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Bioethikos: Bringing Life to Bioethics

Bioethics and Brittany Maynard (32)

December 19th, 2014

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Dr. Mark Pinkerton, professor of pharmacy practice at Cedarville University, discusses the recent passing of Brittany Maynard. He has a unique perspective as both a physician and a father to a young woman with a similar terminal illness.

(Note that the title of this podcast has changed from the former name ‘CedarEthics’)

Christian Radio WHKW
Melinda Pinkerton’s Blog

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To listen, just click on the player below (click on the Audio MP3 button if the player doesn’t appear).

New Name, New Look for Center for Bioethics Blog

December 2nd, 2014

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Bioethikos: Bringing Life to Bioethics

This is the new name for the Center for Bioethics blog. We have also updated the appearance in line with the Center website. We will continue to offer weekly commentaries on issues of ongoing interest, including health care, general ethics, theology, and moral philosophy. The issues will not go away — they include abortion, stem cell research, end of life, rights of conscience, contraceptives, genetics, reproductive technologies, health care (and how to pay for it), and a host of other topics of great interest to all.

Please subscribe and follow along!

Time for Pharmacies to Stop Selling Tobacco

November 19th, 2014

 

Marlboro Cigarettes

(By Douglas Anderson, PharmD, DPh)

A recent study has revealed that 6% of patients receiving medications for chronic lung disorders also bought cigarettes at the same time. Cigarette smoking is well known as a cause of these diseases, and also increases the risk of heart disease, lung cancer, and head and neck cancer. Such conditions are among the leading causes of death in the United States.

It is contradictory for pharmacies to sell cigarettes as well as medications to combat chronic lung ailments. This not only impacts the health of the patient, but it is also contrary to the duties of the pharmacist, whose oath states that the “…welfare of humanity and relief of human suffering [are] my primary concerns.” In February 2014, CVS, the nation’s second largest pharmacy chain, announced that it would stop selling all cigarettes and other tobacco products. This may cost CVS some profits. True, customers can simply buy their cigarettes somewhere else, and this is unlikely to decrease tobacco use overall (grocery stores with pharmacies will probably continue to sell tobacco). But the pharmacy profession is moving away from a customer focus to a patient focus. To this end, CVS put the health of their patients and the sanctity of the pharmacist’s oath above profits, and this is commendable.

It is time for all pharmacies to do the ethical thing, and to stop selling tobacco products that destroy the health that pharmacists are called to protect.

JAMA Internal Medicine article

 

The Ethics of Ebola (31)

November 18th, 2014

Ebola-Virus

My colleague, epidemiologist and public health expert Dr. Ginger Cameron, joins me to discuss the ethics of the current Ebola crisis.

We ask some important questions:

  • What’s going on in West Africa? Why is the outbreak so severe?
  • Was it ethical to treat western missionaries with experimental drugs?
  • What about enforced quarantine? Does that violate individual rights?
  • How does medical triage work?
  • What are the latest ethical challenges?

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To listen, just click on the player below (click on the Audio MP3 button if the player doesn’t appear).

Could GMOs Help Solve Global Health Issues?

November 6th, 2014

gmo-tomato

(By Dr. Heather Kuruvilla)

Genetically modified organisms, or GMOs, are often portrayed as unnatural, potentially harmful, and just plain scary. Like any technology, genetically modified organisms have some potential risks, both to people and to the environment. We don’t know if the newly engineered proteins may be allergenic or otherwise harmful to humans. And there’s always a risk that engineered traits could “migrate” from the engineered species into native species, causing unforeseen environmental consequences.

The potential benefits of GMOs, however, are too often under-reported. What if we could solve pressing global health issues, like malnutrition, or vaccine distribution, using GMOs? The Golden Rice project addresses vitamin A deficiency by engineering rice to produce beta-carotene. In parts of the world where rice is part of the diet and vitamin A deficiency is endemic, golden rice could be a substitute for white rice.

In areas of the world without much infrastructure, vaccine distribution is a formidable challenge. But if folks could grow their own banana vaccines, they might be protected from Hepatitis B. This would also reduce potential complications such as liver cancer. Work on banana vaccines has is tricky, since bananas are not all the same size, and it would be difficult to know when a patient has the right “dose” of a banana.

Even if we can’t use fruit to make oral vaccines, perhaps GMOs can still help us fight disease. For example, the experimental Ebola vaccine ZMapp is grown in genetically modified tobacco plants. A genetically modified flu vaccine, using insect cells to produce viral proteins, has recently been approved by the FDA.

Maybe GMOs aren’t so scary after all.

Sources:

www.goldenrice.org/

www.mdpi.com/1422-0067/14/1/1978/htm

www.webmd.com/news/20140804/ebola-virus-vaccine

http://www.collective-evolution.com/2013/07/12/fda-approves-first-gmo-flu-vaccine-expected-on-market-in-2014

CedarEthics: New Student Papers

October 28th, 2014

The Center for Bioethics is happy to announce the latest edition in our online journal of outstanding student bioethics papers.

For example, in her paper, “Ethical Duties in Ectopic Pregnancy,” recent graduate Josephine Hein describes the clinical condition:

An ectopic pregnancy (EP), from Latin roots meaning “out of place,” is a pregnancy that does not correctly implant into its normal location in the endometrium of the uterus. Instead, the developing embryo implants in the fallopian tube, the cervix, the ovaries, or the abdominal or pelvic cavity. EPs today constitute about 2% of all pregnancies, of which 97% implant in the fallopian tube. A ruptured EP can be deadly, leading to 6% of all maternal deaths from massive hemorrhage. What are the ethical implications of treating this condition?

In addition, current student Lynley Turkelson has a fascinating analysis of end-of-life fears, in her article: “Why Christians are Afraid of Removing Artificial Nutrition and Hydration.”

Finally, bioethics graduate student and professional chaplain Thomas Kehr gives a comprehensive summary of end-of-life care in: “End of Life Ethics: Hospice and Advance Directives.”

All of these papers are available full-text at the Cedarville University Digital Commons: http://digitalcommons.cedarville.edu/cedarethics/

Pro-Life: A Broader Meaning

October 19th, 2014

baby_in_womb

(By Dr. Heather Kuruvilla)

What do you think of when you hear the term “pro-life?” Do anti-abortion protestors come to mind? Do you imagine volunteers faithfully reaching out to women with crisis pregnancies? Do you reflect on lawyers and legislators working to change our laws to recognize the unborn as persons? These are all good and necessary, but being pro-life means much more. A robust pro-life ethic comes from a theological position holding mankind in high regard, created in God’s image.

If we truly believe that all people are image-bearers of God, then this belief involves many ways of “loving our neighbor.” Here are just a few examples:

  • We should reject the “hookup culture” because it devalues human worth and dignity.
  • We should support hospice and palliative care that treats the dying with compassion and dignity until the natural end of their earthly lives.
  • We should search for safe, productive alternatives to the destruction of human embryos for research.
  • We should support sustainable farming practices and wise stewardship of agricultural technologies to adequately feed more of the world’s population.
  • We should provide clean water and increased access to health care for all who lack these resources.
  • We should adopt or provide foster care for the orphans among us, in keeping with biblical commands.

This is not an exhaustive list, but it illustrates the idea that the “pro-life” movement needs people with many different gifts. We need healthcare workers, environmentalists, researchers, biotechnologists, and other committed citizens, united in this common view: human life is precious because it reflects an awesome Creator. A broader definition of “pro-life” means that every member of the body of Christ can uphold these principles, while living a life committed to the Gospel. In fact, many of us are already doing so. May the Lord give us grace to continue.

“The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me’ ” (Matthew 25:40).

Ezekiel Emanuel is Wrong

October 6th, 2014

Physician-ethicist Ezekiel Emanuel seems to love being at the center of controversy. One of the architects of Affordable Care Act, he is director of Clinical Bioethics at the NIH and chairs the Department of Medical Ethics & Health Policy at U Penn. He has frequently (and often unfairly) been criticized for pointing out the flaws in our current health care system, which he describes as  “truly dysfunctional” (Wash. Post). Worse of all, many think of him as a real utilitarian pragmatist, and have accused him of trying to ration health care. He has denied this.

So it comes as a bit of a shock to see Emanuel’s latest article in the Atlantic, “Why I Hope to Die at 75.” He claims that he will stop using the health care system at age 75. He puts it this way:

[H]ere is a simple truth that many of us seem to resist: living too long . . . renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic (source below).

Emanuel goes on to say that this is no death wish, but he feels that he may no longer be productive and enjoy things at age 75. So he hopes that will be the end. If he has cancer or develops pneumonia, he will refuse chemotherapy or antibiotics. His last colonoscopy will be at age 65. And when he hits 75, no flu shot.

Why this somber navel-gazing with 18 years to go?  What is Emanuel trying to prove? He is implying, I think, that there is no more to life than our contributions to society. He is subtly saying that older patients are selfish to use so many health care resources, and that we should all just forget about living long lives. Ah, but that of course is the ultimate lie that so many functionalists would have you believe. We are valuable because of what we do, not for who we are.

On the other hand, the Christian view of the human person teaches that we are valuable for our own right. Each of us was made “a little lower than God,” and our Creator has crowned us “with glory and majesty” (Psalm 8:5, NASB). The elderly deserve honor; they have the right to enjoy the fruit of their labor. Our value is intrinsic, and does not depend on our age or our abilities.

Don’t let a pontificating utilitarian make you feel guilty for living out the full lifespan that God has allotted you.

Article in The Atlantic

Death Panels Redux?

September 30th, 2014

A recent report by the Institute of Medicine is entitled: Dying in America. Among other things, it documents how poorly Americans understand their options at the end of life. The IoM recommends that doctors get paid for having end-of-life discussions with their patients. This idea was unpopular back in 2009, and led some to accuse the government of trying to establish “death panels,” designed to limit treatment options and to ration health care.

But this is a distortion. According to the IoM report:

The [2009] provision would have reimbursed clinicians for the time spent in advance care planning with patients. Such conversations would have included discussion of the documents that can help ensure that patients’ wishes regarding care are followed in the event they become unable to express them (source listed below).

Recent polls have show that the majority of Americans strongly support such discussions, and a growing number have established advance directives for themselves and their loved ones. Nonetheless, a recent Forbes article makes the alarming claim that death panels are “on the rebound.” Why all this suspicion?

The main reason may be that advance directives (e.g., living wills or durable powers of attorney for health care) are not perfect, and they are not always honored. A patient’s prognosis is not always easy to predict. And families are sometimes reluctant to go along with their loved ones’ wishes, even when they are clearly stated.

Yet for all of these concerns, greater clarity in the face of serious illness is not a bad thing. In our technologically-advanced society, we are often able to keep the bodily shell alive, which merely prolongs the dying process. For people of faith, this is unnecessary, for a better life awaits us.

We should all have advance directives – and doctors should be paid for advising us about them.

Dying in America

Forbes Online Article

Slippery Slope: Euthanasia in Belgium (30)

September 20th, 2014

euthan

Belgium legalized euthanasia in 2002, amid reassurances that the practice would be used only under desperate circumstances. In the U.S., where euthanasia is illegal, many feared a “slippery slope” similar to the Netherlands. In this podcast, my special guest is Dr. Douglas Anderson,Professor of Pharmacy Practice. We comment on a disturbing new trend to use terminal sedation as a form of euthanasia in Belgium.

Journal Article

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