Worldwide there are currently over 1200 research studies being performed on the topic of COVID-19. Many of these involve children and adults over age 65 years. There are also numerous studies testing investigational vaccines on healthy volunteers. No research team is exempt from the pressures and speed at which COVID-19 research is occurring. And this can increase the risk of honest error as well as misconduct. To date, 33 papers have been identified as unsuitable for public use and either retracted, (...) withdrawn, or noted with concern. Asia is the source of most of these manuscripts (n=19; 57.6%) with China the largest Asian subgroup (n=11; 57.9%). This paper explores these findings and offers guidance for responsible research practice during pandemics. (shrink)

BackgroundOrgan donation and transplantation in China are ethically complex due to questionable informed consent and the use of prisoners as donors. Publishing works from China can be problematic. The objective of this study was to perform a 10-year follow up on Chinese journals active in donation and transplant publishing regarding the evolution of their publishing guidelines.MethodsEleven Chinese journals were analyzed for 7 properties: (1) ethics committee approval; (2) procedure consent; (3) publishing consent; (4) authorship criteria; (5) conflict of interest; (6) (...) duplicate publication; and (7) data integrity. Results were compared with our 2008 study data. Additionally, open access status, impact factor, and MEDLINE-indexing were explored.ResultsMost journals heightened the ethical requirements for publishing, compared to the results of 2008. All 11 now require their published manuscripts to have data integrity. Ten of 11 require ethics committee approval and informed consent for the publication of research studies, whereas in the original study only 2 journals evidenced these requirements. Nine of 11 have criteria for authorship, require conflict of interest disclosure, and forbid duplicate publishing. None of the journals have a policy to exclude data that was obtained from unethical organ donation practices. Nine of 11 journals are MEDLINE-indexed but only 2 are open-access.ConclusionsMost journals have improved their general ethical publishing requirements but none address unethical organ donation practices. (shrink)

Higgins’ et al recent paper1 presents a well-thought ethical analysis of the problems associated with the publication of unethical transplant research. More generally, research ethics committees never allow the use or reuse of data that has been collected without their required approval. Similarly, in many judicial settings, evidence is generally inadmissible when it is gathered illegally.2 Thus, journals and other publishers should follow in their footsteps and also roadblock any associated publications. Moreover, unethical organ donation and transplantation research is rife (...) with integrity issues, which violate publication norms. If these normally accepted exclusions3 are ignored, then publishers are turning off their moral compass and facilitating an attitude of ‘anything goes’ in the conduct of research. Table 1 presents a timeline of scholarly responses to the problem of publishing unethical transplant research. As shown, since 2007 there has been a slow evolution of changing publisher practices, yet more …. (shrink)

Edo—Kingyo’s Coolness and the Night Aquarium Museum Lounge Content Type Journal Article Category Art Review Pages 1-2 DOI 10.1007/s11673-012-9354-2 Authors Katrina A. Bramstedt, Bond University School of Medicine, University Drive, Gold Coast, Queensland 4229, Australia Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529.

This is a review of the film Big Eyes. Adapted from a true story about artist Margaret Keane, the overarching theme of the movie is plagiarism. While most people think of written works such as books and articles being plagiarized, Big Eyes gives viewers insight into the world of stolen works of visual art, namely paintings. The victim finds moral courage through religion, while the thief lives in denial until death. Anyone with an interest in art, law, or psychiatry will (...) enjoy what Big Eyes has to offer. (shrink)

This is a review of the Japanese film, Like Father, Like Son. The movie tells the story of two families attempting to resolve the dilemma of learning that their 6-year old sons are actually not their biological children, but rather children swapped at birth by a nurse with malicious intent.

This is a review of the narrative medicine documentary, Our Curse. The writer and director of this Oscar-nominated Polish movie is a film student and a young father to a baby born with congenital central hypoventilation syndrome. Using simple cinematography, the film is an autobiographical exploration of the fearful, tearful, and sometimes joyful days and nights in the lives of the child and his parents.

In my work as a transplant ethicist I have always been interested in the topic of altruism. Thus, when a book appeared with the title, Pathological Altruism, I was very intrigued to read it. An exceedingly heavy book, however, arrived in my mailbox, and I admit I was taken aback. But upon reading Pathological Altruism, edited by Barbara Oakley, Ariel Knafo, Guruprasad Madhavan, and David Sloan Wilson, I was not disappointed.

This is a review of the 2013 film Words and Pictures. Surprisingly, the film is not about justifying a role for the humanities in education but, rather, a battle to determine which is more valuable—literature or art?. At a time when many schools question if these have any value at all, this film uses passionate and afflicted teachers to explore which is most important and finds valuable intersections between the two.

Due to COVID-19, the fragile economy, travel restrictions, and generalized anxieties, the concept of antibodies as a “declaration of immunity” or “passport” is sweeping the world. Numerous scientific and ethical issues confound the concept of an antibody passport; nonetheless, antibodies can be seen as a potential currency to allow movement of people and resuscitation of global economics. Just as financial currency can be forged, so too is the potential for fraudulent antibody passports. This paper explores matters of science, ethics, and (...) identity theft, as well as the problems of bias and discrimination that could promulgate a world of pandemic “golden passports.”. (shrink)

This brief report presents the global problem of the shortfall of donor corneal tissue for transplantation, a potential root cause (‘ick factor’ language), and a potential solution (modification of ‘ick factor’ language). Specifically, use of the term ‘eye donation’ is a potential hurdle to ocular tissue donation as it can stimulate the ‘ick factor.’ Verbiage such as ‘ocular (eye tissue)’ could be a method of providing terminology that is less emotive than ‘eye donor’ or ‘eye donation.’ The field of transplantation (...) has experienced terminology shifts over time; for example, ‘cadaver’ has been replaced with ‘deceased donor,’ ‘harvest’ has been replaced with ‘recover,’ and ‘life support’ has been replaced with ‘ventilated.’ Notably, only a small number of regions worldwide are using ‘ocular’ terminology, yet it could be an important step to enhancing the informed consent process and improving donation rates, potentially increasing transplant and optimising patient quality of life for those with treatable blindness. (shrink)

Advances in science and technology have created a plethora of medical therapies in various forms including drugs, devices, and equipment. Many of these therapies are not curative, however, and patients sometimes find themselves being more burdened than benefited by them. These situations result in ethical dilemmas for which the bioethicist is sometimes consulted to resolve. Using philosophical principles of maximizing good, minimizing harm, being just, and respecting the values of others, the bioethicist counsels patients, families, and hospital personnel, sometimes functioning (...) as advocate, arbitrator, negotiator, mediator, and teacher. (shrink)

Advances in science and technology have created a plethora of medical therapies in various forms including drugs, devices, and equipment. Many of these therapies are not curative, however, and patients sometimes find themselves being more burdened than benefited by them. These situations result in ethical dilemmas for which the bioethicist is sometimes consulted to resolve. Using philosophical principles of maximizing good, minimizing harm, being just, and respecting the values of others, the bioethicist counsels patients, families, and hospital personnel, sometimes functioning (...) as advocate, arbitrator, negotiator, mediator, and teacher. (shrink)

In the United States 46 million people are uninsured and it is from within this population that many ‘normal, healthy’ research participants are selected. Research institutions and sponsors are not required to compensate or provide free treatment to participants when they incur research-related harm, and most studies do not stipulate the provision of free medical care to treat research-related adverse events. The consequence for uninsured participants is that they must assume these medical costs unless they successfully sue the study sponsor (...) or research institution. This article discusses the matter of healthy volunteers becoming ‘the sick’ as a result of research participation, and proposes guidance for the informed consent process in order to optimize awareness about injury potential and injury compensation. Guidance regarding health screening for these volunteers is also presented. (shrink)

This study is an analysis of surrogate-focused ethics consultations in the Intensive Care Unit (ICU) and the general wards (Ward) of a large community hospital in Northern California. We identified the major themes of surrogate-focused ethics consultations to better understand the root cause of surrogate conflicts, and identified the similarities and differences between surrogate-based conflicts in the two settings. Consults requested because the surrogate had desires that conflicted with the physicians medical opinion of ‘best interest’, or cases involving surrogates not (...) upholding a patient’s known values reflected the root cause of the majority of surrogate conflicts (72.7% ICU, 83.3% Ward). (shrink)

Machine generated contents note: Introduction Chapter 1: The basics of ethical decision-making Chapter 2: Hospital ethics committees and clinical ethicists Chapter 3: The settings of health care ethical dilemmas Chapter 4: Advance directives Chapter 5: Do Not Resuscitate orders and "Code Blue" Chapter 6: Non-beneficial medical interventions Chapter 7: Quality of life and treatment burdens Chapter 8: Patient privacy and confidentiality Chapter 9: Refusing medical treatment Chapter 10: Health care at the end of life Chapter 11: Transplant ethics Chapter 12: (...) Neuroethics Chapter 13: Ethics and reproductive technology Chapter 14: Genetics and ethics Chapter 15: Pediatric ethics Chapter 16: Participating in a research study Appendix A: Resource List Appendix B: Glossary Index. (shrink)

Last Cab to Darwin is a film about physician-assisted suicide—specifically, a cab driver diagnosed with metastatic cancer and his journey seeking the “machine” that will help him end his life. Along the way, Rex, who has never had a family, creates one, and the result is a reshaping of his values about life, death, and dying.

United States statistics continue to indicate that the human donor heart pool does not and will not meet the great demand for hearts. For those patients unresponsive to maximal medical therapy (approximately 60,000 patients per year), cardiac transplantation is currently their best hope for increased survival. To address the need for additional end-stage congestive heart failure (CHF) therapy options, three medical device manufacturers have developed implantable left ventricular assist devices (LVAD) which act as a pump for hemodynamic support of the (...) patient’s diseased heart. Although LVADs have been shown to improve patient disease state prior to organ transplantation. LVADs do nothing to increase the pool of human donor hearts, and they negatively impact the United Network for Organ Sharing (UNOS) waiting list by increasing the size of the waiting pool. This paper identifies and explores the ethical challenges presented by the use of LVADs as a bridging technology for heart transplant candidates. Although LVADs raise some ethical concerns, these concerns are outweighed by the proven medical efficacy of these devices. Thus, this technology should continue to be used and further developed. (shrink)

Background Medical boards and fitness-to-practice committees aim to ensure that medical students and physicians have “good moral character” and are not impaired in their practice of medicine. Method Presented here is an ethical analysis of stalking behavior by physicians and medical students, with focus on the case of Teleka Patrick, MD (a psychiatry resident practicing medicine while under a restraining order due to her alleged stalking behavior). Conclusions While a restraining order is not generally considered a criminal conviction, stalking behavior (...) is clearly unprofessional and a marker of inappropriate character and fitness, yet the reporting obligations for such matters are complex. Medical schools and training programs that fail to assess, record, and report matters of moral conduct such as this potentially allow impaired students to graduate and enter the work force (unless a robust licensing process identifies them). Patrick’s case should be a wake-up call for medical schools and medical boards to better integrate the professionalism domain into their operations. Further, the professionalism of students and doctors need to be integrated into the legal domain, so that those who are unfit to practice are, in fact, prevented from doing so. Guidance for integration is provided. (shrink)

Where, oh where, has my manuscript gone?Where, oh where, can it be?With its word count cut short and its review time longWhere, oh where, can it be?I worked so hardI worked so longOff it wentOff it’s goneWhen will it come back to me?Days and weeksMonths, a yearWhen will it re-appear?I think I see itNo, a mirageI’m waiting for you, fingers crossed.

Expecting Saving Mr. Banks to be a jolly jaunt about the creative development of the movie Mary Poppins (1964), I found myself waiting endlessly for the “jolliness” to begin—it never did. In fact, rather than joy, there was an ever-present sensation of tension as I watched the film. Having moved house myself in recent days (during a Queensland heat wave), the scenes of the Goff family leaving their home and trekking across hot, dusty Queensland were very emotional. However, seeing the (...) family patriarch Travers Goff (played by Colin Farrell) swig from an alcohol flask in a desperate manner told me that his was no “routine” family move. And, certainly, arriving at their destination—a dilapidated ranch home—shed even more light on the Goff family’s predicament: alcoholism and the cycle of employment and unemployment. Further, it is the downstream consequences of the family predicament that fuel the identity and behaviour of Mary Poppins—a fictional character created by Travers’ daughter, a. (shrink)

The first ethicists of the 1970s paved the way for the three most familiar models of clinical ethics consultation: (1) a single consultant, (2) a member of a hospital ethics committee, and (3) a member of a subcommittee of a hospital ethics committee. Within the single consultant model there are (A) the lone ethicist (a member of hospital staff, working alone when consulting) and (B) the independent ethicist (a freelance, external consultant, working alone). This article discusses the structure and opportunities (...) offered by the freelance, independent ethicist model, and provides guidance for those who employ freelance, independent ethicists, as well as guidance for ethicists who are considering adopting this practice model. (shrink)

Gerald Nissenbaum, JD and John Sedgwick. 2010. Sex, love and money: Revenge and ruin in the world of high-stakes divorce Content Type Journal Article DOI 10.1007/s11673-010-9243-5 Authors Katrina A. Bramstedt, Clinical Ethicist, Program in Medicine & Human Values, California Pacific Medical Center, 2395 Sacramento St, 3rd floor, San Francisco, CA 94115, USA Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 7 Journal Issue Volume 7, Number 3.

The goal of this paper is to examine the impact of leadership and promotion regulatory focus on employees’ willingness to engage in unethical pro-organizational behavior . Building from a person–situation interactionist perspective, we investigate the interaction of leadership style and how leaders frame messages, as well as test a three-way interaction with promotion focus. Using an experimental design, we found that inspirational and charismatic transformational leaders elicited higher levels of UPB than transactional leaders when the leaders used loss framing, but (...) not gain framing. Furthermore, followers’ promotion regulatory focus moderated this relationship such that the effect held for followers with low promotion focus, but not for individuals with high promotion focus. Our findings extend the understanding of UPB, offer theoretical mechanisms to explain when this behavior occurs, and contribute to leadership theory and research on ethical decision making. (shrink)

Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...) refractory dystonia. Given the favorable risk-benefit profile, it is concluded that offering pDBS is ethically justified for certain etiologies of dystonia, but it is less clear for others. In addition, various ethical and policy concerns are discussed, which need to be addressed to optimize the practice of offering pDBS for dystonia. Strategies are proposed to help address these concerns as pDBS continues to expand. (shrink)

The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (n = 23) involved in developing next-generation DBS systems, exploring their perspectives on ethics and policy topics including whether DBS/aDBS can cause such changes. The majority of researchers reported being aware of personality, mood, or behavioral (PMB) changes in recipients of DBS/aDBS. Researchers offered varying estimates of the frequency of PMB changes. A (...) smaller majority reported changes in personality specifically. Some expressed reservations about the scientific status of the term ‘personality,’ while others used it freely. Most researchers discussed negative PMB changes, but a majority said that DBS/aDBS can also result in positive changes. Several researchers viewed positive PMB changes as part of the therapeutic goal in psychiatric applications of DBS/aDBS. Finally, several discussed potential causes of PMB changes other than the device itself. (shrink)