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Hastings Center Report

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https://www.readbyqxmd.com/read/29785711/illness-as-a-crisis-of-meaning
#1
REVIEW
Michael Hauskeller
In Phenomenological Bioethics: Medical Technologies, Human Suffering, and the Meaning of Being Alive, the Swedish philosopher Fredrik Svenaeus aims to show how the continental tradition of phenomenology can enrich bioethical debates by adding important but often-ignored perspectives, namely, that of lived experience. Phenomenology focuses not on supposedly objective, scientifically validated facts, but on the "life world" of the individuals affected by a situation. Individuals' life worlds consist of their experience of their own lived bodies (or Leiber) and the meaning structures of their everyday worlds...
May 21, 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590522/bioethics-and-science
#2
EDITORIAL
(no author information available yet)
Bioethics comes in for furious criticism in Stephen Pinker's new book, Enlightenment Now. Pinker argues that scientists are making human lives better and better, and that lives would get still better even faster if bioethicists did not use ideas like informed consent, dignity, sacredness, and social justice to hobble the scientists. Daniel Callahan, a cofounder of The Hastings Center and arguably of bioethics, is perhaps the best living embodiment of a bioethicist who has written about medical progress, and the March-April 2018 issue of the Hastings Center Report turns to him for a review of Pinker's book...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590521/the-right-to-know-a-revised-standard-for-reporting-incidental-findings
#3
G Owen Schaefer, Julian Savulescu
During the course of biomedical research, researchers sometimes obtain information on participants that is outside the aim of the study but may nonetheless be relevant to the participants. These incidental findings, as they are known, have been the focus of a substantial amount of discussion in the bioethics literature, and a consensus has begun to emerge about what researchers should do in light of the possibility of incidental findings. A consensus, however, is not necessarily correct. In this article, we address the common view that reporting of incidental findings should be based primarily on the possibility of medical benefit, factoring in the findings' validity, clinical actionability, and significance to health or reproduction...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590520/mass-shootings-mental-illness-and-gun-control
#4
Sean Philpott-Jones
In the wake of the Stoneman Douglas School shooting, Republican and Democratic leaders-like the American electorate they represent-remain sharply divided in their responses to gun violence. They are united in their condemnation of these mass shootings, but they disagree about whether stricter or looser gun control laws are the answer. Those on the right side of the political aisle suggest that the issue is one of mental illness rather than gun control. Conversely, those who are more liberal or progressive in their political learnings are quick to condemn attempts to reframe the issue of mass shootings as a mental health problem...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590519/nudge-or-grudge-choice-architecture-and-parental-decision-making
#5
Jennifer Blumenthal-Barby, Douglas J Opel
Richard Thaler and Cass Sunstein define a nudge as "any aspect of the choice architecture that alters people's behavior in a predictable way without forbidding any options or significantly changing their economic incentives." Much has been written about the ethics of nudging competent adult patients. Less has been written about the ethics of nudging surrogates' decision-making and how the ethical considerations and arguments in that context might differ. Even less has been written about nudging surrogate decision-making in the context of pediatrics, despite fundamental differences that exist between the pediatric and adult contexts...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590518/financial-conflicts-of-interest-at-fda-drug-advisory-committee-meetings
#6
Michael J Hayes, Vinay Prasad
The U.S. Food and Drug Administration's drug advisory committees provide expert assessments of the safety and efficacy of new therapies considered for approval. A committee hears from a variety of speakers, from six groups, including voting members of the committee, FDA staff members, employees of the pharmaceutical company seeking approval of a therapy, patient and consumer representatives, expert speakers invited by the company, and public participants. The committees convene at the request of the FDA when the risks and harms of novel products are not immediately clear, and their final decisions carry significant weight, as most therapies that receive advisory committee approval are subsequently approved by the FDA...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590516/organ-transplantation-and-the-uniform-anatomical-gift-act-a-fifty-year-perspective
#7
Blair L Sadler, Alfred M Sadler
Fifty years ago this summer, the Uniform Anatomical Gift Act was adopted by the National Conference of Commissioners on Uniform State Laws and approved by the American Bar Association. The UAGA has provided a sound and stable legal platform on which to base an effective nationwide organ donation system. The cardinal principles of altruism, autonomy, and public trust are still important. At a time when confidence and trust in our government and many private institutions has declined, maintaining trust and confidence in our health care system and its commitment to "first, do no harm" has never been more important...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590515/fetal-medicine-and-the-pregnant-woman
#8
David Wasserman
In coming decades, fetal medicine may become a routine part of reproductive care. The measures pregnant women now take to protect fetal health are largely generic, like restricting their diets and using supplements. Relatively few interventions are based on specific conditions revealed by ultrasound or genetic testing. A recent finding, though, may herald a dramatic rise in "personalized" fetal medicine: certain drugs already approved by the Food and Drug Administration can apparently boost neural growth in fetuses with Down syndrome, improving cognitive functioning in the future child...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590514/one-ventilator-too-few
#9
Noah Polzin-Rosenberg
Sometimes it's better to be lucky than good. As new blood filled our young patient's veins, her breathing became regular and her pulse full. She was so far gone I would not have expected her to recover consciousness for a day, if at all, but within an hour, she began to wake up. We removed the breathing tube a couple of hours later- no ventilator ever needed. As life-sustaining technology becomes more widely available in fortunate parts of the developing world, benefits come with complications. The temptation is to focus on the thing-the ventilator itself-as the crucial element and press to buy more, mistaking the problem for one of resource scarcity only...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590513/genome-surgery
#10
Marnie Klein
When Kai Kupferschmidt writes about CRISPR-based gene editing in German, he faces an obstacle: there's no exact translation for "editing" that has the same connotations as it has in English. Instead, as he explained last fall at The Hastings Center's preconference symposium on new genetic technologies at the World Conference of Science Journalists, he draws on a variety of phrases, including "genome surgery," which conveys precision in Kupferschmidt's assessment, and "gene scissors," which communicates CRISPR's mechanistic nature...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590512/progress-its-glories-and-pitfalls
#11
Daniel Callahan
Steven Pinker, a cognitive psychologist and linguist at Harvard and a savant of big ideas, is one of the latest to take on the idea of progress. He does it under the aegis of "enlightenment," which comes down to a kind of holy trinity of reason, science, and humanism. His new book, Enlightenment Now: The Case for Reason, Science, Humanism, and Progress, is ambitious and cantankerous and heady with hope. On the whole, Pinker makes a good case for the benefits of progress, but with an overdose of feel-good prose...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29590511/abortion-bans-doctors-and-the-criminalization-of-patients
#12
Michelle Oberman
January 2018, the American College of Obstetrics and Gynecology issued a position statement opposing the punishment of women for self-induced abortion. To those unfamiliar with emerging trends in abortion in the United States and worldwide, the need for the declaration might not be apparent. Several studies suggest that self-induced abortion is on the rise in the United States. Simultaneously, prosecutions of pregnant women for behavior thought to harm the fetus are increasing. The ACOG statement responds to both trends by urging doctors to honor the integrity and confidentiality inherent in the doctor-patient relationship...
March 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457244/the-different-moral-bases-of-patient-and-surrogate-decision-making
#13
Daniel Brudney
My topic is a problem with our practice of surrogate decision-making in health care, namely, the problem of the surrogate who is not doing her job-the surrogate who cannot be reached or the surrogate who seems to refuse to understand or to be unable to understand the clinical situation. The analysis raises a question about the surrogate who simply disagrees with the medical team. One might think that such a surrogate is doing her job-the team just doesn't like how she is doing it. My analysis raises the question of whether (or perhaps when) she should be overridden...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457243/raising-the-stakes-for-nondiscrimination-protections-in-the-aca
#14
Kristen Underhill
In the struggle over the durability of the Affordable Care Act, defenders of the ACA stand guard at many fronts. A major contribution of the ACA to nondiscrimination law, however, appears increasingly vulnerable. The ACA established significant new nondiscrimination protections for patients under section 1557 and its implementing regulations. Several of these regulations-including protections on the basis of gender identity and pregnancy termination-are now under reconsideration at the Department of Health and Human Services, after a nationwide injunction lasting almost a year...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457242/bioethics-as-care-work
#15
Joel Michael Reynolds
German philosopher Martin Heidegger argued that humans are defined by care. The term he used, "Sorge," picks out a wide range of caring relations, including sorrow, worry, the making of arrangements, and even fending for another. Since coming to The Hastings Center, I've been struck by the genuine care definitive of its scholars' relationship to their work. Care about newborns, the elderly, and nonhuman animals. Care about doctors, nurses, and health care institutions. Care expressed in the panoply of ways biomedical knowledge and practices inform our havings, doings, and beings in the world...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457241/can-rationing-through-inconvenience-be-ethical
#16
Nir Eyal, Paul L Romain, Christopher Robertson
In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By "rationing through inconvenience" in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457240/manuscript-reviewers-2017
#17
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457239/patient-care-to-public-health-to-synthetic-biology
#18
EDITORIAL
(no author information available yet)
The January-February 2018 issue of the Hastings Center Report includes pieces addressing patient care concerns that lie at the original core of bioethics and pieces that reflect the field's growing breadth. Among the pieces getting at the original core is an article by philosopher Daniel Brudney on the moral values underpinning surrogate decision-making. The article and the two commentaries that follow it contribute to the debate on the moral authority of surrogate decision-makers. Several items in the issue take up matters of public health and health policy...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457238/rationing-care-through-collaboration-and-shared-values
#19
James E Sabin
Although "rationing" continues to be a dirty word for the public in health policy discourse, Nir Eyal and colleagues handle the concept exactly right in their article in this issue of the Hastings Center Report. They correctly characterize rationing as an ethical requirement, not a moral abomination. They identify the key health policy question as how rationing can best be done, not whether it should be done at all. They make a cogent defense of what they call "rationing through inconvenience" as a justifiable allocational technique...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457236/time-is-ethics
#20
Mark Mercurio
Early in my career as a neonatologist, I was called into the hospital for a newborn who would not stop crying. Screaming, really. When I entered the unit, I was greeted by a loud, shrill, distinctive cry. After hearing the history and examining the baby, I just stood there for a while, watching and listening. It took some time, but eventually, I noticed a subtle regularity, a rhythmicity. I took off my watch, placed it on the bed next to the child, and found that the crying briefly grew louder about every six or seven seconds...
January 2018: Hastings Center Report
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