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You can read this editorial and other articles in this month’s issue of The American Journal of Bioethics.

by José R. Maldonado, MD, FAPM

 “Because donated organs are a severely limited resource, the best potential recipients should be identified. The probability of a good outcome must be highly emphasized to achieve the maximum benefit for all transplants.”  (From: OPTN/UNOS Ethics Committee General Considerations in Assessment for Transplant Candidacy White Paper–2010)

The number of transplant surgeries has risen steadily in the last 30 years in the United States (US), while the availability of donated organs has not kept pace with the clinical demands.…

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A new feature on bioethics.net is to post videos of authors talking about the articles they wrote for The American Journal of Bioethics. Let us know what you think!

Authors Brent Kious & Margaret Peggy Battin discuss their recently published Target Article, Physician Aid-in-Dying and Suicide Prevention in Psychiatry. The article is available here.

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This post is presented in collaboration with the American Journal of Bioethics.
You can read the entire issue by clicking here
.

by Sheldon Krimsky

In late November 2018, Chinese scientist Dr. He Jiankui announced at the Second International Summit on Human Genome Editing in Hong Kong that he had used CRISPR/Cas 9 gene editing on two female embryos that were brought to term through an in vitro fertilization (IVF) pregnancy. The world scientific community was ill-prepared for the announcement since the moral issues surrounding the editing of human embryos were under discussion but hardly resolved. The recommendation of the 12-member organizing committee of the 2015 International Summit on Human Gene Editing in Washington, DC, stated that it would be irresponsible to undertake any clinical use of germline editing unless and until the safety and efficacy issues were resolved and there was a broad consensus on the specific application, and that such use could proceed only under appropriate regulatory oversight.…

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by Suzanne van de Vathorst

In 2018, 6126 cases of physician aid in dying (PAD) (4.4% of all deaths) were reported in the Netherlands. Of these 6126 cases, 67 involved patients with a psychiatric disease. Psychiatrists reported 34 of these, general practitioners (part of the Netherlands’ extensive system of family physicians) reported 20. The Netherlands has universal health care insurance, and equitable access to good quality health care, including psychiatric care. The Dutch generally trust their doctors and assume they are doing their job with our best interest in mind. Some general practitioners may know their patients for their whole lives.…

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This post is presented in collaboration with the American Journal of Bioethics.
You can read the entire issue by clicking here
.

by Dan Diaz

My wife, Brittany Maynard, died on November 1, 2014, of a brain tumor, but she used medical aid-in-dying to insure a peaceful death and end the unbearable suffering when no other option would provide relief. After Brittany was diagnosed in January 2014, she endured an eight-hour brain surgery and we researched every treatment option that offered any hope of extending her life. But the brain tumor was growing aggressively. Brittany’s doctors informed her she had six months to live.…

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by Craig Klugman, Ph.D.

I recently read Range: Why Generalists Triumph in a Specialized World written by investigative journalist David Epstein. The crux of the book is that people with more generalized experiences in a variety of different fields tend to do be more successful in their chosen work. The further we range, the better we are.

This idea, that broad learning is beneficial is the basis of the liberal arts model—broad exposure to a wide variety of areas and learning with some depth in one discipline. This idea may seem quaint in an era when people are supposed to gain expertise as early as possible in their life and when education programs are being pressured to focus more on job training than well-roundedness.…

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This post is presented in collaboration with the American Journal of Bioethics. You can read the entire issue by clicking here.

by Marie E. Nicolini, Chris Gastmans & Scott Y. H. Kim

Kious and Battin (K&B) argue that psychiatric PAD (PPAD) should be legal in the US, based on a ‘parity’ argument. This is the most popular approach to argue for PPAD. What K&B add is that since, in their view, the parity argument is valid, there is a dilemma because PPAD conflicts with the practice of involuntary commitment in psychiatry. In this editorial, we sketch out the structure of the argument from parity, pointing out its challenges and limits.…

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This post is presented in collaboration with the American Journal of Bioethics. You can read the entire issue by clicking here.

by Eric Manheimer, MD

SENSE OF URGENCY

The year 2016, with the election of Donald Trump, intensified a sense of urgency in many arenas, including health care. It was clear his administration would usher in assaults on the standards, rules, and ethics that were the glue binding truth and storytelling in every area of society.

Several TV medical shows were sunsetting, and two showrunners were interested in acquiring my book 12 Patients: Life and Death at Bellevue Hospital; both mentioned a sense of urgency in producing a show that highlighted the commitment to caring for other human beings.…

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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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