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Sprinting Down the Road on “The Children We Want”

By Mark McQuain Almost exactly one year ago, this blog asked rhetorically whether your polygenic risk score was a good thing. Jon Holmlund raised this issue again last week, mentioning a company called Genomic Prediction. This company’s claim about the merits of their technology deserves close ethical scrutiny and is my reason for mentioning them …

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Three Ethical Reasons for Vaccinating your Children

Across the country, billboards are popping up suggesting that vaccines can kill children, when the science behind vaccination is crystal clear – vaccinations are extremely safe. Researchers who study the beliefs of anti-vaxxers have found many different reasons, not just religious or political, as to why some parents refuse to get their children vaccinated. As a bioethicist who investigates how societal values impact… Read more

The post Three Ethical Reasons for Vaccinating your Children appeared first on The Hastings Center.

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Brain Death – the Cuba Conference

The program for the VIII INTERNATIONAL SYMPOSIUM ON BRAIN DEATH AND DISORDERS OF CONSCIOUSNESS is packed full of interesting sessions from Tuesday, December 3 to Friday, December 7. Here are some session titles.

Why And When Should Brain Death Be Declared?

Brain Death Uncertainty: Growing Challenges To Its Legal Status

Vegetative State, Minimally Conscious State, Brain Death, Or A New State Of Disorder Of Consciousness?

“I” And “Thou”: The Development Of Individuation In The Context Of Consciousness

World-Wide Consensus Statement On Brain Death Determination.

Changing Tides In “Death By Neurologic Criteria”

Lessons Learned From The Charlie Gard Case

Determination Of Death By Neurologic Criteria For Adults - Usa (State Of New Jersey)

Current Status Of AAN Guidelines For The Determination Of Brain Death In Adults: Where The Guidelines Fall Short

Reversible Brain Death After Cardiopulmonary Arrest And Induced Hypothermia

Round Table On Jahi Mcmath and Other Controversial Brain-Dead Cases

Different Types Of Brain Death

Ethical Controversies In The Diagnosis Of Brain Death: Ancillary Testing

Physiologic Signatures Of Brain Death Using Invasive Intracranial Monitoring

Are ‘Brain Death’ And ‘Death’ Equivalent? Opinions In The General Public And In Clinicians

Determining Brain Death: The Updated Version Of The Brain Death Protocol Of The Netherlands

Euthanasia In The Netherlands

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Brain Death Religious Exemptions – Three Cases Seeking Constitutional Rights

While there were were five or more North American lawsuits, this year, seeking religious exemptions from brain death, now there are only two. This month, the Ontario Court of Justice has dismissed the case of Shalom Ouanounou not only because he ...

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Avoiding Advanced Dementia with a VSED Directive

Anyone who has taken even a cursory look at the medical and bioethics literature knows that leaving advance instructions to stop food and fluids by mouth is complicated.  Several organizations have developed and published planning tools. But thei...

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BioethicsTV (November 13-16): #TheGoodDoctor, #ChicagoMed

by Craig Klugman, Ph.D.

Jump to The Good Doctor (Season 2; Episode 7): Directed donation; Jump to Chicago Med (Season 4; Episode 8): DNR Tattoos and Ethics Committees

As many of our favorite medical dramas head to their fall finales, they focused more on sentimental stories in the personal lives of characters, or feel good cases that did not raise any ethical issues.

The Good Doctor (Season 2; Episode 7): Directed donation

The ethical issue in this week’s episode is located in a storyline about a man who comes to the ED after injuring himself with a nailgun. One nail punctures his kidney which has to be removed but, by a genetic fluke, the man was only born with one kidney.…

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Wrongful Living – Noncompliance with Advance Directives

Fredrick E. Vars and Alberto Lopez at the University of Alabama School of Law have posted a copy of their article forthcoming in the Iowa Law Review: "Wrongful Living."

"Executing an advance directive that specifies a patient’s wishes regarding end-of-life medical care is an exercise of self-determination – a conscious choice about the degree and type of medical intervention one wishes to receive under end-of-life circumstances."

"Empirical studies, however, consistently report that healthcare professionals fail to comply with advance directives; violations of a patient’s interest in self-determination are alarmingly common. From a practical perspective, the conduct of either patients or healthcare professionals may make an advance directive unavailable, which results in noncompliance. Legally, courts have historically rejected claims for “wrongful living” associated with the prolongation of life that results from unwanted medical intervention. As a result, healthcare professionals fear the liability threatened by a wrongful death claim more than the legal exposure risked by keeping an individual alive despite a contrary mandate in an advance directive."

"In response to practical concerns regarding availability, this paper proposes the creation of a nationwide registry of advance directives and argues that sanctions for violations of professional responsibility as well as the risk of liability for legal malpractice encourage utilization of the proposed registry."

"To realign the skewed legal incentives, this paper argues that the compensable harms associated with battery and negligence claims filed in lieu of “wrongful living” claims should include the loss of enjoyment of life. Because damages for loss of enjoyment of life are rarely mentioned by courts or scholars in the context of violating advance directives, this paper describes loss of enjoyment of life damages and argues that such damages should be compensable in the same manner that tort law compensates for similar injuries that lack an objective market value."

"In combination, the practical and legal proposals incentivize compliance with an advance directive and thereby expand the protection afforded a patient’s interest in self-determination."

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Ethics and Society Newsfeed – November 16, 2018

  Climate Change Ethics Death toll rises to 56 in California wildfires “The death toll from the wildfires burning in Northern and Southern California has risen to 56 people, authorities announced, making it the deadliest wildfire in a century. An additional 287 people have been assigned to comb through the rubble for bodies, authorities told […]

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A Bit More on “The Children We Want”

By Jon Holmlund   The Wall Street Journal recently asked “Is it ethical to choose your baby’s eye color?”  This can’t be predicted precisely, yet, because the inheritance involves several genes, but in principle it’s at least possible to play the odds by trying to predict the probability of eye color.  The article in question …

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#InMyLane: Gun Violence and an Ethical Health Care Response

by Craig Klugman, Ph.D.

Since January 1, 2018 through November 15, the United States has seen 311 mass shootings that have killed 339 people and injured 1,249. The Centers for Disease Control & Prevention (CDC), shows that gun deaths are on the rise (mass shootings, all shootings, accidents, suicides, etc.). Shootings are the third leading cause of death in children aged 10-19 years and are responsible for 74% of all homicides. Having a gun in the home is a risk factor for death by gun whether accidental, deliberate, or unintended (a person with Alzheimer’s, a child playing).  According to the Harvard Injury Control Center, there are 265 million guns in the hands of civilians (the entire US population is about 320 million).…

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