by Karen Solomon, Bioethics Program Student Does early to bed and early to rise, make a man healthy, wealthy and more ethical? Earlier research suggested a “morning morality effect”: that people are more ethical early in the morning, becoming less so as they “wear out as a day wears on.” Not so fast, researchers now […]
The Minnesota assisted suicide case against the Final Exit Network begins again at 9:00 a.m. on September 8, 2014, in the Dakota County Judicial Center in Hastings.
In June 2014, the Supreme Court of Minnesota denied the Stat…
<p>Given that continuing controversy surrounding insurance coverage for how contraceptives, I want to point out another drug that also targets sexuality and reproduction yet does not generate the nearly same degree of controversy. In fact, insurance companies began covering it immediately upon approval by the FDA with no fanfare. I’m referring to erectile dysfunction drugs. The public’s different responses to female contraceptives and male sexuality medications has been discussed in academic circles as well as in the media. Here I want to present some feminist perspectives on this topic. </p>
<p>Some feminists argue is that part of the reason we understand and treat pregnancy and impotence differently is because we have different standards for women’s and men’s health, which result from the traditional gender norms at play in our society. We (as a society) expect women to adhere to norms of chastity (e.g. fall on the “virgin” side of the virgin/whore dichotomy by not having sex until marriage) and one way we do this is by limiting their access to sexual and reproductive health care. In contrast, because our notions of masculinity are tied into sexual prowess, we are more receptive to providing health care for men who are not able to maintain an erection. </p>
<p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">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="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20.399999618530273px;"> </span></p>
The clips we are considering: RANGE OF MOTION http://www.imdb.com/title/tt0258078/LIVING PROOF http://www.imdb.com/title/tt1229367/?ref_=nv_sr_1CONTAGION http://www.imdb.com/title/tt1598778/The questions we are as…
The main thrust of this commentary comes from Dr. Roy Poses and:
–which in turn draws on two prior posts:
A little background: HOOKED described a major shift in pharmaceutical research. Initially, the vast majority of drug trials were conducted by universities. Over the past 30 years, companies found that universities were too slow in doing this research for maximum financial gains, and so gradually, contract research organizations replaced universities as the major players. Dr. Carl Elliott (first of two prior posts) has been one of the major writers about the fallout from these policies.
Dr. Elliott describes in some detail a group of subjects who can be found in typical contract research organizations, who talk openly about their ways of qualifying for research trials, and also of dodging the painful and burdensome procedures that typically form a part of some trials. It seems quite clear that the money, and not any goal of contributing to science, is the main and indeed the sole motivator. Dr. Elliott had previously described this “guinea pigging” in earlier published work.
The second prior post, by Peter Aldhous, describes some of the physicians who run the contract studies, and focuses on those who have been censured and who have various licensure problems. Aldhous admits that these misfits count as a minority of all the doctors running the contract research organizations, but adds, “My trawl netted dozens of doctors selected to work on clinical trials over the past five years who had previously been censured by state medical boards. Thousands of doctors are hired each year to test experimental drugs, making this a small minority. But most doctors have clean records, so companies should have few problems finding recruits without red flags against their name.”
Aldhous concludes, “Some experts argue that the FDA’s entire rulebook for clinical trials, with its talk of things like ‘institutional’ review boards, reflects the academic past of clinical research—not today’s industrial juggernaut of for-profit clinical trials firms and for-hire review boards, which oversee a workforce of doctors drawn from regular medical practice. ‘They are regulations for a world that doesn’t exist anymore,’ says Elizabeth Woeckner, president of Citizens for Responsible Care and Research, which campaigns for the safety of medical research volunteers.”
Dr. Poses then notes: “So given the push to do research rapidly at the lowest cost, the lack of supervision and regulation by the FDA, the hiring of physicians with problematic backgrounds, the willingness to take vulnerable patients desperately motivated by money, can we trust that the nice, clean, detailed descriptions of clinical trials implemented by contract research organizations presented in research articles and trial registries have anything to do with the reality of what went on? If not, what then should we make of the validity of the results of such trials?…This is yet another reason to ask whether we need to take research on human subjects meant to evaluate commercial products or services out of the hands of the companies that make those products and provide those services.”
In other words, bait and switch. Get everyone used to research on human subjects while research institutions are running the shop and people who sign up as subjects have at least some motivation to behave in the interests of science. Then gradually change the system so that it’s all about money and one can no longer trust the results. The money affects different players in different ways– the companies and the CROs have their financial motives, the “guinea pigs” have theirs–but the one thing we can count on is that the money plays a role that’s different from the ideal of scientific research. The end result is that things look legitimate up front, and all the people involved have strong motives to do what’s less legitimate behind the scenes. We have no idea how that plays out in terms of scientific rigor.
And this is now how drugs are tested before we use them.
[CNBC] wo years ago, Nathalie Traller spent her days like any seventh-grader might. She played soccer and swam and studied for classes. Then Nathalie started getting bad headaches, the kind that made it hard for her to concentrate. A trip to the doctor revealed the unthinkable: a mass the size of a baseball in her […]
Reported end-of-life care experiences are typically worse in the nursing home setting, according to the latest results of a recent CMS survey developed and field tested by RAND.
The Hospice Experience of Care Survey measured experiences of patients an…
by Arthur Caplan, Ph.D.
Ebola, according to the World Health Organization (WHO) is out of control in West Africa. The disease, which is transmitted by contact with contaminated blood or body fluids, or by close contact with a dead body infected with the virus, has killed more than 1100 people in Guinea, Sierra Leone, Liberia, and Nigeria. The number of dead is most likely higher since people were dying in rural villages without being counted. At least another 1000 persons are infected. The world faces the worst outbreak of this horrific disease since 280 people died when the Ebola first appeared in humans near the Ebola river in the Democratic Republic of the Congo in 1976. …
by Sean Philpott-Jones, Director of the Center for Bioethics and Clinical Leadership There’s an epidemic that is sweeping this country. It’s not Ebola, despite all of the hype and misinformation about that disease that has dominated the news in the past two weeks. Rather, I’m talking about the ice bucket challenge. Anyone who has watched television […]