Open Letter to Health Care Professionals: We Have a Problem
D. Joy Riley, M.D., M.A. Executive Director
To Health Care Professionals: We have a problem. Our health care systems typically have multiple levels of health care “providers” who see and treat patients with or without physician input or oversight. The interposition of electronic medical records and automated systems add another layer of complexity to the health care arena. Young trainees — medical students and others — have, due to various pandemic policies, been “trained” online. The distance between health care professional and patient has increased by many of these factors. The problem we health care professionals have is with the second word ...read more
What Does Autonomy Have to Do with It?
D. Joy Riley, M.D., M.A. Executive Director
On the second day of May, 2022, a U.S. Supreme Court draft opinion in the Mississippi Dobbs case, regarding abortion, was leaked to the media. The resulting cultural distress frenzy has been somewhat akin to dropping meat into a pool of piranhas. Much energy is being spent in projecting what will happen if the final decision resembles the draft. A summer of rage is being threatened by some abortion supporters.
Where, O where, is reason in all of the verbiage? Interestingly and amazingly, a book of compassionate pro-life counters to abortion advocates was published by Moody ...read more
Life and Choice
Janet Liljestrand, M.D., M.A.
In 1862 Louis Pasteur performed the definitive experiment that proved even the smallest organisms, those only seen under the microscope, derived from other like organisms. (1) Life came from life. Fast forward to 1973, and Justice Blackmun, writing for the majority decision in Roe v. Wade stated “We need not resolve the difficult decision of when life begins”. (2) What was the Justice’s definition of life? The human zygote contains all it needs for cellular division–and thus growth–at the union of a living sperm and living egg. How then has its human life not begun? Yes, in ...read more
Risk versus Benefit
Janet Liljestrand, M.D., M.A.
Whether we realize it or not, we weigh the benefit versus the risk of most decisions, large and small. When making medical decisions, physicians will sometimes refer to the risk/benefit ratio. A math problem with numbers? Unfortunately not, but a clinical judgment seeking to determine if the benefit that this particular patient is likely to receive is greater or lesser than the risks the patient will be assuming with the procedure or medication.
Childhood immunizations risks are often stated to be less than one in a million. With such a low risk, the benefits are great by comparison. ...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
Parenting in the Midst of the COVID-19 Pandemic
Janet Liljestrand, M.D., M.A.*
Rearing children is a time-consuming and emotionally taxing undertaking. The current pandemic has magnified the enormity of this task by disrupting the lives of adults and children alike. What does a parent say and do in the midst of a pandemic that has the added burden of activity restrictions, a 24-hour news cycle, multiple voices on social media, and changing messages from the “experts,” all mixed with a touch of hysteria? The basics of parenting in the midst of a pandemic are much the same as any other stressful time with the possible exception that the stressful ...read more
The Prescription for Flourishing Embodiment in Public Bioethics
A Book Review
C. Ben Mitchell, Ph.D. Distinguished Fellow
American public bioethics does not have a sterling history because it misunderstands its most important subject, the human subject. This is the claim of a brilliant new book by O. Carter Snead, the Director of the de Nicola Center for Ethics and Culture and professor of Political Science at the University of Notre Dame.
In What it Means to be Human: The Case for the Body in Public Bioethics (Harvard, 2020), Snead offers a genealogy of American public bioethics. Public bioethics, as contrasted with clinical bioethics, is the realm of human subjects research where, instead ...read more
The Problem of Ill-Gotten Gain in Health Care
C. Ben Mitchell, Ph.D. Distinguished Fellow
The politicized debate about President Trump’s treatment for Covid-19 may have shrouded an important set of questions about the science of developing treatments, viz., the problem of ill-gotten gain.
Among other treatment protocols, the President received Regeneron’s REGN-COV2, a “cocktail” of two neutralizing antibodies that has shown promise in some animal studies (see here and here). The media jumped on an association between REGN-COV2 antibodies and fetal cells, some even claiming that the antibodies were developed from fetal cells.
Screenshot of NYT headline on Oct. 8, 2020
The fact of the matter is REGN-COV2 was tested for its virus-neutralizing ...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
AMA Resists Embracing “Neutrality” on Physician-Assisted Suicide
D. Joy Riley, M.D., M.A. Executive Director
Yesterday, the American Medical Association (AMA) House of Delegates voted to retain the current position of the AMA RE physician-assisted suicide. That was the recommendation of the AMA’s Council on Ethical and Judicial Affairs (CEJA), and the CEJA report was accepted by a 65:35 majority, according to the National Right to Life News.
CEJA is responsible for maintaining and updating the AMA’s Medical Code of Ethics, and promoting “adherence to the Code’s professional ethical standards.” Last year, CEJA recommended maintaining the long-held AMA stance against physician-assisted suicide, but the House of Delegates rejected that recommendation. Further ...read more
