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Author Archive: Blog Editor


This editorial is co-posted with the American Journal of Bioethics.

by Emily A. Largent JD, PhD, RN,  Ezekiel J. Emanuel MD PhD, and Holly Fernandez Lynch JD MBE

Offers of payment made in exchange for research participation are common. And yet they are often regarded as, at best, a “necessary evil.” This is odd. In most nonresearch contexts, people find payment for goods and services unproblematic. Indeed, when goods and services are not intended as gifts, failure to pay for them is a problem; we call it theft. Why should payments made in the context of research participation be of particular ethical concern?…

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by Bray Patrick-Lake MD, MSC & Jennifer C. Goldsack MS, MBA

The target article by Wiggins and Wilbanks reports on the history and typology of the models of citizen science emerging in health and biomedical research with the rapid dispersion and repurposing of technology. Wiggins and Wilbanks describe the variety of models through which nonprofessionals collaborate in the generation of health and biomedical knowledge, and highlight the benefits of these citizen science models.

It is inspiring to see the power of citizen science recognized. Wiggins and Wilbanks argue that the benefits can be substantial, acknowledging patient communities’ ability to identify interesting and highly relevant questions, accelerate the pace of research and new knowledge, and engage research participants in highly effective ways.…

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by Julian Savulescu, Ph.D., MBBS

 “Life’s but a walking shadow, a poor player, that struts and frets his hour upon the stage, and then is heard no more; it is a tale told by an idiot, full of sound and fury, signifying nothing” (Macbeth, Act 5, Scene 5).

One of the well-worn objections in the enhancement literature is based on inequality. Enhancement will only be available to some, so it will create unjust inequality. This was captured in the popular film Gattaca. In the most common form, it is based on concerns about capitalist markets: the rich will buy superior enhancements, exacerbating existing injustice.…

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This blog post made available by the American Journal of Bioethics. You can read this editorial and accompanying articles here.

by John Torous, MD, MBI; Lyle Ungar, Ph.D. & Ian Barnett, Ph.D.

INTRODUCTION
Social media have allowed the scope and scale of biomedical research studies to greatly expand in the last decade. Now able to nearly reach entire populations via platforms like Facebook, researchers can explore new questions and recruit thousands in a matter of minutes. Social media can also help address challenges of longitudinal retention in research and enable researchers to identify participants years later for follow-up, as outlined in the article by Bhatia-Lin and colleagues in this issue, Bhatia-Lin and colleagues also discuss ethical and regulatory concerns with using social media platforms to locate and track research participants and offer an innovative rubric to guide ethical use of social media in biomedical research.…

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by Daniel J Brauner, MD

Wait a minute! I made up the term DNE—Do Not ECMO—not because I thought we needed another RULE, but to motivate a cautionary tale about CPR that may help to avoid the order becoming necessary in the first place.

Cautionary Tale

Attention to the changing indications for resuscitation over its more than 200 year history reveals what in retrospect was a natural experiment performed by the American Medical Association (AMA). The AMA conceived of the Current Procedural Terminology or CPT in response to their fears about increasing government involvement with the medical enterprise. Their goal was to maintain the “private practice” model of medicine under government sponsorship by creating a list of relative values to charge for procedures.…

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This blog post made available by the American Journal of Bioethics. You can read this editorial and accompanying articles here.

by Laura Kelly, MS, Governor of Kansas

A single mother doing her best to raise her children. A small business owner realizing her dreams in a rural Kansas town. A caregiver for a disabled child. All these Kansans deserve the ability to see a doctor when they need one and receive the health care services necessary for them to remain productive members of their communities.

These Kansans are why my campaign prioritized Medicaid expansion and why it remains one of my highest priorities in office.…

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by Craig Klugman, Ph.D.

Jump to The Resident (Seasons 2; Episode 20): Maternal mortality in black women; Jump to New Amsterdam (Season 1; Episode 18): Gestational surrogacy

The Resident (Season 2; Episode 20): Maternal mortality in black women

A young black family is in the OB ward for a C-section to deliver their second baby. The OB displays overt racism when he asks Pravesh, “What country are you from”? Pravesh responds, “New Jersey.” Post-surgery the mother has pain and some blood in her urine output. The OB ignores her. The ward is stretched and understaffed. The patient worsens. Only when Pravesh returns and herurine is mostly blood is she taken to the OR where the trauma team comes in after finding that she has bled most of her blood volume into her abdomen.…

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Editorials appear in cooperation with the American Journal of Bioethics. This article and its associated pieces can be found here.

by Jerry Menikoff

How can we appropriately ensure that people who enroll in clinical research understand what they are getting into? The recent revisions to the primary set of U.S. regulations for protecting research subjects (the Common Rule) attempt to better achieve that goal by, in part, providing more useful information to prospective subjects. In this issue of AJOB, Stephanie Morain and her colleagues address another important aspect of informed consent to research: Who should be obtaining consent? They note that although a variety of ethical guidelines warn against having physician-investigators obtain consent from someone who is already their own patient, U.S.…

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Editorials appear in cooperation with the American Journal of Bioethics. This article and its associated pieces can be found here.

by Jonathan D. Moreno

Let me address the “editorial” aspect of this editorial right away: I wholly agree with the principle that lies behind Mark Kuczewski’s admirable article. I take that principle to be that when clinical ethics issues affect undocumented patients, fostering efficient routine care in the setting of “new immigration-related stressors” is “to be resolved by finding creative means of instancing the values of care, efficiency, and public health.”

In Kuczewski’s article, the clinical ethicist is a kind of mediator and moral conscience.…

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by Craig Klugman, Ph.D.

Exploring the bioethical issues in medical dramas

Jump to New Amsterdam (Season 1; Episode 17): Crisis standards of care and decision-making; Jump to Station 19 (Season 2; Episode 13): POLST, DNR, and battery

New Amsterdam: (Season 1; Episode 17): Crisis standards of care and decision-making

In the midst of a storm isolating the hospital, without power or blood, Sharpe tells Max he has to decide which patients they will save. He wants to save everyone, but Sharpe explains, “Your job is no longer to save everyone; it’s to try to minimize the damage.” They have to decide who to save, who to give the few resources remaining.…

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