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Yale Institution for Social and Policy Studies

Greetings from Stephen Latham, Bioethics Center Director


It's hard to believe (though I am glad to believe) that we've reached the last week of classes at Yale College. That means we have only a couple more issues of this newsletter before summer hiatus, so read this one closely while you can!

This Wednesday, April 27, our friends at Yale's Community Bioethics Forum will host our own Dr. Jack Hughes (Biomedical Ethics, Yale Medical School) speaking on "Ethical Considerations in US Healthcare Policy." The event will be at the Medical School's historical library at 333 Cedar St., and health-policy-themed art and political cartoons will be on display! The event supplies 2 credits of CPE for nurses, social workers and physicians. Refreshments will be served. Please RSVP to Lori.Bruce@Yale.edu.

Check out this episode of PBS's Open Mind (hosted by Alexander Heffner), featuring our own Technology and Ethics Group convenor Wendell Wallach.

Save the date: on Wednesday, May 11, Yale's Program for Biomedical Ethics will present a lecture by Sanjay Kulkarni, MD and Carrie Thiessen, MD (both of Yale Medical School) on "A Donor-Centered Approach to Risk-Assessment: Normative, Empiricaql and Policy Perspectives on Rebalancing Non-maleficence and Autonomy for Living Kidney Donors." The talk will be at 5pm in the Cohen Auditorium of the Child Study Center at 230 S. Frontage Rd.
Refreshments will be served, so please RSVP to Karen.Kolb@Yale.edu.

And don't forget that on May 19 our colleagues at The Hastings Center are putting on a conference in New York entitled, Bioethics Meetings Moral Psychology. Reserve your place now!

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Updates from the Summer Institute

From Summer Institute Director Carol Pollard

Congratulations to Autumn Ridenour on the birth of her second son, William Henry Thomas Ridenour on March 29th! We also send Congratulations to Autumn’s husband Jay and William’s “big brother” John Charles. 

Sahdeea Sultana sent along information on the student ethics conference at Leicester University this June. (Thank you Sahdeea!)

Sierra Alef writes: “Hello from wonderful Copenhagen, Denmark! I've been having a wonderful time here biking everywhere and training for the Copenhagen marathon. I'm also involved in a really interesting research project here; Denmark is aiming to sequence the genomes of all children diagnosed with cancer here in the next few years, and my role is to study the potential ethical implications of the project. It's important work, and I'm really enjoying it! I have a few updates to share. I have received a ThinkSwiss fellowship to do bioethics research at the University of Zurich this summer, where I will be focused again on pediatric oncology. I have also been accepted to attend a conference about randomized control trials at the Brocher Foundation near Geneva in June. I am really looking forward to my time in Switzerland and continuing the research that I am passionate about. I’m also very excited to say I’ll be riding in Obliteride again this summer! I’m heading straight from Europe to Seattle to ride the 2-day, 150-mile route around the Puget Sound.” (Click here for a picture! Congratulations Sierra! Good Luck!)

YouTube presentation by Marcia Angell. Marcia Angell, MD, MACP, is Senior Lecturer, Department of Global Health & Social Medicine, Harvard Medical School and a Faculty Associate in Harvard Center for Bioethics. Trained in internal medicine and anatomic pathology at Boston University School of Medicine, she joined the editorial staff of the New England Journal of Medicine in 1979, was named Executive Editor in 1988, and Editor-in-Chief in 1999.

Summary: Dying in America changed greatly after World War II, mainly because of the development of new drugs and technologies. Although that resulted in many welcome cures, it also created great suffering in patients who were terminally ill. Starting in the 1970s, the problem began to attract attention, and, by 1990, the right of patients or their proxies to refuse life-sustaining treatment became recognized. But the right to forego life-sustaining treatment left the problem of what to do for terminally ill patients not receiving such treatment. In the 1990s, a controversial movement argued that physicians should have the right to help such patients end their lives faster and more peacefully. Now, assisted dying (physician-assisted suicide) is legal in five states, including California.

Kristin Bergman writes: “The Geisinger Health System in Pennsylvania has been offering refunds to patients since October.  I thought this might be of interest.” (Thanks Kristin!) “The Most Unexpected Hospital Billing Development ever: Refunds

Morning Lecturer Wendell Wallach is in a PBS episode discussing the moral challenges of artificial Intelligence. (Congratulations Wendell!)

If you are in the area, The Hastings Center is sponsoring a symposium and public lecture titled “Bioethics Meets Moral Psychology,” May 19th, in New York City. Details at the link. Here is a short overview:

Mainstream bioethicists have traditionally made at least two assumptions about the nature and outcome of their work. The first is that reason drives their conclusions.  The second is that, when presented with those reasoned conclusions, others will change their behavior, practices, or policies accordingly. Findings from moral psychology suggest, however, that neither of those assumptions is wholly correct.  Both exaggerate the power of reason and underestimate the power of feeling or intuition.  At this symposium we will ask: How then should bioethicists take on board the insights of moral psychology?

Carolyn Brokowski writes: “I turned in my MS thesis on CRISPR on Saturday. After finals, all done with the MS! (Congratulations Carolyn!)

Shari Esquenazi writes: “I wanted to let you know about the Call for Abstracts for the 2016 Annual Meeting of the International Neuroethics Society. They have travel funds. Hope everyone is having a great semester!" (Thank you Shari!)

Martyna Sniegocka writes: “Hi Everyone! Do you remember one of our Morning Lecturers (Dr. Gwadz) who spoke about mosquitoes and malaria? He is coming to Jagiellonian University in Krakow in June.  I’m so excited; it will be like a small piece of Yale coming to my city." (Enjoy!)

Please see the Articles Section I’ve prepared for you!

More next week!

Carol

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This Week on Campus

Tuesday, April 26

Yale's William F. Buckley Program is excited to welcome Yuval Levin to speak on "What Are Conservatives For?” on Tuesday, April 26th at 4:30 PM in WLH 119. Levin is a journalist, academic, and political analyst. He is the founding Editor of National Affairs and the Hertog Fellow at the conservative think tank, the Ethics and Public Policy Center. Levin has been a member of White House domestic policy staff under President George W. Bush, was executive director of the President’s Council on Bioethics, and has served as a congressional staffer. In 2013, Levin won the prestigious Bradley Prize, a $250,000 grant to innovative thinkers. Levin also holds a PhD from the Committee on Social Thought at the University of Chicago. Dr. Yuval Levin has been called “probably the most influential conservative intellectual of the Obama era.” Come see him on Tuesday, April 26th at 4:30 PM in WLH 119!

Wednesday,

Yale's Community Bioethics Forum presents Jack Hughes, MD (Biomedical Ethics, Yale Medical School) speaking on "Ethical Considerations in US Healthcare Policy." The event will be at the Medical School's historical library at 333 Cedar St., and health-policy-themed art and political cartoons will be on display. The event supplies 2 credits of CPE for nurses, social workers and physicians. Refreshments will be served. Please RSVP to Lori.Bruce@Yale.edu.

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Conferences & Off Campus Events

NYU is holding triple book-launch party for three new books Deaf studies/Disability. One is "Made to Hear: Cochlear Implants and Raising Deaf Children," by our friend Laura Mauldin (Human Development and Family Studies, UConn), who hosted a cochlear implant discussion at our Bioethics Film Festival last year, and has visited us as a Yale/Hastings Scholar. The others are by Michele Friedner, and Rebecca Sanchez. Details at the link! All three will discuss their new books, this coming Friday the 29th at 4pm at NYU. WIne, cheese and conversation!

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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.  

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In the News

Climate Change

Tatiana Schlossberg. “2016 Already Shows Record Global Temperatures.” The New York Times. April 19, 2016.

This year has been the hottest year to date, with January, February and March each passing marks set in 2015, according to new data from the National Oceanic and Atmospheric Administration. Continue reading…

Disease

Maryn McKenna. “The Entire World is Getting a New Polio Vaccine This Month.” National Geographic. April 15, 2016.

In the final push to end polio, global health planners are embarking on an unthinkably ambitious and potentially risky move. Over the course of two weeks starting Sunday, they will switch 155 countries—a good portion of the world—from one polio vaccine to another. Continue reading…

Genetic Engineering

Ewen Callaway. “Second Chinese team reports gene editing in human embryos.” Nature news. April 8, 2016.

Researchers in China have reported editing the genes of human embryos to try to make them resistant to HIV infection. Their paper1 — which used CRISPR-editing tools in non-viable embryos that were destroyed after three days — is only the second published claim of gene editing in human embryos. Continue reading…

Indigenous Health

Melissa Davey. “Indigenous health: wealthy nations not always better than developing countries.” The Guardian. April 20, 2016.

Being indigenous in a wealthy country like Australia, the US or Canada does not necessarily lead to better health outcomes compared to indigenous people living in disadvantaged countries, a landmark study has found. Continue reading…

Misha Friedman. “The hard road to health care for American Indians.” CNN. April 15, 2016.

The federal government is obligated by law to provide medical care to American Indians and Alaska Natives, and it does it through the Indian Health Service, an agency of the Department of Health and Human Services. But there are still significant gaps in care, both on the reservation and in town. Continue reading...

Organ Donation

Tom Blackwell. “Canadian ‘transplant tourists’ putting their lives at serious risk: study.” National Post. April 15, 2016.

The steady stream of Canadians who continue to buy organs overseas are not only propping up a morally dubious trade, but putting their own lives at serious, long-term risk, suggests a new study. One of the lead authors says the findings offer more reason why the federal government should make participating in transplant tourism a criminal offence. Continue reading...

Medical Research

Nell Greenfieldboyce. “NIH Halts Some Research Amid Concerns Over Contamination And Safety.” NPR. April 19, 2016.

The National Institutes of Health has suspended work in two facilities that manufacture products given to people who are enrolled in research studies, saying the facilities haven't complied with safety standards designed to protect already-sick people from inappropriate risks. Continue reading…

Pharmaceuticals

Peter Loftus. “U.S. Drug Spending Climbs.” The Wall Street Journal. April 14, 2016.

Total spending on prescription drugs in the U.S. rose 12.2% to nearly $425 billion in 2015, continuing a steep climb fueled by the introduction in recent years of expensive new drugs for cancer and infections, as well as price hikes for older drugs, according to a new report. Continue reading…

Reproductive Rights

Nina Lakhani. “'I lost my youth in prison': Salvadoran women seek redress over abortion law.” The Guardian. April 14, 2016.

The case of Guadalupe Vásquez, who was imprisoned for more than seven years after losing the baby she conceived when she was raped at the age of 17, is to be examined by a panel of experts in the first People’s Tribunal to focus on El Salvador’s draconian anti-abortion law. Continue reading…

Ashifa Kassam. “Sperm bank sued as case of mentally ill donor's history unfolds.” The Guardian. April 14, 2016.

He was touted as the best of the best: Donor 9623 had an IQ of 160 and was an internationally acclaimed drummer who was working towards a PhD in neuroscience engineering. A lawsuit, filed by three families in Canada, alleges the donor was instead a convicted felon with multiple mental illness diagnoses, including schizophrenia. Continue reading...

Kira Peikoff. “In IVF, Questions About ‘Mosaic’ Embryos.” The New York Times. April 18, 2016.

New technology has revealed that about 20 percent of embryos – so-called “mosaic embryos” – have both normal and abnormal cells. At least some of these embryos seem to mature into healthy children. These births are now provoking controversy among fertility experts about what to do if mosaics are the only viable embryos a couple has left after IVF. Should would-be parents discard them because they contain abnormalities? Or transfer them in the hopes of achieving a normal pregnancy? Continue reading…

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In the Journals

Brian Mustanski and Celia B. Fisher. “HIV Rates Are Increasing in Gay/Bisexual Teens.” American Journal of Preventive Medicine. Online first, April 6, 2016.

The authors argues that ethics panels may be hindering HIV prevention efforts by requiring gay and bisexual adolescents to get parental consent before taking part in research, experts suggest. Read the original article (behind paywall), or look at Andrew W. Seaman’s coverage for Reuters.

Thomas R. Frieden and Debra Houry. “Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline.” The New England Journal of Medicine, Vol. 374, Issue 16 (2016), 1501-1504.

The author reviews the CDC’s new “Guideline for Prescribing Opioids for Chronic Pain”, a reaction to the recent dramatic increase both in the prescription of opioids and in prescription-opioid overdoses. Continue reading…

David L. Heymann, Joanne Liu, and Louis Lillywhite. “Partnerships, Not Parachutists, for Zika Research.” The New England Journal of Medicine, Vol. 374, Issue 16 (2016), 1504-1505.

The authors argue that effective research into the recent Zika virus pandemic must be conducted collaboratively. They cite failures of collaboration and argue that the global health community should develop and agree on a framework of principles for sharing data and biologic samples during such public health emergencies. Continue reading…

Gail Wilensky. “Addressing Social Issues Affecting Health to Improve US Health Outcomes.” The Journal of the American Medical Association, Vol. 315, Issue 15 (2016), 1552-1553.

Healthcare outcomes in the United States are relatively poor, despite how much money we spend on medical care. The author argues that the most effective way to remedy this situation would be to focus more attention on the social determinants of health. Continue reading…

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Opinion



Bioethics Forum

Rachel Sachs. “Pharmaceutical Transparency Bills: Targeting Disclosures Purposefully.” April 15, 2016.

Several states are currently considering bills that would require pharmaceutical companies to report a range of information on their research & development costs, marketing and advertising costs, and prices charged to a number of different purchasers. In this piece, the author asks what the purpose of these bills is. She argues that their ultimate purpose is (or ought to be) to gather data about drug R&D costs, advertising costs, and pricing that policymakers and researchers can use to make sensible choices about how to regulate pharmaceuticals. Continue reading…

Juliet Guichon. “Canada Backpedals on Medical Aid in Dying.” April 20, 2016.

The author argues that Canada’s new legislation governing medical assistance in dying fails to follow the direction of the Supreme Court of Canada’s ruling, which stated that competent, mentally ill people and people who do not have a terminal illness should be eligible. Continue reading…

The Conversation

Richard Gunderman. “Oxycontin: how Purdue Pharma helped spark the opioid epidemic.” April 19, 2016.

The author chronicles the rise of the prescription opioid epidemic, arguing that the legal opioids prescribed by physicians have proved far more dangerous than the illicit ones. Continue reading…

The Globe and Mail

Editorial. “On assisted death, Ottawa is being cautious – with good reason.” April 15, 2016.

The editors of The Globe and Mail respond to Canada’s new legislation on physician-assisted suicide, arguing that it strikes an admirable balance: it respects the Canadian Supreme Court’s ruling that denying medically assisted death to a consenting adult is a violation of his or her Charter right to security of the person, but it nonetheless refuses to compromise the need for caution in delicate end-of-life situations. Continue reading…

The Guardian

Ally Fogg. “The law will not end infant circumcisions, but education just might.” April 20, 2016.

A judge in the UK ruled that two boys at the centre of her hearing could be circumcised when the time was right. She was also quite clear that the time was not yet right. The author argues that the practice of circumcision will not be ended by an act of parliament, however well-intentioned. But it might well be reduced and eventually even eliminated by growing consideration of the rights of the child, by education, by information and, ultimately, by nothing more than the will of parents. Continue reading…

The New York Times

Austin Frakt. “Why Medical Devices Aren’t Safer.” April 18, 2016.

Things sometimes go wrong with airbags, food and drugs, prompting recalls. It can also happen with medical devices, though you’d think lifesaving devices like heart defibrillators or artificial hips would be closely monitored. But the data needed to systematically and rapidly identify dangerous medical devices are not routinely collected in the United States. It wouldn’t be that hard to do. Continue reading…

Practical Ethics

Simon Beard. “Scientists aren’t always the best people to evaluate the risks of scientific research.” April 19, 2016.

The author considers debate within the scientific community about the risks of research into “Potential Pandemic Pathogens”, arguing that current estimates are flawed and that the debate needs to move beyond the confines of the scientific community. Continue reading…

Dominic Wilkinson. “Striking out? Should we ban doctors strikes?” April 21, 2016.

Next week, junior doctors in England will be taking part in industrial action for 15 hours over two successive days. There are a series of questions raised by these strikes. In this article, the aauthor considers whether such strikes should be legal. Continue reading...

The Washington Post

Ravi Parikh. “When a doctor and patient disagree about care at the end of life.” April 18, 2016.

The author reflects on the end-of-life discussions between doctors and patients, concluding that end-of-life discussions are opportunities to learn more, to start a conversation that doctors have been missing out on for quite a while, one that focuses more on patients’ needs and less on doctors’. Continue reading…

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