Book reviewed in this article: Rights Talk: The Impoverishment of Political Discourse. By Mary Ann Glendon.

In pursuit of the dream that patients' exercise of autonomy could extend beyond their span of competence, living wills have passed from controversy to conventional wisdom, to widely promoted policy. But the policy has not produced results, and should be abandoned.

Law provides a rich language for thinking about bioethical issues and is a tool for action as well as talk. But the language of the law, often inapt, regularly fails to achieve its desired effect.

Almost nobody favors long consent forms for prospective research subjects. Almost everybody thinks they interfere with informed consent’s purpose—good decisions. Nevertheless, almost everybody believes consent forms have long been getting longer. Years ago, Paul Appelbaum lamented the “tendency to cram ever more information into consent forms.”1 Weeks ago, Ilene Albala and her colleagues (one of them Appelbaum) reported in IRB: Ethics & Human Research that the length of one institutional review board’s forms “increased roughly linearly by an average of 1.5 (...) pages per decade. In the 1970s, the average consent form was less than one page long and often only a paragraph or two, but by the mid-1990s the .. (shrink)

In America today, public policy governing an increasing number of social issues is made through the judicial enforcement of constitutional rights. Cruzan raised the question whether policy regarding the withdrawal of medical care from incompetent patients is to be handled similarly. This essay argues that privacy-rights doctrine provides a poor basis for constructing public policy in this area. It suggests that the Court has been unable to articulate a convincing basis for privacy rights and that the basis the Court seems (...) to assume poorly fits many circumstances to which it is applied. The essay further contends that the Court has been unable to describe a persuasive method of analyzing the state interests that are at stake in privacy cases and to accommodate those interests in a reasonable way. The essay concludes that these are issues as to which policy is better formed through a political, not judicial, process. Keywords: constitutional rights, courts, fundamental right, personal right, public policy, rights CiteULike Connotea Del.icio.us What's this? (shrink)

Let us look to America, not in order to make a servile copy of the institutions that she has established, but to gain a clearer view of the polity that will be the best for us; let us look there less to find examples than instruction; let us borrow from her the principles, rather than the details, of her laws. The laws of the French republic may be, and ought to be in many cases, different from those which govern the (...) United States; but the principles on which the American constitutions rest, those principles of order, of the balance of powers, of true liberty, of deep and sincere respect for right, are indispensable to all republics; they ought to be common to all …. —Alexis de Tocqueville Democracy in America. (shrink)

The Censor’s Hand invites us to explore the murky side of formal research-ethics review in the United States, as embodied in “Institutional Review Boards”. Amidst some 340 publications and several blogs that have taken formal research-ethics review to task, this book is the seventh detailed monograph on this topic—the others are Robert Klitzman’s The Ethics Police?, Zachary Schrag’s Ethical Imperialism, Laura Stark’s Behind Closed Doors, and my own works, Walking the Tightrope, The Seduction of Ethics, and The Ethics Rupture. This (...) is a particularly welcome volume. It is the second that comes from the hands of someone in medicine (Schneider is a professor of.. (shrink)

One of the early steps in the process of putting together an issue of the Hastings Center Report is ticking through each column we plan to run in that issue and making sure that we have somebody lined up to write it and—if we already have somebody lined up to write it—that the person hasn't forgotten. But as this issue approached, one of those we had all nicely lined up contacted us first, to say that he was retiring from this (...) particular gig.For many years, we have had a wonderful rotating line-up for At Law: Rebecca Dresser, of Washington University of St. Louis; Lawrence O. Gostin, of George Washington University; and Carl Schneider, of the University of Michigan, have taken turns, each writing twice a year. .. (shrink)

Recent studies indicate that patients who are diagnosed with vegetative states may retain more awareness than their clinical assessments suggest. Disorders of consciousness traditionally have been diagnosed on the basis of outwardly observable behaviors alone, but new functional imaging studies have shown surprising levels of brain activity in some patients, indicating that even higher-level cognitive functions like language processing and visual imagery may be preserved. For example, one recently developed method purports to detect voluntary mental imagery solely on the basis (...) of neural response patterns observed with functional magnetic resonance imaging. This line of research has already led to some widely reported cases of patients who were discovered to have more brain activity than expected. In November 2009, Rom Houben, a Belgian man who was thought to be in a coma for 23 years, was diagnosed with locked-in syndrome through the use of neuroimaging; however, that assessment was later overturned by further testing. (shrink)