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November 18, 2015

Taking Science Seriously in the Debate on Death and Organ Transplantation

Michael Nair-Collins has just published "Taking Science Seriously in the Debate on Death and Organ Transplantation" in the Nov.-Dec. Hastings Center Report.

The effort to develop international guidelines for determination of death purports to start with an objective understanding of the biology of death. So far, however, it is showing once again how moral and metaphysical claims about death often masquerade as scientific facts.

The concept of death and its relationship to organ transplantation continue to be sources of debate and confusion among academics, clinicians, and the public. Recently, an international group of scholars and clinicians, in collaboration with the World Health Organization, met in the first phase of an effort to develop international guidelines for determination of death. The goal of this first phase was to focus on the biology of death and the dying process while bracketing legal, ethical, cultural, and religious perspectives. The next phase of the project will include a broader group of stakeholders in the development of clinical practice guidelines and will use expert consensus on biomedical criteria for death from the first phase as scientific input into normative deliberation about appropriate policies and practices.

Surely, science alone cannot resolve the normative and philosophical questions intertwined in debates about moral status, legal and moral rights, the ethics of killing, and personhood and the nature of the self; however, scientific input is necessary for informed moral deliberation. An objective and unbiased investigation of the biology of death is independent of, and should be undertaken prior to, an analysis of the normative questions engendered by debate about determination of death. This strategy is explicitly endorsed by the International Guidelines for Determination of Death and reflects the prevailing view of these issues in the mainstream medical literature. 

However, this mainstream literature, exemplified by the IGDD group’s recent report, does not exhibit any of the characteristics usually associated with a scientifically rigorous investigation, such as making empirically testable and falsifiable claims, a commitment to evidence and logic over authoritative assertion, or a willingness to revise hypotheses and theories in light of new evidence. 

Indeed, the core claims and methodologies of the mainstream medical literature on death, both of which are represented by the IGDD report, are not merely scientifically unjustified; they are not science at all. This situation creates a problem for the integrity of science and the academy, and it unjustly obscures and prevents legitimate democratic and moral deliberation about issues that, at bottom, are normative, not scientific.

November 17, 2015

Member Discussion of the Intersection of Deliberation and Education

This is the last session of the Bioethics Commission’s twenty-third meeting. During this session, Members discussed what to recommend at the intersection of deliberation and education. In previous meetings, the Bioethics Commission has heard from experts in education that using deliberation as an educational tool builds the skills that will help students become informed and […]
November 17, 2015

Member Discussion of Education

Welcome back to our live coverage of the Bioethics Commission’s twenty-third meeting. During this session, Members discussed recommendations for bioethics education in their next report. Like deliberation, bioethics education is a topic that the Bioethics Commission has discussed at length in its public meetings. They have also developed over 50 educational tools related to the […]
November 17, 2015

Member Discussion of Deliberation

Today, the Bioethics Commission is developing recommendations for its work on deliberation and education. After years of modeling the use of democratic deliberation to arrive at solutions to complex and controversial bioethics and health, science, and technology policy questions, the Bioethics Commission is well-situated to make recommendations in this area. Members discussed three potential recommendations […]
November 17, 2015

Implementing Innovations in Ethics Education

The Bioethics Commission began its discussion on ethics education this morning by focusing on how ethics education might be implemented in different educational settings, particularly in schools. The Bioethics Commission heard from David Steiner, Ph.D., the Executive Director of the Johns Hopkins Institute for Education Policy and Professor of Education at Johns Hopkins University, and […]
November 17, 2015

Call for Abstracts “Contemporary Issues in End-of-Life Care”

University of Ottawa - Desmarais Building
Call for Abstracts for the session “Contemporary Issues in End-of-Life Care” at the Canadian Society for the Sociology of Health Fifth Biennial Conference

Conference date: May 5 – 6, 2016.

Conference location: Ottawa, Ontario, Canada.

Abstract submission deadline: December 4, 2015.

Session Description:  Contemporary end-of-life care is continually evolving since the emergence of palliative care in the 1960s. Various new actors, institutions, and discourses are entering the scene and remaking the field in unexpected ways. At the same time, scholars are paying increased attention to myriad ways in which end-of-life care is enacted, both within and outside of settings more typically associated with health care. Policy makers too are increasingly motivated to pay greater attention to end-of-life care due to the aging of the population and increased public interest. 

For this session, we solicit papers that speak to the various contemporary experiences, changes, conflicts, and successes in the practice of end-of-life care in Canada and elsewhere, in clinical/hospital or other settings. While we welcome theoretical papers, we are primarily interested in papers that build upon empirical data that can make a unique contribution to the social study of end-of-life care. 

The goal of the session is to have a productive interdisciplinary discussion on end-of-life care; as such, we welcome contributions not only from sociology but also from other social and health sciences disciplines such as nursing, education, bioethics, anthropology, geography, and others. Abstract  should include objectives, background, methods, findings and conclusions.

November 17, 2015

Bioethics Committee Meeting 23: Live from Arlington, Virginia

Welcome to Arlington, Virginia for the twenty-third public meeting of the Presidential Commission for the Study of Bioethical Issues (Bioethics Commission). The Bioethics Commission is meeting today, November 17, 2015, from 9 a.m. to 4 p.m. EST. At today’s meeting, the Bioethics Commission will continue to discuss the complementary roles of deliberation and education in […]
November 17, 2015

The United States of Short Hospital Stays

We spend more for medical care in the United States than just about anywhere in the world, but it’s not because people in this country get admitted to the hospital and stay for long periods of time. Instead, we have … Continue reading

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November 16, 2015

Nevada Supreme Court Questions Brain Death Standards

On Monday, November 16, 2015, the Supreme Court of Nevada seriously questioned what are the "accepted medical standards" for determining brain death. THE DISPUTE On May 28, 2015, clinicians at St. Mary's Regional Medical Center determined that 20-year...
November 16, 2015

Medicare Coverage for Advance Care Planning

The Final Rule implementing new Medicare payment codes for advance care planning was published in today's Federal Register. I already blogged about the new rule when CMS first released it.  "Medicare Program; Revisions to Payment Policies Under t...