Up@dawn 2.0

Wednesday, December 14, 2016

Bioethics for Every Generation

In Bioethics for Every Generation: Deliberation and Education in Health, Science, and Technology, the Bioethics Commission demonstrates how democratic deliberation and ethics education can go hand-in-hand to solve some of the most intractable problems in bioethics and beyond. The Bioethics Commission offers eight recommendations to strengthen and advance deliberation and education to improve policy-making in bioethics, and to create a more democratic and just society.

Read Bioethics for Every Generation
Read the Five Steps for Effective Deliberation
Read media coverage on the issue
Read the press release
Relevant public meetings
Blog coverage
-Presidential Commission for the Study of Bioethical Issues

Bioethics for Every Generation (May, 2016)
Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society (Mar, 2015)
Ethics and Ebola: Public Health Planning and Response (Feb, 2015)
Gray Matters: Integrative Approaches for Neuroscience, Ethics, and Society (May, 2014)
Anticipate and Communicate: Ethical Management of Incidental and Secondary Findings in the Clinical, Research, and Direct-to-Consumer Contexts (Dec, 2013)
Safeguarding Children: Pediatric Medical Countermeasure Research (Mar, 2013)
Privacy and Progress in Whole Genome Sequencing (Oct, 2012)
Moral Science: Protecting Participants in Human Subjects Research (Dec, 2011)
"Ethically Impossible" STD Research in Guatemala from 1946 to 1948 (Sep, 2011)
New Directions: The Ethics of Synthetic Biology and Emerging Technologies (Dec, 2010)

Wednesday, November 9, 2016

Harvard Med School (@harvardmed)
Manjinder Kandola, an HMS student, discusses the importance of being a physician for patients and how that role impacts society #EdWed pic.twitter.com/DcO4ewlygt

Treating depression and anxiety with psilocybin...

Frank Spencer (@Frankwspencer)
Female Doctors Beat Male Counterparts In Caring For The Elderly : Shots - Health News : NPR npr.org/sections/healt…

Tuesday, November 1, 2016

Returning to MTSU, Spring 2017

PHIL 3345,


TTh 4:20-5:45 pm, BAS S330

Supporting the philosophical study of bioethics, bio-medical ethics, biotechnology, and the future of life, at Middle Tennessee State University and beyond... "Keep your health, your splendid health. It is better than all the truths under the firmament." William James

The anchoring theme will again be the psychological and social dimensions of medicine and the life sciences, from birth to death.

Texts 2017. We’ll begin with these texts:

·         Bioethics: The Basics (Campbell) ”...the word ‘bioethics’ just means the ethics of life…”

·         On Immunity (Biss) “If we imagine the action of a vaccine not just in terms of how it affects a single body, but also in terms of how it affects the collective body of a community, it is fair to think of vaccination as a kind of banking of immunity.”

·         Gratitude (Oliver Sacks) “Oliver Sacks was like no other clinician, or writer. He was drawn to the homes of the sick, the institutions of the most frail and disabled, the company of the unusual and the ‘abnormal.’ He wanted to see humanity in its many variants and to do so in his own, almost anachronistic way—face to face, over time, away from our burgeoning apparatus of computers and algorithms. And, through his writing, he showed us what he saw.” -Atul Gawande, author of Being Mortal

For more info contact phil.oliver@mtsu.edu, or visit http://bioethjpo.blogspot.com/

Friday, October 7, 2016

"A Letter to the Doctors and Nurses Who Cared for My Wife"

After his 34-year-old wife suffered a devastating asthma attack and later died, the Boston writer Peter DeMarco wrote the following letter to the intensive care unit staff of CHA Cambridge Hospital who cared for her and helped him cope.
As I begin to tell my friends and family about the seven days you treated my wife, Laura Levis, in what turned out to be the last days of her young life, they stop me at about the 15th name that I recall. The list includes the doctors, nurses, respiratory specialists, social workers, even cleaning staff members who cared for her.
“How do you remember any of their names?” they ask.
How could I not, I respond.
Every single one of you treated Laura with such professionalism, and kindness, and dignity as she lay unconscious. When she needed shots, you apologized that it was going to hurt a little, whether or not she could hear. When you listened to her heart and lungs through your stethoscopes, and her gown began to slip, you pulled it up to respectfully cover her. You spread a blanket, not only when her body temperature needed regulating, but also when the room was just a little cold, and you thought she’d sleep more comfortably that way.
You cared so greatly for her parents, helping them climb into the room’s awkward recliner, fetching them fresh water almost by the hour, and by answering every one of their medical questions with incredible patience. My father-in-law, a doctor himself as you learned, felt he was involved in her care. I can’t tell you how important that was to him.
Then, there was how you treated me. How would I have found the strength to have made it through that week without you?
How many times did you walk into the room to find me sobbing, my head down, resting on her hand, and quietly go about your task, as if willing yourselves invisible? How many times did you help me set up the recliner as close as possible to her bedside, crawling into the mess of wires and tubes around her bed in order to swing her forward just a few feet?
How many times did you check in on me to see whether I needed anything, from food to drink, fresh clothes to a hot shower, or to see whether I needed a better explanation of a medical procedure, or just someone to talk to?
How many times did you hug me and console me when I fell to pieces, or ask about Laura’s life and the person she was, taking the time to look at her photos or read the things I’d written about her? How many times did you deliver bad news with compassionate words, and sadness in your eyes?
When I needed to use a computer for an emergency email, you made it happen. When I smuggled in a very special visitor, our tuxedo cat, Cola, for one final lick of Laura’s face, you “didn’t see a thing.”
And one special evening, you gave me full control to usher into the I.C.U. more than 50 people in Laura’s life, from friends to co-workers to college alums to family members. It was an outpouring of love that included guitar playing and opera singing and dancing and new revelations to me about just how deeply my wife touched people. It was the last great night of our marriage together, for both of us, and it wouldn’t have happened without your support.
There is another moment — actually, a single hour — that I will never forget.
On the final day, as we waited for Laura’s organ donor surgery, all I wanted was to be alone with her. But family and friends kept coming to say their goodbyes, and the clock ticked away. About 4 p.m., finally, everyone had gone, and I was emotionally and physically exhausted, in need of a nap. So I asked her nurses, Donna and Jen, if they could help me set up the recliner, which was so uncomfortable, but all I had, next to Laura again. They had a better idea.
They asked me to leave the room for a moment, and when I returned, they had shifted Laura to the right side of her bed, leaving just enough room for me to crawl in with her one last time. I asked if they could give us one hour without a single interruption, and they nodded, closing the curtains and the doors, and shutting off the lights.
I nestled my body against hers. She looked so beautiful, and I told her so, stroking her hair and face. Pulling her gown down slightly, I kissed her breasts, and laid my head on her chest, feeling it rise and fall with each breath, her heartbeat in my ear. It was our last tender moment as a husband and a wife, and it was more natural and pure and comforting than anything I’ve ever felt. And then I fell asleep.

I will remember that last hour together for the rest of my life. It was a gift beyond gifts, and I have Donna and Jen to thank for it.
Really, I have all of you to thank for it.
With my eternal gratitude and love,
Peter DeMarco

Thursday, August 18, 2016

"Long Long Lives: Should We Want Them?"

Today, as our capacity to prolong life increases, people dispute whether indefinite prolongation could possibly be good. A leading bioethicist, Ezekiel Emanuel (brother of Rahm) has written that we should all want to die at 75! I'll approach this question by drawing on ancient Greek arguments about why immortal life is undesirable -- arguments that I find fatally flawed. I then turn to two more recent philosophers who try to reconcile us to finite and reasonably short mortal lives: "Younger Martha" (i.e. me in 1994), and my teacher Bernard Williams, who wrote about the "tedium of immortality." I find those consolatory arguments flawed too. But a better argument is found in the Roman philosopher Lucretius, and it applies to indefinite prolongation as well as to outright immortality.

Martha Nussbaum is the Ernst Freund Distinguished Service Professor of Law and Ethics.

Presented on April 5, 2016, at the University of Chicago Law School.

Thursday, May 12, 2016

A bioethicist's "last lecture"

Glenn McGee (@glenn_mcgee)
Here is my last lecture, or at least this is what I would say if I could only give one more. I hope you enjoy it: youtube.com/watch?v=evYuZD…

Thursday, May 5, 2016

Misconception of Vaccines in the Anti-Vaccination Movement

            The purpose of this post is to inform the reader about common misconceptions of vaccines that some of the anti-vaccination public falsely rally behind.  In short, vaccinations are a preparation of killed microorganisms, living attenuated organisms, or living fully virulent organisms that is administered to produce or artificially increase immunity to a particular disease. No licensed American physician prescribes the use of vaccines containing fully virulent organisms, as it will most likely result in the virus infecting the patient resulting in the patient exhibiting the disease. This is not an option for most diseases. Live, attenuated viruses are a weakened version of the virus that will not cause the disease, unless the vaccine is not prepared properly. The overwhelming majority of vaccines are killed, purified. This killed, purified virus can in no way result in infection and disease. In most cases, no infectious material is present in a killed, purified vaccination and the immune response is triggered by the viral capsule and antigens (none infectious material).
            This leads into one of the big reasons individuals are anti-vaccination on a small scale and do not get annual vaccinations such as the flu shot. As you know, the flu changes early, so that our immunity induced the previous year is already null in our bodies combating of the disease. We require annual vaccination to combat the every changing virus. However, most individuals have the belief that every year they receive the flu from the flu shot. This is impossible as killed, purified vaccinations can in no way cause the illness for which it is designed to prevent. It is possible, though highly unlikely, for a patient to contract the virus when receiving the vaccines live, attenuated version, but this version is given as a mist instead of a shot and is virtually never used by doctors. In actuality, patients contract a minor disease with flu like symptoms before getting the vaccine. When symptoms appear due to the disease patients commonly attribute this to the vaccine. The flu is actually a very serious illness that doesn’t just leave you feeling crummy for two days. 36,000 people die and more than 200,000 are hospitalized by the flu yearly in the U.S. alone. Please take the time to get the vaccination yearly.
            Another issue the public has with vaccinations are the number that infants need to receive in one doctors visit. There are many reasons for the vaccination schedule being as it is. Firstly, we want to vaccinate our children as quickly as possible because unvaccinated children are at risk of being infected by a life ending and debilitating illness. Secondly, the vaccinations follow a pattern of about every three months. Parents remember to come to a doctors visit if it is for multiple different things, one of which is vaccinations. If vaccinations are separated, often parents miss appointments as they do not deem one vaccination as important or just forget to attend. This is shown by the irregularity of the schedule in which a hepatitis booster shot is not given at the same timing as any other shot. For this reason, it is the most missed shot on the CDC schedule. It is best to get three vaccinations done at one time to save time for more enjoyable activities. Finally, the schedule is in place with follow up shots placed at times critical for obtaining optimal immunity response. This schedule has been reviewed and established by professionals, and even though three shots is a lot for one baby in a single afternoon, the schedule is recommended for a reason. Please talk in length with a virologist if you wish to follow a non-CDC proscribed regiment.
            There are many other misconceptions that can be talked about in this article such as how vaccines had been fraudulently linked to autism, how they contain harmful ingredients, and treat non-existent viruses. However, as I am well over my word count, I will leave these up to you to research. I am happy talking about some of the lesser argued topics that vaccine and non-vaccine supporters both debate. Just please, no matter what side of the argument you believe in, do you research and find scientifically proven data that supports your claim. Do not just believe the catchy slogan posted on a Facebook wall or celeb tweet.

            Thank you for reading.

Hospice part two

My last post I discussed my interaction with Hospice.
With this post I will just discuss questions and then myths and facts about Hospice that I learned through my experience.

What does hospice really do?
How do I know when it’s time for end-of-life care?
When should hospice be called?
Where is hospice care provided?
Are all hospices the same?
Can my pain and symptoms be controlled at home?
Does Hospice provide 24-hour in-home care?
Can I live alone and still receive Hospice services?
Can a hospice patient choose to return to curative treatment?
Can I go back to the hospital and still receive hospice care?
Is the decision for hospice care giving up hope or waiting to die?
Does hospice do anything to bring death sooner?
Do I have to be homebound to receive hospice services?
Does hospice provide support to the family after the patient dies?
These are all common questions about Hospice. 

What does hospice really do?
Hospice provides specialized care services (patient care including symptom management, emotional support, spiritual support and psychosocial intervention), addressing issues most important to the patient’s needs and wants at the end of their life focusing on improving the individual’s quality of life.

When should hospice be called?
Hospice should be called at any time the patient has been diagnosed with a life-limiting illness. It is appropriate to discuss all of the patient’s care options, including hospice.

Is the decision for hospice care giving up hope or waiting to die?
No. Hospice is about living. Hospice strives to bring quality of life and comfort to each patient and their family. Our successes are in helping a patient and family live fully until the end. Often patients will feel better with good pain and symptom management. Hospice is an experience of care and support, different from any other type of care.

Myth: Hospice care is only for cancer patients
Truth: Hospice care is for all patients with a terminal illness with a prognosis of 6 months or less including but not limited to: Alzheimer’s, cardiac disease, ALS, stroke, liver disease.

Myth: Hospice is just for the elderly
Truth: Hospice is for all age groups during their final stages of life, including children and adults of all age groups.

Myth: Hospice is just for the patient
Truth: Meeting the needs of the patient and family is a top priority. The family unit is at the center of all decision making. Hospice recognizes that it takes many caregivers to meet the unique needs of each patient.

These are just some of the things that I learned with my experience with Hospice 

Wednesday, May 4, 2016

Owing Health to Our Neighbors

We owe our health to our neighbors. This, to me, feels part of a basic human duty; rather, I would go as far to say that it is a privilege. We can do what we can to give our neighbors health as they do the same for us, what better way to improve lives and work together than this simple statement. Unfortunately, that is not the case in most scenarios today, specifically when it comes to vaccines. So it then comes to how can we convince the rest of the world that this is a necessary course of action. We can look at some examples of how looking after one another, or even working together can produce positive effects, then understand why this is necessary.
            Alone, many animals are easily stalked and attacked by predators, leading to technique of predators separating singles out of a herd as a method of attack. Together, however, they are able to outnumber the predators with brute force or strength and protect one another. This is the case with vaccines and herd immunity. If everyone is vaccinated, producing immunity, then there is no host for a disease. Even if a vaccine is mostly ineffective, if given to everyone, a virus or sickness has trouble bouncing around and eventually dies out. There are also some exceptions for people who can’t take the vaccine for medical reasons or who the vaccine doesn’t fully work who are still susceptible, but because of herd immunity, they are protected from the virus being unable to reach them regardless. The problem is when fully capable people don’t have the vaccine. They not only expose themselves, but those who physically can’t take the vaccine.
            There is a case saying that these vaccines may cause harm themselves in very few cases, and if this were true there would be a reasonable claim. However, any of these claims have been proven false numerous times. There have only been very few cases that would even begin to link vaccines to sickness, and these are are not truly connected to vaccines. There is no real case as to why anyone would avoid vaccines. Rather, vaccines have helped the world by getting rid of nasty diseases that have ravaged the world for a long period of time, as seen in the graphic above.
            It is important for people to know the risks they put onto others by refusing vaccines. There is no real circumstantial evidence that they can cause illness and their proven success at eradicating diseases are irrefutable. It is easy for people to partake in certain activities that are proven to be harmful to themselves and still do them, and that is okay because it doesn’t effect anyone else. They understand the risks and are willing to endure them for something they are passionate about or enjoy doing. What is hard for me to grasp is that when they can do something that helps themselves as well everyone around them, there are some people who choose to take the safe route. To truly convince others, it is necessary for they themselves to look into the facts for themselves, on both sides, to understand what is true and what is necessary.
            Taking this class has allowed me to see the importance of looking into things through research and through introspection as well. It is important to understand that one’s own viewpoint isn’t the only one, and there are other views that likely make more sense and more valid. My biggest take away is to step back and look at situations from every possible angle before making rash assumptions.