Friday, February 15, 2019

Quizzes Feb 19, 21

Beyond 7-9. Add your questions, comments, links... Anyone care to volunteer to report on Tuesday?

1. The advent of what common metric made it possible to calculate the efficacy of selling?

2. What was lacking in the '60s that Principlism offers to provide?

3. What was the final impetus for government intervention in research ethics?

4. What would be the key problem of letting each Institutional Review Board determine its own principles?

5. Feminist theory is an attempt to do what?

6. Who wrote in 1952 that woman is the "second sex"?

7. When is society more willing to intrude on human autonomy?

8. What accounts for the special feeling of abandonment some patients get from their seemingly uncaring surgeons?

9. What expectation for disability rights debates is "sadly" unmet?

10. What is "animal farm bioethics," and what are some issues and debates in which it is evident?

DQs

  • Is the culture of business healthy, on balance, for healthcare?
  • Why is the medical profession so slow to respond to whistle-blowing like Henry Beecher's "Ethics and Clinical Research"? What might make it more responsive and generally more vigilant in policing itself?
  • Is the culture of mistrusting authority in our society good for healthcare and the regulation of healthcare?
  • Is there a general problem with individuals and aggregates of individuals (committees, boards, states...) determining their own principles of conduct? Is there a problem with them not doing so? Is there a solution to the dilemma?
  • Have you ever questioned the "system" of a committee of which you were a member? How did that go?  92
  • Can you give an example of gender bias resulting in unethical behavior by health practitioners?
  • Have we moved significantly away from androcentrism in your lifetime? Will we move further?
  • Can the medical profession, or any particular profession, become less gender-biased if the larger society remains relatively moreso? As women increasingly join the ranks of physicians, will that happen?
  •  What do you think of the stereotypical "association of women with emotion and men with reason"? 100
  • Do you associate emotion more with the body than the mind? How in general does the classic mind-body problem relate, in your thinking, to gender issues (if at all)?
  • Do you think sex selection and disability deselection are ethically equivalent or commensurable? Is any stipulated difference between them arbitrary or "hierarchical"?
  • How do you define "cosmetic" (vs. "medical")?
  • How do you define "disease"?

==
Health news... Health news quiz...
==
‘The Unwinding of the Miracle’ Is About How to Die — and Live

She didn’t know it then, but Julie Yip-Williams began her memoir, “The Unwinding of the Miracle” — which enters the list at No. 8 — in July 2013. That’s when the 37-year-old mother of two, in the E.R. with stomach pains and nausea, learned she had Stage 4 colon cancer.

The next month, she started a blog, partly as a record for her daughters, Mia and Belle (“especially if this cancer-fighting journey doesn’t end in the way we all hope it ends”), and partly, she wrote, “to carve out my own little space out there to express my sadness, anger, joy, hope, despair and a slew of other emotions that come with living with cancer.”

Mark Warren, her editor at Random House, says, “Julie was my friend for a couple of years before the prospect of a book even came up. It was in the last year of her life, when her health was turning toward its end, and she was resolving all she could resolve, that we began to contemplate whether the blog could be a book.” Yip-Williams had been searching for a book that would help her prepare to die, but she hadn’t found one. “She was unnerved by the level of denial that she found in the culture at large,” Warren recalls...
==
Embryo ‘Adoption’ Is Growing, but It’s Getting Tangled in the Abortion Debate
As evangelical Christians, Paul and Susan Lim believe that life begins at conception. So when they decided to have a third child, in vitro fertilization was out of the question, since the process often yields extra embryos.

But “adopting” the frozen embryos of another couple who had gone through I.V.F. was not.

Dr. Lim called it a “rescue operation.” To him, transferring donated embryos to his wife’s uterus was akin to saving a life. “These children are being abandoned in a frozen state,” he said. “If they don’t get adopted, they’re dead.”

As I.V.F. becomes more widespread and the number of spare embryos rises, giving birth with donated embryos is becoming more popular, especially among couples who oppose abortion and are struggling with infertility. But many of the agencies that offer donated embryos, including a vast majority of those supported by federal grants, are affiliated with anti-abortion rights or Christian organizations, leading some people to question whether single people, gay couples and others who might be interested could be missing out.

Even the term “embryo adoption” is caught up in the rhetoric of debate over abortion.

“The issue in the medical community is that by calling it ‘adoption,’ we give too much personhood to the embryo,” said Kimberly Tyson, the marketing and program director at Snowflake Embryo Adoption in Loveland, Colo...
==
A Mother Learns the Identity of Her Child’s Grandmother. A Sperm Bank Threatens to Sue.
The results of a consumer genetic test identified the mother of the man whose donated sperm was used to conceive Danielle Teuscher’s daughter. Legal warnings soon followed.

Danielle Teuscher decided to give DNA tests as presents last Christmas to her father, close friends and 5-year-old daughter, joining the growing number of people taking advantage of low-cost, accessible genetic testing.

But the 23andMe test produced an unexpected result. Ms. Teuscher, 30, a nanny in Portland, Ore., said she unintentionally discovered the identity of the sperm donor she had used to conceive her young child.

The mother of the donor was identified on her daughter’s test results as her grandmother. Excited and curious, Ms. Teuscher decided to reach out.

“I wrote her and said, ‘Hi, I think your son may be my daughter’s donor. I don’t want to invade your privacy, but we’re open to contact with you or your son,’” she recalled. “I thought it was a cool thing.” (continues)

Beyond 10-12. Add your questions etc.

1. What does Catherine Myser mean by "whiteness"?

2. What did James Baldwin say about immigration and identity?

3. Decentering whiteness would enable bioethics to do what?

4. What obvious bioethical significance in Freddie Gray's death was generally ignored by the bioethical community?

5. Bioethicists are fixated on what, with what implication for the demogaphics of the field's concerns and utility?

6. Who is Glenn McGee?

7. Why did the Nashvillian participate in Eli Lilly's drug tests?

8. What was the "God Committee"?

9. What did Glenn McGee predict in 2003?

10. Bioethicists can claim credit for what regulatory innovation?

11. Who "invented" Bob Dole?


DQs

  • What's your initial response to any of Myser's questions of origin & knowledge? 118
  • Did the Obama presidency do anything to dismantle the historical legacy of equating American-ness with whiteness? Will the Trump presidency unintentionally have that impact, eventually?
  • Is there something inherently wrong, unseemly, or troubling about bioethicists who are also entrepreneurs? 
  • Did Arthur Caplan do the right thing with his Celera stock options? 133
  • Should financial incentives for participation in clinical trials be regulated, reduced, or eliminated?
  • Is it unwise to prognosticate, particularly with respect to future developments in biotechnology?
  • Are IRBs effective? How might they be improved?
  • Is our culture's seeming obsession with ED symptomatic of more deeply rooted issues?



Five Things I Wish I’d Known Before My Chronic IllnessBy Tessa Miller
Finding out you have a chronic illness — one that will, by definition, never go away — changes things, both for you and those you love.

Seven Thanksgivings ago, I got sick and I never got better.

What I thought was food poisoning turned out to be Crohn’s disease, a form of inflammatory bowel disease (IBD) that doesn’t have a cure. It fools my immune system into attacking my digestive system, resulting in what I can only describe as the attempted birth of my intestines through my butthole. It’s a cruel and often debilitating disease.

Since that first hospital stay, I’ve had colonoscopies, biopsies, CT scans, X-rays, blood and stool tests, enemas, suppositories, rectal foams, antiemetics, antidiarrheals, antivirals, antibiotics, anti-inflammatories, opiates, steroids, immunoglobulin, biologics and three fecal transplants (if you want to hear a story about my 9-year-old poop donor and a blender, find me on Twitter).

My disease is managed now thanks to an expensive drug called infliximab, but the future is unpredictable. IBD works in patterns of flares and remissions, and little is known about what causes either.

When I was diagnosed, I didn’t know how much my life would change. There’s no conversation about that foggy space between the common cold and terminal cancer, where illness won’t go away but won’t kill you, so none of us know what “chronic illness” means until we’re thrown into being sick forever...
==
A Better Path to Universal Health Care
By Jamie Daw
Dr. Daw teaches health policy and management at Columbia University.

The United States should look to Germany, not Canada, for the best model.
As a Canadian living and studying health policy in the United States, I’ve watched with interest as a growing list of Democratic presidential candidates — Senators Bernie Sanders, Kamala Harris, Elizabeth Warren, Kirsten Gillibrand and Cory Booker — have indicated support for a Canadian-style single-payer plan with little or no role for private insurance. Approval of such a system has become almost a litmus test for the party’s progressive base.

But rather than looking north for inspiration, American health care reformers would be better served looking east, across the Atlantic.

Germany offers a health insurance model that, like Canada’s, results in far less spending than in the United States, while achieving universal, comprehensive coverage. The difference is that Germany’s is a multipayer model, which builds more naturally on the American health insurance system.

Although it receives little attention in the United States, this model, pioneered by Chancellor Otto von Bismarck in 1883, was the first social health insurance system in the world. It has since been copied across Europe and Asia, becoming far more common than the Canadian single-payer model. This model ensures that all citizens have access to affordable health care, but it also incorporates age-old American values of choice and private competition in health insurance...

19 comments:

  1. "Drug company used rap video to push for higher doses, sales"

    https://www.nbcnews.com/health/health-news/drug-company-used-rap-video-push-higher-doses-sales-n972196

    DQ: Do drug companies and large organizations have the right to advertise and market their product any way that they please? What limitations should be in place?

    ReplyDelete
    Replies
    1. Constitutionally, they do have the right to market as they please; however, I believe that it should be marketed in a serious manner to those that are in need, not advertised as if it was something for companies to only obtain profit.

      Delete
    2. I think that as long as they have a doctors discretion sign or warning there is no issue. I do think however it is their ethical duty to uphold the patients well being above all when considering forms of advertisement.

      Delete
  2. 1. What is the only way to justify disability deselection but not gender deselection? (112)
    2. The term __________ is rather undefined and by itself a social construct. (110)
    3. Define cosmetic. (110)
    4. What is "the" moral question about abortion? (102)
    5. What are some of the "traditional" characteristics of women and their philosophy? (100-101)
    6. What is the purpose of the "presidential commission"? (91)

    ReplyDelete
    Replies
    1. 1. We would have to arbitrarily define disabilities, defects, and diseases as medical problems in need of medical solutions.
      2. Disease
      3. Cosmetic is something, usually a certain look, based on established norms.
      4. A battle between maternal and fetal rights.

      Delete
  3. In response to the DQ: Are women more emotion based and men more reason based?

    I feel that men and women have biological differences that impact their behaviors. However, I have met men who show a more emotional, sensitive nature and some men who show emotion through anger and instability, not that those are the only two categories. In the same sense, I know women who have more anger and explosiveness than any male I know. Additionally, I know females who are more cold, calculated and indifferent to any given situation. In conclusion, I feel that biological differences may make us predisposed to be more emotional in a certain sense, but environmental influences are also equally or more so reflective in how we show emotion or use reason.

    ReplyDelete
  4. Biological differences matter less and less, as the culture of gender equality (of opportunity) rises and we are treated to visible demonstrations that rigid exclusionary restrictions based on sex are invalid. It's generally that way with gendered thinking, isn't it? So many of our "natural" categories must give way to our actual experience.

    ReplyDelete
  5. I agree. There are some biological predispositions for both males and females, but environmental influences are having more and more impact on how people show or control their emotions.

    ReplyDelete
  6. Alt quiz questions
    1. How did Aristotle define woman? 99
    2. Define androcentrism. 95
    3. Define commensuration. 87
    4. What three principles were first articulated by the Belmont Report. 85
    5. Describe two facts which strengthen animal farm philosophy. 113
    6. What is Wolbrings thought provoking conclusion regarding arguments justifying sex-selection prohibition? 112
    7. Wolbring states diseases are what....? 112
    8. Infanticide and neglect are being increasingly replaced by which two technologies? 108
    9. Why is feminist theory important to bioethics? 103
    10. Andrew Brown made what claim about rights? 110

    ReplyDelete
    Replies
    1. 1) a mutilated man
      2) a male centered system, where the man is the “tacit standard for human”
      3)”measuring different properties normally represented by different units with a single common standard or unit”
      4)respect for person,beneficence & Justice
      5)a disability rights approach being mostly excluded from the discourse & a disability rights approach towards bioethics that are ignored due to the marginalization of the disabled
      6)that The justification of sex selection could ultimately justify disability deselection. & the only way to avoid that would be through holding disabilities in a different “moral” light based on its label.

      Delete
  7. What do you think of the stereotypical "association of women with emotion and men with reason"? 100

    While some of the more traditional viewpoints of moral philosophy tend to have a dualistic viewpoint of men and women, often devaluing women or asserting males have an innate ability to reason better. It's easy to surmise that judgement calls rendering a specific group inferior should be avoided but I believe that it is by challenging these stereotypes that we advance as a society. Some of the same iconic figures in Philosophy are not considered racist but they held similar viewpoints regarding non-European whites as inferior and sub-species. In terms of biological makeup they couldn't have been more wrong. I believe it's worth it to challenge the concepts otherwise there wouldn't have been Women's Sufferage and Civil Rights movements.

    ReplyDelete
  8. Alt Quiz Questions
    1. Who described medical ethics as "a mixture of religion, whimsy, exhortation, legal precedents, various traditions, philosophies of life, miscellaneous moral rules and epithets."?(86)
    2. Why was the spread of Principlism so effective? (91)
    3. Why were women underrepresented in early clinical drug trials? (98)
    4. What is the feminist argument regarding the "loving perception" or "sympathetic thinking"? (101)
    5. Who said "Women's philosophy is not to reason but to sense." (102)

    Alt DQ
    1. Considering androcentrism dominated much of human history, what considerable differences are imaginable with Woman as the central figure of the public sphere?

    ReplyDelete
    Replies
    1. 5. 101 (not 102)

      Making due allowance for the occasional Ann Coulter, Marsha Blackburn, or Phyllis Schlafly, I'm quite confident that an alternate history with women in charge would surely have been at least a bit less bloody (on the hypothesis that violent aggression and testesterone are in fact and to an extent correlative). BUT, I'd really rather we'd had a history of gender equality and shared governance, in which all individuals had learned to curb their predispositions to aggression and intolerance. We can dream.

      Delete
  9. DQ: when discussing cosmetic v medical surgery should the effect of certain cosmetic issues be taken into consideration? Effects like mental traumas? Ex.) a large lipoma is very visible on a person, it was diagnosed as a benign thus the insurance will not cover it, however it is causing emotional trauma on this individual because of bullying.

    ReplyDelete
    Replies
    1. Any physical condition that impairs normal functionality, which includes markers of mental health and an integrated personality like self-esteem, should (IMHO) be a candidate for insurance coverage. Calling such a condition "cosmetic" is in that case misleading at best.

      Delete
  10. Alternative Questions:
    1. In recent years, what industry had "taken a beating"? (147)
    2. Bob Dole was a senator for what state? (146)
    3. Who maintains an IRB registry? (145)
    4. What does GAO stand for? What did they announce in 2009? (142)
    5. What are the "trappings" of clinical ethicist? (140)
    6. What was the catalyzing event where bioethics emerged as view by the United Kingdom? (137)
    7. ___________ is a myth. - DeRenzo (134)
    8. What book examines the history of the biotechnology industry? (134)

    ReplyDelete
    Replies
    1. 1. the pharmaceutical industry
      2. Kansas
      3. the federal Office for Human Research Protections
      4. Government Accountability Office; They announced successful "sting" operations that investigated the rigor of IRB cases.
      5. A white coat, an office, a hospital ID, and responsibility for certain committees.
      6. Mary Pappworth's 1967 book titled Human Guinea Pigs
      7. Objectivity
      8. Merchants of Immortality

      Delete
  11. Alt Quiz Questions:

    1. What is WASP (120)
    2. What could DuBois validly assert three decades later (121)
    3. What does McIntyre warn of and how does he describe it? (124)
    4. What are "white coat die-ins" (129)
    5. What tendency has leigh Turner criticized bioethics for? (130)
    6. How did Gelsinger's death stunn sceintists? (141)

    ReplyDelete
  12. 1. White Anglo Saxon Protestant
    2. Whiteness is a modern concept, whiteness is ownership of the world
    3. White talk, a way of speaking and perceiving the world which insulated white people from self examination of individual or collective roles in racism.
    4. A protest movement started by medical students to raise awareness of the killings of unarmed black men.
    5. A tendency to shy away from discussions of raise and instead devout attention to issues of new technology.
    6. Because it undermined a perception about gene therapy research.

    ReplyDelete