Is It Science or Scientism?
Joyce Shelton, Ph.D. Professor of Biology, Trinity International University Guest Column
In the climate of fear, uncertainty and urgency engendered by the COVID-19 pandemic, it is often difficult to know what to do or whom to trust. Public policy makers are daily making decisions and enacting rules that affect our lives and dictate our actions in the name of protection. They lend authority and justification to their decisions by claiming that they are following the science, implying that this appeal to a trusted, rational voice should be enough to calm our concerns and guarantee our compliance. But the elevation of science to the ...read more
The Ethics of Rationing COVID-19 Vaccine for the Sickest Among Us
C. Ben Mitchell, Ph.D Distinguished Fellow
We must not allow our combined COVID-19 fatigue to prevent us from asking important questions about public health ethics. At the time I am writing this essay, we are just transitioning into Phase 2 of the vaccination plan. I am sure our public health officials are doing the best they can under unprecedented circumstances, so we should give them the benefit of the doubt. But for the sake of clarity in the future, some retrospective analysis will be crucial.
For instance, in our own state, we have abandoned traditional triage ethics in favor of a purely age-based ...read more
A Project for Our Time
D. Joy Riley, M.D., M.A. Executive Director
The responses to the COVID-19 pandemic have been by turns dramatic and disconcerting, and, at times, draconian. I read about Steve Reiter’s deplorable experience and his new project in a BreakPoint commentary in July, and he was kind enough to speak with me by telephone on 24 July.
Steve’s beloved wife, Elizabeth, had diagnoses of lupus and pulmonary hypertension, among other difficulties. She had had a lengthy hospitalization in 2014, but had recovered. Steve attributes her recovery to excellent medical care and the 24/7 presence of her family. She had a Hickman line placed, and Steve ...read more
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
