The Bioethics Podcast 2006

The Bioethics Podcast is an audio resource exploring the pressing bioethical challenges of our day featuring staff, fellows, and associates of The Center for Bioethics & Human Dignity. For more information, click here for The Bioethics Podcast FAQ

Grey Matters: Neuroscience, Nuance, AND Neuroethics

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A primary task of ethics is to recognize valid distinctions in the face of uncertainty concerning moral obligations. When wrestling with life’s toughest questions, facts are often incompletely accessible or their interpretations ambiguous. Available theoretical approaches often yield conflicting solutions. When confronted with healthcare dilemmas, in particular, people differ in how they prioritize and apply their personal values to reach decisions that entail life-altering consequences.

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Materias grises: Neurociencia, matiz y neuroética

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Una tarea primaria de la ética es reconocer distinciones válidas frente a la incertidumbre con relación a las obligaciones morales. Cuando lidiamos con las cuestiones más difíciles de la vida, los hechos a menudo son accesibles incompletamente o sus interpretaciones son ambiguas. Los enfoques teóricos disponibles a menudo arrojan soluciones contrapuestas. Cuando los confrontamos con los dilemas del cuidado de la salud, en particular, las personas difieren en cómo priorizan y aplican sus valores personales para llegar a decisiones que implican consecuencias trascendentes para la vida.

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End of Life Decisions 101

The care of patients near the end of life can be ethically challenging. Physicians and other health care professionals may find certain concepts vague and hard to understand. Furthermore, there must be a balance between two extremes: a treat-at-all-costs vitalism on the one hand, and a too-rapid withdrawal of potentially beneficial treatments on the other. The purpose of this article is to provide some conceptual clarity.

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Show Me State Duped by Deceptive Amendment 2

Executive Director of The Center for Bioethics & Human Dignity (CBHD) C. Ben Mitchell, PhD, says of the passage of Missouri’s Amendment 2: “This is no triumph for science, it is a victory for dishonesty and confusion—a new Tower of Babel—where words have no meaning.”

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Open Letter from Experts in Science, Medicine, Law, and Ethics on the Cloning Provisions of Missouri's Amendment 2

A key question regarding Missouri's proposed Amendment 2 is: Would this constitutional amendment prohibit or promote "human cloning"? As individuals who have studied this issue in depth, we hold that it clearly authorizes and promotes human cloning.

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When Will We Ever Learn? Social Valuation without Help from Henry David Thoreau and Alan Paton

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It surely qualifies as a “worst of times” for medicine. Although it may be hard to believe today, beginning in the decade of the 1960s, dialysis therapy was rationed in the United States of America! The grim statistic for those outside the pale would be 100% mortality. In the group selected to receive life-saving treatment, one attribute was conspicuous by its presence—proof of “service to society.”[1] In fact, the infamous “Seattle committee” excluded people from treatment if they were not “self supporting.”[2] The rationing process itself was roundly and appropriately criticized for its transparent “prejudices . . . measuring people in accordance . . . (and solely by) middle class values.”[3] Those values also imposed a racial stigma, imbedded in service and self-support criteria. Someone commented dryly that Henry David Thoreau’s myriad eccentricities would have eliminated him from eligibility. The definition for “service” in Seattle wasn’t inclusive enough for Thoreau’s civil disobedience, ardent abolitionism, as well as his proclivities towards poetry and environmentalism. In the context of allocation decisions, these economic and sociological measures represent “social value” criteria. They have absolutely no place in the compassionate allocation of medical resources—whether the resources in question are scarce or not.

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Scientists, Ethics, and Public Engagement

In a refreshingly candid “point of view” piece in The Chronicle of Higher Education, the CEO of the American Association for the Advancement of Science (AAAS) calls for scientists to make a greater effort to get to know “their fellow citizens.” Alan Leshner, who is also the executive publisher of the journal Science, perceptively points out:

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Stem Cells 101

Human stem cells are the “starter” cells that act as precursors of mature bodily tissues. Such cells have not yet differentiated (become specialized) into their mature forms. All human beings possess such cells. For example, precursors of mature blood cells are the pluripotent stem cells of the bone marrow. These cells are called “pluripotent” (L. “many” + “powers”) because one of these undifferentiated cells can become any of a variety of different blood cells. These include the various white blood cells that protect against bodily infection, platelets that help the blood to clot, and the red blood cells that carry oxygen throughout the body.

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26

Public Language and the Common Good

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Lee Silver, professor of molecular biology and public affairs at Princeton, recently published another provocative book. Challenging Nature: The Clash of Science and Spirituality at the New Frontiers of Life is a 400-page rant favoring his own version of scientism against nearly every form of religion and spirituality. His is an equal opportunity harangue. Anyone who is skeptical about Silver’s optimism about some kind of techno-utopian future gets blasted, whether Catholic, evangelical, green, Mother Nature worshipper, or something else.

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The Future of Medicine: When Will Quality and Safety Become Job Number One?

Let’s face it, providing medical care in an era of advanced technology is both a prohibitively expensive as well as an error-prone proposition. For example, the Leapfrog Group, comprised of 150 public and private organizations organized from the Business Roundtable, an association of Fortune 500 companies, has defined some statistics directly related to the cost and safety of medical care.[1] The benefit packages of these organizations include providing healthcare services to 34 million Americans at a cost of $62 billion dollars a year. Since the Leapfrog members pay that bill, they want to have some say in what their constituencies receive for the considerable monies spent. The Leapfrog group is not alone in this regard. They have been joined by a host of significant others including the Institute of Medicine, the Institute for Healthcare Improvement (IHI), the Center for Medicare Services, and another consortium called Bridges to Excellence, to name a few from a rapidly growing number. Lest one think that this is solely a business venture, the concern is not just dollars and cents. Did you know that if the airline industry committed as many errors as healthcare does, the equivalence in lives lost would equal a passenger jet crashing every one to two days? Contemporary medicine is in a fine mess. How should it go about fixing these potentially fatal problems?

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A Review of the Novel Intuition

Jewish American novelist Allegra Goodman was already delving deep into such issues before this scandal broke in January 2006. In her most recent novel Intuition, Goodman offers an unflinching look at the strengths and weaknesses of a diverse cast of characters as they confront the real-life pressures inherent in scientific research today. Goodman weaves a host of themes throughout the progression of her narrative, including the role of perception in defining reality; competing epistemologies; and the place of individual recognition and achievement in a collective atmosphere.

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Neuroética: Informe de la Conferencia Nueva Frontera

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Neuroethics: The New Frontier Conference Report

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“Nothing is for sure,” said Raul Alvarez at the end of an interview on the opening night of the CBHD conference on neuroethics. He had been telling participants from all across the U.S. and half a dozen countries overseas about his younger brother, Mario. Mario has been severely neurologically disabled due to traumatic brain injuries sustained in a hit and run incident in March of the year 2000.

The story of his medical care, of the ethical issues faced, of the health provider who continues to sue the family over bills that should be paid by government sources, of the attorney who has provided free assistance, and of the extraordinary commitment of the family who are with Mario 24/7, brought tears to some eyes. Invited to share one final message, Raul reminded us all of the ever-present uncertainties in clinical practice—sometimes about diagnosis but always about prognosis. The family wanted to stress to professionals the importance of hope, and had certainly lived and worked by that principle themselves.

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The Stem-Cell Veto

President Bush’s veto on Wednesday of any change in his stem cell research policy was derided by many as a sop to his conservative base. But the price that the president and his party are sure to pay for this decision leads me to the conclusion that, whatever the politics of the move, the president actually has been persuaded by the moral argument against embryonic stem cell harvesting.

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Dignidad humana: Aún desafiando la devaluación

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¿Sirve de algo el concepto de "dignidad humana" en bioética? ¿Arroja luz importante sobre toda la gama de temas bioéticos, desde la investigación del embrión y la reproducción asistida, pasando por las mejoras biomédicas, hasta el cuidado de los discapacitados y moribundos? ¿O es, al contrario, inútil; cuando mucho un vago sustituto para otros conceptos más precisos, y en el peor de los casos un simple eslogan que camufla argumentos poco convincentes y prejuicios no expresados?

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