Tuesday, September 30, 2008

A quip only a bioethicist might appreciate...

Overheard at a recent gathering of bioethics colleagues:

Question: Can you explain the difference between morality and ethics?

Response: Lipstick.

Sunday, September 28, 2008

Dear Mr. President...

Over at the American Journal of Bioethics blog, colleague Summer Johnson reports on the recommendations from a report issued by the National Academy of Sciences, the Institute of Medicine, and the National Academy of Engineering about how to appoint new science and technology policy advisors. In similar spirit, Wired has come out with their own non-partisan list of advisors and their amazing ideas: "The 2008 Smart List: 15 People the Next President Should Listen To." Here are just a few of their suggestions:

~ Leroy Hood - Look to the Genome to Rebuild Health Care

~ Peter Gleick - Deal With the Water Crisis Now

~ Carolyn Porco - Use Big Robots—and Big Rockets

~ Mark Smolinski - Detect Epidemics Before They Start

To underscore what the AJOB blog said, this list takes the politics out of science and technology advice and tries to make sure the next president has some of the very best minds on the planet giving their advice. For the complete list, click here.

Art Caplan: Force-Feeding A Starving Inmate Violates Medical Ethics

Art Caplan's recent trip to Ireland prompted him to pen this Op Ed in the Hartford Courant on Prisoner's Rights:

Earlier this year, I spent a week in Belfast, Northern Ireland. While there, my wife and I took a tour of the city focusing on the events surrounding "The Troubles" -- the bitter fight by the Irish Republican Army to gain independence from Britain.

The troubles have, happily, been resolved by goodwill and diplomacy, but you cannot go far in downtown Belfast without being reminded of the price that was paid. Everywhere in Catholic neighborhoods, there are huge murals remembering the 10 men who died in the 1981 hunger-strikes and the more than a dozen who died in earlier starvation protests. Prisoners in Northern Ireland and elsewhere have long used hunger strikes as a last-ditch form of protest. Now, William Coleman is doing so in a Connecticut prison. The issue is should prison authorities force-feed him?

I think not.

William Coleman is at the Osborn Correctional Institution in Somers. The 48-year-old Coleman is serving an eight-year sentence for rape. Coleman says he was unjustly convicted. In protest, he has gone on a hunger strike, which during the past year has caused him to lose more than 100 pounds.

Recently, he took a turn for the worse. Prison officials, fearing for his life, sought and received a court order giving them the right to force-feed Coleman by giving food and water intravenously. They are wrong. Competent prisoners should not be fed medically against their will.

Feeding Coleman or any other prisoner will require a doctor, nurse or other medically-trained prison worker to use restraints while inserting needles carrying artificial nutrition into the body. Feeding of this sort, as the U.S. Supreme Court recognized in the 1990 case of Nancy Cruzan, a young woman in a permanent coma whose relatives wished to discontinue her feeding tube, constitutes medical treatment. And that makes force-feeding any competent adult against their will unethical.It is a long-established right, both in the United States and under international law, that a competent person may refuse any and all forms of medical treatment including artificial food and water on religious or personal grounds. A competent, adult Jehovah's Witness does not have to accept a blood transfusion even if it means leaving behind a widow and children. A severely ill Christian Scientist, who understands the consequences and risks, can, if competent and an adult, say "no" to life saving care, including feeding tubes. You can decide that you do not want to be a patient and leave any hospital or nursing home as long as you are making an informed and competent choice. And so can a prisoner.

Some would argue that refusing food and water is an act of suicide and prisons do not have to accept suicides on the part of inmates. But a hunger-strike is not a suicide attempt. It is an act of protest. Coleman himself says he does not want to die, but he is willing to in order to draw attention to what he believes is his unjust conviction. Risking death is a means to an end. The end may be horrific, but even prisoners have the right to refuse medical care to make their point.

The World Medical Association specifically prohibits force-feeding as does the American Medical Association. No prison worker at Osborn should become involved in carrying out the court order to feed Coleman. Whether the courts want to reconsider his case or not, he is well within his rights to decline medical treatment.

Prisoners do not have many rights while in jail. But, one right they do have is the right to protest including the decision not to eat or drink. As horrible as it is to watch someone starve when they need not do so, the state of Connecticut should accept that a competent prisoner may make that choice. I hope that Coleman decides that he has made his point and ends his hunger-strike. But it is not right to use medical treatment to force him not to do so.

The original article can be found here.

Friday, September 26, 2008

Paying poor women in Louisiana not to have kids

Concerned over rising public assistance rolls in Louisiana, Republican State-Representative John LaBruzzo this week proposed that the state pay poor women $1,000 to undergo tubal ligation. To further combat what he described as "generational welfare" -- his belief that poorly-educated people receiving such government aid as food stamps and subsidized housing have more kids than affluent and well-educated folks -- this ardently anti-abortion legislator is also championing tax incentives to encourage college-educated, higher-income people to have more children.

Personal outrage aside, I'm not sure there's much more that I can add about this Social Darwinist proposal that Kate Harding at Broadsheet and "Ann" at Feministing haven't already said.

Top 10 Hot Careers for 2012

I'm often asked by my students "what kind of job can I get with a master's degree in bioethics?" -- the short answer is that one needs to look at the master's degree as a supplemental degree -- that is, it is beneficial in terms of analysis, problem-solving, and critical thinking in your basic field. Last month, Daily Galaxy published a Future 'Top 10' Hot Careers in 2012, and all ten arguably have aspects that could benefit from an bioethics (that is the broadest spectrum definition of bioethics -- from food ethics to neuroethics to healthcare ethics to computer ethics and beyond) perspective:

1) Organic food Industry

2) Computational Biology

3) Parallel Programming

4) Data Technology

5) Simulation Engineering

6) Boomer Caregiving

7) Genetic Counseling

8) Brain Analysts

9) Space Tourism

10) Roboticists

Some wag wrote in a cheerful comment to the original article "I'd also add 'AI wrangler' (for when the Singularity happens)" -- but that's more likely in 2025, at according to Ray Kurzweil and the experts at TechCast.

Full article can be accessed here.