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The Importance of Advance Directives and Power of Attorneys

This week I had the privilege of job shadowing in the clinical ethics department at a hospital here in Illinois. In clinical ethics, it is impossible to know exactly what your days will look like in advance, since your schedule depends on the varying needs of others in your workplace. There may be several days in a row where no requests for consults come in,... // Read More »

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The Unbefriended – NYC HHC Annual John Corser Ethics Conference

The New York City Health and Hospitals Corporation is the largest municipal  health care system in the United States.  This year, its John Corser Ethics Conference is tackling one of the biggest, yet perennially neglected, topics in clinical bioethics: medical decision making for patients without surrogates.

The term "unbefriended" describes those persons--regardless of age--who reach the end of life with neither decision-making capacity nor surrogates.  All concerned agree these patients need special compassion and protection. Yet it can be unclear at the end of life which treatments are in the patients' best interest and which are an undesirable burden.

Compelling case presentations and audience interaction will define and clarify clinical, ethical, and legal approaches to the New York Family Health Care Decision Act.

At the conclusion of the seminar, attendees will be able to:

  • Identify the scope of the national response to the Unbefriended client
  • Describe at least 2 issues which are relevant to the national discussion of the Unbefriended client.
  • Identify issues considered when drafting the FHCDA and how they determined the outcome pertaining to the unbefriended.
  • Identify clinical and ethical issues confronted when working with the Unbefriended client.
  • Describe clinical and ethical impasses created by the FHCDA law pertaining to the Unbefriended cllient.
  • Identify potential solutions to ethical/legal issues that confront clinicians when working with their Unbefriended clients.
This program is free to all NYC HHC employees.  A light breakfast and lunch will be served.  Continuing Education Credits have been applied for.  Space is limited.


Breakfast and Registration


Welcome and Opening Remarks
Ross Wilson, MD HHC Senior Vice President, Quality and Corporate Chief Medical Office

Nature of Conference and Opening Remarks
Susan Sanelli-Russo, MD, Chairperson of the HHC Ethics Council, Director of Neurology Queens Hospital Center.

Conference Algorithm
Nancy L. Dubler, LLB, Ethics Consultant, New York City Health and Hospitals Association

Lecture: Raising Legal Consciousness about Unbefriended Persons
Erica Wood, JD, Assistant Director, American Bar Association Commission on Law and Aging

Presentation and Interactive Discussion of Case: PEG Placement for Nursing Home Resident
Audience Response Vote 1
Panel Discussion: Experts from the  facility and invited faculty
Audience Response Vote 2
Audience discussion

Presentation and Interactive Discussion of Case: DNR Order for a Hospital Patient Admitted from Nursing Home
Audience Response Vote 1
Panel Discussion: Experts from the facility and invited faculty
Audience Response Vote 2
Audience discussion

Lecture: The Evolution of NYS Laws on Health Care Decisions for Unbefriended Patients
Robert Swidler, JD, Vice President Legal Services, St. Peter’s Health Partners, Governor’s appointee to the NYS Task Force on Life and the Law 7chevy


Lecture: Ethical Complexity of Protecting Unbefriended Patients under the FHCDA
Tia P. Powelll, MD, Director, Montefiore Einstein Center
for Bioethics; Director, Einstein Cardozo Master of Science in Bioethics; Professor of Clinical Epidemiology,
Division of Bioethics & of Clinical Psychiatry, AECOM

Lecture: National Efforts to Protect Unbefriended  Patients
Erica Wood, JD

Working Lunch Video:   “Food for Thought”  Modeling  Mediation Pertinent to the Unbefriended

Presentation and Interactive Discussion of Case: Refusal of Treatment by Hospital Patient  with a Psychiatric Diagnosis
Audience Response Vote 1
Panel Discussion: Experts from the  facility and invited faculty
Audience Response Vote 2
Audience discussion

Panel Discussion of Day’s Activities/Audience Discussion
Erica Wood, JD, Robert Swidler, JD, Tia Powell, MD

Conclusion and Attendee Evaluation

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International Association of Bioethics, 13th World Congress Edinburgh

The 13th World Congress of Bioethics will be in Edinburgh from 14 - 17 June, 2016.  

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Cigarette Smoking Is So 1970!

I have two reasons for showing you this picture, illustrating the decline in cigarette sales in Germany, France, Japan, Switzerland and the US over the past few decades. First, to show you the decline in cigarette sales in Germany, France, … Continue reading

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This entry was posted in Health Care, Public Health and tagged , , . Posted by Peter Ubel. Bookmark the permalink.


Law, Religion, and Health in America

I am looking forward to participating in this conference in a few weeks at Harvard.

2015 Annual Conference
Law, Religion, and Health in America

May 8 - 9, 2015

Conference Description

Religion and medicine have historically gone hand in hand, but increasingly have come into conflict in the U.S. as health care has become both more secular and more heavily regulated.  Law has a dual role here, simultaneously generating conflict between religion and health care, for example through new coverage mandates or legally permissible medical interventions that violate religious norms, while also acting as a tool for religious accommodation and protection of conscience.  
This conference will: (1) identify the various ways in which law intersects with religion and health care in the United States; (2) understand the role of law in creating or mediating conflict between religion and health care; and (3) explore potential legal solutions to allow religion and health care to simultaneously flourish in a culturally diverse nation. 


Note: All keynote, plenary, and panel sessions will include time for Q & A.

Thursday, May 7: Pre-conference session: After Hobby Lobby: What Is Caesar's What Is God's?

As prelude to “Law, Religion, and Health in America,” please join us for a pre-conference session examining the role of religion in the American public sphere. Our expert panel will discuss the nature of conscience and conscientious objection, religious freedom, and religious accommodation from philosophical, theological, historical, legal, and political perspectives.  

4:00 - 6:00pm: Panel Discussion

  • E. J. Dionne, Jr., Columnist, The Washington Post; Senior Fellow, The Brookings Institution
  • Diane L. Moore, Senior Lecturer on Religious Studies and Education and Senior Fellow at the Center for the Study of World Religions, Harvard Divinity School
  • Charles Fried, Beneficial Professor of Law, Harvard Law School
  • Frank Wolf, Representative, Virginia’s 10th Congressional District, U.S. House of Representatives, 1981-2015 (retired)
  • Moderator: Daniel Carpenter, Freed Professor of Government, Harvard University and Director, Center for American Political Studies at Harvard University 
  • Moderator: I. Glenn Cohen, Professor of Law, Harvard Law School and Faculty Director, Petrie-Flom Center

5:20 - 5:30pm: Remarks from Dean Minow

  • Martha Minow, Morgan and Helen Chu Dean and Professor of Law, Harvard Law School

5:30 - 6:00pm: Audience Q & A

6:00 - 7:00pm: Reception

This event is free and open to the public, but seating is limited. Register online!
Co-sponsored by the Petrie-Flom Center and the Ambassador John L. Loeb, Jr. Initiative on Religious Freedom and Its Implications at the Center for American Political Studies at Harvard University.

Friday, May 8

8:00 - 8:30am: Registration

A continental breakfast will be provided.

8:30 - 8:35am: Welcome

8:35 - 9:20am: Plenary Address

  • Douglas Laycock, University of Virginia School of Law - Religious Liberty, Health Care, and the Culture Wars

​9:20 - 10:25am: Panel 1, Opening the Conversation: Testing the Scope of Legal Protections for Religion in the Health Care Context

  • R. Alta Charo, University of Wisconisin Law School - Creating Life as Protected Expressive Conduct
  • Leslie C. Griffin, University of Nevada, Las Vegas William S. Boyd School of Law - What Would American Health Care Look Like if it Respected the Religion Clauses? How Would the Religion Clauses be Interpreted If They Valued American Health Care?
  • Samuel J. Levine, Touro College Jacob D. Fuchsberg Law Center - A Critique of Hobby Lobby and the Supreme Court’s Hands-Off Approach to Religion
  • Moderator: I. Glenn Cohen, Professor, Harvard Law School and Faculty Director, Petrie-Flom Center

10:25 - 10:40am: Break

10:40 - 11:45am: Panel 2, Law, Religion, and Health Care Institutions

  • Ryan D. Meade, Loyola University Chicago School of Law - Can a Hospital Have a Conscience If It Doesn’t Have an Intellect and Will?
  • Elizabeth Sepper, Washington University School of Law - Contracting Religion: The Role of Private Law in Constructing Religious Identity and Enforcing Individual Compliance in Health Care Institutions
  • David M. Craig, Indiana University-Purdue University Indianapolis - Mission Integrity Matters: A Consistent Approach on Catholic Health Care Values and Public Mandates
  • Moderator: Christine Mitchell, Executive Director, Center for Bioethics, Harvard Medical School

​11:45am - 12:30pm: Lunch

Lunch will be provided.

12:30 - 1:15pm: Panel 3, Professional Responsibilities, Religion, and Health Care

  • Claudia E. Haupt, Columbia Law School - Religious Outliers: Professional Knowledge Communities, Individual Conscience Claims, and the Availability of Professional Services to the Public
  • Nadia N. Sawicki, Loyola University Chicago School of Law - Informed Consent and Disclosure of Providers’ Religious Convictions
  • Moderator: Holly Fernandez Lynch, Executive Director, Petrie-Flom Center

​1:15 - 2:35pm: Panel 4, The Impact of Religious Objections on the Health and Health Care of Others

  • Amy Sepinwall, University of Pennsylvania - Conscience and Complicity: Assessing Pleas for Religious Exemption inHobby Lobby's Wake
  • Nelson Tebbe, Brooklyn Law School, and Micah Schwartzman, University of Virginia School of Law - Religion Exemptions and Legal Baselines
  • Mary Anne Case, University of Chicago Law School - Why “Live-And-Let-Live” Is Not a Viable Solution to the Difficult Problems of Religious Accommodation in the Age of Sexual Civil Rights
  • Robin Fretwell Wilson, University of Illinois College of Law - Religious Conscience and Access: Choke Points, Gateways, and Bounded Measures
  • Moderator: Richard H. Fallon, Jr., Harvard Law School

​2:35 - 2:45pm: Break

2:45 - 3:50pm: Panel 5, A Case Study – Religious Beliefs and the Health of the LGBT Community

  • Craig Konnoth, University of Pennsylvania Law School - Reclaiming Biopolitics: Religion and Psychiatry in the Sexual Orientation Change Therapy Cases
  • Susan Stabile, University of St. Thomas School of Law - Religious Convictions About Homosexuality and the Training of Counseling Professionals: How Should We Treat Opposition to Counseling Homosexuals on Religious Grounds?
  • Shawn Crincoli, Touro College Jacob D. Fuchsberg Law Center - Transgender Health Care & Religious Exemptions in Post-Hobby Lobby America
  • Moderator: Noa Ben-Asher, Harvard Law School and Pace Law School

​3:50 - 5:30pm: Panel 6, Accounting for and Accommodating Patients’ Religious Beliefs

  • Thaddeus Pope, Hamline University School of Law - Brain Death Rejected: Expanding Clinicians' Legal Duties to Accommodate Religious Objections and Continue Physiological Support
  • Teneille R.  Brown, S.J. Quinney College of Law, University of Utah - Accommodating Miracles
  • Jonathan Will, Mississippi College School of Law - Religion as a Controlling Interference that Prevents Autonomous Choice in Medical Decision Making by Minors Attempting to Utilize the Common Law Mature Minor Doctrine
  • Matthew J.B. Lawrence, Petrie-Flom Center, Harvard Law School - Paid Exercise: Hospital Chaplains and the Hobby Lobby Problem
  • Stacey A. Tovino, University of Nevada, Las Vegas William S. Boyd School of Law - The Relationship Between Health Care and Religion in the HIPAA Privacy Rule
  • Moderator: Robert D. Truog, Professor, Harvard Medical School and Director, Center for Bioethics, Harvard Medical School

​Saturday, May 9

8:30 - 9:00am: Registration

A contintental breakfast will be provided.

9:00 - 9:05am: Welcome

9:05 - 10:10am: Panel 7, Religious Reasons in the Context of Reproductive Health Care

  • B. Jessie Hill, Case Western Reserve University School of Law - Regulating Reasons: Governmental Regulation of Private Deliberation and Religious Reasons in Reproductive Decision-Making and Health Care Decisions for Minors
  • I. Glenn Cohen, Faculty Director, Petrie-Flom Center - Religion, Rape, Incest, and Abortion: Should the State Evaluate the Reasons for Abortion? 
  • Dov Fox, University of San Diego School of Law - When Regulating Reproduction Establishes Religion
  • Moderator: Mindy Jane Roseman, Academic Director, Human Rights Program, Harvard Law School

​10:10 - 10:55am: Panel 8, Law, Religion, and Health Insurance 

  • Holly Fernandez Lynch, Executive Director, Petrie-Flom Center, and Gregory Curfman, Harvard Medical School - Hobby Lobby, Religious Employers, and Moving Away from Employer-Sponsored Health Care 
  • Rachel E. Sachs, Petrie-Flom Center, Harvard Law School - Religious Exemptions to the Individual Mandate: Health Care Sharing Ministries and the Purposes of the Affordable Care Act
  • Moderator: Marc A. Rodwin, Suffolk University Law School

​10:55 - 11:10am: Break

11:10am - 12:40pm: Plenary Session, The Contraceptives Coverage Mandate Litigation

12:40 - 1:30pm, Lunch

1:30 - 2:50pm, Panel 9, When Religion Intersects with Mental, Public, and Environmental Health

  • Abbas Rattani, Meharry Medical College School of Medicine - Religious Delusion, Decision-Making Capacity, and Culpability: Understanding Subjective Mental Illness Diagnoses in the Context of the Insanity Defense and Religious Freedom
  • Michele Goodwin, University of California, Irvine School of Law - Race, Religion, and AIDS
  • Aileen Maria Marty, Florida International University College of Medicine, Elena Maria Marty-Nelson, Nova Southeastern University Shepard Broad Law Center, and Eloisa C. Rodriguez-Dod, Florida International University College of Law - The Intersection of Law, Religion, and Infectious Disease on the Handling and Disposition of Human Remains
  • Jay D. Wexler, Boston University School of Law - When Religion Pollutes: How Should the Law Respond to Religious Beliefs and Practices That Harm the Environment and Risk the Public’s Health?
  • Moderator: Ahmed Ragab, Harvard Divinity School

​2:50 - 3:00pm: Closing Remarks

How to Register

The conference is free and open to the public, but space is limited and registration is required. REGISTER ONLINE!

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Human Remains for Compost: Repugnant or Resourceful?

<p><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">I am a lousy gardener. Just this year I am considering a small attempt at growing a few vegetables organically in my backyard. Maybe it was the long winter, maybe it is a drive to live more sustainably, maybe it is the challenge of overcoming decades of plant growing failures. After carefully selecting a few packets of easy to grow seeds and starting a few slow-growers inside, I have turned my attention to creating the best growing environment for these fragile plants. Part of this effort includes learning how to create compost from kitchen and yard waste materials. While I search for a suitable compost bin to take position behind the garage, I am diligently collecting fruit cores, egg shells, coffee grounds, and discarded greens in airtight containers in my fridge. Researching my options, I stumbled across an article that had me doing a double take, “A Project to Turn Corpses Into Compost” in the </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href=";contentCollection=N.Y.%20%2F%20Region&amp;module=MostEmailed&amp;version=Full&amp;region=Marginalia&amp;src=me&amp;pgtype=article&amp;_r=0">New York Times</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"> online. I gasped in horror. Could this possibly be an ethical option for burial? Could this be legal? Was this environmentally safe? Was this a joke?</span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>

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This entry was posted in End of Life Care, Health Care and tagged , . Posted by Hayley Dittus-Doria. Bookmark the permalink.


Polarized Views on Science

Sometimes when I disagree with friends or family about contentious issues, and they accuse me of being partisan, I try to defend myself by explaining that I am basing my position on science, not politics. According to a recent poll, … Continue reading

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Baby F – Oklahoma Supreme Court Requires Clear & Convincing Evidence to Stop Life Support

This week, the Oklahoma Supreme Court issued its opinion in the Baby F case.  The court held that for children in DHS custody, Oklahoma courts may authorize the withdrawal of life-sustaining medical treatment or the denial CPR only after det...

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Designer Embryos: The Future is Now

by Craig Klugman, Ph.D.

Oh, wonder!
How many goodly creatures are there here!
How beauteous mankind is! O brave new world,
That has such people in ’t! (Shakespeare, The Tempest, Act 5, Scene 1.

Nature News on Wednesday reported a group of Chinese researchers have successful genetically engineered a human embryo.

Researchers used “non-viable” embryos from fertility clinics. These embryos had an extra set of chromosome, having been fertilized by two sperm and containing three nuclei. Such embryos were chosen because of the impossibility of them gestating into a human being. The team then used the enzyme CRISPR/Cas9 which permit scientists to snip out genes and insert new ones.…

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This entry was posted in Featured Posts, Research Ethics, Science and tagged , , . Posted by Craig Klugman. Bookmark the permalink.


Resolution on the Human Trafficking Bill

Wednesday’s Wall Street Journalreports that the Senate has reached a resolution of the impasse on the human trafficking bill.  I must say I rather expected this.  The resolution clears the way for the nomination of Loretta Lynch to be Attorney General.  The Senate Republican leadership had been holding that vote “hostage” as leverage for an acceptable resolution on the trafficking bill.  It was never about... // Read More »

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This entry was posted in Health Care and tagged , . Posted by Jon Holmlund. Bookmark the permalink.