Yale Friday Newsletter – 02/01/13

Another week, another Yale Friday Newsletter!  Enjoy.

A few announcements from Stephen Latham, Center Director:

  BIOETHICS EVENTS
  Wednesday, February 6 at 4:15 PM

Tech & Ethics group

Location: 77 Prospect St, rm B012

Speaker: Gregory Kaebnick, Research Scholar, The Hastings Center, and Editor of the Hastings Center Report

Topic: Toward Just and Prudent Implementation of Synthetic Biology

 

This Week on Campus

Monday, February 4

History of Science and Medicine’s McGovern Lecture

Time: 4:30 PM

Location: 333 Cedar St, Historical Library

Speaker: David Rosner, Columbia University, Ronald H. Lauterstein Professor of Sociomedical Sciences and Professor of History, Graduate School of Arts and Sciences

Topic: Lead Wars: The Politics of Science and the Fate of America’s Children

Tuesday, February 5

Rudd Center Seminar
Time: 12:30 PM
Location: 309 Edwards St, conf room
Speaker: Amy Yaroch, PhD, Executive Director, Gretchen Swanson Center for Nutrition
Topic: Hunger and Obesity: A Continuing Conundrum

Poynter Fellowship Master’s Tea
Time: 4 PM
Location: Branford Master’s House, 80 High St.
Speaker: Charlayne Hunter-Gault, journalist and activist
Topic: Social Justice, Equity, and Public Health

Divinity School Lecture
Time: 5:30 PM
Location: 409 Prospect St, Marquand Chapel
Speaker: Allan Boesak, author, minister, anti-apartheid activist
Topic: Reconciliation, Justice, and the Spirit of Ubuntu

Overseas Ministries Study Center Lecture
Time: 7:30 PM
Location: 490 Prospect St.
Speaker: John T. Nwangwu, World Health Organization consultant
Topic: The World Health Organization: A conversation with a Christian consultant

Wednesday, February 6

Pediatric Ethics Seminar

Time: 4:30 PM

Location: 230 South Frontage Rd, Cohen Auditorium

Speaker: Dr. Kathy Weise, Cleveland Clinic

Topic: Ethical Issues in the Care of Infants and Children with Disabilities

Humanities in Medicine Lecture
Time: 5 PM
Location: 300 Cedar St, Anlyan Auditorium
Speaker: Anne Fadiman, Author and Adjunct Professor, Francis Writer in Residence, English Department, Yale University
Topic: The Spirit Enters and You Fall Down

Thursday, February 7

Schell Center Lecture
Time: 4:15 PM
Location: 127 Wall St, Faculty Lounge
Speaker:  Troy Elder, YLS ’95, Senior Schell Visiting Human Rights Fellow, Yale Law School
Topic: Doping Medellin: Getting Extradition (Humanly and Ethically) Right

Yale Himalaya Lecture
Time: 6:30 PM
Location: 34 Hillhouse Ave, room 203
Speaker: Mark Arnoldy, Executive Director, NYAYA Health
Topic: Delivering Health Care to the World’s Poorest

Friday, February 8

Zigler Center Lecture
Time: 11:30 AM
Location: 100 Wall St, room 116
Speaker: Walter S. Gilliam, PhD
Topic: Expelled from Preschool!?! Who, Why, and Results from a Random-Controlled Trial of a Statewide Intervention

 

Off Campus Events & Conferences

Zoe Weil, co-founder and president of the Institute for Humane Education, will present the lecture, “The Interconnectedness of All Life: Animal Welfare, Environmental Preservation and Human Rights,” at 7 p.m. on Tuesday, Feb. 5, in the Clarice L. Buckman Theater on the Mount Carmel Campus at Quinnipiac University. This event, sponsored by the Albert Schweitzer Institute at Quinnipiac, is free and open to the public. “Humane education not only instills the desire and capacity to live with compassion, integrity and wisdom, but also provides the knowledge and tools to put our values into action in meaningful, far-reaching ways,” Weil said. “It enables us to find solutions that work for all by approaching human rights, environmental preservation and animal protection as interconnected and integral dimensions of a healthy and just society.” Weil has served as a consultant on humane education to people and organizations around the world. In 2012, she debuted her one-woman show, “My Ongoing Problems with Kindness: Confessions of MOGO Girl,” which explores humane education issues through humor and stories about Weil’s life as she tries, and periodically fails, to always be kind. In 2010, Weil was inducted into the Animal Rights Hall of Fame, and in 2012 she received an award from the Women in Environmental Leadership Program (WE Lead) at Unity College. Weil received a master’s in theological studies from Harvard Divinity School and a master’s in English literature from the University of Pennsylvania. She is certified in psychosynthesis counseling, a form of psychotherapy which relies upon the intrinsic power of each person’s imagination to promote growth, creativity, health and transformation. For more information about Weil’s lecture, call 203-582-8652.

 

Just Food Conference, February 22-23, 2013
Yale Divinity School will host Just Food, a conference on local food justice and sustainability, for Yale University and Greater-New Haven community members to connect, learn, eat, and celebrate.  Friday evening will include an introductory welcome by John Elder, Middlebury College professor emeritus of English and Environmental Studies, film screenings of Fresh and Soul Food Junkies, and a panel discussing the local food system.  Saturday will offer a community fair, multiple workshop sessions, a panel with New Haven Food Policy Council members, and a community lunch.  Please save the date and register today.  Spaces are limited, but all are welcome. Learn more…

 

Global Bioethics Initiative to convene Expert Panel on Crimes of 21st Century: Organ Trafficking, Global Health and Security
The black market for organs and body parts is flourishing in many parts of the world. The World Health Organization estimates over 10,000 cases of illegal sales of organs in 2010 – one organ trafficking incident per hour. On February 14th, the Global Bioethics Initiative, in cooperation with the Turkish Center, will convene a panel of experts to discuss the challenges of combating organ trafficking in the 21st Century. Topics to be addressed include the widespread organ “trade” from executed prisoners and unwilling donors. A review of recent criminal trials and a case made against use of executed prisoners as sources of organs will be presented.
When: Thursday, February 14, 2013, 6:30-8.30PM followed by reception at Turkish Center
Where: ONE UNITED NATIONS Plaza Hotel, 44st Street and 1st Avenue
Suggestions: Please RSVP ahead of time by clicking on http://humanistbioethics.org/donate/ for your names to be placed on the entrance list by Feb 12, 2013.
Call (212) 687-3324 or alita@globalbioethics.org
Students: $25.00; General Public: $45.00
Click “Donate Now” http://humanistbioethics.org and you will receive an email receipt confirming your RSVP.

 

Grants, Fellowships, & Jobs

The Petrie-Flom Center has just opened the search for an Administrative Director to support the Executive Director and Faculty Co-Directors in administration of the Petrie-Flom Center.  Primary responsibilities will involve program coordination, communications/web development, event planning, and financial administration.  If you’re interested, or know someone who may be a good fit, additional information may be found by visiting www.Employment.Harvard.edu and searching Req # 28723BR. Note that all offers are made by Harvard Law School Human Resources.

 

Harvard Kennedy School Postdoctoral Position in Science, Technology and Society
The Harvard Kennedy School’s Program on Science, Technology and Society (STS) and the School of Engineering and Applied Sciences (SEAS) at Harvard University are seeking to hire a Postdoctoral Fellow with expertise in STS. The one-year position will carry a teaching load of one course in Technology and Society; the successful candidate will also assist in STS Program activities and build links between STS and SEAS. Renewal for a second year may be possible contingent on satisfactory performance and available funding. Candidates should preferably have some background in physical sciences or engineering and be qualified to carry out research on the social implications of one or more aspects of engineering or applied sciences, such as information and communication technologies, biotechnology, or nanotechnology. Areas of specialization might include studies of innovation; risk and regulation; intellectual property; new research partnerships and research governance; and ethical issues in technological R&D. Research experience on comparative, international and global issues is especially welcome. Interdisciplinary teaching experiences are highly desirable. Candidates should hold a Ph.D. or equivalent degree in an appropriate field, including STS, sociology, law, political science, economics, or engineering. Interested candidates should submit a curriculum vitae, a cover letter with a statement of research interests, a writing sample or representative publication, and names of three referees via the form on the STS Program website: http://sts.hks.harvard.edu/people/fellows.html/postdoctoral-fellowship-application-form/ Review of applications will begin on January 28, 2013 and continue until the position is filled. Applications from women and minorities are especially encouraged. Harvard University is an Equal Opportunity, Affirmative Action Employer. Cover letters should be addressed to Professor Sheila Jasanoff, Director, Program on Science, Technology and Society, Harvard University, John F. Kennedy School of Government, 79 John F. Kennedy Street, Mailbox 17, Cambridge, MA 02138. Questions about the application process should be directed to Shana Rabinowich, the STS Program Administrator, at shana_rabinowich@hks.harvard.edu.

 

Duke Institute for Genome Sciences & Policy: Law & Biosciences Fellowship Program
Duke University invites applications for the 2013-2014 Fellowship Program at the Institute for Genome Sciences and Policy. This fellowship is ideal for individuals who are interested in an academic or policy career working on issues in science and society, with a particular interest in the legal, ethical, and social implications of the biosciences. The Institute for Genome Science and Policy (IGSP) is an interdisciplinary institute at Duke designed to advance the biosciences and to study and inform their implications for science, health and society. Through conferences, workshops, lectures, and education, the Institute promotes research, education and public outreach on the biosciences and their ethical, legal, and social implications for society sciences.  For more information, visit our website at http://www.genome.duke.edu. The Law and Biosciences Fellowship is a residential fellowship that provides an opportunity to become involved in the activities of the IGSP and the University, while pursuing independent scholarship at the intersection of biosciences and law.  To enable integration in the Duke community and to allow the fellow(s) to complete a significant body of independent scholarship, we prefer two-year terms, but will consider shorter term fellowships, as well.  We expect fellows to dedicate approximately one third to one half of their time to supporting the science and society activities of the IGSP, working with Nita A. Farahany, JD, Ph.D., while dedicating the other half of their time to independent research.  For the 2013-2014 fellowship, we will provide fellows with office space, a competitive stipend and benefits. Applicants should have a JD or other doctoral level degree (MD, PhD) in a relevant area.  A law degree is a significant advantage, but is not a requirement. Applicants should submit a CV, contact information for three references, a writing sample, and a research proposal (in 2000 words or less) to Melissa Segal (melissa.segal@duke.edu) by February 15, 2013.  We will choose fellows based on demonstrated academic merit, likelihood of future success in academia or science policy, and on strength of their research proposals.  Decisions will be made by March 15, 2013. Duke University is an equal opportunity/affirmative action employer.

 

Harvard Medical School/Brigham and Women’s Hospital Fellowship in Pharmaceutical Law and Health Services Research
The Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital Department of Medicine and Harvard Medical School invites applications for a new postdoctoral fellowship in pharmaceutical law and health services research.  Areas of focus include regulation, intellectual property, and comparative effectiveness, as well as the development, approval, and evidence-based use of drugs, devices, vaccines, procedures, or diagnostics. Applications are invited from scholars with doctoral degrees (M.D., J.D., Ph.D., Pharm.D., or equivalent) or who will complete such training by July 2013. Fellows will have an appointment at Harvard Medical School, receive close mentorship from faculty members in the Division, and engage in one or more projects intended to start their careers in law and public health research. Appropriate candidates will also be able to enroll in the Harvard School of Public Health summer Clinical Effectiveness Program with the option to pursue a Master’s degree in public health.  Deadline is March 1, 2013.  Email Aaron Kesselheim, M.D., J.D., M.P.H. at akesselheim@partners.org for more information.

 

Postdoctoral Internship, Chronic Disorders of Consciousness Research Group
The York-Cardiff Chronic Disorders of Consciousness Research Groups are multi-disciplinary research groups bringing together sociologists, communications scholars, historians, philosophers, lawyers and other academics and practitioners from across a range of different areas of expertise to explore issues related to the vegetative and minimally conscious states.  Details about our current research projects can be found on our web pages: for the York group click here and for the Cardiff group click here.  A core part of our research is collaborative work on a data set of nearly 50 interviews with family members of people with disorders of consciousness (and we are also currently collecting a data set of interviews with professionals in the field). We are looking for an intern with a PhD (or equivalent) to join the York research group for one year starting as soon as possible. This is a ‘discipline-hopping’ internship funded by the university’s “Centre for Chronic Diseases and Disorders” with money from the Wellcome Trust.  This innovative scheme is aimed at preparing future research leaders. It offers the best and most imaginative early-career researchers, studying chronic illnesses and conditions, the opportunity to step out of their original discipline and spend up to a year developing complementary skills and knowledge in a different academic area. The intern for the Chronic Disorders of Consciousness research group will come from a health sciences (or similar) background. We especially encourage applicants with experience in clinical practice or social care.  The intern will have the opportunity to work in Sociology, Philosophy and Law and to extend their existing health-related expertise to interdisciplinary collaborative research questions relating to the vegetative and minimally conscious states. The deadline is 6 February 2013 and the salary will be £23,339 per annum. If you are interested in applying please read the formal university advertisement (click here) – which covers a range of different internships in addition to the Chronic Disorders of Consciousness one.  You can download a full job description from the university webpage.  You are strongly encouraged to contact Professor Celia Kitzinger, Director of the York Chronic Disorders of Consciousness Group (celia.kitzinger@york.ac.uk) to discuss your application in advance.  Formal interviews are on 7th March 2013. For further information and to apply on-line, please visit our website: https://jobs.york.ac.uk

 

Grant: Engaging Social, Behavioral, and Economic Scientists through Social and Policy Entrepreneurship

America’s advancement has originated in part from the ability to capitalize on scientific discovery and innovation. While a strong capacity for leveraging fundamental scientific discoveries into powerful engines of commercial innovation is essential to maintain our competitive edge, actionable knowledge is equally critical to other national priorities, such as quality education, public health, and environmental sustainability. Much scientific knowledge – especially in the social, behavioral, and economic sciences – will produce the greatest societal benefit by informing public policy or contributing to innovative social ventures, rather than through the production of commercial products. Increasing the accessibility of such science for policy-makers, non-profit organizations, and community groups is an important step toward achieving many important social goals. Taking advantage of the potentially applicable results of these sciences requires more than simply fostering better communication; explicit attention to the interactions among scientific innovation, public decision-making, and social action is needed. Building on the National Science Foundation’s commitment to increasing the broader impacts of its science, the Directorate for Social, Behavioral, and Economic Sciences (SBE) seeks to explore possible avenues for guiding scientific discoveries closer to the development of public policy and social ventures. To this end, SBE would like to invite proposals for organizing interdisciplinary, multi-sector workshops that focus on (but are not limited to) the following topics and issues:

  • What is the nature of the system within which scientific knowledge is transformed into public policy or social action? What interactions characterize this system? What system failures or barriers impede the utilization of non-commercial science by governments, non-profit organizations, community groups, and other social ventures? How can universities and scholars best serve this system?
  • What non-commercial pathways best connect academic science to public policy and management and to social ventures designed to meet public needs? What types of interactions with scientists are most fruitful in these contexts?
  • How should scholars, social entrepreneurs, policy-makers, and administrators engage each other to facilitate better application of SBE science?
  • What skill sets and partnerships do scientists need to develop in order to optimize the transformation of their science into actionable and useful knowledge in the non-commercial contexts of public policy, management, and social need?
  • What types of curricula or educational activities should be developed to advance knowledge in the area of social and policy entrepreneurship?

Ideally, the reports generated by these workshops could be used by a variety of audiences as starting points for the development of a curriculum or a specific set of activities designed to facilitate the transformation of fundamental SBE science into actionable knowledge. Proposals should have as their goal the development of high quality collaborations to advance social science engagement with public policy and social ventures – specifically, via a workshop to be held in July or August 2013. SBE expects to fund 1-2 workshops each with a total cost of up to $50,000. Workshops are not intended solely for planning activities that would primarily benefit a single institution and should include academic and practitioner participants from a variety of disciplines, institutions, and sectors, including (for example): academic experts in public policy, social entrepreneurship, or engaged scholarship; policy and social entrepreneurs; local, state, or federal decision-makers; and researchers who have successfully bridged the academic – policy/social-need gap. A successful workshop proposal will demonstrate a compelling rationale, with clear goals, a committed team, leveraged resources, and strategic planning. An implementation plan and plan for the dissemination of results must also be included. Collaborative proposals between scholars, entrepreneurs and policy-makers are also welcomed. This is not a special competition or new program. Proposals should be prepared and submitted via FastLane using the specific guidelines below for completing the Cover Sheet information.

  • For the Program Announcement, select “NSF 13-1 Grant Proposal Guide – GPG”.
  • For the NSF Unit Consideration, select “SMA-SBE Office of Multidisciplinary Activities” for the Division and “CROSS-DIRECTORATE ACTIV” as the Program.
  • Under the Remainder of the Cover Sheet section, precede the proposal title with the text: “ENGAGING SBE”.

Proposals submitted in response to this DCL should be submitted via FastLane by March 29, 2013 in accordance with the general guidelines contained in the NSF Grant Proposal Guide (GPG) as well as the additional specific Cover Sheet criteria listed above. The complete text of the GPG is available electronically on the NSF website (http://www.nsf.gov/publications/pub_summ.jsp?ods_key=gpg). Specific questions about this call for workshop proposals should be directed to Quinetta Roberson, Science of Organizations Program Director, at qroberso@nsf.gov.

 

Calls for Papers & Nominations

The abstract submission deadline for STEMCONN 2013 has been extended to February 15.

 

9th World Conference on Bioethics, Medical Ethics and Health Law
University of Napoli, Italy, 19-21 November, 2013
The Conference is designed to offer a PLATFORM for the exchange of information and knowledge and to hold discussions, lectures, workshops and an exhibition of programs and databases. The conference is suited to physicians, lawyers, nurses, hospital managers, psychiatrists, psychologists, social workers, ethicists, teachers and educators in Medical Schools, Nursing Schools, Law Schools, Schools of Social Work, Faculties of Philosophy and Ethics, Professional Organizations, Governmental and Public Bodies. Topics will include bioethics, medical ethics, health law, ethical codes. Bioethics: Scientific, social, cultural, legal, economic, religious and psychological aspects. Nursing law and ethics. Bioethics and human rights. Patients’ rights. Pharmacy ethics. Professional liability. Autonomy and paternalism. Informed consent. Research and medical experimentation. Human genome project, genetics. Ethics Committees. Environmental ethics. Bioethics Education. The Conference is sponsored by the World Medical Association (WMA), and is organized by the UNESCO Chair in Bioethics (Haifa), the Zefat Academic College, the International Center for Health, Law and Ethics, and is supported by the Israel Medical Association and the Israel National Commission for UNESCO. Abstracts of approximately 250 words are invited for oral and poster presentations. The deadline for abstract submission is March 15, 2013. For additional information: www.isas.co.il/bioethics2013. For registration please contact: seminars@isas.co.il.

 

Apply to present at the 6th annual University Research and Entrepreneurship Symposium (URES).  URES is an annual event that has quickly become a seminal conference for New England’s top venture capitalists and entrepreneurs, among whom there is great demand to gain access to the most commercially promising technologies developed at universities from across the country. URES 2013 will be held on Wednesday, April 3rd at The Microsoft New England Research and Development Center in Cambridge, MA. The symposium includes 3 tracks: IT, Deep Tech, and Life Sciences. With your strengths in all of these areas, Yale would be uniquely suited to participate in the conference. Over the past 5 years, 110 projects from nearly 40 universities including Boston University, Brown, Carnegie Mellon, Columbia, Cornell, Dartmouth, Harvard, Johns Hopkins, MIT, NYU, Purdue, Rensselaer Polytechnic, Tufts, UCLA, University of Kansas, University of Pennsylvania, University of Wisconsin, Yale, and more, have presented to entrepreneurs and venture capitalists at the event resulting in more than 15 companies receiving nearly $100 million in funding to date. The submission and review process for technologies to be eligible for presentation at the event is available at http://www.universitysymposium.com/proposal.  Please note, the deadline for submissions is February 13, 2012. Please share this with other faculty colleagues and student entrepreneurs that may be working on interesting projects and may have an interest in commercializing their technologies via startups.  If you have any questions, please feel free to contact me at kmisra@mba2013.hbs.edu or visit the URES website at www.universitysymposium.com.

 

Articles of Interest

In the News

Drugs & Pharmaceuticals

Rabin, Roni Caryn. The Drug-Dose Gender Gap. New York Times. 28 January 2013.
Most sleeping pills are designed to knock you out for eight hours. When the Food and Drug Administration was evaluating a new short-acting pill for people to take when they wake up in the middle of the night, agency scientists wanted to know how much of the drug would still be in users’ systems come morning. Blood tests uncovered a gender gap: Men metabolized the drug, Intermezzo, faster than women. Ultimately the F.D.A. approved a 3.5 milligram pill for men, and a 1.75 milligram pill for women. Continue reading…

Pollack, Andrew. Biotech Firms, Billions at Risk, Lobby States to Limit Generics. New York Times. 28 January 2013.
In statehouses around the country, some of the nation’s biggest biotechnology companies are lobbying intensively to limit generic competition to their blockbuster drugs, potentially cutting into the billions of dollars in savings on drug costs contemplated in the federal health care overhaul law. Continue reading…

Environment

Fears, Darryl. A desperate try to restock the Potomac’s sturgeon. Washington Post. 27 January 2013.
Convinced that one of the Potomac’s signature fish might be gone for good, the Interstate Commission on the Potomac River Basin has thrown its support behind a Maryland and U.S. Fish and Wildlife plan to use 60 domesticated Atlantic sturgeon, mostly from New York’s Hudson River, to restock the Potomac. But the effort to bring them back has its own troubles. Continue reading…

Health Care

Roberts, Michelle. Cancer Fight ‘Hampered in UK By Stiff Upper Lip’. BBC News. 29 January 2013.
The UK’s “stiff upper lip” culture may explain why it lags behind other countries when it comes to beating cancer, say experts. Researchers, who surveyed nearly 20,000 adults in six high-income countries, said they found embarrassment often stopped Britons visiting the doctor. Continue reading…

Chace, Zoe. Free Breast Pumps and the Cost of Health Care. NPR. 25 January 2013.
Health insurance plans now have to cover the full cost of breast pumps for nursing mothers. This is the result of a provision in the Affordable Care Act (aka Obamacare), and the new rule took effect for many people at the start of this year.It’s led to a boom in the sale of the pumps, which can cost hundreds of dollars. Continue reading…

Law and Bioethics

Bronner, Ethan. A Flood of Suits Fights Coverage of Birth Control. New York Times. 26 January 2013.
In a flood of lawsuits, Roman Catholics, evangelicals and Mennonites are challenging a provision in the new health care law that requires employers to cover birth control in employee health plans — a high-stakes clash between religious freedom and health care access that appears headed to the Supreme Court. Continue reading…

Research Ethics

Safeguards Needed for Tissue Donors. Science Daily. 28 January 2013.
Donors to biobanks — vast collections of human tissue samples that scientists hope will lead to new treatments for diseases — have a right to basic information about how their donations may be used, a Michigan State University ethicist argues in a new paper. Continue reading…

Brown, Eryn. California Stem Cell Agency Proposes Change After Critical Report. Los Angeles Times. 25 January 2013.
Changes may be on the way at California’s stem cell funding agency. The California Institute for Regenerative Medicine, or CIRM, came under fire in December when an Institute of Medicine report concluded that the agency was plagued by conflicts of interest. Continue reading…

Technology

Greenwood, Veronique. Goodbye Silicon, Hello DNA. The Future of Data Storage? Time. 24 January 2013.
One night a few years ago, two biologists sat in a bar in Hamburg, discussing DNA. Ewan Birney, the associate director of the European Bioinformatics Institute, and Nick Goldman, a research scientist there, were wondering how to handle the tsunami of data flooding the institute, whose job it is to maintain databases of DNA sequences, protein structures, and other biological information that scientists turn up in their research—databases that are growing exponentially, thanks mostly to dropping costs and increased automation. The maintenance of all this data on hard drives was pressing their budget to the breaking point.  Continue reading…

Pollack, Andrew. F.D.A. Approves Genetic Drug to Treat Rare Disease. New York Times. 29 January 2013.
The Food and Drug Administration approved a new drug Tuesday that not only treats a rare inherited disorder that causes extremely high cholesterol levels and heart attacks by age 30, but does so using a long-sought technology that can shut off specific genes that cause disease.  Continue reading…

Spiegel, Alix. No Mercy for Robots: Experiment Tests How Humans Relate to Machines. NPR. 28 January 2013.
Many people have studied machine-human relations, and at this point it’s clear that without realizing it, we often treat the machines around us like social beings. Continue reading…

 

In the Journals

Huesch, Marco D. One and done? Equality of opportunity and repeated access to scarce, indivisible medical resources. BMC Medical Ethics. 2012.
Background: Existing ethical guidelines recommend that, all else equal, past receipt of a medical resource (e.g. a scarce organ) should not be considered in current allocation decisions (e.g. a repeat transplantation).
Discussion: One stated reason for this ethical consensus is that formal theories of ethics and justice do not persuasively accept or reject repeated access to the same medical resources. Another is that restricting attention to past receipt of a particular medical resource seems arbitrary: why couldn’t one just as well, it is argued, consider receipt of other goods such as income or education? In consequence, simple allocation by lottery or first-come-first-served without consideration of any past receipt is thought to best afford equal opportunity, conditional on equal medical need. There are three issues with this view that need to be addressed. First, public views and patient preferences are less ambiguous than formal theories of ethics. Empirical work shows strong preferences for fairness in health care that have not been taken into account: repeated access to resources has been perceived as unfair. Second, while difficult to consider receipt of many other prior resources including non-medical resources, this should not be used a motive for ignoring the receipt of any and all goods including the focal resource in question. Third, when all claimants to a scarce resource are equally deserving, then use of random allocation seems warranted. However, the converse is not true: mere use of a randomizer does not by itself make the merits of all claimants equal.
Summary: My conclusion is that not ignoring prior receipt of the same medical resource, and prioritizing those who have not previously had access to the medical resource in question, may be perceived as fairer and more equitable by society. Continue reading…

Jay, Jonathan S. Ethical Challenges of Preexposure Prophylaxis for HIV. The Journal of the American Medical Association. 2012.
On July 16, 2012, emtricitabine/tenofovir (Truvada; Gilead Sciences) became the first drug approved by the US Food and Drug Administration (FDA) for preexposure prophylaxis (PrEP) of human immunodeficiency virus (HIV) for adults at high risk. Clinical trials have demonstrated that daily use of oral antiretroviral drugs can reduce the risk of HIV acquisition through sexual intercourse. With 50 000 new HIV infections per year in the United States and 2 million per year worldwide, PrEP could become a major component of “combination prevention” along with condoms, counseling, testing, and treatment. Continue reading…

Sheard, Laura. The ethical decisions UK doctors make regarding advanced cancer patients at the end of life – the perceived (in) appropriateness of anticoagulation for venous thromboembolism: A qualitative study
Background: Cancer patients are at risk of developing blood clots in their veins – venous thromboembolism (VTE) – which often takes the form of a pulmonary embolism or deep vein thrombosis. The risk increases with advanced disease. Evidence based treatment is low molecular weight heparin (LMWH) by daily subcutaneous injection. The aim of this research is to explore the barriers for doctors in the UK when diagnosing and treating advanced cancer patients with VTE.
Method: Qualitative, in-depth interview study with 45 doctors (30 across Yorkshire, England and 15 across South Wales). Doctors were from three specialties: oncology, palliative medicine and general practice, with a mixture of senior and junior staff. Framework analysis was used.
Results: Doctors opinions as to whether LMWH treatment was ethically appropriate for patients who were symptomatic from VTE but at end of life existed on a shifting continuum, largely influenced by patient prognosis. A lack of immediate benefit coupled with the discomfort of a daily injection had influenced some doctors not to prescribe LMWH. The point at which LMWH injections should be stopped in patients at the end of life was ambiguous. Some perceived ‘overcaution’ in their own and other clinicians’ treatment of patients. Viewpoints were divergent on whether dying of a PE was considered a “good way to go”. The interventionalism and ethos of palliative medicine was discussed.
Conclusions: Decisions are difficult for doctors to make regarding LMWH treatment for advanced cancer patients with VTE. Treatment for this patient group is bounded to the doctors own moral and ethical frameworks. Continue reading…

Swetz, Keith M. Balancing evidence-based medicine, justice in health care, and the technological imperative: A unique role for the paliative medicine clinician. Journal of Palliative Medicine. April 2012.
This article discusses the unique role of palliative medicine clinicians in balancing evidence based medicine, justice in health care, and the technological imperative. The technological imperative suggests that any new technology that is introduced must be accepted and even embraced, with little reflection on its impact. Hemodialysis (HD) and end-stage renal disease (ESRD) provide an interesting paradigm for exploring the tension that often exists with practicing evidence-based medicine, using technology, and appreciating cost in the health care system. In a study, it is noted that US patients with ESRD who were nursing-home residents and began HD were noted to have a concurrent, “substantial and sustained decline in functional status.” Fatigue is often associated with participation in HD. Few other studies have recently looked at the efficacy of HD and note that patients who have a 48-hour interval between HD treatments are more likely to have adverse events. The findings of these studies seem to juxtapose an important consideration at the heart of this concern. Palliative care clinicians are well poised to bridge the current evidence available to guide practice and to go beyond the evidence to frame options within the goals of an individual patient and are likely to be called upon to do this increasingly in the foreseeable future. Continue reading…

 

Opinion

Ars Technica

Timmer, John. Texas, where science and history have become ideological battlegrounds. January 26, 2013.
Some of the most important decisions that influence the public’s knowledge aren’t made by scientific societies and they don’t take place in Washington DC. For the most part, they’re made in the capitals of each state, as each has its own standards for what students leaving its public schools should know. Those standards set lesson plans and help decide which textbooks are acceptable. Continue reading…

Los Angeles Times

Editorial. Roe v. Wade turns 40. January 22, 2013.
Forty years ago Tuesday, the Supreme Court ruled that women had a constitutional right to an abortion. This one sweeping decision transformed abortion from what was often a secret, illicit and dangerous act, sometimes crudely self-inflicted, into a generally legal and safe procedure. But it also turned abortion, always an emotional issue, into one of society’s most divisive. Continue reading…

Editorial. The DEA’s marijuana mistake. January 25, 2013.
For a muscular agency that combats vicious drug criminals, the U.S. Drug Enforcement Administration acts like a terrified and obstinate toddler when it comes to basic science. For years, the DEA and the National Institute for Drug Abuse have made it all but impossible to develop a robust body of research on the medical uses of marijuana. Continue reading…

Miami Herald

Letter to the Editor. US Energy policy isn’t sustainable. January 30, 2013.
While climate campaigners are encouraged by President Barack Obama’s boosting of sustainable energy sources in his inaugural address, those who understand our energy needs are appalled. Here is why: The president was right to say that we must “respond to the threat of climate change, knowing that the failure to do so would betray our children and future generations.” Continue reading…

Letter to the Editor. Privacy laws must change to help spot mental illness. January 31, 2013.
The issues and causes of most, if not all, of the mass slayings by an individual that we have witnessed over the past decade is mental illness; a lack of citizen awareness of the early signs of mental illness; and, various well-intended laws that protect privacy rights. Continue reading…

New York Times

Editorial. Paying doctors for performance. January 27, 2013.
In line with the goals of national health care reform, New York City’s public hospital system has embarked on a radical change in the way it will pay doctors. Instead of granting automatic pay increases, it will pay them based on how well they reduce costs, increase patient satisfaction and improve the quality of care. The Health and Hospitals Corporation, which runs the city’s 11 public hospitals, deserves praise for an ambitious proposal that will need to be refined as it is put into practice. Continue reading…

Editorial. The Bird Flu Experiments. January 26, 2013.
Scientists who had stopped research during the past year on a newly created bird flu virus because of safety and terrorism concerns have announced plans to resume their work. We wish we could be as sanguine as they are that all the earlier concerns have been dealt with. Continue reading…

USA Today

Editorial. NFL faces super existential threat. January 30, 2013.
By almost any measure, the National Football League is enjoying another extraordinary year. During the 17-week NFL regular season, the 22 highest-rated shows on television were NFL games. And roughly 155 million people, or half the U.S. population, are expected to watch at least some of Sunday’s Super Bowl. Continue reading…

Washington Post

Editorial. Taking women seriously in abuse cases. January 31, 2013.
We have reported about the case of a 15-month-old boy allegedly murdered by his father for insurance money after the father obtained unsupervised visits over the objections of the child’s mother. The tragic death of Prince McLeod Rams has raised questions about the family court system in Montgomery County and whether there are differences in how it listens to men and women. Continue reading…

Editorial. Pollution here or abroad. January 27, 2013.
During his confirmation hearing Thursday, Sen. John Kerry (D-Mass.), President Obama’s pick to be the next secretary of state, said that he intends to press China on climate change. The rapidly developing behemoth, he noted, “is soon going to have double the emissions of the United States.” His words are a welcome dose of reality. Continue reading…

Editorial. Pentagon must do more to understand sucide problem. January 25, 2013.
Suicides in the U.S. military rose in 2012 to a record high of 349, with more personnel dying by their own hand than on the battlefield. The numbers are a grim reminder of the challenge that suicide has long posed for the military — and they should lend urgency to the Pentagon’s efforts to combat this insidious problem. Continue reading…

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