When Breath Is (Not Enough) Air: Let’s Talk about Ventilators
There has been much public discussion about ventilators amidst the COVID-19 pandemic. It is humbling to consider that we, or someone we love, might require one. Most people know something about the benefit of a ventilator when needed; but how well do we really understand the functions and risks of mechanical ventilation? The pandemic presents an opportune time to learn about this. So I posed a series of questions about these machines and the processes involved in using them to a physician, who is a specialist in using ventilators to treat very ill patients. Those questions, and her answers, follow.
1) ...read moreWhen the Foundations Are Wobbling, Part II
Death Certificates and COVID-19
D. Joy Riley, M.D., M.A. Executive Director
One of the tasks assigned to physicians is the completion of death certificates—at least, the portion of death certificates that list cause of death (COD). I learned the importance of accuracy of death certificate completion as a pathology student fellow, an extra year of pathology training in the middle of my medical school career. We were instructed never to use the mechanism of death, such as cardiac or respiratory arrest, as a cause of death. Additionally, the use of terms like “probable” or “suspected” were not allowed. After all, the goal of ...read more
When the Foundations Are Wobbling, Part I
The Denominator of Death Rates
D. Joy Riley, M.D., M.A. Executive Director
How many people in the U.S. have died of SARS-CoV-2 infection, or COVID-19? That is difficult to say, and not for lack of numbers on the website of the Centers for Disease Control and Prevention (CDC). The case fatality rate for a particular disease is, basically, the number of persons dying of a disease, divided by the number of persons who have the disease, and multiplied by 100, to give an answer in terms of percentage:
# persons dying of COVID-19 disease X 100 # persons infected with SARS-CoV-2
How is this complicated? ...read more
Flourishing in the Midst of Crisis
Focus on the “Local”
D. Joy Riley, M.D., M.A. Executive Director
It may seem ironic in this time of coronavirus* epidemic that The Tennessee Center for Bioethics & Culture’s theme for 2020 is Human Flourishing. Of course, the theme was chosen before the populace was on such intimate terms with the infection. The theme was also chosen before tornadoes** struck Middle Tennessee; before we knew we would need a hefty dose of encouragement in 2020. In this month’s post, several Tennesseans are featured. From a pharmacist in western Tennessee to a group of studio singers in Music City, these can help us to ...read more
Flourishing . . . In a Time of Debate
Ben Voth, Ph.D., associate professor of corporate communications and public affairs at Southern Methodist University, is also director of debate at SMU. His book, James Farmer, Jr.: The Great Debater (Lanham, MD: Lexington Books, 2017) provides exemplars of debate from the previous century – ones from whom we could learn much today. Voth’s book is not a biography of James Farmer, Jr., but a dissection of how Farmer, reared by his capable parents (his father was both a minister and a professor) and trained by Melvin Tolson at Wiley College, used rhetoric properly fitted to action to change the world. ...read more
COVID-19 in Wuhan: Plea for Help Retracted
D. Joy Riley, M.D., M.A. Executive Director
One thing is clear: COVID-19, the newest coronavirus to infect humans, has our attention. Locally, people planning to travel—almost anywhere—are wondering about where to obtain face masks. As of Tuesday of this week, reports the New York Times, the United States had 57 cases, with 40 of those related to the Diamond Princess cruise ship that docked in Japan. The NYT article further reported,
“We cannot hermetically seal off the United States to a virus,” Alex M. Azar II, the secretary of health and human services, told a Senate panel on Tuesday. “And we need to ...read moreFlourishing: The 2020 Theme of the TNCBC
In the midst of the quandaries posed in the bioethics arena, survival may seem the only goal that is desirable or achievable. The conclusion of the board of The Tennessee Center for Bioethics & Culture, however, is that while survival is certainly important, our organization should be about more. It should be about human thriving, or flourishing. We even have a visual image for that!
Last June, local multimedia artist, Carol Harkness, gifted our organization with this beautiful original mixed media mosaic on birchwood (11.5″ X 11.5″), in a hand-rubbed walnut frame. It was presented to June’s top donors to The ...read more
23andMe and Drug Development
D. Joy Riley, M.D., M.A. Executive Director
More than a decade ago—in a different time and a different place—a neighbor offered me a box of stuff he had bought as part of a lot at some estate sale. He needed to get rid of no small amount of “stuff,” so he gave me that box of tarnished silverware and odds and ends. I took it home and spent a couple of days cleaning it. We were already planning a yard sale, and so I placed the now-cleaned items I did not need from the neighbor’s box in the sale. Imagine his surprise ...read more
Human Flourishing in an Age of Gene Editing
A Book Review By R. Henry Williams, M.D., F.A.C.P., M.A. (Ethics) Board Chairman, The Tennessee Center for Bioethics & Culture
Human Flourishing in an Age of Gene Editing Erik Parens and Josephine Johnston, Editors Oxford University Press, 2019
As we now live in a time when our genetic code can be altered, whether for better or worse, how should we think about what is best for ourselves? How can we as a human species and as individuals flourish? These are the questions posed in the new volume, Human Flourishing in an Age of Gene Editing. The essays here are interactive, frequently referencing one another, as the ...read more
Statement on the Clinical Use of Human Germline Genome Editing
Given that According to the canons of research on children, experiments are only ethically justified when there are clear benefits to that individual child and proportional burdens to that child. Risks and burdens beyond truly “minimal” to individual children are not justified to benefit other children. To do so is to treat one child as a means to another child’s ends (i.e., to instrumentalize that child).
Whereas Human germline genome editing is experimentation on embryonic humans who cannot give consent, ...read more
