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Hastings Center Report

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https://read.qxmd.com/read/30586187/poverty-not-a-justification-for-banning-physician-assisted-death
#1
Lindsey M Freeman, Susannah L Rose, Stuart J Youngner
Many critics of the legalization of physician-assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much more likely to influence a decision to pursue or reject aggressive life-extending care than it is to influence a request for PAD...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586186/of-monsters-and-men
#2
Gregory E Kaebnick
The November-December 2018 issue of the Hastings Center Report celebrates two anniversaries. In a supplement to the issue, the fifty-year-old debate about what "dead" means-a debate launched in 1968 by the publication of the Harvard report on brain death-is dissected and reinvigorated in a set of essays assembled by Robert Truog, of Harvard Medical School's Center for Bioethics, and The Hastings Center's Nancy Berlinger, Rachel Zacharias, and Mildred Solomon. Inside the regular issue, a set of essays celebrates the two-hundredth anniversary of the publication of Frankenstein; or, The Modern Prometheus, the novel about death, dissection, and reinvigoration and a touchstone for much commentary about emerging biotechnologies...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586185/rereading-frankenstein-what-if-victor-frankenstein-had-actually-been-evil
#3
Jason Scott Robert
As we reread Mary Shelley's Frankenstein at two hundred years, it is evident that Victor Frankenstein is both a mad scientist (fevered, obsessive) and a bad scientist (secretive, hubristic, irresponsible). He's also not a very nice person. He's a narcissist, a liar, and a bad "parent." But he is not genuinely evil. And yet when we reimagine him as evil-as an evil scientist and as an evil person-we can learn some important lessons about science and technology, our contemporary society, and ourselves...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586184/medical-aid-in-dying-bioethics-as-sideshow
#4
Courtney S Campbell
Twenty years ago, the passage of the Oregon Death with Dignity Act prompted vigorous debate in my bioethics classrooms; now, the issue barely generates a ripple. Instead, we focus on an issue my students' generation will confront, as illustrated by an amendment to the ODDA introduced in the last Oregon legislative session that would have effectively rescinded two core procedural safeguards: patient decision-making capacity when requesting life-ending medication and self-administration of the medication. Patient requests for medication could be stipulated on an advance directive that appoints an "expressly identified agent" authorized, in the event of loss of decision-making capacity, "to collect and to administer to the patient the prescribed medication...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586183/2018-manuscript-reviewers
#5
(no author information available yet)
No abstract text is available yet for this article.
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586182/research-information-for-reasonable-people
#6
Rebecca Dresser
In 2017, federal officials issued a revised version of the Common Rule, the federal regulations that govern much of the human subject research conducted in the United States. Two provisions on information disclosure have reportedly provoked confusion among researchers and people responsible for research oversight. These provisions incorporate the familiar and foundational legal concept known as the reasonable person standard, applying this to research disclosure. Although other, long-standing Common Rule provisions require reasonableness judgments, the new provisions differ in that they require reasonableness to be judged from the ordinary person's perspective instead of the perspective of scientists, clinicians, and other experts generally involved in designing and reviewing human studies...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586181/the-social-value-requirement-in-research-from-the-transactional-to-the-basic-structure-model-of-stakeholder-obligations
#7
Danielle M Wenner
The history of research ethics includes ethical norms that do not neatly fit into a rubric of "human subjects protections" but that are nevertheless seen as fundamental ethical dictates. Among these norms is the so-called social value requirement for clinical research. Recently, however, the ethical foundation for the social value requirement has come under criticism. I seek to clarify the terms of this foundational debate. I contend that much of this discussion-both critiques of the social value requirement as well as recent defenses-is predicated on a framework of research ethics that I refer to as the "transactional model of stakeholder obligations...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586180/on-cute-monkeys-and-repulsive-monsters
#8
Tod S Chambers
When I heard that a laboratory in China had cloned two long-tailed macaques, I thought of Mary Shelley's novel Frankenstein. When academics write about the novel, many point out that the reason the creature becomes a "monster" is not that he has any inherently evil qualities but that Victor Frankenstein, the creature's "mother," immediately rejects him. All later problems can be traced to the fact that Frankenstein does not take responsibility for his creation. While I do not disagree with this, we need to think beyond (or before) Frankenstein's rejection to the reason he rejects it...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586179/contributors
#9
(no author information available yet)
No abstract text is available yet for this article.
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586178/work-requirements-that-don-t-work
#10
Stephen R Latham
Early in 2018, the Trump administration's Centers for Medicare and Medicaid Services issued a guidance letter outlining a new and controversial kind of Medicaid waiver proposal. The administration invited states to propose waivers that would impose work (or other "community engagement") requirements as a condition of eligibility for Medicaid. The Trump administration and state proponents of work requirements want to force able-bodied Medicaid beneficiaries into the workplace. Critics allege that this is because they mistakenly believe that low-income individuals are not working because they're lazy or because aid programs provide them with a disincentive to work...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586177/locating-the-source-s-of-the-social-value-requirement-s
#11
David Wendler
In this issue of the Hastings Center Report, Danielle Wenner looks at a few prominent analyses of the social value requirement for clinical research, claiming that they are all based on what she calls a transactional model of research ethics. She argues that the transactional model fails to provide a secure foundation for the social value requirement, and then, appealing to John Rawls, she argues that a more secure foundation lies in the principles of social justice. Wenner's attempt to locate the source of the social value requirement raises important questions regarding its scope and strength...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586176/wrestling-with-the-monster-frankenstein-and-organ-transplantation
#12
Eric Trump
In December 1967, Louis Washkansky, a grocer living in South Africa, became the first person to awaken after a heart transplant. Some accounts say that his first words were, "I am the new Frankenstein." Others claim that Christiaan Barnard, his transplant surgeon, uttered these. Much as people have long mixed up who Frankenstein is-creature or creator?-in Mary Shelley's novel, so patient and surgeon, repaired and repairer, are confused in retellings of this post-op Frankensteinian moment. Whether Washkansky identified with Frankenstein's monster or not, he was probably feeling a bit monstrous after taking the donor heart of Denise Darvall into his chest...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586175/who-deserves-access-to-care-in-children-s-hospitals
#13
Amy E Caruso Brown, Katherine Frega
An eighteen-year-old with sickle cell disease was admitted to the pediatric hematology service at his local children's hospital for management of an acute pain crisis, one of many such admissions. He had a good relationship with his primary hematologist and primary nurse, but with other health care providers, there was evident friction. Sometimes, he was simply rude, rolling over and pretending to sleep in response to questions about his symptoms. When frustrated or convinced that his pain was not being addressed appropriately, he was prone to yelling and cursing at his nurses...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586174/difficulties-with-applying-a-strong-social-value-requirement-to-clinical-research
#14
David B Resnik
In an insightful article published in this issue of the Hastings Center Report, Danielle Wenner criticizes what she describes as transactional approaches to the social value requirement in clinical research and defends a "basic structure approach." Transactional approaches understand social value obligations as arising from transactions (or relationships) between research subjects, investigators, sponsors, and other parties. The basic structure approach, by contrast, understands social value obligations as stemming from the demands of Rawlsian social justice...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586173/who-are-you
#15
Susan Gilbert
At a time when our views on practically everything are polarized, there's one thing that growing numbers of us agree on: we want genetic information about ourselves. About 15 million people have taken a direct-to-consumer genetic test, up from 4 million two years ago. Millions more are likely to give these tests as holiday gifts. Many people consider genetic findings deeply meaningful to their understanding of who they are. This information is a gift, but it is also a weight-a paradox that was the theme of a conference organized by my colleagues Erik Parens and Joel Michael Reynolds in October 2018...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30586172/unexpected-creatures-procreative-liberty-and-the-frankenstein-ballet
#16
Rosemarie Garland-Thomson
One of the most recent and original adaptations of Mary Wollstonecraft (Godwin) Shelley's Frankenstein; or, The Modern Prometheus (1818) is the ballet version choreographed by Liam Scarlett and performed by the Royal Ballet in 2016 and the San Francisco Ballet in 2017 and 2018. What emerges from this translation is an economical, emotionally wrenching, and visually elegant drama of family tragedy from which we can draw a cautionary tale about contemporary bioethical dilemmas in family making that new and forthcoming biomedical technologies present...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30584867/imposing-death-religious-witness-on-brain-death
#17
Courtney S Campbell
The bioethical, professional, and policy discourse over brain death criteria has been portrayed by some scholars as illustrative of the minimal influence of religious perspectives in bioethics. Three questions then lie at the core of my inquiry: What interests of secular pluralistic societies and the medical profession are advanced in examining religious understandings of criteria for determining death? Can bioethical and professional engagement with religious interpretations of death present substantive insights for policy discussions on neurological criteria for death? And finally, how extensive should the scope of policy accommodations be for deeply held religiously based dissent from neurological criteria for death? I begin with a short synopsis of a recent case litigated in Ontario, Canada, Ouanounou v...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30584866/a-conceptual-justification-for-brain-death
#18
James L Bernat
Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that paralleled advances in intensive care unit treatment...
November 2018: Hastings Center Report
https://read.qxmd.com/read/30584865/authors
#19
(no author information available yet)
No abstract text is available yet for this article.
November 2018: Hastings Center Report
https://read.qxmd.com/read/30584864/the-public-s-right-to-accurate-and-transparent-information-about-brain-death-and-organ-transplantation
#20
Michael Nair-Collins
The organ transplantation enterprise is morally flawed. "Brain-dead" donors are the primary source of solid vital organs, and the transplantation enterprise emphasizes that such donors are dead before organs are removed-or in other words that the dead donor rule is followed. However, individuals meeting standard diagnostic criteria for brain death-unresponsiveness, brainstem areflexia, and apnea-are still living, from a physiological perspective. Therefore, removing vital organs from a heart-beating, mechanically ventilated donor is lethal...
November 2018: Hastings Center Report
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