Tag: Bioethics and the Law

Blog Posts (5)

May 23, 2016

The Politics of Fetal Pain

Earlier this year, Utah passed a fetal pain bill that requires the use of general anesthesia on women seeking abortions at 20 weeks gestation or later.  This bill, which relies on a controversial claim that fetuses may feel pain as early as 20 weeks, has been heavily criticized as an attempt to abrogate abortion rights rather than serving a legitimate protective purpose. 

The issue of fetal pain has long been a source of contention in the scientific community, and the dispute has led to several states restricting or prohibiting abortions 20 weeks or later on the basis of potential fetal pain.  While many argue that this law is just one of many across the country aimed not at protecting health, but at restricting or eliminating abortion rights, this law, in fact, seems to be justified in its goal of minimizing the possible experience of suffering by the fetus. 

While studies have not proven that a fetus can feel pain prior to the third trimester, reasonable doubt about the possibility of fetal experience of pain exists.  As E. Christian Brugger argues in his article entitled “The Problem of Fetal Pain and Abortion: Toward an Ethical Consensus for Appropriate Behavior,” there is no moral certitude that fetuses do not feel pain after 20 weeks, and “a preponderance of evidence supports the conclusion that fetal-pain experience beginning in the second trimester of pregnancy is a real possibility.”  Brugger makes the argument, drawing from several researchers of fetal neuroanatomy that all the neural structures for both pain perception and consciousness are in place by 18-20 weeks.  Furthermore, he argues that those who deny fetal consciousness until much later in pregnancy may be relying on outdated assumptions which place the seat of consciousness in the cerebral cortex, despite growing evidence that the upper brainstem and subcortical tissues may actually play a greater role.

If it is reasonable to believe that the fetal experience of pain is possible after 20 weeks, it seems equally reasonable to consider requiring anesthetic or analgesia for such fetuses to prevent unnecessary suffering.  Despite statements from ACOG and others supporting the assertion that fetal pain is not likely before the third trimester, even the possibility that the fetus may experience significant pain and distress supports the notion that, in the face of uncertainty, we should err on the side of preventing such pain.

Opponents of such requirements argue that anesthesia can pose significant and disproportionate risks to the woman with no corresponding benefit, and that the use of anesthesia will increase the cost of abortion significantly, potentially limiting access to the procedure for many women for financial reasons.  While mandating anesthesia or analgesia is not without risks, these risks are not disproportionate if the benefit is eliminating possible pain experienced by the fetus. 

Whether or not the primary purpose of this law is to curtail abortion rights, its effect is, in fact humane; that is, it is an attempt, in light of scientific and moral uncertainty, to prevent unnecessary fetal pain if, in fact, the fetus can and does experience it.  This compassionate approach seems eminently reasonable, and should be supported.

 

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 website.

April 16, 2015

Gonzales vs. Oregon

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">We are always pleased to support the activities of young scholars who are interested in bioethics. <a href="http://www.tiki-toki.com/timeline/entry/440733/Gonzales-v.-Oregon/">This link</a> is a timeline of the Supreme Court case Gonzales vs. Oregon. It was prepared by Ms. Maggie Kirby who attends high school at U-32 in Vermont. It does a terrific job of documenting this important bioethics case and binging awareness to the ongoing debate about physician-assisted suicide. Great work Maggie! </p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><strong style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;">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="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"> </span></p>
April 6, 2015

American Pharmacists Association Votes to Discourage Pharmacists from Participating in Executions

<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 22.3999996185303px;"><span style="line-height: 22.3999996185303px; font-size: 11.1999998092651px;">On March 30, 2015, the American Pharmacists Association (APhA) House of Delegates – the group’s representative assembly – <a href="http://www.pharmacist.com/apha-house-delegates-adopts-policy-discouraging-pharmacist-participation-execution">adopted a policy</a> discouraging pharmacists from participating in executions. </span><span style="line-height: 22.3999996185303px; font-size: 11.1999998092651px;">The APhA policy is only one sentence long: “</span><span style="line-height: 22.3999996185303px; font-size: 11.1999998092651px;">The American Pharmacists Association discourages pharmacist participation in executions on the basis that such activities are fundamentally contrary to the role of pharmacists as providers of health care.”</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 22.3999996185303px;"><span style="font-size: 11.1999998092651px; line-height: 22.3999996185303px;">In defending the new policy, APhA Executive Vice President and CEO, Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, stated, “Pharmacists are health care providers and pharmacist participation in executions conflicts with the profession’s role on the patient health care team. This new policy aligns the APhA with the execution policies of other major health care associations including the American Medical Association, the American Nurses Association, and the American Board of Anesthesiology.”</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="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
July 14, 2014

New York’s Medical Marijuana Law May Just Be a Political Hoax?

<p class="MsoNormal" style="line-height: 22.399999618530273px;">On the very last day of the 2014 legislative session, the New York Senate passed “The Compassionate Care Act” (S.1682-A, Savino) approving the <a href="http://www.usatoday.com/story/news/nation/2014/06/20/ny-set-to-legalize-medical-marijuana-/11033195/">legalization of medical marijuana</a>.  The Assembly had previously passed a companion bill (A.6357-A, Gottfried). The Senate bill has been sent to Governor Cuomo for his signature. The governor endorsed the bill in the legislature, but as of July 4, 2014, has yet to sign it.</p> <p class="MsoNormal" style="line-height: 22.399999618530273px;">New York medical marijuana proponents have been <a href="http://www.compassionatecareny.org">advocating</a> for the <a href="http://www.drugpolicy.org/new-york">availability of cannabis</a> for several years. Neighboring states Connecticut, New Jersey, and Vermont, and 18 other states and the District of Columbia currently allow medical marijuana. However, last minute compromise changes to the New York law will severely restrict access to medical cannabis. In fact, the limitations are so rigid that some might say the bill is a hallow shell, a sham, one designed to appear to allow medical marijuana yet really not. Regardless of how one feels about medical cannabis, to hype the public into believing that marijuana will be available for medical purposes and then establishing barriers to its accessibility that is a fraud. It would be unconscionable to raise the hopes of distressed patients, many suffering with chronic and painful conditions, only to see those hopes dashed.</p> <p class="MsoNormal" style="line-height: 22.399999618530273px;"><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></p>
June 6, 2014

To Properly Care for Veterans, Do We Really Need a VA Health System?

<p><span style="line-height: 22.399999618530273px;">The ongoing VA scandal is indeed unfortunate and sad. In a speech on May 30, 2014, in Washington, DC, <a href="http://www.nytimes.com/2014/05/31/us/politics/va-chief-eric-shinseki.html">Eric K. Shinseki apologized</a> for the “systemic, totally unacceptable lack of integrity” shown by some administrators in managing the Veterans Administration health care system hospitals and clinics. Within hours of the apology, Secretary Shinseki <a href="http://www.nytimes.com/2014/05/31/us/politics/eric-shinseki-resigns-as-veterans-affairs-head.html">resigned</a>.</span></p> <p class="MsoNormal" style="line-height: 22.399999618530273px;">It is clear that the trouble within the VA has been brewing for some time. The fuse that set off this latest explosion may have been <a href="http://www.azcentral.com/longform/news/arizona/investigations/2014/05/31/va-scandal-whistleblower-sam-foote/9830057/">whistleblower claims</a> that managers at the Phoenix VA Medical Center were keeping two sets of books which logged wait times for veterans seeking primary care appointments. There are allegations that some of the delays resulted in veteran deaths. Acting VA Inspector General Richard J. Griffin issued a <a href="http://www.nytimes.com/2014/05/29/us/va-report-confirms-improper-waiting-lists-at-phoenix-center.html">preliminary report</a> confirming that Phoenix VA administrators had manipulated wait times possibly to assure more favorable annual performance reviews and higher bonuses and compensation for staff.  The unethical behavior by those entrusted with the care of our veterans is inexcusable.</p> <p class="MsoNormal" style="line-height: 22.399999618530273px;"><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></p>