» Health Care Where the World Finds Bioethics Sat, 28 May 2016 10:00:34 +0000 en-US hourly 1 Court Permits Hospital to Evict Patient Sat, 28 May 2016 10:00:00 +0000 0 Support New York State’s Oncofertility Legislation Fri, 27 May 2016 12:33:56 +0000 As I have discussed in previous blogs, fertility preservation for cancer patients is very expensive and it is rarely covered by insurance. Cost is the primary barrier for why cancer patients do not preserve their fertility before undergoing lifesaving, yet potentially sterilizing, treatments. One cycle of IVF is on average $12,400 and estimates for ovarian tissue cryopreservation range from $5,000-$30,000. Furthermore, annual storage fees for frozen gametes and embryos can run up to hundreds of dollars a year. For many, especially while in the midst of a life-threatening health emergency, these costs are prohibitive, and future fertility is left to chance.

Legislation, however, is currently being considered in New York State that could change this situation. SB7219, authored by State Senator Diane Savino, would alter the current infertility mandate in New York to include coverage for standard fertility preservation services needed by those facing possible iatrogenic (medically-induced) infertility due to treatments such as chemotherapy, radiation, and surgery.

If you are a resident of New York and care about this issue, please contact your state representative to let them know how important this is for you! By bringing together voices of patients, professionals, and families we can help make this change.

How You Can Get Involved:

If you are a cancer patient, survivor or family member who has been touched by this issue, please submit your email here:

Coalition to Help Families Struggling with Infertility - Link for Individuals

If you are a healthcare provider serving patients in New York who would be positively impacted by this coverage, please submit your email here:

Coalition to Help Families Struggling with Infertility - Link for Family Building Professionals

If your institution or nonprofit organization is interested in joining the Coalition to Help Families Struggling with Infertility, email

Time is of the essence! All communications should be submitted by June 2nd if possible; the last day of the NY legislative session is June 16th.


  1. To read the entire Bill:
  2. To learn more about the Bill or the Coalition: Coalition to Help Families Struggling with Infertility Website


- See more at:

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.


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Three New Technologies for Self Deliverance Fri, 27 May 2016 10:00:00 +0000 0 A Bump on the Road to “3-Parent Babies” Fri, 27 May 2016 04:06:43 +0000 Read More »]]> 0 Career Paths in Public Health Law and Health Law (webinar) Thu, 26 May 2016 22:03:00 +0000 Join me on Wednesday. June 1 from 2:00 – 3:00 p.m. ET for a free webinar: "Career Paths in Public Health Law and Health Law."

This webinar will provide attendees with a better understanding of the evolving nature of the public health law field and will share targeted strategies and practical advice on how to find jobs in the field. Two experienced professionals will discuss the relationship between health law and public health law, offer examples of opportunities in both the traditional public health law realm and in evolving areas of work and provide tips on a number of career topics. 


  • Thaddeus Pope, J.D., Ph.D., Director, Health Law Institute and Professor of Law, Mitchell Hamline School of Law
  • Dan O'Brien, J.D., Consultant, Network for Public Health Law and Former Counsel, Maryland Department of Health and Mental Hygiene

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Not Your Father’s Medical Humanities Thu, 26 May 2016 16:14:31 +0000 ]]> 0 An Easy (But Politically Complicated) Way To Save Billions Of Dollars On Medical Care Thu, 26 May 2016 14:21:29 +0000 I sometimes worry that my wife Paula won’t be able to see me grow old. Not that I expect to outlive her. She is four years my junior and has the blood pressure of a 17-year-old track star. It’s her … Continue reading

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Obsessed with Smartness Thu, 26 May 2016 13:24:54 +0000 I came across an article published recently in The Chronicle of Higher Education with the rather surprising title: “Are Colleges Too Obsessed With Smartness?”

I have spent the last forty-eight years at one college or another as a student, fellow or faculty member and for nearly all of that time I have always thought of smartness as a good and admirable thing in those who taught me, those I taught, and my colleagues. I thought therefore, that it might be worth taking a look to find out exactly what he meant by “smartness” and what he thought was wrong with higher educators being interested in smartness. I will admit that I began reading with the idea that the contention might possibly be misguided. I also went into that consideration aware of the frequency with which overreaching statements made in The Chronicle of Higher Education by retired professors really mean that they are promoting a book. In this case the latter was true but I will not name the book as I do not wish to promote it.

Eric Hoover, Professor Emeritus at UCLA actually appears to define smartness pretty much the same way everybody else does “in the traditional sense, kids who get the highest grades and testy scores.” He objects that the “emphasis on these students” is “to the detriment of everybody else”. He does not really provide much of an argument, in this article, how this is to the detriment of everybody else. It may very well be true that these students have an advantage in gaining admission to some institutions and being awarded certain scholarships. Is this necessarily bad? I am not sure I believe this is a problem. There are many scholarships awarded on the basis of need. Is it wrong that some are awarded on merit?

When I served as a consultant to my local public school system I learned that the curriculum was aimed at the average students and that there were many programs in place to assist lower achieving students. The smartest students were often left underserved, bored and uninterested and as a result underachieving. I was happy to advocate and help design programs for these students.

There are many opportunities in place where a student’s innate qualities may be to their advantage. When I made my rather marginal attempts to succeed on my high school football team I accepted the fact that the largest, strongest, fastest players had an advantage. In defense of my teammates I will note that many of them were quite smart as well. I do not think there is anything wrong with obtaining advantage based on being smart, especially in an educational system in a society and economy which rewards merit and accomplishment. I could not have achieved much if I had to be strong and fast to succeed. I am glad there was an opportunity for me to achieve and succeed based on the things I was able to do. I am glad that others will also be able to succeed based on what they can do.

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.

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Bioethics Commission’s New Recommendations Bolster Ethics Education Thu, 26 May 2016 10:40:00 +0000 0 Doctors Falsely Certified Patients as Terminally Ill Thu, 26 May 2016 10:00:00 +0000 0 Specialty Drugs at Especially High Prices Wed, 25 May 2016 13:33:58 +0000 There have been many wonderful new medications in the past decade or so, drugs that finally bring hope for many people with serious illnesses like rheumatoid arthritis, multiple sclerosis and even some advanced cancers. But these drugs often come at … Continue reading

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Why do families have different expectations at the end of life than physicians? Wed, 25 May 2016 13:31:04 +0000 Read More »]]> 0 Beppino Englaro Wins Judgment for Unwanted Treatment Wed, 25 May 2016 10:00:00 +0000 0 Colorado Enacts Legislative Solution for Unrepresented Patients Wed, 25 May 2016 02:36:00 +0000 0 HEARING THE CALL: A Feature on How Physicians and Medical Educators Came to Understand their Vocation Tue, 24 May 2016 16:45:46 +0000 ]]> 0 Just 5% of Terminally-Ill Cancer Patients Fully Understand Prognosis, Study Finds Tue, 24 May 2016 12:36:54 +0000 0 Israel Stinson, Still Dead, Transferred from California to Cuba Tue, 24 May 2016 08:30:00 +0000 Like Jahi McMath in early 2014, Israel Stinson has been transferred from a California hospital, despite having been determined dead.

On May 23, the family withdrew as moot their emergency motion for an injunction from the U.S. Court of Appeals for the Ninth Circuit.  

That motion is moot, because on Saturday, May 21, 2016 at 5:30 a.m. "an air transport team consisting of a registered nurse and a respiratory therapist, as well as a ground transport team, prepared Israel for transport with the assistance of Kaiser’s medical team."

"At approximately 7:30 a.m., Israel was transported by ambulance to McClellan Airport in  Sacramento. From there, Israel and his parents were transported by air ambulance to a hospital where he has been admitted as a patient."

The family reports that he was transferred "out of the United States."  They further report that a neurologist and pediatric specialist at the new hospital have concluded that [Israel] is NOT brain dead." 

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Hastening Death by Voluntarily Stopping Eating and Drinking – 2 Day Conference Tue, 24 May 2016 03:58:00 +0000 I am looking forward to this conference on VSED.  

As recent op-eds suggest, this is an under-discussed means of hastening death.

                                University School of Law

Hastening Death by Voluntarily Stopping Eating and Drinking: Clinical, Legal, Ethical, Religious and Family Perspectives

Voluntarily stopping eating and drinking (VSED) is one way to assuredly hasten death. Though generally regarded as legal, VSED has not gained nearly as much public or scholarly attention as the physician-assisted dying that is legal in only five states. This interdisciplinary conference will address ethical, legal, clinical, religious, personal, family, and institutional issues posed by VSED, including contexts of hospice and dementia care.

October 14-15, 2016
11.75 General CLE credits pending; Social Work and Nursing credits application pending

Featured Speakers Include:

  • Margaret Battin, PhD, University of Utah

  • Norman Cantor, JD, Rutgers University School of Law

  • Annette E. Clark, JD, Dean, Seattle University School of Law

  • Amy Freeman, JD, WA State Long Term Care Ombudsman Program Attorney

  • Linda Ganzini, MD, MPH, Oregon Health Sciences University

  • Gerri Haynes, RN, BSN, palliative care leader, Seattle

  • Trudy James, MRE, Multi-Faith Chaplain, Seattle

  • Anson Laytner, rabbi and author, Seattle

  • Michael Jaycox, PhD, Theology & Religious Studies, Seattle University

  • Paul T. Menzel, PhD, Pacific Lutheran University

  • Thaddeus M. Pope, JD, PhD, Mitchell Hamline Law School

  • Timothy E. Quill, MD, University of Rochester School of Medicine

  • Diane Rehm, Diane Rehm Show (NPR, APR), author

  • Judith Schwarz, RN, PhD, Clinical Coordinator, EOLCNY

  • Phyllis Shacter, TEDx talk “Not Here By Choice”

  • Sarah Shannon, RN, PhD, Oregon Health Sciences University

  • Paula Span, NY Times reporter, NewOldAge blog

  • Joan M. Teno, MD, MS, Palliative Care, University of Washington

  • Stanley Terman, MD, PhD, Caring Advocates (Carlsbad, CA)

  • Robert Truog, MD, Center for Bioethics, Harvard University

Learn more about the program and pricing at:

Thank you to our sponsors:
Seattle University School of Law, Seattle Journal for Social Justice, University of Washington Philosophy Department, University of Washington Bioethics & Humanities Department, End of Life Choices New York, Harvard University Center for Bioethics, Mitchell-Hamline School of Law, and End of Life Washington

Seattle University School
                                          of Law : Educating Powerful
                                          Advocates for Justice

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The Politics of Fetal Pain Mon, 23 May 2016 18:50:45 +0000

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.

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Welcome 2016 HIV and Drug Abuse Prevention Research Ethics Training Institute Fellows! Mon, 23 May 2016 17:01:58 +0000 Continue reading ]]> 0 Brain Cancer Awareness Month Mon, 23 May 2016 10:00:59 +0000 Read More »]]> 0 Making End-of-Life Care More Scientific Mon, 23 May 2016 10:00:00 +0000 0 British Court of Protection Decides Another Medical Futility Case Sun, 22 May 2016 09:30:00 +0000 0 Ninth Circuit Cautious about Brain Death Stay Sat, 21 May 2016 13:30:00 +0000 0 4% to 5% of Patients Are Incapacitated and Unrepresented Sat, 21 May 2016 10:00:00 +0000 0 Roundup Ready® Humans Fri, 20 May 2016 20:26:27 +0000 Read More »]]> 0 New Case – Lawson v. VCU Medical Center Fri, 20 May 2016 12:28:00 +0000 0 Fonseca v. Kaiser – Briefing on Stay from Ninth Circuit Fri, 20 May 2016 10:00:00 +0000 0 Fabricating Man Fri, 20 May 2016 04:48:52 +0000 Read More »]]> 0 Peer Comparison Can Reduce Antibiotic Prescribing Thu, 19 May 2016 13:04:42 +0000 Very interesting article in the Lancet recently, from the nudge unit in the United Kingdom. They give physicians feedback on how much they prescribed antibiotics compared to their peers, and found that such feedback reduced antibiotic prescriptions. I hope to … Continue reading

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New Georgia Case – Parents Will Not Consent to DNR for Dinah Whited Thu, 19 May 2016 11:33:00 +0000 0 Democratic Deliberation in Bioethics for Every Generation Thu, 19 May 2016 10:00:06 +0000 0 Fonseca v. Kaiser – Brain Death Dispute Now at U.S. Court of Appeals Wed, 18 May 2016 14:50:00 +0000 0 Sexual Harassment in the Medical Profession Wed, 18 May 2016 14:09:41 +0000 Here is a report from a study I collaborated on, led by the amazing Reshma Jagsi, a physician at the University of Michigan. It reveals just how common it is for female academic physicians to report experiencing sexual harassment in … Continue reading

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What Does "Futility" Mean? An Empirical Study of Physician Perceptions Wed, 18 May 2016 09:30:00 +0000 0 Here’s Why Insulin Is So Expensive, And How To Reduce Its Price Tue, 17 May 2016 14:38:15 +0000 She drew the life-saving medication into the syringe, just 10cc of colorless fluid for the everyday low price of, gulp, several hundred dollars. Was that a new chemotherapy, specially designed for her tumor? Was it a “specialty drug,” to treat … Continue reading

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A Selfish Request for Honest Conversations Tue, 17 May 2016 14:15:00 +0000 Rev. Shanna Steitz 
On Monday of this last week, I had to fill out a medical advance directive for my husband, Ryan. He was in the hospital at North Kansas City, and they needed a document on file. We have documents at home, but the form was easiest because it was in front of us and immediate. I had to smile when I read the form and saw the small print at the bottom: “This document is provided as a service by the Center for Practical Bioethics.“ I smiled because I was headed to the Center’s annual dinner the very next night.  

If you aren’t familiar with the Center, it is a nonprofit, free-standing and independent organization nationally recognized for its work in practicalbioethics. For more than 30 years, the Center has helped patients and their families, healthcare professionals, policymakers, and corporate leaders grapple with difficult issues in healthcare and research involving patients. I am so proud that several members of our congregation are involved with this important organization:  Myra Christopher is the former President and CEO and still on the staff, Dr. Sandra Stites serves on the Board of Directors, and Rev. George Flanagan is a Center Fellow and formerly on the staff. I saw several other members and friends of our congregation in attendance.  

When I got home from the dinner, my 12-year old son Jacob was up waiting for me. He wanted to know about the evening. We discussed the Center and what our friends there did. It was an interesting we’ve had many times before, but it was especially unique given that his dad was spending a third night in the hospital. Ryan wasn’t dying, but Jake knows his parents’ wishes if we should. He has for years. I say this not to use our family as an example, but to remind you that it is my prayer that we will continue to be a congregation where we can be our most real selves. Where we can be truly authentic and have honest conversations. And where we can help one another to do and be that - Authentic. Real.

It is important that you have these honest conversations with your family members about what is important to you.  They can be hard talks, I know.  But it’s important for you and your family and it’s also important to me.  Because if you don’t have those exchanges now...I end up in the middle of those discussions with families later - during stress and crisis moments.  So, this is a selfish request (wink, smile).  It’s easier on me later if you do it now.  The Center has great resources to help begin those talks, and obviously we at Community have people who can help.

This is a first conversation for us around this... you and me.  I look forward to more of them.

May it be so. May it be so for us.

-- Rev. Shanna

P.S. My Ryan is fine. As I finish this on Friday, we are hopeful to go home tomorrow! 

Blog Editor’s Note

Rev. Shanna Steitz is the senior minister at Community Christian Church in Kansas City, Missouri. We welcome her contribution to our blog, which was originally published in the church’s May 8, 2016, newsletter under the title, “What I really want to say…”

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What’s Laremy Tunsil Got To Do With It? Professionalism, Social Media, and Medical Education Tue, 17 May 2016 13:47:38 +0000 ]]> 0 Should Your Doctor Ask If You Own Guns? Tue, 17 May 2016 12:29:39 +0000 0 Juniper French – 23 Weeks and 6 Days Tue, 17 May 2016 10:00:00 +0000 0 Taking a ride down the slippery slope Mon, 16 May 2016 15:09:18 +0000

Did you know: we can now make sperm from embryonic stem cells (in mice).  Not only can we create this sperm, but we can use it to successfully fertilize an egg and develop into a fully grown mouse.  And what is the role of bioethics in this scientific discovery, according to the article?  A brief mention of theoretical ethical issues relegated to the end of the news article that no one reads far enough to see, anyway.


Scientific advancements in reproduction have occurred at an unbelievable rate.  We not only have the ability to create sperm, but we can also create an embryo using three genetic donors, choose or reject embryos based on their genetic traits, such as sex, and correct genetic defects by essentially cutting and pasting healthy DNA sequences over defective ones.  Conversely, using such technology, we also have the potential to clone human beings, choose or reject embryos based on traits such as hair color or athletic ability, and irreversibly alter a germ cell line, potentially leading to unknown negative effects in later generations.


While breakthroughs in reproductive technologies have the potential to address issues as important and varied as male infertility, uterine factor infertility, mitochondrial disease, genetic defects and disease, and even artificial gestation, one wonders whether anyone is stopping to ask: to what end?  How will we use this technology?  What are the short- and long-term effects?  How might this technology be misused?  And, my personal favorite, when will we start to regulate how and when we tinker with biology at a genetic level?


Despite the promise of treatment or eradication of genetic diseases using this technology, there is still a persistent and very realistic fear that this technology will be misused.  Even worse, the misuse may become so common as to be considered acceptable, particularly in our profit-driven fertility industry.  Will the desire to prevent Huntington’s disease also lead to the desire to enhance intelligence?  Can we really resist the urge to create so-called designer babies, and should we accept that while some may win the genetic lottery, others will be able to afford to stack the deck?


Bioethicists are sometimes viewed as obstructionists on the path of progress, unnecessarily blocking scientists from discovering all that can be accomplished through science and medicine. (For an excellent rebuttal, read here).  But the very purpose of the vast and diverse field of bioethics is to identify and acknowledge the normative implications of scientific advances and engage in a dialogue that directly addresses the “should” in a world of “could.”  Hence, the age-old question that is often asked but rarely answered: just because we can do it, does it mean we should?


In the world of reproductive technologies and germline manipulation, perhaps the answer, sometimes, is no.



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.


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Bioethics Commission Recommends Deliberation and Education to Facilitate Civic Engagement with Pressing Bioethical Concerns Mon, 16 May 2016 14:29:31 +0000 0 Voluntarily Stopping Eating and Drinking: Exploring an End of Life Option for Suffering Patients Mon, 16 May 2016 09:30:00 +0000 0 US District Court Rejects Attack on Brain Death Sun, 15 May 2016 12:16:00 +0000 0 Honoring Choices Minnesota Conference Sun, 15 May 2016 10:00:00 +0000 0 New York Bill Would Punish Clinicians Who Disregard Patient Directives Sat, 14 May 2016 09:30:00 +0000 0 Reframing Conscientious Care: Q&A with Mara Buchbinder Fri, 13 May 2016 14:54:00 +0000 0 WHEN DO YOU GIVE UP ON TREATING A CHILD WITH CANCER? Fri, 13 May 2016 12:41:49 +0000 0 Does Florida Require Surrogate Consent for a DNAR Order? Fri, 13 May 2016 09:30:00 +0000 0 Doctors Push the PAS Envelope Fri, 13 May 2016 03:59:39 +0000 Read More »]]> 0