.nature.com/news/regulation-sell-help-not-hope-1.15409)discussing a movement to permit stem cell medicines, among others, to be sold in the market without the requirement to show much safety and efficacy data permitting the market to determine safety and effectiveness of compounds. Here, patients would basically pay to obtain products and also be research subjects. Certain powerful groups are calling for the deregulation of clinical medicine as a business model to bring innovative products to the marketplace. But before I begin explaining what Bianco and Sipp discuss, we need to cover the current system of regulatory oversight of medical products.

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 20, 2014 | Posted By Lisa Campo-Engelstein, PhD

In the last couple of years, the media has reported women undergoing uterus transplantations. Just last month, the media reported that the first baby was born from a transplanted uterus. While the woman’s identity remains unknown, she is a 36 year old Swedish woman who was born with ovaries, but not a uterus. She and her partner underwent IVF to produce embryos that could then be transferred into the transplanted uterus. This donor is a friend of hers who is 61 years old and had experienced menopause seven years beforehand. The quality of a woman’s uterus does not diminish over time, so she is able to successfully carry a pregnancy event postmenopausally (it is the quality and quantity of her eggs that leads to infertility and eventually menopause).  Both the woman and the baby are doing fine, according to media reports. However, the baby was born prematurely at 32 weeks because the women developed preeclampsia and the fetal heart rate became abnormal. It is not clear from the media reports whether the development of preeclampsia was related to the uterus transplantation.

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 17, 2014 | Posted By Wayne Shelton, PhD

Let me emphatically state at the outset of this short blog: I have always thought the elective termination of pregnancy (ETOL) was a serious moral issue. As I have taught students over the years on this topic, to fully appreciate the moral conflict around abortion (or any other moral conflict) one must be willing to put oneself in the middle of two important value positions. In other words, one must be willing to hold and take seriously in one’s mind simultaneously two opposing thoughts or value positions in order to weigh them fairly.  

Though I don’t think that a fetus is a person with a personal or social identity, it is biologically human—and that alone is a relevant piece of moral information. The fetus has a unique genetic code and has the potential to grow to full term into a new baby and eventually grow into a child, adolescent, and adult human being. Because a fetus has the potential to become a full-fledged member of the human community, all things equal, we should not destroy it. But rarely in human life are all things equal.

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.

Previous Posts

November 13, 2014 | Posted By Michael Brannigan, PhD
November 11, 2014 | Posted By Jane Jankowski, DPS, LMSW
November 6, 2014 | Posted By Bruce D. White, DO, JD
November 3, 2014 | Posted By Luke Gelinas, PhD
October 30, 2014 | Posted By Thomas Andersen, PhD
October 27, 2014 | Posted By Zubin Master, PhD
October 23, 2014 | Posted By Lisa Campo-Engelstein, PhD
October 21, 2014 | Posted By Jane Jankowski, DPS, LMSW
October 13, 2014 | Posted By Wayne Shelton, PhD
October 10, 2014 | Posted By John Kaplan, PhD
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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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