Year:

  1.  6
    The Real‐World Ethics of Adaptive‐Design Clinical Trials.E. Bothwell Laura & S. Kesselheim Aaron - 2017 - Hastings Center Report 47 (6):27-37.
    From the earliest application of modern randomized controlled trials in medical research, scientists and observers have deliberated the ethics of randomly allocating study participants to trial control arms. Adaptive RCT designs have been promoted as ethically advantageous over conventional RCTs because they reduce the allocation of subjects to what appear to be inferior treatments. Critical assessment of this claim is important, as adaptive designs are changing medical research, with the potential to significantly shift how clinical trials are conducted. Policy-makers are (...)
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  2.  4
    Delegating Informed Consent.Valerie Gutmann Koch - 2017 - Hastings Center Report 47 (6):5-6.
    Ten years ago, Megan Shinal sought the care of neurosurgeon Steven Toms for the surgical treatment of a recurrent nonmalignant tumor in the pituitary region of her brain. In their twenty-minute meeting, Shinal did not make a final decision about which surgical approach she wished to pursue. Subsequently, she spoke with Tom's physician assistant once by phone and once in person, when she signed the consent form, which did not appear to designate which surgical approach she had chosen. During the (...)
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  3.  2
    “What's in a Name?” CAR‐T Gene Therapy.Eric Kodish - 2017 - Hastings Center Report 47 (6):inside back cover-inside back co.
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  4.  2
    Global Bioethics.Carolyn P. Neuhaus - 2017 - Hastings Center Report 47 (6):inside front cover-inside front.
    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. Europe's Oviedo Convention prohibits human (...)
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  5.  2
    The Sticky Standard of Care.Michelle Oberman - 2017 - Hastings Center Report 47 (6):25-26.
    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 (...)
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  6.  7
    Being Better Bodies. [REVIEW]Joel Michael Reynolds - 2017 - Hastings Center Report 47 (6):46-47.
    Bioethics has an uneasy relationship with embodiment. Only with vigilance does knowledge of the body as it is lived counterbalance the momentous inertia of knowledge of the body as an object brought about by modern medical sciences. As a field tethered to detached, technical ways of knowing the world, bioethics must toil to treat the body as more than mere material and machine. To be more is, among other things, to be social—to live in the thickets of interdependence and the (...)
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  7.  1
    Real‐World Evidence, Public Participation, and the FDA.L. Schwartz Jason - 2017 - Hastings Center Report 47 (6):7-8.
    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, (...)
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  8.  1
    Contemplating Resectability.Andrew G. Shuman - 2017 - Hastings Center Report 47 (6):3-4.
    Suzie loves to talk. A successful mid-thirties businesswoman, she is a self-described social butterfly—which made her diagnosis of tongue cancer even more devastating. She came to the clinic complaining of a lump in her throat, which in most young healthy people turns out to be benign and easily treated. But not for Suzie, who had a very rare salivary tumor arising in the back of her tongue. Its slow growth was both a blessing and a curse; such tumors do not (...)
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  9. Stemming the Standard-of-Care Sprawl.Spector-Bagdady Kayte, De Vries Raymond, Harris Lisa Hope & Low Lisa Kane - 2017 - Hastings Center Report 47 (6):16-24.
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  10.  7
    Stemming the Standard‐of‐Care Sprawl.Kayte Spector-Bagdady, Raymond Vries, Lisa Hope Harris & Lisa Kane Low - 2017 - Hastings Center Report 47 (6):16-24.
    The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of whether (...)
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  11.  1
    Stemming the Standard‐of‐Care Sprawl.Spector‐Bagdady Kayte, Vries Raymond, Harris Lisa Hope & Low Lisa Kane - 2017 - Hastings Center Report 47 (6):16-24.
    The “best interests of the patient” standard—a complex balance between the principles of beneficence and autonomy—is the driving force of ethical clinical care. Clinicians’ fear of litigation is a challenge to that ethical paradigm. But is it ever ethically appropriate for clinicians to undertake a procedure with the primary goal of protecting themselves from potential legal action? Complicating that question is the fact that tort liability is adjudicated based on what most clinicians are doing, not the scientific basis of whether (...)
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  12.  9
    The Morality of Health Care Reform: Liberal and Conservative Views and the Space Between Them.Timothy Stoltzfus Jost - 2017 - Hastings Center Report 47 (6):9-13.
    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, (...)
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  13.  8
    Ending DACA Has Pragmatic and Ethical Implications for U.S. Health Care.Danish Zaidi & Mark Kuczewski - 2017 - Hastings Center Report 47 (6):14-15.
    In 2012, Loyola University Chicago's Stritch School of Medicine became the first medical school in the United States to actively recruit and accept undocumented immigrants who received protections granted under the Deferred Action for Childhood Arrivals program that was established by presidential memorandum. By 2016, sixty-one medical schools were considering applications from DACA recipients for admission, and more than 110 students applied. According to the Association of American Medical Colleges, sixty-five DACA recipients matriculated in U.S. medical schools in the 2016–2017 (...)
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  14.  1
    Public Health Autonomy: A Critical Reappraisal.Frederick J. Zimmerman - 2017 - Hastings Center Report 47 (6):38-45.
    The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy—childhood vaccine mandates, for example—there are many more areas where not only is there no tension, but public health and autonomy come down to the (...)
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  15.  6
    Charlie Gard and the Limits of Parental Authority.Arthur Caplan & Kelly McBride Folkers - 2017 - Hastings Center Report 47 (5):15-16.
    The parents of Charlie Gard, who was born August 4, 2016, with an exceedingly rare and incurable disease called mitochondrial DNA depletion syndrome, fought a prolonged and heated legal battle to allow him access to experimental treatment that they hoped would prolong his life and to prevent his doctors from withdrawing life-sustaining care. Charlie's clinicians at the Great Ormond Street Hospital in London believed that the brain damage Charlie had suffered as a result of frequent epileptic seizures, along with many (...)
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  16.  4
    Mitochondrial Replacement Techniques, Scientific Tourism, and the Global Politics of Science.Chan Sarah, Palacios-González César & Arellano María De Jesús Medina - 2017 - Hastings Center Report 47 (5):7-9.
    The United Kingdom is the first and so far only country to pass explicit legislation allowing for the licensed use of the new reproductive technology known as mitochondrial replacement therapy. The techniques used in this technology may prevent the transmission of mitochondrial DNA diseases, but they are controversial because they involve the manipulation of oocytes or embryos and the transfer of genetic material. Some commentators have even suggested that MRT constitutes germline genome modification. All eyes were on the United Kingdom (...)
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  17.  4
    Mitochondrial Replacement Techniques, Scientific Tourism, and the Global Politics of Science.Sarah Chan, César Palacios‐González & María De Jesús Medina Arellano - 2017 - Hastings Center Report 47 (5):7-9.
    The United Kingdom is the first and so far only country to pass explicit legislation allowing for the licensed use of the new reproductive technology known as mitochondrial replacement therapy. The techniques used in this technology may prevent the transmission of mitochondrial DNA diseases, but they are controversial because they involve the manipulation of oocytes or embryos and the transfer of genetic material. Some commentators have even suggested that MRT constitutes germline genome modification. All eyes were on the United Kingdom (...)
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  18.  1
    Despairing About Health Disparities.Leonard M. Fleck - 2017 - Hastings Center Report 47 (5):43-44.
    I have never doubted that the problem of inequalities in health status and access to needed care is a difficult ethical and political challenge. After reading the essays in Understanding Health Inequalities and Justice: New Conversations across the Disciplines, edited by Mara Buchbinder, Michele Rivkin-Fish, and Rebecca Walker, I concluded that despair was the only suitable response in the face of daunting ethical and political complexity. The editors of this volume have three questions in mind that they asked contributors to (...)
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  19.  1
    Are Transplant Recipients Human Subjects When Research Is Conducted on Organ Donors?Kate Gallin Heffernan & Alexandra K. Glazier - 2017 - Hastings Center Report 47 (5):10-14.
    Interventional research on deceased organ donors and donor organs prior to transplant holds the promise of reducing the number of patients who die waiting for an organ by expanding the pool of transplantable organs and improving transplant outcomes. However, one of the key challenges researchers face is an assumption that someone who receives an organ that was part of an interventional research protocol is always a human subject of that same study. The consequences of this assumption include the need for (...)
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  20.  1
    Empty Spaces.Adira Hulkower - 2017 - Hastings Center Report 47 (5):3-4.
    “I'm Jewish, you know, and my mother said, ‘Always trust the rabbis.’” I never heard Mr. Weisman's refrain from his own lips. I never heard him say any words all. By the time I met him he was in a vegetative state, a man on the precipice of invisibility—white hair, thin pale limbs, melting into sheets of the same color. When I think about Mr. Weisman, I see empty spaces—the absence of his voice, the too-large bed for his shrinking frame, (...)
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  21.  2
    When Public Health Becomes Politicized.Barron H. Lerner - 2017 - Hastings Center Report 47 (5):inside back cover-inside back co.
    Perhaps nothing symbolizes the current polarized political climate in the United States more than the world of public health. Public health schools and health departments are full of “true believers,” people willing to crusade for any program designed to reduce morbidity and mortality. But in the “real world,” proven programs and strategies—such as gun-control measures, universal vaccination, and improved traffic safety—are routinely thwarted. Why do critics oppose efforts to improve the public's health? History can provide some answers.
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  22.  1
    The Pluralism of Coherent Approaches to Global Health.Alex John London - 2017 - Hastings Center Report 47 (5):26-27.
    Stakeholders in global health, including governments, international and nongovernmental organizations, and corporations, face complex decisions about how to help improve the lives of those most burdened by sickness and disease while upholding their rights and facilitating the transition to a more just social and political order. In “The Case for Resource-Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health,” Govind Persad and Ezekiel Emanuel argue that “[t]he provision of health care in developing countries should reflect (...)
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  23.  1
    Urgently Creating the Better in Global Health.Richard Marlink - 2017 - Hastings Center Report 47 (5):25-26.
    In this issue of the Hastings Center Report, Govind Persad and Ezekiel Emanuel argue that “[t]he provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.” I agree that we should not let the perfect get in the way of the good, but just providing cheaper, less effective treatment for utilitarian or other reasons is not a comprehensive approach to global (...)
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  24. Standards of Care in Global Health: Identifying the Right Question.Paul Ndebele - 2017 - Hastings Center Report 47 (5):28-29.
    Govind Persad and Ezekiel Emanuel's article “The Case for Resource Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health,” in this issue of the Hastings Center Report, is a reminder of the debates around resources for health care that raged during the years immediately preceding and following the fifth revision of the Declaration of Helsinki, in 2000. In global health, it is a common expectation for rich countries to assist poor countries in resolving health challenges, (...)
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  25.  31
    The Case for Resource Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health.Govind C. Persad & Ezekiel J. Emanuel - 2017 - Hastings Center Report 47 (5):17-24.
    We consider an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.
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  26.  6
    A Modern, Rational Jeremiad.David H. Smith - 2017 - Hastings Center Report 47 (5):45-47.
    I have been a Daniel Callahan reader for over thirty years. My first published review was of Abortion: Law, Choice, and Morality. Callahan's latest book, The Five Horsemen of the Modern World: Climate, Food, Water, Disease, and Obesity, is a sustained and detailed explanation of a series of challenges facing humankind in this century. Callahan's prognosis is bleak, his analyses credible, and while hope is not lost, the moral of the story is that we had better get our act together (...)
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  27.  10
    Physician‐Assisted Death and Severe, Treatment‐Resistant Depression.Bonnie Steinbock - 2017 - Hastings Center Report 47 (5):30-42.
    Should people suffering from untreatable psychiatric conditions be eligible for physician-assisted death? This is possible in Belgium and the Netherlands, where PAD for psychiatric conditions is permitted, though rare, so long as the criteria of due care are met. Those opposed to all instances of PAD point to Belgium and the Netherlands as a dark warning that once PAD is legalized, restricting it will prove impossible because safeguards, such as the requirement that a patient be terminally ill, will inevitably be (...)
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  28.  5
    CRISPR Becomes Clearer.Andrew W. Torrance - 2017 - Hastings Center Report 47 (5):5-6.
    In this pivotal year for gene editing, the breakthrough molecular system CRISPR–Cas9 has advanced on three fronts. In under seven months, an influential scientific body—the National Academies of Sciences, Engineering, and Medicine the National Academies of Sciences, Engineering, and Medicine—cracked open the door to human germline gene editing, ownership of patents covering CRISPR–Cas9 came into much sharper focus as a result of a dispute between two parties, and experiments showing proof of concept of the most controversial of uses—altering germlines of (...)
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  29. Shared Decision‐Making in Pediatrics: Honoring Multiple Voices.Daniel J. Benedetti - 2017 - Hastings Center Report 47 (4):46-47.
    Historically, parents looking for guidance turned to a small cadre of trusted individuals such as grandparents and pediatricians. In the Internet era, this paradigm has shifted. With a few keystrokes, anxious parents have access to a seemingly endless array of opinions from faceless sources with unknown agendas. For some parents, this can cause more uncertainty, and for the parents of a child with a medical condition, navigating this information can be overwhelming. In this modern paradigm, the pediatrician's duty has also (...)
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  30.  3
    Patients as Rights Holders.Johan Brännmark - 2017 - Hastings Center Report 47 (4):32-39.
    Autonomy and consent have been central values in Western moral and political thought for centuries. One way of understanding the bioethical models that started to develop, especially in the 1970s, is that they were about the fusion of a long-standing professional ethics with the core values underpinning modern political institutions. That there was a need for this kind of fusion is difficult to dispute, especially since the provision of health care has in most developed countries become an ever more important (...)
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  31.  1
    How Long a Life Is Enough Life?Daniel Callahan & Willard Gaylin - 2017 - Hastings Center Report 47 (4):16-18.
    Humans have long been troubled by the prospect of old age and its culmination in death. Whether to rebel against or accept this fate have been wrestled with down through the centuries. But new medical technologies and the growing science of aging have sided with rebellion. We know that aging can be pushed back and improved in its quality. That progress is well under way, but now intensified by many scientists and Silicon Valley entrepreneurs. In 2016, Mark Zuckerberg and Priscilla (...)
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  32.  6
    Artificial Wombs and Abortion Rights.I. Glenn Cohen - 2017 - Hastings Center Report 47 (4):inside back cover-inside back co.
    In a study published in late April in Nature Communications, the authors were able to sustain 105- to 115-day-old premature lamb fetuses—whose level of development was comparable to that of a twenty-three-week-old human fetus—for four weeks in an artificial womb, enabling the lambs to develop in a way that paralleled age-matched controls. The oldest lamb of the set, more than a year old at the time the paper came out, appeared completely normal. This kind of research brings us one step (...)
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  33.  1
    Please Amputate My Child's Arms.Mary Devereaux & Dennis John Kuo - 2017 - Hastings Center Report 47 (4):9-11.
    Jeremy sustained bilateral complete brachial plexus injuries in an auto collision on an icy road a month before his third birthday. The accident rendered both upper extremities completely flail and insensate: he has no motor or sensory function of his shoulders, elbows, wrists, or digits. Jeremy does, however, have normal function of the lower extremities. Physical therapists have worked with the child for over a year with no noted improvement in arm function. Jeremy falls frequently, causing injury to his face (...)
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  34.  8
    On Legalizing Physician‐Assisted Death for Dementia.Dresser Rebecca - 2017 - Hastings Center Report 47 (4):5-6.
    Last November, soon after Colorado became the latest state to authorize physician-assisted suicide, National Public Radio's The Diane Rehm Show devoted a segment to legalization of “physician assistance in dying,” a label that refers to both physician-assisted suicide and voluntary active euthanasia. Although the segment initially focused on PAD in the context of terminal illness in general, it wasn't long before PAD's potential application to dementia patients came up. A caller said that her mother had Alzheimer's disease and was being (...)
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  35. Conservationism and Bioethics.Gregory E. Kaebnick - 2017 - Hastings Center Report 47 (4):2-2.
    The lead article in this issue of the Hastings Center Report explores the ideas underpinning the Precision Medicine Initiative, the effort announced by President Obama in 2015 to promote the development of treatments adjusted to genetic and other variations. Authors Maya Sabatello and Paul Appelbaum hold that the effort works by appealing to a sense of collective identity and shared commitment—an understanding that they call the “PMI nation.” But what are the moral implications of this idea? Sabatello and Appelbaum's question (...)
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  36.  3
    It's “the End of Sex” As We Know It, and I Feel … a Little Nervous.Louise P. King - 2017 - Hastings Center Report 47 (4):42-43.
    Reading Henry Greely's wonderful book, The End of Sex and the Future of Human Reproduction, while riding public transport sparked awkward looks and equally awkward discussions. I thought of removing the dust jacket, yet I was reminded that Greely's stated purpose in writing the book was to spark conversation. The title is, of course, intentionally provocative. Greely does not, in fact, believe that humans will stop having sex for the multitude of reasons that we do already. Quite the contrary; he (...)
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  37.  2
    Trump's Abortion‐Promoting Aid Policy.R. Latham Stephen - 2017 - Hastings Center Report 47 (4):7-8.
    On the fourth day of his presidency, Donald Trump reinstated and greatly expanded the “Mexico City policy,” which imposes antiabortion restrictions on U.S. foreign health aid. In general, the policy has prohibited U.S. funding of any family-planning groups that use even non-U.S. funds to perform abortions; prohibited aid recipients from lobbying for liberalization of abortion laws; prohibited nongovernment organizations from creating educational materials on abortion as a family-planning method; and prohibited health workers from referring patients for legal abortions in any (...)
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  38.  2
    Decision‐Making for an Incapacitated Pregnant Patient.Mabel Hilary, L. Rose Susannah & Kodish Eric - 2017 - Hastings Center Report 47 (4):12-15.
    Decisions about continuing or terminating a pregnancy touch on profound, individualized questions about bodily integrity, reproductive autonomy, deeply held values regarding one's capacity for parenthood, and, in the case of a high-risk pregnancy, the risks one is willing to take to have a baby. So far as possible, reproductive decisions are made between a patient, in some cases her partner, and her medical provider. However, this standard framework cannot be applied if the patient lacks decision-making capacity. In this essay, we (...)
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  39.  1
    A Failure to Be Candid.Jennifer McGuirl - 2017 - Hastings Center Report 47 (4):3-4.
    I was a second-year neonatal-perinatal fellow in a meeting between other members of the neonatal intensive care team and parents who had just received devastating news about their planned-for and highly desired baby, born after what had been an uncomplicated pregnancy. At home, a little sister was waiting to meet her new brother. These conversations are never easy, but this one I found particularly disturbing. John had been born at term via emergency cesarean section after his mother, Muriel, had come (...)
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  40. The Art of the Cover.Nora Porter - 2017 - Hastings Center Report 47 (4):inside front cover-inside front.
    Often, it's difficult to match up our cover artwork with the subjects of our lead articles and special reports. Of necessity, we sometimes turn to pure abstraction. How else to illustrate technical policy articles on subjects such as changing research protocols or informed consent, or abstract ideas like congruence, duality, imbalance, causality? At such times, we have to be pretty creative, and my search for cover art can be long and challenging. In the end, we hope that the reader will (...)
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  41.  1
    The Precision Medicine Nation.Maya Sabatello & Paul S. Appelbaum - 2017 - Hastings Center Report 47 (4):19-29.
    The United States’ ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients’ empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. (...)
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  42.  2
    Genomic Justice and Imagined Communities.Schwartz‐Marin Ernesto - 2017 - Hastings Center Report 47 (4):30-31.
    In this issue of the Hastings Center Report, Maya Sabatello and Paul Appelbaum explore the assumptions about community embedded in the U.S. Precision Medicine Initiative, which aims to recruit donor-partners who reflect the United States’ racial and ethnic diversity. As Sabatello and Appelbaum discuss, the initiative is like other national biobanking efforts in bringing to life an imagined genetic community in need of critical attention, and given the public-private forms of partnership at the heart of the PMI, such efforts could (...)
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  43.  1
    Expanding the Horizon of Our Obligations in the Clinician‐Patient Relationship.Robert D. Truog - 2017 - Hastings Center Report 47 (4):40-41.
    Johan Brännmark's article “Patients as Rights Holders,” in this issue of the Hastings Center Report, squarely identifies some important problems with the way we in clinical practice conceive of our obligations to our patients. As a solution, he helpfully suggests augmenting our focus on autonomy and informed consent with a broader menu of considerations drawn from the literature on human rights. Respect for autonomy is, of course, one of the hallowed principles of bioethics. In our traditional understanding, our patients deserve (...)
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  44. Looking Back at the Ethical Tangles of Pediatric AIDS.Abigail Zuger - 2017 - Hastings Center Report 47 (4):44-45.
    The place is San Francisco, the year 1981. The newly minted young doctor, all shiny confidence, sits at his desk. Suddenly, he stares down at a lab result, startled. This opening scene can mean only one thing in a medical memoir: the mysterious disease not yet known as AIDS has come to town. As the generation who first encountered AIDS ages into its memoir-writing years, we will be seeing more of these first chapters, and despite their inevitable redundancies, each may (...)
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  45.  1
    From the Foundation Up.Daniel Callahan - 2017 - Hastings Center Report 47 (3):inside front cover-inside front.
    In 2019, The Hastings Center will celebrate its fiftieth anniversary. It is more than a bit staggering to think how far we have come since 1969. When I floated the idea of a center on bioethics to my friend and neighbor, psychiatrist Willard Gaylin, at a Christmas party in 1968—even before the word “bioethics” was used—I had only the fuzziest idea of where that would take us. Neither Will nor I had run anything, nor did we know how to raise (...)
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  46.  3
    How to Rethink the Fourteen‐Day Rule.Sarah Chan - 2017 - Hastings Center Report 47 (3):5-6.
    Recently, attention has been drawn to the basic principles governing the use of human embryos in research: specifically, the so-called fourteen-day rule. This rule stipulates that human embryos should not be allowed to grow in vitro past fourteen days of development. For years, the fourteen-day limit was largely theoretical, since culture techniques were not sufficient to maintain embryos up to this point. Yet in the past year, research has suggested that growing embryos beyond fourteen days might be feasible and scientifically (...)
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  47.  1
    Toward Public Bioethics?E. Kaebnick Gregory - 2017 - Hastings Center Report 47 (3):2-2.
    This issue of the Hastings Center Report features a couple of interesting takes on the governance challenges of emerging technologies. In an essay on the National Academies of Science, Engineering, and Medicine report published this February on human germ-line gene editing, Eric Juengst, a philosopher at the University of North Carolina, argues that the NASEM committee did not manage to rethink the rules. Juengst reaches what he calls an “eccentric conclusion”: “The committee's 2017 consensus report has been widely interpreted as (...)
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  48.  5
    The Anatomy of Research Scandals.Carl Elliott - 2017 - Hastings Center Report 47 (3):inside back cover-inside back co.
    For the past two years, I have taught a seminar on medical research scandals. The syllabus looks like a highlight reel of exploitation and abuse: children fed plutonium-laced breakfast cereal, prisoners dosed with the active ingredient in Agent Orange, mental patients given psychedelic drugs and massive electroconvulsive therapy before being sent into curare-induced paralysis and a coma. I designed the seminar to crush the idealism of future physicians by illuminating the dark patterns that research scandals typically follow. The most recent (...)
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  49.  2
    Reconciling Patient Safety and Epistemic Humility: An Ethical Use of Opioid Treatment Plans.Anita Ho - 2017 - Hastings Center Report 47 (3):34-35.
    In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about “the requirements entailed by undergoing opioid therapy,” rather than as contractual agreements to alter patients’ individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, (...)
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  50.  2
    Foreign Relations.Alejandro Hoz, Eduardo Díaz & Max Moses Feinstein - 2017 - Hastings Center Report 47 (3):7-8.
    In a large Colombian teaching hospital, a fifty-five-year-old woman complaining of stomach pain is examined by a foreign-exchange medical student from the United States. Speaking in Spanish, the student elicits a medical history that suggests a possible recurrence of gallstones, but nothing further. Upon discussing the patient's case in private with the attending physician, the student is shocked to learn that the patient is suffering from terminal, metastatic gastric cancer but is unaware of her diagnosis. The attending physician explains that (...)
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  51.  3
    Closed Financial Loops: When They Happen in Government, They're Called Corruption; in Medicine, They're Just a Footnote.Kevin Jesus-Morales & Vinay Prasad - 2017 - Hastings Center Report 47 (3):9-14.
    Many physicians are involved in relationships that create tension between a physician's duty to work in her patients’ best interest at all times and her financial arrangement with a third party, most often a pharmaceutical manufacturer, whose primary goal is maximizing sales or profit. Despite the prevalence of this threat, in the United States and globally, the most common reaction to conflicts of interest in medicine is timid acceptance. There are few calls for conflicts of interest to be banned, and, (...)
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  52.  9
    Crowdsourcing the Moral Limits of Human Gene Editing?Eric T. Juengst - 2017 - Hastings Center Report 47 (3):15-23.
    In 2015, a flourish of “alarums and excursions” by the scientific community propelled CRISPR/Cas9 and other new gene-editing techniques into public attention. At issue were two kinds of potential gene-editing experiments in humans: those making inheritable germ-line modifications and those designed to enhance human traits beyond what is necessary for health and healing. The scientific consensus seemed to be that while research to develop safe and effective human gene editing should continue, society's moral uncertainties about these two kinds of experiments (...)
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  53.  4
    Regulating Research with Biospecimens Under the Revised Common Rule.Holly Fernandez Lynch & Michelle N. Meyer - 2017 - Hastings Center Report 47 (3):3-4.
    Since 2011, the research community had waited with bated breath as regulators contemplated for the first time bringing secondary research with nonidentifiable biospecimens under the Common Rule and dramatically tightening the criteria for waiving consent to biospecimen research. After considerable pushback from both researchers and patients and amid rumors of intractable disagreement among Common Rule agencies, the Final Rule published on the last day of President Obama's administration left out these troubling changes, and there was a collective sigh of relief. (...)
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  54.  9
    Research with Pregnant Women: New Insights on Legal Decision‐Making.Anna C. Mastroianni, Leslie Meltzer Henry, David Robinson, Theodore Bailey, Ruth R. Faden, Margaret O. Little & Anne Drapkin Lyerly - 2017 - Hastings Center Report 47 (3):38-45.
    U.S. researchers and scholars often point to two legal factors as significant obstacles to the inclusion of pregnant women in clinical research: the Department of Health and Human Services’ regulatory limitations specific to pregnant women's research participation and the fear of liability for potential harm to children born following a pregnant woman's research participation. This article offers a more nuanced view of the potential legal complexities that can impede research with pregnant women than has previously been reflected in the literature. (...)
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  55.  7
    Opioid Treatment Agreements Repurposed—But Who Monitors the Monitors?Richard Payne - 2017 - Hastings Center Report 47 (3):36-37.
    In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz reframe the justification for the use of opioid treatment agreements. Instead of documents used to define the roles and responsibilities of doctors and patients to one another in the course of opioid treatment for chronic pain and to describe the risks and benefits of therapy for the individual, OTAs are now proposed for use as “surveillance and monitoring” instruments. As such, they are specifically meant to disclose the (...)
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  56.  1
    Flu, Floods, and Fire: Ethical Public Health Preparedness.Alexandra L. Phelan & Lawrence O. Gostin - 2017 - Hastings Center Report 47 (3):46-47.
    Even as public health ethics was developing as a field, major incidents such as 9/11 and the SARS epidemic propelled discourse around public health emergency preparedness and response. Policy and practice shifted to a multidisciplinary approach, recognizing the broad range of potential threats to public health, including biological, physical, radiological, and chemical threats. This propelled the development of surveillance systems to detect incidents, laboratory capacities to rapidly test for potential threats, and therapeutic and social countermeasures to prepare for and respond (...)
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  57.  12
    Defending Opioid Treatment Agreements: Disclosure, Not Promises.Joshua B. Rager & Peter H. Schwartz - 2017 - Hastings Center Report 47 (3):24-33.
    In order to receive controlled pain medications for chronic non-oncologic pain, patients often must sign a “narcotic contract” or “opioid treatment agreement” in which they promise not to give pills to others, use illegal drugs, or seek controlled medications from health care providers. In addition, they must agree to use the medication as prescribed and to come to the clinic for drug testing and pill counts. Patients acknowledge that if they violate the opioid treatment agreement, they may no longer receive (...)
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  58.  2
    Enrolling in Clinical Research While Incarcerated: What Influences Participants’ Decisions?Paul P. Christopher, Lorena G. Garcia‐Sampson, Michael Stein, Jennifer Johnson, Josiah Rich & Charles Lidz - 2017 - Hastings Center Report 47 (2):21-29.
    As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...)
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  59.  5
    Bioethics and “Rightness”.Arthur W. Frank - 2017 - Hastings Center Report 47 (2):page inside back cover-page insi.
    If bioethics seeks to affect what people do and don't do as they respond to the practical issues that confront them, then it is useful to take seriously people's sense of rightness. Rightness emerges from the fabric of a life—including the economy of its geography, the events of its times, its popular culture—to be what the sociologist Pierre Bourdieu calls a predisposition. It is the product of a way of life and presupposes continuing to live that way. Rightness is local (...)
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  60.  25
    Facts, Values, and Journalism.Susan Gilbert - 2017 - Hastings Center Report 47 (2):page inside front cover-page ins.
    At a time of fake news, hacks, leaks, and unverified reports, many people are unsure whom to believe. How can we communicate in ways that make individuals question their assumptions and learn? My colleagues at The Hastings Center and many journalists and scientists are grappling with this question and have, independently, reached the same first step: recognize that facts can't be fully understood without probing their connection to values. “Explaining the basics is important, of course, but we also need to (...)
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  61.  3
    Justifying Clinical Nudges.Moti Gorin, Steven Joffe, Neal Dickert & Scott Halpern - 2017 - Hastings Center Report 47 (2):32-38.
    The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably (...)
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  62.  1
    Best Evidence Aside: Why Trump's Executive Order Makes America Less Healthy.Lawrence O. Gostin - 2017 - Hastings Center Report 47 (2):5-6.
    What are the health impacts of President Trump's January 27, 2017, executive order suspending the resettlement of refugees and temporarily banning entry of nationals from Iraq, Syria, Iran, Sudan, Libya, Somalia, and Yemen? Even if the President's constitutional arguments are credible, the order is deeply troubling under international law and humanitarian values. Under the 1967 Refugee Protocol, the United States has assumed a legal obligation to examine the claims of asylum seekers who reach U.S. territory without discrimination based on race, (...)
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  63. Space for the Prisoner's Point of View.Laura Haupt - 2017 - Hastings Center Report 47 (2):2-2.
    The lead article in this issue discusses a potentially free metaphorical space—that of decision-making—within the confines, tangible and intangible, of life in jail or prison. By interviewing prisoner-participants from six clinical studies, Paul Christopher and colleagues sought to find out how these men and women would answer open-ended questions about their decision to enroll in the research. What the interviewers heard was that none saw themselves as having been inappropriately pressured to do so. In fact, a significant percentage of the (...)
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  64.  9
    Rethinking Reprogenetics.Michael Hauskeller - 2017 - Hastings Center Report 47 (2):50-51.
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  65.  10
    Reprioritizing Research Activity for the Post‐Antibiotic Era: Ethical, Legal, and Social Considerations.Spencer Phillips Hey & Aaron S. Kesselheim - 2017 - Hastings Center Report 47 (2):16-20.
    Many hold that the so-called golden era of antibiotic discovery has passed, leaving only a limited clinical pipeline for new antibiotics. A logical conclusion of such arguments is that we need to reform the current system of antibiotic drug research—including clinical trials and regulatory requirements—to spur activity in discovery and development. The United States Congress in the past few years has debated a number of bills to address this crisis, including the 2012 Generating Antibiotic Incentives Now Act and the 2016 (...)
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  66.  4
    Authenticity, Best Interest, and Clinical Nudging.Søren Holm - 2017 - Hastings Center Report 47 (2):38-40.
    In this issue of the Hastings Center Report, Moti Gorin, Steven Joffe, Neal Dickert, and Scott Halpern offer a comprehensive defense of the use of nudging techniques in the clinical context, with the aim of promoting the best interests of patients. Their argument is built on three important claims: Nudging is ubiquitous and inescapable in clinical choice situations, and there is no neutral way of informing patients about their treatment choices; many patients do not have authentic preferences concerning their treatment (...)
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  67.  8
    Implementing California's Law on Assisted Dying.Ruchika Mishra - 2017 - Hastings Center Report 47 (2):7-8.
    On October 5, 2015, Governor Jerry Brown approved bill ABX2 15, the End of Life Option Act, making California the fifth state in the country to allow physician-assisted dying. The law was modeled after Oregon's 1997 Death with Dignity Act. When the legislative special session ended on March 10, 2016, California health care providers had only ninety days to respond to the state mandate before the law would take effect, on June 9, 2016. Experience with the law so far suggests (...)
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  68.  2
    Toward an Ethically Sensitive Implementation of Noninvasive Prenatal Screening in the Global Context.Jessica Mozersky, Vardit Ravitsky, Rayna Rapp, Marsha Michie, Subhashini Chandrasekharan & Megan Allyse - 2017 - Hastings Center Report 47 (2):41-49.
    Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential “paradigm shift” in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire (...)
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  69.  2
    Coercion and Access to Health Care.Keramet Reiter - 2017 - Hastings Center Report 47 (2):30-31.
    In this issue of the Hastings Center Report, Paul Christopher and colleagues describe a study of why prisoners choose to enroll in clinical research. The article represents an important methodological and policy contribution to the literature on prisoner participation in research and medical experimentation. Given the methodological and ethical debates to which this research seeks to make an empirical contribution, the careful manner in which the study was conducted and the transparency with which the authors describe the research is especially (...)
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  70.  10
    Managing Opioid Withdrawal for Hospital Patients in Custody.R. Shi Connie, S. Kandola Manjinder, Tobey Matthew & Singer Elizabeth - 2017 - Hastings Center Report 47 (2):9-10.
    Dr. Brown, a hospitalist, admits Mark, a patient transferred from a local jail for management of cellulitis. The patient, who was taken into custody two days prior to hospital admission, has a history of intravenous heroin use. Mark explains that he had been prescribed buprenorphine-naloxone maintenance therapy for opioid use disorder for several years prior to being arrested and had not used other opioids during that time. As a policy, the jail where Mark is detained does not prescribe opioid agonists, (...)
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  71. Bioethics and Populism: How Should Our Field Respond?Mildred Z. Solomon & Bruce Jennings - 2017 - Hastings Center Report 47 (2):11-16.
    Across the world, an authoritarian and exclusionary form of populism is gaining political traction. Historically, some populist movements have been democratic and based on a sense of inclusive justice and the common good. But the populism on the rise at present speaks and acts otherwise. It is challenging constitutional democracies. The polarization seen in authoritarian populism goes beyond the familiar left-right political spectrum and generates disturbing forms of extremism, including the so-called alternative right in the United States and similar ethnic (...)
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  72. The Clue.Tyler Tate - 2017 - Hastings Center Report 47 (2):3-4.
    As I stood outside of Carlos's room, I felt caught on the horns of a dilemma. It seemed impossible to truly “be there” for Carlos without sacrificing my other intern duties. This tension pervaded much of my residency training, as I often found myself spending more time completing chart notes, answering pages, and giving sign out than I did at the bedside with my patients. I knew I had a duty to “do my job”—I could not let my team down. (...)
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  73. Managing Conflicts Between Physicians and Surrogates.Carol Bayley - 2017 - Hastings Center Report 47 (1):24-26.
    Two articles in this issue of the Hastings Center Report explore two sides of the same problematic coin. In “The Limits of Surrogates’ Moral Authority and Physician Professionalism,” Jeffrey Berger discusses the moral problem of a surrogate refusing a treatment, palliative sedation, on behalf of a patient whose suffering is refractory to intensive palliative efforts provided by a multidisciplinary team. In “After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation,” Ellen Robinson and her colleagues analyze data from a study (...)
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  74.  27
    The Limits of Surrogates’ Moral Authority and Physician Professionalism: Can the Paradigm of Palliative Sedation Be Instructive?Jeffrey T. Berger - 2017 - Hastings Center Report 47 (1):20-23.
    With narrow exception, physicians’ treatment of incapacitated patients requires the consent of health surrogates. Although the decision-making authority of surrogates is appropriately broad, their moral authority is not without limits. Discerning these bounds is particularly germane to ethically complex treatments and has important implications for the welfare of patients, for the professional integrity of clinicians, and, in fact, for the welfare of surrogates. Palliative sedation is one such complex treatment; as such, it provides a valuable model for analyzing the scope (...)
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  75.  5
    The ACA From Behind the “Veil of Ignorance”.Susan Dentzer - 2017 - Hastings Center Report 47 (1):inside back cover-inside back co.
    John Rawls posited that we could determine the nature of justice if we imagined ourselves observing conditions in society from behind a hypothetical “veil of ignorance.” Not knowing how or where we would end up—rich, poor, empowered, disabled—we would choose governing principles that did not leave one disadvantaged because of his or her circumstances. Rawls's concepts are implicitly embedded in the Affordable Care Act, which guarantees that vastly more Americans can obtain health insurance. The law effectively closed down the de (...)
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  76.  1
    Care Under the Influence.Joseph J. Fins & Samantha F. Knowlton - 2017 - Hastings Center Report 47 (1):8-9.
    A forty-year-old man is brought to the emergency room by his wife at five in the morning, two hours after he fell down the stairs at home, hitting his head and injuring his arm. He tells the ER physician that he got up to get a drink of water and tripped in the dark. His speech is slurred, and he smells strongly of alcohol. Lab results reveal elevated liver enzymes, and his blood alcohol level is 0.1. His medical history is (...)
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  77.  1
    Permanent Patients: Hospital Discharge Planning Meets Housing Insecurity.Jennifer L. Herbst - 2017 - Hastings Center Report 47 (1):6-7.
    Not all hospital inpatients need the level of care uniquely available in the acute-care setting. In the United States, these longer-term, nonacute inpatients tend to be some combination of chronically ill, poor, homeless, undocumented, uninsured, and disabled—all groups who have struggled for health equity, political recognition, and voice. Even so, these “permanent patients” continue to receive care in one of the most expensive settings. This phenomenon is the result of federal legislation that creates an affirmative duty to care for all (...)
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  78.  1
    Decisions and Authority.Gregory E. Kaebnick - 2017 - Hastings Center Report 47 (1):2-2.
    This issue of the Hastings Center Report features three articles exploring aspects of decision-making for others. In the first two, the focus is on the limits of surrogate decision-makers’ authority when the surrogates’ judgments about a patient's treatment conflict with the physicians’. If a physician decides that a patient will not benefit from CPR, for example, but the patient's surrogate insists on it, is the physician obliged to proceed with the procedure? Or can the physician, pointing to a duty to (...)
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  79. Childbearing Choices: What Helps, What Doesn't, and What You Thought You Knew.Mark R. Mercurio - 2017 - Hastings Center Report 47 (1):42-43.
    Childbearing is an increasingly complicated matter, which has evolved significantly over the past several decades. Treatment options for infertility have expanded. Prenatal testing and treatment have led to an evolution in obstetrical decision-making, wherein the risks and benefits to the fetus and future child are better understood and more strongly considered in medical management of the pregnant woman. Obstetrics appears to be increasingly interventional; one in three babies in the United States is now born by cesarean section. Neonatal intensive care (...)
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  80.  6
    A Good Death.Tia Powell & Adira Hulkower - 2017 - Hastings Center Report 47 (1):28-29.
    A good death is hard to find. Family members tell us that loved ones die in the wrong place—the hospital—and do not receive high-quality care at the end of life. This issue of the Hastings Center Report offers two articles from authors who strive to provide good end-of-life care and to prevent needless suffering. We agree with their goals, but we have substantial reservations about the approaches they recommend. Respect for the decisions of patients and their surrogates is a relatively (...)
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  81.  8
    After the DNR: Surrogates Who Persist in Requesting Cardiopulmonary Resuscitation.Ellen M. Robinson, Wendy Cadge, Angelika A. Zollfrank, M. Cornelia Cremens & Andrew M. Courtwright - 2017 - Hastings Center Report 47 (1):10-19.
    Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a (...)
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  82.  2
    Employer Wellness Programs Challenged in Court.Mark A. Rothstein - 2017 - Hastings Center Report 47 (1):4-5.
    Many employers faced with rising health care costs have adopted “voluntary” wellness programs that urge employees to engage in various health-promotion activities, such as smoking cessation and weight reduction. In the proper setting, measures to promote a more healthful lifestyle are difficult to question, but there is little compelling evidence that workplace wellness programs have significant, sustained health benefits or substantially reduce health care costs other than through cost-shifting to unhealthy employees. Congressional support for workplace wellness programs has persisted on (...)
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  83.  1
    Conflating Capacity & Authority: Why We're Asking the Wrong Question in the Adolescent Decision‐Making Debate.Erica K. Salter - 2017 - Hastings Center Report 47 (1):32-41.
    Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents—their being neither children nor adults—in a variety of ways. However, recently there has been a trend (...)
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  84.  1
    Show Code.Shalev Daniel - 2017 - Hastings Center Report 47 (1):3-3.
    “Let's get one thing straight: there is no such thing as a show code,” my attending asserted, pausing for effect. “You either try to resuscitate, or you don't. None of this halfway junk.” He spoke so loudly that the two off-service consultants huddled at computers at the end of the unit looked up… We did four rounds of compressions and pushed epinephrine twice. It was not a long code. We did good, strong compressions and coded this man in earnest until (...)
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  85.  1
    Bioethics in the Law.Zachary E. Shapiro - 2017 - Hastings Center Report 47 (1):inside front cover-inside front.
    The role of law in bioethics is clear. Laws are enforcement tools: they govern which conditions qualify an individual for disability benefits, or what oversight is necessary for clinical trial protocols, or how patent applications for medical devices should be regulated. I initially studied the law in order to enhance my work in bioethics, but in examining how the law works, I have become convinced that the converse opportunity also exists: there are many areas of law that would benefit from (...)
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  86.  1
    On Patient Well‐Being and Professional Authority.Mildred Z. Solomon - 2017 - Hastings Center Report 47 (1):26-27.
    Two papers in this issue address the limits of surrogates’ authority when making life-and-death decisions for dying family members or friends. Using palliative sedation as an example, Jeffrey Berger offers a conceptual argument for bounding surrogate authority. Since freedom from pain is an essential interest, when imminently dying, cognitively incapacitated patients are in duress and their symptoms are not manageable in any other way, clinicians should be free to offer palliative sedation without surrogate consent, although assent should be sought and (...)
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  87. The Theory and Practice of Surrogate Decision‐Making.David Wendler - 2017 - Hastings Center Report 47 (1):29-31.
    When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the “best scientific evidence available, as well as the patient's values, goals, and preferences” with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances. To the extent that this approach works, (...)
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  88.  3
    Reproductive Autonomy and Regulation-Coexistence in Action.Ruth Deech - 2017 - Hastings Center Report 47 (s3):S57-S63.
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  89.  1
    How the Criminalization of Pregnancy Robs Women of Reproductive Autonomy.Michele Goodwin - 2017 - Hastings Center Report 47 (s3):S19-S27.
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  90.  1
    A Call for Empirical Research on Uterine Transplantation and Reproductive Autonomy.Cristie Cole Horsburgh - 2017 - Hastings Center Report 47 (s3):S46-S49.
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  91.  3
    The Future of Reproductive Autonomy.Josephine Johnston & Rachel L. Zacharias - 2017 - Hastings Center Report 47 (s3):S6-S11.
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  92.  4
    Should Clinicians Set Limits on Reproductive Autonomy?Louise P. King - 2017 - Hastings Center Report 47 (s3):S50-S56.
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  93.  3
    Autonomy in Tension: Reproduction, Technology, and Justice.Louise P. King, Rachel L. Zacharias & Josephine Johnston - 2017 - Hastings Center Report 47 (s3):S2-S5.
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  94.  2
    Parenting in the Age of Preimplantation Gene Editing.Sigal Klipstein - 2017 - Hastings Center Report 47 (s3):S28-S33.
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  95.  2
    Reproductive Rights Without Resources or Recourse.Kimberly Mutcherson - 2017 - Hastings Center Report 47 (s3):S12-S18.
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  96.  3
    The Shifting Landscape of Prenatal Testing: Between Reproductive Autonomy and Public Health.Vardit Ravitsky - 2017 - Hastings Center Report 47 (s3):S34-S40.
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  97.  3
    Freezing Eggs and Creating Patients: Moral Risks of Commercialized Fertility.Elizabeth Reis & Samuel Reis-Dennis - 2017 - Hastings Center Report 47 (s3):S41-S45.
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