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01/02/2017

The Year in Bioethics That Was – 2016

by Craig Klugman, Ph.D.

Happy New Year. As has become a tradition at the bioethics.net blogs, the ending of one year and beginning of another is a time for reflection, for reviewing the year that has passed and planning for the year to come.

In 2015, bioethics.net is pleased to have had 17 bloggers contribute to our 106 posts. A very big thank you to these insightful scholars: Keisha Ray, Jennifer Blumenthal-Barby, Kayhan Parsi, Nanette Elster, Art Caplan, David Magnus, Steven Miles, Stuart Chambers, Andrea Kalfoglou, Bela Fishbeyn, Amanda Zink, Sebastian Sattler, Adam Houston, Kelly McBride Folkers, Abhi Amarnani, and Nancy King. Their insights, reporting, and reflection on the big topics and ideas of this past year helped enrich the bioethics conversation.

While most of our blogs are complex, covering multiple topics, for the purposes of looking at the themes in the 2016 blogs, each post was placed in only one category.

TOPIC NUMBER OF BLOG POSTS
·      ACA 1
·      Bioethics Profession 5
·      BioethicsTV 24
·      Children 1
·      Clinical Ethics 5
·      Drug/Pharma/FDA 7
·      End of Life 4
·      Environment 3
·      Guns 3
·      Humanities 1
·      Media 5
·      Medical Professionalism 4
·      Military/Torture/War 1
·      Obit 1
·      PAS/Euthanasia 2
·      Patients 1
·      Philosophy 5
·      Politics/Policy/Law 10
·      Privacy 2
·      Public Health/Social Justice 3
·      Race/Discrimination/Disparities 2
·      Reproductive 3
·      Research 2
·      Sports 3
·      Transplants/Donation 1
·      Year in Review 1
·      Zika 6

 

This was the first year of our BioethicsTV column which led to it being our most common topic. Not surprisingly in this contention election year, politics/policy/law was the second most frequent topic, the same as in 2015.

This reflection and counting is hardly a scientific look at the major bioethics topics in the year. Topics are not assigned to bloggers and do not come from a random topic generator. This analysis reviews one blog site and thus shows more the interests of the bloggers, the stories that were in the public mind, and reports issued by government and professional agencies.

In last year’s wrap up of 2015, I made several predictions as to what would be the hot issues in the following year (2016). Among those were using technology to track and measure bodies, repealing the ACA act, and the revised human subjects regulations.

For 2017, with a majority federal administration and a new president, I have a number of big predictions.

First, laws that restrict abortion will increase. Consider that Ohio that just passed a 20-week restriction, a similar bill is likely to make its way to the U.S. Congress. Consider a court ruling in Illinois that set aside a law that required so-called “pregnancy clinics”—which do not encourage or perform abortions—to refer patients to doctors who do perform abortions. Under the ruling, clinics do not have to suggest that patients go elsewhere or even that abortion is an option. The clinic supporters successfully argued that having to refer would violate their religious freedom. The law would have required such information be told to patients. Women with ectopic pregnancies or women who are raped, in such clinics, will not be told that an abortion could save their life or could help them not give birth to their rapist’s child. Women who go to such clinics would be subject to the religion of their doctors, not their own beliefs.

More evidence is the number of “religious freedom” bills likely to be introduced this year. Vice-President-elect Mike Pence signed such a bill in Indiana. These laws make it so that one can discriminate against others if one holds a true religious belief. These bills have their origins in businesses that wanted to refuse to provide flowers or bake cakes for same-sex weddings because they religiously disagree with the idea of two men or two women being married. Georgia, Mississippi and Missouri passed such bills in 2016. One was introduced this year in the Congress but was not passed. In 2017, it will be. 2017 will be the year that discrimination makes a return as legally acceptable in many places.

The end of the Affordable Care Act. As Republicans have promised for 6 years and for more than 60 votes, they will finally be able to pass this repeal without threat of a presidential veto. I predict that they will repeal it to satisfy their campaign promise, but that the actual demise of the law will be put off for a couple of years while the Republicans try to find a replacement, something they have not done in 6 years. Thus, 20 million people won’t instantly lose their health insurance, but will have a year or two notice that the marketplace is going away. In fact, 2016 ended with record enrollments in Obamacare. Parts of the law may ultimately be maintained because they are well liked—no lifetime caps, no rejection based on pre-existing conditions, staying on your parents insurance until age 26—though without mandated insurance these aspects are financially untenable.  The conservative-opposed birth control mandate—which requires insurance company to cover the cost of contraceptives will not be kept even though, ironically, this has led to a decrease in abortions.

Decrease in medical research. Trump’s new pick for budget director, Mick Mulvaney, has spoken before the ultra bigoted John Birch Society and wrote on his Facebook page “[D]o we need government-funded research at all?” With the Republican pledge to shrink government spending, medical research and education funding at all levels are likely to be slashed.

Lastly, the fall of bioethics in the public arena. Several bioethicists have predicted that the new administration will not be friendly to bioethics (Jonathan Moreno Wesley Smith, Arthur Caplan). The listing of several bioethicsists on the ProfessorWatchList further suggests that bioethics analysis may not be as welcome anymore. At the very least, they do not expect to see an presidential bioethics commission.

From all of the bloggers at bioethics.net, we wish you a happy and healthy new year.

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