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Author Archive: Steven Miles


by Steven H. Miles, MD

In the face of the COVID-9 pandemic, many bioethicists are turning their attention to scholarship of triage ethics. Some focus on technology, i.e., the commandeering or allocating of mechanical ventilators or extracorporeal membrane oxygenators (ECMO). Others focus on patients, i.e., who shall be given most or least priority for health care resources in dire scarcity? Implicit in all triage proposals is the potential for Conflicts of Commitment.

There are nuanced differences between a Conflicts of Commitment and a Conflict of Interest. The latter is usually thought of in monetary terms, for example a person who stands to gain a financial advantage (or avoid a loss) by influencing a policy decision in which that incentive is not known to be bearing on their exercise of authority or expertise. …

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by Steven H Miles, MD

The Nazi Doctors at Nuremberg in 1945 brought enormous attention on medical war crimes. The unearthing of complicity of United States physicians and psychologists with interrogational torture during the war on terror of  at the beginning of the 21st century reignited attention to participation of physicians in human rights crimes. In retrospect, two aspects of that renewed attention deserved more scrutiny. There was a lack of attention to international context for the United States experience and, against this background, the fact that no US physicians were held accountable for complicity with torture was as noteworthy as their collaboration with that practice.…

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by Steven H. Miles, MD and Arthur Caplan, Ph.D.

Nicole Mone Arteaga was trying to get pregnant. It had been difficult for her. She had a miscarriage. Then, unexpectedly, she got pregnant again. Because of her miscarriage history, she cooperated with weekly medical monitoring, On June 19th, she was told, according to news interviews, that the fetus no longer had a heartbeat. Her doctor offered her a choice between a medication to cause the uterus to expel the fetal remains or a surgical procedure. She decided on the drug option so that she could avoid a surgical procedure and remain at home.…

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bioethics.net is proud to present this live release of the talks given by the 2017 ASBH Lifetime Achievement Award honorees. If you are at the ASBH Meeting, you can read along; if you were unable to attend, then you can see their talks here. Please join us in congratulating these luminaries who have contributed significantly to the field of bioethics.

ASBH Lifetime Achievement Award-2017
Bioethics and an Ethics of Solidarity
Steven H Miles, MD
Professor Emeritus, Department of Medicine, Center for Bioethics
University of Minnesota

I am deeply honored to receive the ASBH Lifetime Achievement Award. Time is too short for the infinite thank yous that I owe to colleagues, patients, and administrators who taught me and accommodated my quixotic career.…

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Some bioethicists link the beginnings of our field to the Nazi Medical experiments and the Nuremberg Trial (Annas). Whether this is the beginning of bioethics is debatable, but without a doubt, research ethics has been a central topic in the field. In fact, the very first federal bioethics commission laid out the principles of research ethics in the Belmont Report. Later, the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research recommended to the President and Congress that a uniform framework and set of regulations should govern human subjects research.  This effort reached fruition under The Federal Policy for the Protection of Human Subjects or the “Common Rule” that was issued in 1991. 

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by Steven Miles, MD

The following remarks were delivered on April 27, 2017 upon Steven Miles’ retirement

Bioethics is not scholastic theorizing. It must venture outside the walls of Academic Health Centers to speak on behalf of marginalized and silenced people including those without access to affordable health care, prisoners and enemies, nursing home residents and refugees. Bioethics is about our ethos—how we live.

No one who reveres Universities ever really leaves. I set out as an itinerant emeritus carrying a backpack stuffed with University’ values and tools.

  • The practice of medicine has been my liberal arts education. Intimate moments with those in profound despair schooled me.

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by Steven H. Miles, MD

Bioethicist Steven Miles suggest that making the new Common Rules regulations easy to read is as important as the content

The new Common Rule to protect human subjects has an extraordinarily large and diverse audience.[i] The new Rules defines the obligations of an enormous number of personnel at the National Institutes of Health as well as virtually any other government agency engaged in research with human subjects. The Rules define the requisite knowledge, training, and work of staff who oversee and conduct clinical research in the United States. The Rules are a template for institutions in other countries, including those that don’t use English as a primary language.…

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by Steven H. Miles, MD

A friend of mine is dying of metastatic cancer. She does not have long to live; she will possibly die before the end of this year. Throughout her life, she actively participated in civic life. She donated her time and money to charities and political campaigns. She did not shirk a call to jury duty as many do. Disability from her illness has constrained her public life. She watches television when she is not too tired. She follows a prominent local race and a race for national office. This week, I will take her to city hall to cast her ballot for the 2016 election.…

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by Steven H. Miles, MD

In December 2013, a Hearing Panel for the Health Professions Council of South Africa found Wouter Basson MD culpable for unprofessional conduct because of his work to produce chemical weapons, to medically assist rendition by commandos (kidnappings), and to provide cyanide containing suicide capsules to Special Forces’ operatives leaving for clandestine meetings. I served as an expert witness for the prosecution in the Basson matter in the area of medical ethics and military medicine.

The French philosopher-sociologist Emile Durkheim (1858-1917) is partly responsible for the confusion about strategic military suicide. He defined suicide as “all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result.”

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