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Reason, Emotion, and Implanted Devices
John D. Lantos

Pullman and Hodgkinson (2016) present a case that, it seems, should have been an easy one. A competent adult makes a simple request to discontinue a medical therapy. Further, it was a therapy that he’d already tried so personal experience informed his preference to discontinue therapy. His request was repeated over time. He was determined to have adequate decisional capacity. So why did both the...

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Target Article

The Curious Case of the De-ICD: Negotiating the Dynamics of Autonomy and Paternalism in Complex Clinical Relationships
Daryl Pullman & Kathleen Hodgkinson

This article discusses the response of our ethics consultation service to an exceptional request by a patient to have his implantable cardioverter defibrillator (ICD) removed. Despite assurances that the device had saved his life on at least two occasions, and cautions that without it he would almost certainly suffer a potentially lethal cardiac event within 2 years, the patient would not be sway...

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IRB and Research Regulatory Delays Within the Military Health System: Do They Really Matter? And If So, Why and for Whom?
Michael C. Freed, Laura A. Novak, William D. S. Killgore, Sheila A. M. Rauch, Tracey P. Koehlmoos, J. P. Ginsberg, Janice L. Krupnick, Albert "Skip" Rizzo, Anne Andrews & Charles C. Engel

Institutional review board (IRB) delays may hinder the successful completion of federally funded research in the U.S. military. When this happens, time-sensitive, mission-relevant questions go unanswered. Research participants face unnecessary burdens and risks if delays squeeze recruitment timelines, resulting in inadequate sample sizes for definitive analyses. More broadly, military members are ...

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