» Health Disparities Where the World Finds Bioethics Fri, 24 Jun 2016 14:48:31 +0000 en-US hourly 1 Best intentions, worst outcomes: Ethical and legal challenges for international research involving sex workers Fri, 17 Jun 2016 16:00:52 +0000 Continue reading ]]> 0 Should we medicate healthy children to fight social inequality? Wed, 01 Jun 2016 18:53:23 +0000 by Sebastian Sattler, PhD

A proposed solution seeks a quick fix, without tackling the deep roots of the problem.

It’s a statistic that seems almost unbelievable: the richest one percent now has more wealth than the rest of the world combined, according to an Oxfam report. Inequality exists between nations such as Great Britain and Sudan, within different social strata in countries such as the United States, and on lower levels of societal entities, like within the city of Chicago.…

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Cancer deaths rose during the recession. But why? Fri, 27 May 2016 09:54:01 +0000 0 The Potential for Infrastructure Benefits and the Responsiveness Requirement Wed, 25 May 2016 19:43:10 +0000 by David Wendler, PhD

The distribution of resources around the globe is characterized by staggering inequalities and inequities, with the result that individuals in lower income countries have greater disease burden and shorter lives than individuals in high-income countries. Commentators on research ethics are well aware of this concern and have searched for ways to design and conduct clinical trials to help to address it. Much of this work focuses on how to protect individuals and communities in lower income countries from exploitation.…

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Clinical Trials Infrastructure as a Quality Improvement Intervention in Low- and Middle-Income Countries Tue, 24 May 2016 20:25:28 +0000 0 The Potential for Infrastructure Benefits and the Responsiveness Requirement Tue, 24 May 2016 20:23:22 +0000 0 Inefficient pain management for black patients shows that there is a fine line between ‘inhumane’ and ‘superhuman’ Wed, 04 May 2016 17:17:36 +0000 by Keisha Ray, Ph.D.

It’s well known that in America there are great disparities in health, access to health care, and health care outcomes between black people and white people, with black people, on average, faring much worse than white people. For example, if you are black in America you are more likely to die from breast cancer, heart disease, strokes, and giving birth than if you are white in America. According to the National Institute of Medicine, health disparities between races exist even when factors such as stage of disease presentation and the severity of disease are the same.…

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Feds Act To Help More Ex-Inmates Get Medicaid Mon, 02 May 2016 13:27:22 +0000 0 The Paradigm of the Paradox: Women, Pregnant Women, and the Unequal Burdens of the Zika Virus Pandemic Wed, 27 Apr 2016 22:18:04 +0000 by Lisa H. Harris, Neil S. Silverman, and Mary Faith Marshall

The inequalities of outcome are, by and large, biological reflections of social fault lines (Paul Farmer)

Three paradoxes characterize the Zika virus pandemic and clinical and policy responses to it:

  1. Zika virus has been shown to cause severe developmental anomalies in the fetuses of infected women. As a result, both women and men in endemic areas are asked to avoid or delay pregnancy. However, access to effective contraception and safe pregnancy termination is either not available (especially for those living below the poverty line) or a crime for many women in Zika-endemic regions.
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Social determinants: Why are they so difficult to address? Tue, 12 Apr 2016 14:42:32 +0000 ]]> 0 The disturbing reason some African American patients may be undertreated for pain Tue, 05 Apr 2016 14:11:38 +0000 0 What can celebrities do for bioethics? Wed, 30 Mar 2016 20:01:09 +0000 by Keisha Ray, Ph.D.

Television, film, theater, sports, and music celebrities (and other famous people who only seem to be famous for being famous) capture the public’s attention with tales of the celebrity lives and the perks and downfalls that come with being a public figure. Occasionally, their narratives include topics that are frequently discussed in bioethics. Although it’s great to have the public engaged in topics that we discuss behind closed doors in our offices, classrooms, and laboratories, many times, much to bioethicists and medical practitioners’ irritation, because of their celebrity status they have a large platform to damage the work the medical profession and bioethicists have done to establish a relationship with the public.…

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No Paid Sick Leave Means Workers Skip Medical Care Tue, 08 Mar 2016 17:51:25 +0000 0 Code Black Ends the Season on Bioethics Tue, 01 Mar 2016 19:27:47 +0000 BioethicsTV is an occasional feature where we examine bioethical issues raised in televised medical dramas.

by Craig Klugman, Ph.D.

The season finale of Code Black (season 1; episode 18 – February 24, 2016) presented a plethora of ethical challenges for the hard working doctors and nurses of Angels Memorial Hospital’s emergency department. The conceit for this show is that this is the busiest emergency room in the country, entering “code black” on over 300 days a year. The show defines a code black as overwhelmed, understaffed, overcrowded.…

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Imposter Syndrome Tue, 05 Jan 2016 15:54:54 +0000 by Keisha Ray, Ph.D.

As a junior scholar, Imposter Syndrome is as a part of my daily life as some people’s morning coffee is a part of their morning routine. Despite considering myself to be a very confident person, Imposter Syndrome is an omnipresent force in my life. Imposter Syndrome is the belief that you are not qualified for a task, job, or promotion despite evidence to the contrary usually in the form of experience, education, degrees, etc. It’s a feeling of phoniness, a feeling that you do not deserve the accolades you have received coupled with the fear that everyone knows you’re a fake.…

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The Increasing Divide: How Do We Improve Health In a Stratifying Society? Fri, 11 Dec 2015 06:25:09 +0000 by Craig Klugman, Ph.D.

While editing a book chapter dealing with public health, I came across the author talking about inequalities in health. Then this followed my morning read of the paper that spoke about the declining middle class. Whereas making it into the middle class is a long-time American dream, the reality is different.

In 1971, the middle class comprised 61% of society. Today, only 49.9% of Americans qualify as being middle class. The rest are either in the upper or lower classes.…

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Exclusive – Transatlantic divide: how U.S. pays three times more for drugs Mon, 12 Oct 2015 19:52:33 +0000 0 State of the Armed Union Tue, 06 Oct 2015 17:57:52 +0000 by Craig Klugman, Ph.D

In the first 274 days of 2015, there were 294 mass shootings (yes, that is more than 1 per day). As a nation, there were over 39,000 gun incidents leading to 10,104 deaths and 20,544 injuries so far in 2015.

For points of comparison

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Black patients fare better than whites when both get same healthcare, study finds Thu, 24 Sep 2015 17:02:49 +0000 0 Poverty may increase odds of repeat hospitalizations Wed, 16 Sep 2015 20:01:04 +0000 0 U.S. government to extend healthcare nondiscrimination law to transgender people Thu, 03 Sep 2015 19:42:21 +0000 0 Effect of poverty on brains may explain poor kids’ lower test scores Mon, 20 Jul 2015 21:02:23 +0000 0 Reflections on Father’s Day from a “Single” Mother Mon, 22 Jun 2015 05:02:29 +0000 by Nanette Elster, JD, MPH

Today on Father’s Day, as I miss my own father who has been gone for 17 years now, I am reflecting on my decision to intentionally become a single mother. I think about all of the ways my father shaped the woman I am today and how he is the one who gave me the courage to become a mother with or without a husband or partner. He is the one who gave me career advice, dating advice, took me to get my first prom dress (and even my first bra).…

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MERS: Another Lesson in Quarantine and Health Disparity Tue, 09 Jun 2015 02:34:52 +0000 by Craig Klugman, Ph.D.

At the G7 meeting this week, the developed nations which compose the Group of 7 pledged to “wipe out Ebola.” With over 11,000 Ebola-related deaths worldwide since March 2014, this certainly is worth public health efforts and funding.

While the “world leaders” focus on Ebola, which of course made small incursions in to the U.S. and Europe, a new epidemic lurks on the horizon—MERS. Middle East Respiratory Syndrome was first reported in September 2012 in Saudi Arabia.…

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A Case for Viewing The Baltimore Protests as a Bioethics Issue Mon, 04 May 2015 22:17:56 +0000 by Keisha Ray, Ph.D.

Freddie Gray’s Death
On April 12, 2015, Freddie Gray, a twenty-five year old black man was arrested and placed in a police van in Baltimore, Maryland for carrying a switchblade (Baltimore State Attorney, Marilyn Mosby later announced that Gray was legally carrying a knife). Perhaps one of the more troubling aspects of Gray’s fateful police van ride was that officers reportedly observed Gray’s unresponsive body on the floor of the police van but still did not take him to see a medic.…

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A Pill for Compassion or Misunderstood Science? Wed, 25 Mar 2015 06:36:37 +0000 by Craig Klugman, Ph.D.

For at least a decade, studies have shown that empathy and compassion decline in medical students. The response is often more curricula dedicated to ethics, humanities, communication skills, and patient contact. But what if the answer was simply medicating the students.

An article in Time magazine reported that a study from researchers at the University of California Berkeley and University of California San Francisco have found “that by manipulating a brain chemical, people can become more compassionate and act in prosocial ways to equalize differences.”

Compassion is “a sympathetic consciousness of other’s distress with a desire to alleviate it.” According to the article, the study of 35 subjects found that when taking a drug a person’s desire to alleviate inequity increased.…

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Online offers of personalized cancer medicine may not be trustworthy Wed, 11 Mar 2015 22:29:08 +0000 0 The Social Determinants of Health: Why Should We Care? Sun, 01 Mar 2015 19:40:41 +0000 0 World’s diet worsening with globalization, major study finds: TRFN Tue, 24 Feb 2015 23:29:07 +0000 0 A Plan to Cut Costs and Crime: End Hurdle to Job After Prison Mon, 10 Nov 2014 19:35:02 +0000 0 U.N. Group Urges China’s Wealthy to Fight Ebola Mon, 20 Oct 2014 18:11:48 +0000 0 U.S. agency moves to end sex bias in biomedical research Tue, 23 Sep 2014 17:54:11 +0000 0 How do we talk about enhancement after Ferguson and the death of Michael Brown? Tue, 16 Sep 2014 22:49:23 +0000 by Keisha Ray, Ph.D.

No other area of philosophy has captured my interests like bioethics. Thinking about the ways that we can use health care to justly distribute opportunities and what those opportunities are is my greatest interest. My specific interest in biomedical enhancement stems from my interests in the relationship between health care and opportunities. As health is essential to living the kind of lives that we want to live, I’m always thinking about how traditional practices and advances in health care can help us lead better lives, even when there is nothing medically abnormal about or minds or bodies.…

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The raging Ebola epidemic in West Africa—will the key lessons be learned? Mon, 18 Aug 2014 04:30:14 +0000 by Arthur Caplan, Ph.D.

Ebola, according to the World Health Organization (WHO) is out of control in West Africa.  The disease, which is transmitted by contact with contaminated blood or body fluids, or by close contact with a dead body infected with the virus, has killed more than 1100 people in Guinea, Sierra Leone, Liberia, and Nigeria.  The number of dead is most likely higher since people were dying in rural villages without being counted. At least another 1000 persons are infected. …

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U.S. Democrats aim to turn contraception into campaign drive Tue, 08 Jul 2014 21:15:24 +0000 0 The Principle of Equivalence Reconsidered: Assessing the Relevance of the Principle of Equivalence in Prison Medicine Tue, 01 Jul 2014 19:36:48 +0000 0 Observations on the Nature and Extent of Injustice in the American Prison System Tue, 01 Jul 2014 19:31:34 +0000 0 Tragedy in Research History: The Children of Ireland Tue, 10 Jun 2014 19:14:40 +0000 by Craig Klugman, Ph.D.

For many people, the film Philomena was an introduction to a history of Irish babies being taken from their unwed mothers and adopted to “good” Catholic families in other countries. I put “good” in quotes because often what qualified a couple was the ability to pay. In the last week, news has come out of Ireland of a mass grave holding the remains of 796 infants buried in a septic tank on the grounds of a former “mother and baby” home in Galway.…

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Insured young cancer patients fare better, live longer: study Tue, 03 Jun 2014 00:04:20 +0000 0 Why vampires stay young Fri, 09 May 2014 04:42:19 +0000 by Craig Klugman, Ph.D.

In the world of fantasy, the vampire is known for its immortality. In most incarnations, the vampire lives forever in a youthful state by feeding on the blood of humans. Now it turns out that science may have proven that the blood of the young keeps you young.

At least, if you’re a mouse. Three papers published in the last week (two in Science and one in Nature Medicine) showed that giving blood from young mice to older mice reduced many of the signs of aging.…

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Ethical Conditions for Transnational Gestational Surrogacy in Asia Thu, 01 May 2014 18:06:40 +0000 0 Panel Says No to Medicare Coverage for Lung Cancer Screening Thu, 01 May 2014 17:03:42 +0000 0 The Richer You Are the Older You’ll Get Mon, 21 Apr 2014 16:47:19 +0000 0 Hawaii police urge lawmakers to let undercover cops have sex with prostitutes Fri, 21 Mar 2014 18:46:20 +0000 0 Elizabeth Warren vows fight for gender equality in medical studies Tue, 11 Mar 2014 18:10:22 +0000 0 Women Still Left Out of Medical Research: Report Mon, 03 Mar 2014 21:08:33 +0000 0 Intersextion: Germany Allows Parents to Choose “No Sex” on Birth Certificate Wed, 26 Feb 2014 23:48:23 +0000 by Craig Klugman, Ph.D.

In Jeffrey Eugenides Pulitzer-Prize winning novel Middlesex, readers are introduced to a protagonist, Cal Stephanides, who is male with female traits. This best seller helped to bring into the mainstream consciousness the notion of people who are born intersex—having characteristics of male and female sex organs. Or more generally, a person born with sex organs that fall outside what is considered the male or female norm. For example, a girl with a very large clitoris, or a boy with a very small penis or scrotum that looks more like labia.…

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Autism-friendly travel now officially aboard Royal Caribbean cruises Tue, 25 Feb 2014 20:14:18 +0000 0 Insured patients are often not transferred for better care, study finds Thu, 20 Feb 2014 22:45:32 +0000 0 Ethical Review of Health Systems Research in Low- and Middle-Income Countries: A Conceptual Exploration Thu, 20 Feb 2014 21:43:08 +0000 0