Bioethics.net

February 18, 2014

Freedom for the corporation, religious servitude for the individual

by Craig Klugman, Ph.D.

Many women in this country gained insurance coverage for their contraceptive costs under the controversial Affordable Care Act (ACA).…

January 1, 2014

The Year in Bioethics That Was

by Craig Klugman, Ph.D.

Happy New Year. The ending of one year and the beginning of another is often a time for reflection, for reviewing the year that has passed and for making plans/predictions for the year to come.…

December 19, 2013

A Call to Physicians: To Do No Further Harm, or Ethical Practice as Just Distribution of Healthcare

Bandy X. Lee, M.D.

*Primum non nocere*, to first do no harm, is the unchanging foundation for Hippocratic medical ethics. Each generation must, nevertheless, redefine what “doing no harm” means for its time.…

October 3, 2013

Health Care for All in the Year 2154

By Jessica Jerome, PhD

Imagine a world where the wealthy separate themselves off from everyone else, living in mansions with perfectly coiffed lawns, enjoying long and healthy lives of sedentary pleasure.…

October 1, 2013

Purchasing Health Insurance as a Civic Duty

by Kayhan Parsi, JD, PhD

Every fall, I co-teach a course on justice and health care.  In this course, my students and I discuss various theories of justice, examine different health systems, and reflect on what kind of society we live in.  When we come to the issue of health care reform in the United States, I try to impart a long, historical view.  I remind my students that attempts at providing universal health care access date back to the administration of Theodore Roosevelt over a century ago.  Similar attempts were thwarted under the administrations of FDR and Truman.  Not until LBJ did we finally achieve a watershed moment in US history—the creation of Medicare and Medicaid that has been a safety net for literally millions of seniors, people with disabilities, and indigent women and children.   As Bruce Vladeck and Eliot Fishman argue in one of the books I have my students read: “It is remarkable that Medicare got passed at all.  That only happened because of the unique landslide of 1964.”  Vladeck and Fishman claim that our Madisonian style of federal government gives inordinate power to local interests and state governments: “Divided governments, localism, weak national political parties—these are the structural elements of American government that have produced the most inequitable health care system in the Western world.”

The very structure of our democracy has now created this current crisis.  Despite the re-election of President Obama and the endorsement of the Affordable Care Act by the US Supreme Court, Republican representatives that represent parochial, local interests are able to bring the US government to a shutdown.  This kind of obstructionism is simply irresponsible.  As Atul Gawande commented in a recent New Yorker piece: “Conservative groups are campaigning to persuade young people, in particular, that going without insurance is ‘better for you’—advice that no responsible parent would ever give to a child.”  The narrative that has been promoted by conservative groups is that the Affordable Care Act is a government takeover of health care.  It’s not.  A better way to interpret the new health care law is to promote it as a civic duty of all Americans to purchase health insurance in order to mitigate against the potential financial and health risks of getting sick and not having insurance.…

September 27, 2013

The Sky Is Falling: Health Exchanges and Government Shutdown

by Craig Klugman, Ph.D.

In case you have not heard, the world is going to end on Tuesday. Like the Y2K bug and Harold Camping’s prophecy of the rapture in May 2011, the political media is predicting the end of modern civilization on October 1, when the Affordable Care Act Health Exchanges begin a 6-month period of signing up participants.…

August 28, 2013

Paying for Patient Empowerment

by Craig Klugman, Ph.D.

Way back in 2009 when the Affordable Care Act (ACA) was being debated across the country, one of the more controversial elements was a section (HE 3200, Section 1233) that would provide physician reimbursement for conversations about end-of-life advance care planning.…

August 23, 2013

Privacy for Sale

by Craig Klugman, Ph.D.

How much is your privacy worth? Would you be willing to give up your rights to medical privacy for $50?…

July 23, 2013

Pride in A Health Care System

Craig Klugman, Ph.D.

This past month I was fortunate to spend several weeks touring northern Europe with my family. These are the lands of the midnight sun, where smoked salmon is more popular than hamburgers, and where a summer temperature of 75 is unseasonably warm.…

June 10, 2013

A Tale of Two (or Three) States

Kayhan Parsi, JD, PhD

I recently learned that my home state of Texas has refused to participate in Medicaid expansion that is part and parcel of the Affordable Care Act.…