End-of-Life Decision-Making — Withholding vs. Withdrawing Treatment

June 23, 2010

Families will struggle with these choices, regardless of whether withholding or withdrawing treatment is being considered. For the ethics consultant, it’s good to begin with the understanding that withholding and withdrawing are moral and ethical equivalents. That clears the playing field.
It seems likely that family members who are guilt-ridden — for all the things they [...]

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Distributive Justice and Assisted Reproductive Technology

June 23, 2010

Distributive justice does not imply that everyone should have equal access to everything all the time. This would be an extreme position and lead to severe distortions in availability of medical services. Competing needs must be balanced fairly and opportunities to access medical care must be equitable. In the American health care marketplace, however, the [...]

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Ethical Relativism and Ethical Inquiry

June 23, 2010

Ethical relativism provides a flimsy moral gloss condoning questionable activities of global pharmaceuticals in developing nations. But the Emperor has no clothes. Ultimately, there’s no such thing as a little bit of ethics.
Medical ethics became an area of concern in the wake of the Nuremberg Trials. The Nuremberg Code was developed in response to the [...]

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Genetic Testing — Breast Cancer, Huntington’s Disease, and Bioethics

June 23, 2010

For genetic analysis related to breast cancer and Huntington’s disease, it is likely such investigations are initiated for an asymptomatic patient with a relevant family history. Testing for Down’s syndrome is routine for pregnant women older than 35. With the advent of maternal serum markers, aggressive obstetricians may recommend such screening to all their patients.
The [...]

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Embryos, Ethics, and Edicts

June 23, 2010

The overarching ethical concern related to type 2 PGD/HLA testing is the moral status of the embryo. Many books have been written on this topic and many more are being contemplated.
One set of outliers on the bell curve of ethical commentators states that life begins at conception (or, variously, fertilization). The antipodal group states that [...]

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Health Care and the Free Market

November 24, 2009

The free market has not fared well in recent years. Adam Smith’s “invisible hand” has had its thumb on the scales for a very long time. In the last 75 years U.S. markets have been free only in the sense that businesses are free to seek as much government protection as they believe necessary.
Agricultural markets [...]

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Emergency Department Staff as Family Physicians

November 20, 2009

Former President George W. Bush blithely asserted to a national (virtually global) audience that the U.S. already has universal health care — “all they have to do is go to the emergency room”. Bush unwittingly demonstrated his unconscionable ignorance of health care imperatives and basic economic principles.
The cost of emergency department (ED) services is several [...]

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When ‘Insurance’ Is No Insurance At All

November 18, 2009

When “Insurance” Is No Insurance At All
Although the ranters rant that those without health care insurance should “get a job”, investigating the facts tells a different story. But in early 21st century America, facts are easily swept aside as mere inconvenience.
Who needs facts when we have opinions? Blather, posturing, speciousness, and irresponsible inanities are the [...]

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Health Care Is a Right

November 17, 2009

Health Care is a Right
As we’re all aware, the U.S. is the only developed nation that does not provide its citizens with some form of universal health care. Are we special, or are we stupid?
We’re certainly not special. Former President George W. Bush enjoyed proclaiming that we have “the best medical care in the world”, [...]

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