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Hastings Center Report

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https://www.readbyqxmd.com/read/29077986/the-morality-of-health-care-reform-liberal-and-conservative-views-and-the-space-between-them
#1
Timothy Stoltzfus Jost
We have just completed an exhausting nine-month debate on the future of the Affordable Care Act. I see this debate as having ended-as of this writing-in a draw. After months of repeal efforts, Republicans in the House barely passed in early May, with a 217-to-213 margin, the American Health Care Act, which would have significantly amended the ACA. Republicans in the Senate spent the summer trying to arrive at amendments to the AHCA that could attract fifty of their fifty-two votes, but in the end, the clock ran out on their opportunity to enact an amendment without Democratic input...
October 27, 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171895/how-the-criminalization-of-pregnancy-robs-women-of-reproductive-autonomy
#2
Michele Goodwin
In 2003, the South Carolina Supreme Court upheld the conviction of Regina McKnight, an African American woman who was convicted at the age of twenty-two for committing "homicide by child abuse." She became the first woman in the United States to be arrested, prosecuted, and convicted for experiencing a stillbirth. Rather than an outlier case in the annals of American jurisprudence that stretched law beyond reason while restraining compassion and justice, McKnight's conviction inspired similar prosecutions of other poor black women and then of other women...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171894/the-future-of-reproductive-autonomy
#3
Josephine Johnston, Rachel L Zacharias
In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy-they just don't talk about it...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171893/should-clinicians-set-limits-on-reproductive-autonomy
#4
Louise P King
As a gynecologic surgeon with a focus on infertility, I frequently hold complex discussions with patients, exploring with them the risks and benefits of surgical options. In the past, we physicians may have expected our patients to simply defer to our expertise and choose from the options we presented. In our contemporary era, however, patients frequently request options not favored by their physicians and even some they've found themselves online. In reproductive endocrinology and infertility, the range of options that may be offered or that patients may themselves seek out is continuously widening...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171892/parenting-in-the-age-of-preimplantation-gene-editing
#5
Sigal Klipstein
Medical science at its core aims to preserve health and eliminate disease, but a common theme in scientific discovery is the application of findings in ways that were not the primary intent. The development of diagnostic modalities to predict the health of resulting children has been a fundamental aim underpinning research into prenatal and preimplantation diagnostic modalities; however, the knowledge gained has in some cases been utilized for nonmedical purposes. As an example, amniocentesis developed to determine whether the pregnancy is chromosomally normal also provides information about the sex of the fetus, which normally does not affect health...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171891/about-the-special-report
#6
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171890/reproductive-autonomy-and-regulation-coexistence-in-action
#7
Ruth Deech
On occasion, British in vitro fertilization practitioners look over the ocean to the practice of IVF and embryo research in the United States, wonder why these areas are subject to less regulation than in the United Kingdom, and ask how much less risky and more progressive IVF and embryo research might be if subject to additional federal, or at least state, regulation. To an American audience, imbued with the centuries-old spirit of independence, regulation and autonomy can seem in tension. From a British perspective, there is no necessary conflict...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171889/the-shifting-landscape-of-prenatal-testing-between-reproductive-autonomy-and-public-health
#8
Vardit Ravitsky
Since the 1970s, prenatal testing has been integrated into many health care systems on the basis of two competing and largely irreconcilable rationales. The reproductive autonomy rationale focuses on nondirective counseling and consent as ways to ensure that women's decisions about testing and subsequent care are informed and free of undue pressures. It also represents an easily understandable and ethically convincing basis for widespread access to prenatal testing, since the value of autonomy is well established in Western bioethics and widely recognized by funders of health care...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171888/authors
#9
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171887/freezing-eggs-and-creating-patients-moral-risks-of-commercialized-fertility
#10
Elizabeth Reis, Samuel Reis-Dennis
There's no doubt that reproductive technologies can transform lives for the better. Infertile couples and single, lesbian, gay, intersex, and transgender people have the potential to form families in ways that would have been inconceivable years ago. Yet we are concerned about the widespread commercialization of certain egg-freezing programs, the messages they propagate about motherhood, the way they blur the line between care and experimentation, and the manipulative and exaggerated marketing that stretches the truth and inspires false hope in women of various ages...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171886/reproductive-rights-without-resources-or-recourse
#11
Kimberly Mutcherson
The U.S. Supreme Court declared procreation to be a fundamental right in the early twentieth century in a case involving Oklahoma's Habitual Criminal Sterilization Act, an act that permitted unconsented sterilization of individuals convicted of certain crimes. The right that the Court articulated in that case is a negative right: it requires that the government not place unjustified roadblocks in the way of people seeking to procreate, but it does not require the government to take positive steps to help people procreate if they wish to...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171885/about-the-hastings-center
#12
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171884/autonomy-in-tension-reproduction-technology-and-justice
#13
Louise P King, Rachel L Zacharias, Josephine Johnston
Respect for autonomy is a central value in reproductive ethics, but it can be a challenge to fulfill and is sometimes an outright puzzle to understand. If a woman requests the transfer of two, three, or four embryos during fertility treatment, is that request truly autonomous, and do clinicians disrespect her if they question that decision or refuse to carry it out? Add a commitment to justice to the mix, and the challenge can become more complex still. Is it unfair for insurance policies to exclude from coverage the costs of giving fertility to those who lack it or restoring fertility in those who have lost it? What does "just reproduction" look like in the face of multifarious understandings of both justice and autonomy and in light of increasingly complex and costly reproductive technologies? In today's dialogue about reproduction, medicine, and ethics in the United States, old ethical issues-such as whether women ought to be allowed to access pregnancy termination-are more contested than they have been in decades, while new technologies-like those used to edit the genes of human embryos-suggest that our species could face unprecedented questions about who should exist...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171883/a-call-for-empirical-research-on-uterine-transplantation-and-reproductive-autonomy
#14
Cristie Cole Horsburgh
Uterine transplantation could give women who suffer from uterine factor infertility the possibility of experiencing gestation. Much of the ethical discussion about uterine transplantation has focused on whether research on it should even be pursued, but researchers are nevertheless moving forward with several uterine transplant research protocols. Scholars should therefore already be identifying and engaging in an intimate examination of the ethical realities of offering uterine transplantation in a clinical setting...
December 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171057/real-world-evidence-public-participation-and-the-fda
#15
Jason L Schwartz
For observers of pharmaceutical regulation and the Food and Drug Administration, these are uncertain times. Events in late 2016 raised concerns that the FDA's evidentiary standards were being weakened, compromising the agency's ability to adequately perform its regulatory and public health responsibilities. Two developments most directly contributed to these fears-the approval of eteplirsen, a treatment for Duchenne muscular dystrophy, against the recommendations of both FDA staff and an advisory committee and the December 2016 signing of the 21st Century Cures Act, which encouraged greater use by the FDA of "real-world" evidence not obtained through randomized controlled trials...
November 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171056/-what-s-in-a-name-car-t-gene-therapy
#16
Eric Kodish
No abstract text is available yet for this article.
November 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171055/global-bioethics
#17
Carolyn P Neuhaus
This August, I participated in the conference "Genome Editing: Biomedical and Ethical Perspectives," hosted by the Center for the Study of Bioethics at the University of Belgrade and cosponsored by the Division of Medical Ethics of NYU Langone Health and The Hastings Center. The prime minister of Serbia, Ana Brnabić, spoke of the significance of bringing together an international community of bioethicists, acknowledging that ethical, social, and legal issues surrounding gene editing technologies transcend national boundaries...
November 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171054/the-sticky-standard-of-care
#18
Michelle Oberman
The problem at the heart of "Stemming the Standard-of-Care Sprawl: Clinician Self-Interest and the Case of Electronic Fetal Monitoring," an article by Kayte Spector-Bagdady and colleagues in the November-December 2017 issue of the Hastings Center Report, is the persistence of a suboptimal standard of care long after evidence-driven approaches would dictate a change. That problem is not simply defensive medicine, or what the authors call "standard-of-care sprawl." Instead, it is that, in some cases, the standard of care lags behind best practices...
November 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171053/contributors
#19
(no author information available yet)
No abstract text is available yet for this article.
November 2017: Hastings Center Report
https://www.readbyqxmd.com/read/29171052/social-practices
#20
(no author information available yet)
In one way or another, several pieces in the November-December 2017 of the Hastings Center Report reflect an insistence on turning away from abstractions to learn how a whole community understands a problem at issue-how a community understands what's at stake in individuals' autonomous choices, how a community understands the results of a clinical trial, how a community understands, and generates and adjusts, medical standards. In the lead article, Kayte Spector-Bagdady and colleagues argue that, given extensive research showing that electronic fetal monitoring during childbirth offers very little benefit to the mother and child, a mechanism is needed to ensure that the medical standard of care is based on the right kinds of considerations...
November 2017: Hastings Center Report
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