The HPV (human papillomavirus) vaccine Gardasil (Merck & Co.) was licensed for use by the FDA on June 8, 2006. The Centers for Disease Control and major physician professional organizations have recommended routine universal vaccination in young girls. However, questions remain regarding the safety and efficacy of the vaccine in this age group. Also, vaccine use will not eliminate the need for routine Pap screening, and it may not decrease future cervical cancer rates. This paper surveys the natural history of (...) HPV infection as well as the controversies surrounding the vaccine’s use as currently recommended. National Catholic Bioethics Quarterly 10.3 (Autumn 2010): 459–469. (shrink)

Possession of a BRCA1 or BRCA2 gene mutation puts a woman at very high risk of developing breast and ovarian carcinoma at an early age. One treatment option is surgical removal of the target organs—breasts, ovaries, and fallopian tubes—before the malignancy develops. This risk-reduction surgery has been shown to significantly reduce the likelihood that a woman will develop one of these cancers. This paper argues that such surgeries do not violate Catholic moral principles, but can be justified using the principles (...) of double effect and totality and integrity. The paper does not recommend or endorse any specific treatment option. National Catholic Bioethics Quarterly 15.1 : 75–89. (shrink)

In the 1930s, the Home Owners’ Loan Corporation (HOLC) graded the mortgage security of urban US neighborhoods. In doing so, the HOLC engaged in the practice, imbued with racism and xenophobia, of “redlining” neighborhoods deemed “hazardous” for lenders. Redlining has caused persistent social, political and economic problems for communities of color. Linkages between redlining and contemporary food access remain unexamined, even though food access is essential to well-being. To investigate this, we used a census tract-level measure of low-income and low (...) grocery store food access from the US Department of Agriculture Food Access Research Atlas, redlining data from Mapping Inequality Project, and demographic data from the American Community Survey. We employed generalized estimating equations with robust covariance estimates to analyze data pertaining to 10,459 census tracts in 202 US cities. Tracts that the HOLC graded as “C” (“decline in desirability”) and “D” (“hazardous”) had reduced contemporary food access compared to those graded “A” (“best”). Increases in contemporary census tract proportions of Black, Hispanic, or other racial/ethnic minority residents, as well as disabled residents, were associated with reduced food access. Increases in contemporary proportions of residents age 75 years and older or those without a car were associated with better food access. Tracts that underwent housing redevelopment since being graded had better food access, while those undergoing gentrification had reduced food access. Results suggest that issues of redlining, housing discrimination, racism, ableism, displacement, and food inaccessibility are deeply intertwined. (shrink)