Where the World Finds Bioethics Sat, 30 Aug 2014 09:30:00 +0000 en-US hourly 1 Religiously Affiliated ICU Patients Receive More Aggressive End-of-Life Care Sat, 30 Aug 2014 09:30:00 +0000 0 Influencing Young Minds Fri, 29 Aug 2014 16:20:44 +0000 Continue reading ]]> 0 The Boys in the Ban Fri, 29 Aug 2014 12:06:06 +0000 ]]> 0 Jahi McMath Still Responding to Verbal Commands Fri, 29 Aug 2014 09:00:00 +0000 0 “Release to Elsewhere” and (vs?) the Reality Thu, 28 Aug 2014 19:59:23 +0000 Read More »]]> 0 Is It Irrational For Carmelo Anthony To Take So Many Three Pointers? Thu, 28 Aug 2014 18:08:26 +0000 Continue reading ]]> 0 Bioethics at Yale, Encyclopedic Edition Thu, 28 Aug 2014 14:51:00 +0000 0 Providence Institute for Human Caring Thu, 28 Aug 2014 09:00:00 +0000 0 Direct cell reprogramming to grow a new organ and the ice bucket challenge Thu, 28 Aug 2014 01:04:17 +0000 Read More »]]> 0 Brain Death Is a Flash Point in End-of-Life Law, Ethics and Policy Wed, 27 Aug 2014 16:45:00 +0000 0 Emotional Adaptation and Desire Wed, 27 Aug 2014 16:23:40 +0000 Continue reading ]]> 0 Brain Death Is a Flash Point in End-of-Life Law, Ethics and Policy Wed, 27 Aug 2014 15:00:08 +0000 by Thaddeus M. Pope, J.D., Ph.D.

The August 2014 issue of the American Journal of Bioethics includes nearly 20 articles on the status of death determined by neurological criteria (DDNC or “brain death”).  Not coincidentally, this summer, several other leading bioethics journals are also covering “brain death.”  (See recent and forthcoming articles in the Cambridge Quarterly of Healthcare Ethics, the Hastings Center Report, and the Journal of Medical Ethics.)  I have myself contributed to a multi-article examination of the topic in the imminently forthcoming Journal of Clinical Ethics 25(3).…

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Celebrating a Social Media Milestone: 1,000 Followers on Twitter! #Publicbioethics Wed, 27 Aug 2014 14:30:17 +0000 0 Update: How Ebola Kills Wed, 27 Aug 2014 12:08:38 +0000 0 (Gun) Violence as a Public Health Issue Wed, 27 Aug 2014 01:41:57 +0000 Read More »]]> 0 The Anechoic RUC: Some Small Efforts at Reform Tue, 26 Aug 2014 19:53:00 +0000 0 Medical Humanities – Initiating the Journey at Xavier University School of Medicine Tue, 26 Aug 2014 15:30:33 +0000 0 Will Lowering The Price Of Genetic Testing Raise The Cost Of Medical Care? Tue, 26 Aug 2014 15:11:15 +0000 Continue reading ]]> 0 Death: Why the Brain Matters (Video) Tue, 26 Aug 2014 13:40:00 +0000 0 Elder Mediation Training in Minneapolis Mon, 25 Aug 2014 23:25:00 +0000 0 Limning Autonomy in Surgery Mon, 25 Aug 2014 18:08:08 +0000 Read More »]]> 0 Patient Modesty: Volume 69 Mon, 25 Aug 2014 01:24:00 +0000 0 Not-So-Personalized Medicine Sat, 23 Aug 2014 15:37:00 +0000 0 Supreme Court of Canada – Assisted Suicide Oral Arguments on October 15 Sat, 23 Aug 2014 12:49:00 +0000 Lee CarterOn October 15, 2014, the Supreme Court of Canada will hear oral arguments in the case of Lee Carter, et al. v. Attorney General of Canada, et al.  Written  Factums of key parties are available here.

The plaintiffs were terminally ill patients seeking physician aid in dying.  Ms. Kay Carter and the applicant Ms. Gloria Taylor both suffered from intractable and progressive diseases and are now deceased. They had joined with the others in bringing a civil claim before the British Columbia Supreme Court challenging the constitutionality of the Criminal Code provisions against assisted suicide and euthanasia, specifically ss. 14, 21(1)(b), 21(2), 22, 222(1)-222(5), and 241. They focused their case, however, on s. 241, which prohibits aiding another person to commit suicide. 

The plaintiffs succeeded at trial notwithstanding the Supreme Court of Canada's 1993 decision in Rodriguez v. British Columbia (Attorney General) that s. 241 did not infringe Charter rights. A majority of the Court of Appeal, however, allowed the Attorney General of Canada’s (“AGC”) appeal.

The questions to be addressed concern the Canadian  Charter of Rights (Right to life, Equality, Fundamental justice).  Specifically, 

  • Whether trial judge erred in distinguishing Rodriguez
  • Whether the Criminal Code provision prohibiting aiding person to commit suicide infringes the Charter
  • If so, whether such infringement is justifiable 

There are quite a number of interveners.  Their briefs/factums are due August 29. 
  • Attorney General of Ontario
  • Attorney General of Quebec
  • Attorney General of British Columbia
  • Council of Canadians with Disabilities and the Canadian Association for Community Living
  • Christian Legal Fellowship
  • Canadian HIV/AIDS Legal Network (the 'Legal Network'') and the HIV & AIDS Legal Clinic Ontario (''HALCO'')
  • Association for Reformed Political Action Canada
  • Physicians' Alliance Against Euthanasia
  • Evangelical Fellowship of Canada
  • Christian Medical and Dental Society of Canada
  • Canadian Federation of Catholic Physicians' Societies
  • Dying with Dignity
  • Canadian Medical Association
  • Catholic Health Alliance of Canada
  • Criminal Lawyers' Assocation (Ontario)
  • Farewell Foundation For The Right To Die
  • Association québécoise pour le droit de mourir dans la dignité
  • Canadian Civil Liberties Association
  • Catholic Civil Rights League
  • Faith and Freedom Alliance and Protection of Conscience Project
  • Alliance Of People With Disabilities Who Are Supportive of Legal Assisted Dying Society
  • Canadian Unitarian Council
  • Euthanasia Prevention Coalition and Euthanasia Prevention Coalition - British Columbia
  • Advocates' Society
  • David Asper Centre For Constitutional Rights

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Who Lives, Who Dies, Who Decides… Sat, 23 Aug 2014 12:33:54 +0000 Read More »]]> 0 Hello world! Sat, 23 Aug 2014 05:36:20 +0000 0 In Redesigned Room, Hospital Patients May Feel Better Already Fri, 22 Aug 2014 20:06:49 +0000 0 Sagan the Quipster Fri, 22 Aug 2014 16:58:12 +0000 Continue reading ]]> 0 Responding to Ebola: Selected Commentaries on Key Ethical Questions Fri, 22 Aug 2014 14:54:00 +0000 0 Breast Cancer, BRCA Mutations, and Attitudes about PGD Fri, 22 Aug 2014 03:01:38 +0000 Read More »]]> 0 Facebook and ‘Being Experimented Upon’ Thu, 21 Aug 2014 22:38:18 +0000 ]]> 0 Suicide and Terminal Diseases: A Personal Choice and Rational Approach Thu, 21 Aug 2014 19:41:28 +0000 by Craig Klugman, Ph.D.

My spouse and I have an ongoing conversation, really more of an argument, about one end-of-life scenario. I have stated on several occasions that being in my middle-40s, if I was struck by a serious disease (usually the disease in the scenario is cancer) with a less than 50 percent chance of survival (remission), and a course of treatment that is prolonged and painful, then I would choose not to receive treatment. Instead, I would do a lot of traveling (if able), visit with friends (if able), and then die comfortably.…

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Science Writing Prodigy Thu, 21 Aug 2014 16:46:43 +0000 Continue reading ]]> 0 Commission to Formally Take up Issue of Bioethics Education: Builds Growing Body of Educational Materials Thu, 21 Aug 2014 16:01:27 +0000 0 Roundtable Discussion: Identifying Priority Ethical Questions in Neuroscience Research and Applications Wed, 20 Aug 2014 21:22:25 +0000 0 Who Can Consent to Neuroscience Research? Wed, 20 Aug 2014 20:45:18 +0000 0 Identifying the Ethical Considerations in Neuroscience Research, Clinical Innovations and Applications Wed, 20 Aug 2014 20:22:51 +0000 0 Direct-to-Consumer Neurotechnology: Ethical Applications Today and Tomorrow Wed, 20 Aug 2014 17:45:59 +0000 0 Ethics, Law & Clinical Practice – Spectrum Health 2014 Ethics Conference Wed, 20 Aug 2014 16:02:00 +0000 If you will be in or near Grand Rapids, Michigan on Friday, September 5, 2014, come to Spectrum Health's 2014 ethics conference for clinicians: “Ethics, Law and Clinical Practice" at the Calvin College Prince Conference Center.

This is a one-day symposium addressing the ethical complexities in health care today. Conference sessions and networking opportunities are designed to increase awareness and provide strategies to clinicians from all disciplines to support ethical care in a variety of settings. 

Hubris to Humility: Medical Power in Medical Futility Conflicts
Thaddeus Pope, JD, PhD
Director, Health Law Institute Associate Professor of Law
Hamline University School of Law

When Parents and Providers Disagree: Understanding and Responding to Conflicts in the Care of Children
Douglas Diekema, MD, MPH
Director, Education Treuman Katz Center for
Pediatric Bioethics
Professor of Pediatrics and Bioethics
University of Washington School of Medicine

Current Concepts in Disclosure
Kelly Saran, MS, RN, CPHRM
Administrative Director, Office of Clinical Safety
University of Michigan Health System

Humor: Finding a Balance
Judge Sara Smolenski, JD
Chief Judge, State of Michigan 63rd District Court


  • Provide a forum to discuss challenges in clinical practice from an ethical perspective.
  • Explore how legal considerations influence clinical and ethical decision making at the bedside in a range of clinical settings.
  • Explore the interrelationship between ethics and law
  • Identify ethically- and legally-informed personal, professional and institutional strategies for addressing challenging situations in clinical practice.

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Price Transparency Thoughts from a Thought Leader (And Former Student) Wed, 20 Aug 2014 15:51:27 +0000 Continue reading ]]> 0 Considering the Ethical Implications of Cognitive Enhancement Wed, 20 Aug 2014 15:22:48 +0000 0 Deep Dive Today into Ethical Implications of Neuroscience Research and its Applications Wed, 20 Aug 2014 13:09:48 +0000 0 Live from Washington Wed, 20 Aug 2014 13:00:59 +0000 0 The Early Bird Get the Ethics? Wed, 20 Aug 2014 06:59:16 +0000 ]]> 0 How Good is Healthcare in Your Country? Tue, 19 Aug 2014 15:17:07 +0000 Continue reading ]]> 0 The FDA Proposes Roadblocks to Laboratory Diagnostics Tue, 19 Aug 2014 14:54:00 +0000 0 Minnesota v. Final Exit Network – Assisted Suicide Case Resumes Tue, 19 Aug 2014 09:00:00 +0000 0 Viagra Versus the Pill Tue, 19 Aug 2014 01:08:48 +0000 0 BIOETHICS SCREEN REFLECTIONS HOSTS TWITTER CHAT #Bioethx ABOUT BIOETHICS AND FILM TODAY 5:30 PM PDT Mon, 18 Aug 2014 23:41:00 +0000 0 Research on Pharmaceuticals: From Confidence to Commercialism Mon, 18 Aug 2014 16:52:00 +0000
--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.]]> 0