Crossing Cultural Barriers (by 7 March)

Read the "Crossing Cultural Barriers" case distributed in hard copy in class on Thursday 27 Feb and electronically via email.

Respond to the following questions from the case:
if you worked in a group, you can provide just one answer, but please note group members.
1. What are Ellen's responsibilities to Sebena, to Terfera, to her adviser and to the research study?
2. How could the informed consent form or the process of obtaining informed consent be modified to address Ellen's concerns?  Consider issues such as different cultural meanings of disease, the need for background knowledge about science, medicine and research study design, and the length and depth of the information provided.

Answer on your own or in a group:
4. What are the ethical implications of providing a U.S. standard of medical care through a research study in a society that cannot support the cost of such care outside a foreign-sponsored research protocol?  (please refer to at least 1 of the 3 readings on international research ethics that we've discussed in class).

What is Health? (due by 22 April)

In our course we're talking about how to best treat disease, restore health, fix health problems. But all of that discussion presupposes that we know what "health" is.  Please start the discussion here.  Think about all aspects of health, whether the definition should include more than any single individual (i.e., consider psycho-social dimensions), and don't forget the low-tech, non-invasive solutions to many problems which might broadly be included in a discussion of health (e.g., healthy communities where access to green space, fresh air, and places to exercise are important, I'd argue, to maintaining health.  That's a much more holistic way of thinking about health as opposed to merely thinking about health as the absence of disease).

Informed Consent (due by 28Feb)

Informed Consent (domestic & international)
Address 1-2 of the following, then comment on 1-2 of your classmates' responses.

1) What do we mean when we ask about the quality of informed consent?  What could undermine informed consent (see the Glantz et al. essay in particular).
2) Who are vulnerable populations which might need special attention when asked to participate in research?
3) What is exploitation?  How could medical research be exploitative?
4) Should there be different standards (of risk/benefit, or informed consent, etc.) for developed vs. developing countries?


Background
Institutional Review Boards (IRB)
UC's IRB http://researchcompliance.uc.edu/Home.aspx

More info from
Hastings Center Report (a bioethics periodical)  http://www.thehastingscenter.org/Publications/IRB/
& Harvard http://www.hsph.harvard.edu/ohra/ 

Immortal Life of Henrietta Lacks  
http://rebeccaskloot.com/the-immortal-life/

Tuskegee Syphilis "experiments"

• Transcript of President Clinton's 1997 formal apology to study members.

http://clinton4.nara.gov/textonly/New/Remarks/Fri/19970516-898.html

• Centers for Disease Control (CDC) Tuskegee study Web site .
http://www.cdc.gov/tuskegee/   

• Background on the Tuskegee study, from the Tuskegee University National Center for Bioethics.
http://www.tuskegee.edu/about_us/centers_of_excellence/bioethics_center.aspx

• Tributes to Herman Shaw, who died Dec. 3, 1999, and Fred Simmons, who died Feb 5, 2000.

http://www.dollsgen.com/special_obituary_tribute.htm

 

Alt assignments - ec/substitute for exam Q (before spring break)

Please let me know via this blog if you are interested in reading one of the following:
Atwal Gawande’s Better, 
Five Days at Memorial by Sheri Fink, or 
The Immortal Life of Henrietta Lacks by Rebecca Skloot.

Assignment to be completed before Easter (late April)
up to 3 points extra credit for reading & informal discussion with me and whomever has read.

up to 10 points (substitution for a final exam essay) -- I'll have to create the specific questions once I figure out who is reading what.

Case 7 Cosmetic Surgery (due 14Feb14)

A perfect case for Valentine's Day, no?

Analyze the case by starting with the questions at the end.  First 4 to respond just answer the questions from your own perspective.  Next 4 answer from Utilitarian perspective, next 4 from Kant, next 4 from Virtue Ethics, next 4 from Principles of Bioethics, next 4 from Ethics of Care, next 4 from Ross' Principles.

criteria for physician-assisted suicide (PAS)

Under what circumstances do you think that PAS could be permissible?  Name as many constraints as you wish, but read what your classmates have written so that we don't all say the same thing.  If others have posted before you, add to what they've said -- give additional reasons for support or play devil's advocate or provide examples/illustrations.

Current Events February

Posted 25Feb14 Genetically modified babies
http://www.nytimes.com/2014/02/24/opinion/genetically-modified-babies.html?nl=todaysheadlines&emc=edit_th_20140225&_r=0

posted 12Feb14  ‘Aid in Dying’ Movement Takes Hold in Some States - NYTimes.com

http://mobile.nytimes.com/2014/02/08/us/easing-terminal-patients-path-to-death-legally.html?nl=todaysheadlines&emc=edit_th_20140208&_r=0&referrer=

posted 12Feb14  NYTimes: Vast Study Casts Doubts on Value of Mammograms

http://nyti.ms/1eSbFcm

A 25-year study involving 90,000 women has found that the breast-cancer screenings did not lower the death rate from the disease and had harms.

posted 11Feb14 NYTimes: The Path to Reading a Newborn’s DNA Map

http://nyti.ms/1bAhvxr

As technology becomes more sophisticated, genomic sequencing will inevitably expand into the world of newborns. The process has both medical and ethical implications.

Ethics Questions Arise as Genetic Testing of Embryos Increases - NYTimes.com

http://mobile.nytimes.com/2014/02/04/health/ethics-questions-arise-as-genetic-testing-of-embryos-increases.html?nl=todaysheadlines&emc=edit_th_20140204&_r=0&referrer=