Year:

  1.  4
    Integrity and Conscience in Medical Ethics: A Ciceronian Perspective.Jed W. Atkins - 2019 - Perspectives in Biology and Medicine 62 (3):470-488.
    The past decade has seen a vigorous debate in medical ethics over whether and under what conditions physicians can refuse requests from patients for medical interventions that the physician believes are morally inappropriate to perform. The debate has typically been framed in terms of "conscientious refusal": when, if ever, is the physician justified in refusing an intervention when the reasons of refusal have to do with the convictions of the physician's conscience? To this version of the question, a range of (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  2.  4
    Conscience, Moral Reasoning, and Skepticism.Larry R. Churchill - 2019 - Perspectives in Biology and Medicine 62 (3):519-526.
    Lauris Kaldjian makes a strong case for respecting the role of conscience in the practice of medicine. His excellent book, Practicing Medicine and Ethics, presents an historically informed and carefully crafted explication of the role of conscience in Western ethics and its relevance for medical practitioners. The essay that initiates the discussion in this issue of Perspectives in Biology and Medicine is an equally well-written and lucid account of this important component of morality. But it is also worrisome in its (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  3.  3
    Editors' Introduction: Examining Deeper Questions Posed by Disputes About Conscience in Medicine.Farr A. Curlin & Kevin Powell - 2019 - Perspectives in Biology and Medicine 62 (3):379-382.
    Over the past decade, scores of articles have been published debating whether and when it is ethical for physicians to refuse requests from patients for legal, professionally permitted interventions. Numerous voices have condemned "conscientious refusals" for obstructing patients' access to needed and "standard" health-care services, for imposing physicians' personal ideologies on patients, and for contradicting physicians' professional ethical obligations. Conversely, other voices argue that conscientious refusals are essential for maintaining the integrity of clinicians as moral agents, for assuring the renown (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  4.  7
    Conscience and the Way of Medicine.Farr A. Curlin & Christopher O. Tollefsen - 2019 - Perspectives in Biology and Medicine 62 (3):560-575.
    Doctors often refuse patients' REQUESTS, even when patients request interventions that are legal and permitted by the medical profession. This is a fact about the practice of medicine so familiar that it is easy to overlook.Doctors' refusals are neither new nor infrequent, and only a small minority occasion any controversy. Surgeons refuse to operate when they believe a surgery is unlikely to succeed. Physicians refuse medications when they believe the medications are unlikely to be helpful. Clinicians refuse requested interventions because (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  5.  5
    Integrity in Action: Medical Education as a Training in Conscience.John Brewer Eberly & Benjamin W. Frush - 2019 - Perspectives in Biology and Medicine 62 (3):414-433.
    Cowardice asks the question, is it safe? Expediency asks the question, is it politic? Vanity asks the question, is it popular? But conscience asks the question, is it right? And there comes a time when one must take a position that is neither safe, nor politic, nor popular, but he must take it because conscience tells him it is right.Your burden is not to clear your conscience but to learn how to bear the burdens on your conscience.Since the time of (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  6.  3
    Understanding Conscience as Integrity: Why Some Physicians Will Not Refer Patients for Ethically Controversial Practices.Lauris Christopher Kaldjian - 2019 - Perspectives in Biology and Medicine 62 (3):383-400.
    Given the moral pluralism that characterizes Western democratic societies and their health professions, it should be expected that there will be ethical differences among citizens and health professionals, due to contrasts between the foundational beliefs and values on which their ethical convictions rest. It should also be expected that some of these differences will have practical implications for the way professionals are willing to practice, and the way patients are willing to receive, health care. These practical implications include our responses (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  7.  2
    When Deeply Held Personal Beliefs Conflict with Collective Societal Norms.John D. Lantos - 2019 - Perspectives in Biology and Medicine 62 (3):503-518.
    In complex societies, there will always be situations in which an individual's deeply held beliefs conflict with the collective norms of the society. When only one individual challenges those norms, the norms generally hold. When challenges come from many individuals, the norms themselves may change. The tolerance for different beliefs will depend upon the political structure of the society and the specific beliefs that are being challenged.The Greek tragedy Antigone is an exploration of the choices that rulers can make regarding (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  8.  4
    Protecting Moral Integrity Through Justified Exemption.Christopher Meyers - 2019 - Perspectives in Biology and Medicine 62 (3):527-542.
    To be a professional is to accept the obligation to sometimes participate in activities and to engage with people that one might otherwise choose to avoid. Lawyers, for example, must advocate on behalf of despicable clients, professors must teach and fairly evaluate lazy and insolent students, and physicians must minister to persons whose beliefs—and actions—run afoul of their core values. For example, at least three of the professionals who treated Robert Bower—the person who murdered 14 people in a Pittsburgh synagogue—were (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  9.  3
    Alternatives to War Within Medicine: From Conscientious Objection to Nonviolent Conflict About Contested Medical Practices.Abraham M. Nussbaum - 2019 - Perspectives in Biology and Medicine 62 (3):434-451.
    Martial metaphors shape the practice of medicine. Bioethicists who disagree participate in culture wars; public health officials who advocate declare wars on cancer and drugs; surgeons who operate map theaters and fields; physicians who enter graduate training become housestaff officers; nurses who act clinically follow doctor's orders; patients who become ill wage battles against disease. But when we figure medicine as warfare, clinicians become either dutiful combatants or conscientious objectors. Clinicians who serve the mission of medicine are described as loyal, (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  10.  3
    Bad Blood and Unsettled Law: Are Healing and Justice Even Possible When Biocapitalism Prevails?Stephen Pemberton - 2019 - Perspectives in Biology and Medicine 62 (3):576-590.
    Catastrophically bad decisions were an all-too-frequent occurrence when it came to managing blood for therapeutic purposes in the first decade of the AIDS epidemic. The victims of those bad decisions were, first and foremost, the persons who received HIV-contaminated blood via their medical treatments. During the 1980s, at least 20,000 patients in the United States contracted HIV infections via "tainted" blood treatments. More than half of the nation's 16,000 hemophilia patients were among that number. Unlike the roughly 12,000 Americans who (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  11.  3
    Reasonable Accommodation of Conscientious Objection in Health Care Is Morally and Legally Required.Kevin Powell - 2019 - Perspectives in Biology and Medicine 62 (3):489-502.
    Human beings working in fields involving life, death, and morality are going to have fundamental and occasionally irreconcilable differences of opinion regarding goals, values, and actions. This has been true from the beginning of civilization. Along the way, civilized peoples have created laws that accommodate these differences so that a diverse population can coexist peaceably in one pluralistic society. As such, the Law is the practical, inchoate expression of that society's combined morals.For more than a decade, scholarly articles about conscientious (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  12.  4
    Physicians' Refusals of Service on Grounds of Conscience.Lance K. Stell - 2019 - Perspectives in Biology and Medicine 62 (3):452-469.
    … no physician, in so far as he is a physician, considers his own good in what he prescribes, but the good of his patient, for the true physician … is not a mere money-maker.A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.[We] are agents. Our constitution is put in our power. We are charged with it; (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  13.  3
    Patients Need Doctors with Consciences.Victoria Sweet - 2019 - Perspectives in Biology and Medicine 62 (3):401-413.
    For the past 45 years a passionate debate has been going on about whether doctors should be allowed or forbidden to bring their consciences—defined as their religious beliefs and moral convictions—into the exam room.1 Focusing explicitly or implicitly on abortion and assisted suicide, this debate has made it almost impossible to talk about conscience in a broader way. And yet it is critical to do so today, as huge corporations take over medicine and, with it, power over doctors' actions.Here, then, (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  14.  3
    Conscientious Objection, Moral Integrity, and Professional Obligations.Mark R. Wicclair - 2019 - Perspectives in Biology and Medicine 62 (3):543-559.
    Typically, a refusal to provide a medical service is an instance of conscientious objection only when the medical service is legal, professionally accepted, and clinically appropriate. That is, conscientious objection typically occurs only when practitioners reject prevailing norms or practices. Insofar as refusing to provide antibiotics for a viral infection does not violate prevailing clinical norms, there is no need for the physician in Case 1 to justify his refusal to provide antibiotics by appealing to his conscience.1 By contrast, insofar (...)
    Direct download (2 more)  
     
    Export citation  
     
    Bookmark  
  15.  1
    Reconceiving Decisions at the End of Life in Pediatrics: Decision-Making as a Form of Ritual.Amy E. Caruso Brown - 2019 - Perspectives in Biology and Medicine 62 (2):301-318.
    Medical anthropologists have long recognized variation between cultures with regard to the locus of healing in different systems and traditions: that is, in some cultures, the human body is a “bounded physical unit” and healing is thus focused on the body alone. This perspective will be most familiar to Western health-care providers, and indeed, many providers do not imagine an alternative perspective. However, in many cultures, experiences of health, illness, disease, and healing are intricately connected with the social spheres. In (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  16.  1
    Concepts at the Bedside: Variations on the Theme of Autonomy.Daniel Brudney - 2019 - Perspectives in Biology and Medicine 62 (2):257-272.
    Let’s start with three cases of refusal of treatment.[A] 24-year old graduate student is brought to the emergency room by a friend. Previously in good health, he is complaining of a severe headache and stiff neck. Physical examination shows a somnolent patient without focal neurologic signs but with a temperature of 39.5 degrees centigrade and nuchal rigidity. Examination of spinal fluid reveals cloudy fluid with a white blood cell count of 2000; Gram stain of the fluid shows many Gram-positive diplococcic. (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  17.  9
    Three Problems with Big Data and Artificial Intelligence in Medicine.Benjamin Chin-Yee & Ross Upshur - 2019 - Perspectives in Biology and Medicine 62 (2):237-256.
    We live in the Age of Big Data. In medicine, artificial intelligence and machine learning algorithms, fueled by big data, promise to change how physicians make diagnoses, determine prognoses, and develop new treatments. An exponential rise in articles on these topics is seen in the medical literature. Recent applications range from the use of deep learning neural networks to diagnose diabetic retinopathy and skin cancer from image databases, to the use of various machine learning algorithms for prognostication in cancer and (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  18. “Undoing” Capacity: The Capability Approach in Pediatrics.Eva De Clercq, Jürg Streuli, Katherina Ruhe & Bernice S. Elger - 2019 - Perspectives in Biology and Medicine 62 (2):319-336.
    Viola and Ben, two pediatric oncology patients, need to undergo chemotherapy that might decrease their fertility. Both of them want to participate in the decisions related to their cancer treatment and fertility preservation. Should they be involved, and if so when and how?In many jurisdictions, children are not entitled to provide legally valid consent for medical decisions.1 As a result, others, usually parents, take on the role of surrogate decision-makers who act in their best interest. Still, it is important to (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  19.  1
    The Problem of Female Genital Cutting: Bridging Secular and Islamic Bioethical Perspectives.Rosie Duivenbode & Aasim I. Padela - 2019 - Perspectives in Biology and Medicine 62 (2):273-300.
    Recent events in the United States and beyond have brought debates over the practice of female genital cutting back into public, academic, and policy discourses.1 In April 2017, Jumana Nagarwala, a Michigan-based emergency medicine physician from a small Shia sect known as the Dawoodi Bohra, was charged with performing female genital mutilation. The procedure is prohibited by federal law and defined as the circumcision, excision, or infibulation of the whole or any part of the female genitalia under the age of (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  20.  2
    The Patient as Professor: How My Life as a Person with Quadriplegia Shaped My Thinking as an Ethicist.Brooke Ellison - 2019 - Perspectives in Biology and Medicine 62 (2):342-351.
    I should not be here. By nearly all medical prognostication and statistical realism, I should not be here. In fact, anyone with any wagering savvy might have—and quite justifiably—placed her chips on someone else. But lives do not always adhere to probabilities, bell curves, or standard deviations. Personal will favors the long game over the short; determination and hopefulness strive for the less likely instead of the more—the extreme rather than the mean.I have lived for 28 years with quadriplegia, a (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  21.  2
    Credit and Priority in Scientific Discovery: A Scientist’s Perspective.Jeffrey S. Flier - 2019 - Perspectives in Biology and Medicine 62 (2):189-215.
    Public credit for scientific discovery plays a central role in the reward structure of science, and over many years, it has powerfully influenced the norms and institutional practices of the research ecosystem. While the benefits of credit to scientists who make the most important discoveries are obvious, credit is also important to the great majority whose discoveries are of lesser importance. The basic tenets of credit are embedded deep within the background of scientific norms and culture and are often taken (...)
    Direct download (4 more)  
     
    Export citation  
     
    Bookmark  
  22. Suffering, Medicine, and What Is Pointless.Arthur W. Frank - 2019 - Perspectives in Biology and Medicine 62 (2):352-365.
    In my ideal academy of healing arts, students of all health-care professions would spend their first semester together, thinking only about suffering. No coursework on bodies, diseases, or basic science. No socialization into distinct professional identities. Just suffering from multiple perspectives: literary, philosophical, spiritual, historical, crosscultural. They would be led to ask what forms of suffering have been responded to in which ways, when, by whom. Whose suffering has been systematically ignored, and what finally led to the recognition of that (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  23.  13
    The New Science of Practical Wisdom.Dilip V. Jeste, Ellen E. Lee, Charles Cassidy, Rachel Caspari, Pascal Gagneux, Danielle Glorioso, Bruce L. Miller, Katerina Semendeferi, Candace Vogler, Howard Nusbaum & Dan Blazer - 2019 - Perspectives in Biology and Medicine 62 (2):216-236.
    We are drowning in information, while starving for wisdom.Are the smartest people also the wisest? Not necessarily. While traditional intellectual reasoning and procedural knowledge have helped build the communities we live in, there is a growing scientific understanding that we need emotionally balanced and better-fitting prosocial frameworks for coping with the uncertainties and complexities of life and addressing new challenges of the modern world. We are now poised on the edge of a new science of wisdom.The concept of wisdom, long (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  24.  4
    The History and Future of the Gene.Thomas McDonald - 2019 - Perspectives in Biology and Medicine 62 (2):366-378.
    There is nothing like a little controversy to generate publicity for your new book. In May of 2016, two weeks before the release of The Gene: An Intimate History, author and physician Siddhartha Mukherjee published a New Yorker article that generated a firestorm of criticism. His subject was epigenetics, a newly popular subdiscipline of genetics that seeks to explain how an organism’s traits can be affected by factors other than its genes. The conventional view within biology is that an organism’s (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  25. Encounters of a Different Kind.Farhat Moazam - 2019 - Perspectives in Biology and Medicine 62 (2):337-341.
    It has been a little over three months since I returned. My day begins with an altercation with a new security guard who stops me as I drive up to the gate of the brand-new university hospital. He tells me that I am to use the other entrance, as only the chairman’s car is allowed through this gate. I inform him that I am the chairman. He peers at me suspiciously. The chairman sahib is a man not a woman, he (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  26.  6
    Who Should Be Driving US Science Policy?Carole R. Baskin - 2019 - Perspectives in Biology and Medicine 62 (1):20-30.
    This essay argues that scientific progress in STEM areas and US national biosecurity are best achieved when US scientists self-regulate, work to influence the lawmaking process at every stage of their career, and welcome or even initiate interactions with the public. Events that draw negative public attention drive laws because laws are proposed by elected representatives of the public. Laws are therefore reactive in nature, as are regulations promulgated by agencies that implement these laws. Laws and regulations are difficult and (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  27.  4
    The Rise and Fall of the "Personal Equation" in American and British Medicine, 1855–1952.Rory Brinkmann, Andrew Turner & Scott H. Podolsky - 2019 - Perspectives in Biology and Medicine 62 (1):41-71.
    Medicine today, as both art and science, embodies a split personality. The ensuing tension—between individualized consideration, experience, and judgment on the one hand, and standardization, objective evidence, and guidelines on the other—plays out in the simultaneous aspirations of the medical humanities and evidence-based medicine, and in a host of other telling terms and movements. This is not a new tension, however. We turn in this paper to the critical but complex history of the term “personal equation” as both reflective and (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  28.  4
    Science and Serendipity: Finding Coca-Cola in China.Susan Greenhalgh - 2019 - Perspectives in Biology and Medicine 62 (1):131-152.
    “Coca-cola Funds scientists Who shiFt Blame for Obesity Away from Bad Diets.” Thus began the August 9, 2015 New York Times article that alerted the public and the wider scientific community to the secret tactics the soda industry was using to protect its profits on a product known to harm health and contribute to the obesity epidemic, one of the leading public health crises of our day. Following the lead of the tobacco industry, Coca-Cola was funding leading exercise scientists to (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  29.  5
    Exploring the Asymmetrical Relationship Between the Power of Finance Bias and Evidence.Jeremy Howick - 2019 - Perspectives in Biology and Medicine 62 (1):159-187.
    Power determines what counts as knowledge, what kind of interpretation attains authority as the dominant interpretation. Power procures the knowledge which supports its purposes, while it ignores or suppresses that knowledge which does not serve it.In many important cases, sociological forces, mostly financial conflicts of interest are powerful enough to upstage evidence when it comes to deciding whether interventions are safe and effective. Using three widely cited historical cases that are hailed as successes of evidence vis-à-vis finance bias, I show (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  30.  10
    On Collaboration in Bioethics Scholarship.Franklin G. Miller - 2019 - Perspectives in Biology and Medicine 62 (1):31-40.
    I came to bioethics scholarship in 1990 at age 42. My first two published papers were solo-authored. But subsequently most of my bioethics research, including 223 articles and 22 book chapters written with many coauthors, has been collaborative; and my one monograph book, Death, Dying, and Organ Transplantation, was a collaborative venture with Robert Truog. As my academic field is philosophy, where collaborative work is rare, I had no background for doing this. I lacked any formal mentorship in bioethics and (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  31.  7
    New Metaphors for New Understandings of Genomes.Sarah Tinker Perrault & Meaghan O'Keefe - 2019 - Perspectives in Biology and Medicine 62 (1):1-19.
    New techniques have made genome modification cheaper, easier, and faster than before, leading to a boom in research—both “basic” research and research applied to many species, and to germlines as well as somatic cells, with especially strong interest in biomedical uses. Given the scope and potential power of this work, it is vital that people be provided with accurate information about what is being done or proposed, and why. Such information is crucial to their making good decisions both in their (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  32.  4
    Leave Lamarck Alone! Why the Use of the Term "Lamarckism" and Its Cognates Must Be Shunned.Koen B. Tanghe - 2019 - Perspectives in Biology and Medicine 62 (1):72-94.
    Neither can we... improve a science, without improving the language or nomenclature which belongs to it.Ludwig Wittgenstein famously claimed that it was the task of scientists to investigate matters of fact, whereas philosophers merely had to clarify the meaning of terms. One could also—or more precisely—argue that philosophers should identify and remedy five kinds of possible dysfunctions in the relationship between epistemic terms and their referent: they can be meaningless, imprecise, indiscriminate, ambiguous, or inapt. One of the main reasons why (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  33.  3
    What We Mean When We Talk About Suffering—and Why Eric Cassell Should Not Have the Last Word.Tyler Tate & Robert Pearlman - 2019 - Perspectives in Biology and Medicine 62 (1):95-110.
    Marie was 15 when her abdominal pain began. After two years of negative work-ups, countless visits to gastroenterologists, and over 70 days of high school missed, she found herself readmitted to the hospital. “Refractory abdominal pain” was her ostensible diagnosis; “troubled teen” who was “going to be difficult” was embedded in the emergency department’s sign-out. When the medical team arrived to meet Marie, she was huddled in the corner of her hospital bed, silent and withdrawn. Her intern noted the numerous (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark   1 citation  
  34.  5
    The Role of Physicians During Hunger Strikes of Undocumented Migrant Workers in a Non-Custodial Setting.Rita Vanobberghen, Fred Louckx, Anne-Marie Depoorter, Dirk Devroey & Jan Vandevoorde - 2019 - Perspectives in Biology and Medicine 62 (1):111-130.
    Hunger striking is a form of nonviolent action of last resort. It is a tactic used by powerless individuals to challenge those in power and achieve change. Many authors have emphasized that hunger strikers are not suicidal, but when oppressed people run out of other ways to protest or demand sociopolitical change, some of them are willing to place their health and life at risk to achieve their goals. Hunger strikes have a long, widely diffused history, and studies reveal that (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
  35.  3
    When Darkness Starts.Neha Verma - 2019 - Perspectives in Biology and Medicine 62 (1):153-158.
    “The women here in Los Terreros are worried,” Don Alonzo says. “Last year, one of them died from invasive cervical cancer. Thirty-eight years old. Never had a pap in her life.” He leans back in his chair and sighs. “Her husband wouldn’t let her, said he didn’t see the point.” A tabby cat rubs against his legs. “So now the women, they keep worrying. They’ve had the day your group is coming memorized for weeks, maybe months.”Don Alonzo is the local (...)
    Direct download (3 more)  
     
    Export citation  
     
    Bookmark  
 Previous issues
  
Next issues