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EDITORIAL

What Is a Clinical Ethicist?
Jonathan D. Moreno

Let me address the “editorial” aspect of this editorial right away: I wholly agree with the principle that lies behind Mark Kuczewski’s admirable article. I take that principle to be that when clinical ethics issues affect undocumented patients, fostering efficient routine care in the setting of “new immigration-related stressors” is “to be resolved by finding creative means of instanc...

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How Conducting “Usual Care” Research Might Affect Obtaining Consent
Jerry Menikoff

How can we appropriately ensure that people who enroll in clinical research understand what they are getting into? The recent revisions to the primary set of U.S. regulations for protecting research subjects (the Common Rule) attempt to better achieve that goal by, in part, providing more useful information to prospective subjects. In this issue of AJOB, Stephanie Morain and her colleagues addres...

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Why Insurance Companies Should Pay for Medical Cannabis
David Casarett & Donald I. Abrams

Although medical cannabis has been legalized in 33 states and the District of Columbia, it has not yet gained federal acceptance. The Drug Enforcement Administration (DEA) still classifies it with a Schedule I designation, indicating that it has significant risks but no medical benefits. This discrepancy in legality between the state and federal levels has created numerous challenges for patients ...

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The DNA Test Results That Uncovered a Family Secret
Dani Shapiro

Two and a half years ago, after whimsically submitting my DNA to Ancestry.com for analysis, I made the discovery that the father who raised me—the long-dead father I adored—had not been my biological father. I could easily have never known this. I could have lived my entire life not knowing the truth of my paternity. As I stared at the results on my computer screen, as I saw a match with a fir...

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Target Article

Clinical Ethicists Awakened: Addressing Two Generations of Clinical Ethics Issues Involving Undocumented Patients
Mark Kuczewski

Because the United States has failed to provide a pathway to citizenship for its long-term undocumented population, clinical ethicists have more than 20 years of addressing issues that arise in caring for this population. I illustrate that these challenges fall into two sets of issues. First-generation issues involve finding ethical ways to treat and discharge patients who are uninsured and inelig...

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When Is It Ethical for Physician-Investigators to Seek Consent From Their Own Patients?
Stephanie R. Morain, Steven Joffe & Emily A. Largent

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the resear...

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