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Yale Institution for Social and Policy Studies

Greetings from Stephen Latham, Bioethics Center Director


Two items for your calendar: First, our friends at the Yale Pediatric Ethics Program are hosting Drs. Ray Barfield and Megan Jordan (Duke, Palliative Care), speaking on the topic: “Brain surgery with Words: Navigating Difficult Conversations at the End of Life.” The presentation will be on Tuesday, March 15, from 5:00 pm to 6:30 pm at the Park Street Auditorium, 35 Park Street, New Haven. Because “heavy snacks” will be served, please RSVP by March 11 to Karen.Kolb@yale.edu.

Second, our Robert Levine lecturer this year will be Dr. John Iaonnides (Stanford, Medicine and Statistics), probably the world's leading scholar on, and a controversial critic of, medical research methodology, and of scientific research standards more broadly. He'll be speaking on the evening of March 28; save the date and look here for more details in coming weeks.

Congratulations to our Technology and Ethics Group convener and Bioethics Scholar Wendell Wallach on being featured in this piece on "killer robots" in the Daily Mail.

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Updates from the Summer Institute

From Summer Institute Director Carol Pollard

James Fleming writes from Erlanger Hospital in Chattanooga, Tennessee: “I have not worked somewhere with such a general enthusiasm and mission since the Bioethics Center.  I have my own nurse practitioner. We knocked out over 100 strokes in the Emergency Room this week. Enrolling patients in several international trials. Staff are very proud that a community hospital could be so well known for something. We even took out an ad locally during the Super Bowl with our helicopters flying in formation with a stroke patient. J“ (James, enjoy!!)

Laura Ballantyne-Brodie sent this posting from The Hastings Center: “Please see the attached announcement for a new position at The Hastings Center for you to share. This is a slightly different position than in years past as it is for the position of Project Manager & Research Assistant, is not limited to two years, and is now open to applicants with both bachelor’s and master’s degrees.” Please click here for the announcement. (Thank you Laura!)

Matt Jones writes: “Could someone hack your medical device?  This is interesting because it falls under the wider lens of who is responsible when a medical device fails. This has been an interesting topic in the medical device area lately. This is about post-market surveillance of medical devices.  I have worked on a few devices that use remote operation systems, and I remember that this was a concern. One device could deliver a hazardous shock if someone ‘hacked’ the device since it was an automatic defibrillator. Not only that, but someone could hack it to receive medical information for many diagnostic devices. The only question I have is that since cybersecurity is a constantly evolving field and security software is obsolete in such a short time-frame, should medical device manufacturers be required to do post-market updates to their software. Can they be held liable for a failure to protect against such attacks? These are just recommendations from the FDA, but it got me thinking about the future. Since in the future, almost every product will contain software in some fashion, and that seems to be a trend in medical devices as well.” (Thanks Matt!) “FDA Recommends Medical Device Manufacturers Implement a Comprehensive Cybersecurity Risk Management Program in Accordance with NIST Standards,” The National Law Review, February 2, 2016

Kristen Bergman has been accepted into several MPH Programs. (Congratulations and Good Luck making your choice!)

Check out this new medical education blog & consider contributing an entry. Reflective MedEd seeks insights on teaching, the social context in which our students are developing including insights related to race, culture, and social justice. We welcome illness narratives and poetry. In short, we welcome creativity of all kinds as long (as it doesn’t exceed 650 words).  You can follow this blog @reflectivemeded on Twitter and contribute as well.

Vitoria Souza Pagnussat sent in an article that I also added to my Articles Section.  (Thank you Vitoria!) “Argentine and Brazililan doctors name Monsanto’s Larvicide as Potential Cause of Microcephaly in Brazil” – GMWATCH, February 10, 2016

Cristina Pardini writes: “Santa (Slokenberga) and I have just spent an amazing day together in Pisa and Lucca. She is doing some research in Florence and came to visit me. We were thinking of you and thought that you would enjoy a few pictures. It was great to have a taste of the “Yale Family” before coming back to the US. We are looking forward to our summer teaching!  (Click here for more pictures. Thanks Cristina. We’re looking forward to seeing you both soon!)

Jennifer Chevinsky is completing a volunteer month-long medical elective at the Institute for Indian Mother and Child in Kolkata, India. (What a wonderful opportunity!  We’re looking forward to your teaching this summer!)

Sam Garner is on a roll! His latest article is up on the NPR homepage. It’s on animal research ethics.  (Congratulations….again!)

Zohar Lederman writes: “Please see a summary of a One Health conference we just organized in Israel. Guess who the Keynote Speaker was….and it all started at The Summer Institute! (Congratulations Zohar! We’re looking forward to your teaching again  this summer!)

“There are those who find themselves torn between creating machines capable of undertaking many tasks, and concern over the impact this may have on people’s jobs,” says Wendell Wallach, scholar at the Yale Interdisciplinary Center for Bioethics, and author of A Dangerous Master: How to keep Technology from Slipping beyond our Control, in a telephone interview with The Christian Science Monitor.” From “Will the robots take our Jobs,” Jason Thomson, The Christian Science Monitor, February 16, 2016. (Wendell also was interviewed in the YaleNews, by Jim Shelton, on February 15, 2016. Congratulations Wendell!)

Please see my Articles Section!

Carol

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This Week on Campus

Friday and Saturday, February 26-27,

New Directions in Environmental Law

Sponsored by Yale Law School and Yale School of Forestry and Environmental Studies

This year's theme: "Cascading Change: Innovation, Organizing and Disruptive Strategies."

Conference details and registration information is here.

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Grants, Fellowships, & Jobs

The Hastings Center has a new position for a Project Manager and Research Assistant, for BA and MA-level candidates with strong interests in bioethics. The job would begin this summer. Applicants must already be eligible to work in the US. More details about the job and the qualifications are here.

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Articles of Interest

To read the full text of an article, click on its link and it will open in a new window.  

Some sites may require free registration; others may require that you or your organization have a paid subscription.

In the News

Environmental management

Abrahm Lustgarten and ProPublica. “A Free-Market Plan to Save the American West From Drought.” The Atlantic. March 2016.

Amidst rising drought conditions in the American west, the author examines a controversial free-market plan that would fundamentally alter the region’s water management system. Continue reading…

Devin Henry. “Obama climate envoy warns against pulling out of Paris deal.” The Hill. February 18, 2016.

There will be “diplomatic consequences” if the next president pulls the United States out of the Paris climate deal, President Obama’s top climate negotiator said on Thursday. Continue reading…

Ian Urbina. “Palau vs. the Poachers.” The New York Times Magazine. February 17, 2016.

The island nation has mounted an aggressive response to illegal fishing in their waters. How they protect themselves may help the rest of the world save all of the oceans. Continue reading…

Margo McDiarmid. “Canada, the United States and Mexico have signed a trilateral agreement that could mark the start of discussions on the first North American accord on climate change and clean energy.” CBC News. February 12, 2016.

Canada, the United States and Mexico have signed a trilateral agreement that could mark the start of discussions on the first North American accord on climate change and clean energy. Continue reading…

Public health

Nicholas Casey. “Zika Virus in Colombia Presents Complicated Choice About Abortion.” February 15, 2016.

Colombia has emerged as the second front in the battle against Zika in the Americas. At least 25,000 Colombians have contracted the virus, a number officials say could surge to 600,000. Unlike in Brazil, in Colombia some expecting mothers are being given the choice to end their pregnancies, under laws that allow abortions in some cases. Continue reading…

Robert Pear. “Surge in Medicare Advantage Sign-Ups Confounds Expectations.” The New York Times. February 12, 2016.

Five years into Medicare spending cuts that were supposed to devastate private Medicare options for older Americans, enrollment in private insurance plans through Medicare has shot up by more than 50 percent, confounding experts and partisans alike and providing possible lessons for the Affordable Care Act’s insurance exchanges. Continue reading…

 Sewell Chan. “Zika Virus Test Is ‘Weeks, Not Years’ Away, W.H.O. Says.” The New York Times. February 12, 2016.

Scientists are “weeks, not years” from developing a test for the fast-spreading Zika virus, but large-scale clinical trials for a potential vaccine are at least 18 months away, the World Health Organization announced on Friday. Continue reading…

Reproductive rights

Sarah Pulliam Bailey and Michelle Boorstein. “Pope Francis suggests contraception could be permissible in Zika fight.” The Washington Post. February 18, 2016.

Pope Francis told reporters Thursday that using artificial contraception may be morally acceptable in fighting the Zika virus. Continue reading…

Emily Wagster Pettus and Jonathan Mattise. “Several States Seek to Block 2nd Trimester Abortion Method.” ABC News. February 11, 2016.

Abortion opponents in Mississippi, West Virginia and several other states are filing bills to ban an abortion procedure commonly used in the second trimester that opponents describe as dismembering a fetus. Continue reading…

Sustainability

Kim Brunhuber. “Data centre dilemma: How online consumption is leading to higher energy use, costs.” CBC News. February 12, 2016.

Every time you update your Facebook profile, every time you email a friend, every time you stream your favourite show, somewhere in a dark room in a building far away, lights flicker, servers whir and air conditioners roar. Every year, we use more data. Every year, the number of data centres grows. And every year, those data centres use more electricity. Continue reading…

In the Journals

Sandro Galea and George J. Annas. “Aspirations and Strategies for Public Health.” JAMA Vol. 315, Issue 7 (2016), 655-656. February 16, 2016.

Public health is responsible for extraordinary achievements over the past century, such as remarkable gains in life expectancy and substantial decreases in infectious disease mortality, and could make similar critical contributions to health in this century. In order to do so, however, the authors argues that public health must adopt new strategies in order to address itself to changing needs. Continue reading…

Rita Rubin. “Despite Potential Health Benefits of Maternity Leave, US Lags Behind Other Industrialized Countries.” JAMA Vol. 315, Issue 7 (2016), 643-645. February 16, 2016.

The United States and Papua New Guinea usually aren’t mentioned in the same sentence, but they have at least 1 unlikely thing in common. They’re the only 2 countries worldwide that don’t guarantee paid maternity leave, according to the International Labour Organization, a United Nations agency, which recommends at least 18 weeks of maternity leave. Continue reading…

Dominic Wilkinson, Loane Skene, Lachlan De crespigny, and Julian Savulescu. “Protecting Future Children from In-Utero Harm.” Bioethics. February 12, 2016.

The authors argue that, even if a fetus is not regarded as a separate person and does not have the legal or moral status of a child, indeed, even if the fetus is regarded as having no legal or moral status, there is an ethical and legal case for intervening to prevent serious harm to a future child. Continue reading…

Scott Y. H. Kim, Raymond G. De Vries, John R. Peteet. “Euthanasia and Assisted Suicide of Patients With Psychiatric Disorders in the Netherlands 2011 to 2014.” JAMA Psychiatry. February 10, 2016.

The authors review psychiatric euthanasia or assisted-suicide case summaries made available online by the Dutch regional euthanasia review committees as of June 1, 2015. They find that, of the 66 cases reviewed, 70% were women, and that the granting of their requests involved considerable physician judgment. Continue reading…

Tracy Hampton. “Ethical and Societal Questions Loom Large as Gene Editing Moves Closer to the Clinic.” JAMA Vol. 315, Issue 6 (2016), 546-548. February 9, 2016.

Over the last few decades, researchers have developed innovative techniques for altering genetic sequences. More recently, scientific breakthroughs have greatly reduced the cost and complexity of making highly targeted changes in living cells. There is consensus among experts that these advances could have wide-ranging clinical applications. Although the advances may have the potential to prevent or even cure a variety of diseases when used in adults, children, and even fetuses or gametes, they also raise many important ethical and societal questions. Continue reading…

Michael Yudell, Dorothy Roberts, Rob DeSalle, Sarah Tishkoff. “Taking race out of human genetics.” Science Vol. 351, Issue 6273 (2016), 564-565. February 5, 2016.

While claims about the alleged genetic basis of social differences between races have been refuted, biology nonetheless remains stuck in a paradox, both believing race to be a tool to elucidate human genetic diversity and believing that race is a poorly defined marker of that diversity and an imprecise proxy for the relation between ancestry and genetics. In an attempt to resolve this paradox, the authors propose that scientific journals and professional societies insist on using terms such as “geographic ancestry”, “culture”, “socioeconomic status”, and “language” – not “race” – when discussing the complicated relationship between humans, their evolutionary history, and their health. Continue reading…

Opinion

Bioethics Forum (The Hastings Center)

Nancy Berlinger and Caroline Rath. “El agua no es potabo: Immigration and Public Health Policy in Flint.” February 17, 2016.

The public health catastrophe known as the Flint water crisis is also a textbook case about the consequences of immigration policy, since undocumented immigrants are particularly vulnerable during public emergencies.

The Presidential Commission for the Study of Bioethical Issues

Elizabeth Pike. “Bioethics in Action: Bringing Bioethics Deliberation into the Classroom.” February 17, 2016.

The author discusses highlights the efforts of Dr. Rachel Fink, a developmental biologist and professor of biological sciences at Mount Holyoke College, to incorporate the ethical and policy dimensions of pressing scientific issues into her basic science courses. Continue reading…

The Conversation

Andrew George. “Judging Jenner: was his smallpox experiment really unethical?” February 16, 2016.

Edward Jenner developed a vaccination for smallpox and saved countless lives in the process, yet is often accused of conducting unethical experiments. On May 14, 1796 Jenner vaccinated James Phipps, the eight-year-old son of his gardener, with material obtained from a milkmaid who had cowpox. A few weeks later he deliberately infected Phipps with smallpox to see if he would develop the disease. But the story is more complex than this simple narrative suggests. Continue reading…

Dame Magazine.

Paula Lee Young. “The Three Letter Word Missing From the Zika Virus Warnings.” February 3, 2016.

The WHO has declared Zika a global emergency, and government officials in Brazil,  Colombia, Ecuador and El Salvador are “advising women to avoid getting pregnant, for fear that the fast-spreading Zika virus may cause severe brain defects in unborn children.” The problem with these warnings is that none of them consider warning men to stop having procreative sex. Continue reading…

Richard Gunderman. “Facing a physician shortage, can we leave medical school grads on the sidelines?” February 12, 2016.

Last year, 52,860 U.S. and international medical graduates applied for residency positions in the U.S., yet only 26,252 actually matched into a program. The painful irony is that the U.S. now faces a substantial shortage of physicians, which is on track to worsen in the decades to come. Continue reading…

Health Affairs

Leo Beletsky, Wendy Parmet, and Ameet Sarpatwari. “Expanding Coercive Treatment Is The Wrong Solution For The Opioid Crisis.” February 11, 2016.

Amidst a surging crisis of opioid abuse and overdoses, many policymakers have called for expanded use of coercive treatment. But new legislation currently before the Massachusetts state legislature could expand the scope of involuntary treatment and reduce judicial oversight. This proposal is an ill-considered response to a public health crisis. Continue reading…

The New York Times

Aaron E. Carroll. “Medical Residents, Misplaced Pride and Saner Hours.” February 15, 2016.

The author discusses the long hours associated with medical residency. Continue reading…

NPR

Samuel Garner. “The 'Necessity' Of Animal Research Does Not Mean It's Ethical.” February 14, 2016.

A few weeks ago, two prominent scientists, Hollis Cline and Mar Sanchez, wrote a brief piece in The Hill newspaper arguing that animal research is "necessary." Scientists have long been fond of claims of necessity — in fact, justifications for animal research have remained largely the same since the writings of 19th century French physiologist Claude Bernard. However, this claim is problematic for a number of reasons. Continue reading…

Practical Ethics

Albert Barqué-Duran. “Does Humanity Want Computers Making Moral Decisions?” February 17, 2016.

A runaway trolley is approaching a fork in the tracks. If the trolley is allowed to run on its current track, a work crew of five will be killed. If the driver steers the train down the other branch, a lone worker will be killed. If you were driving this trolley what would you do? What would a computer or robot driving this trolley do? Continue reading…

Slate

Michelle Goldberg. “Is a Surrogate a Mother?” February 15, 2016.

A battle over triplets raises difficult questions about the ethics of the surrogacy industry and the meaning of parenthood. Continue reading…

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