Biomedical subjects
R A Charo
Publications and source records attributed to R A Charo.
Cloning: ethics and public policy.
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The National Bioethics Advisory Commission: bridging the tension between scientific and public policy analysis.
During the period between the early 1980s to the mid 1990s, the U.S. was distinguished from most other developed countries by its lack of a national-level public body to assist the government in its policy-making on topics of biomedical ethics. While Canada, Denmark, France, Spain, and other countries regularly sought advice from public commissions on issues ranging from reproductive technologies to euthanasia, the U.S. relied on myriad state commissions, court decisions, and academic bodies. The result was a pattern of policy-making that was slower and more unpredictable than that of its peers. With the 1996 appointment of the National Bioethics Advisory Commission (NBAC) by President Clinton, there has been a change in the process of U.S. public policy development. This article provides an overview of the NBAC and highlights recent areas of focus and related recommendations.
The hunting of the snark: the moral status of embryos, right-to-lifers, and Third World women.
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Legal and regulatory issues surrounding carrier testing.
Genetic testing has arrived, probably earlier than patients and physicians need. For the moment, professional societies are taking the lead in monitoring the quality of physician education and laboratory services. The federal government will soon take over the role of monitoring the quality of genetic test kits themselves, but the most significant development will be the evolving physician-patient relationship in the context of primary and prenatal care. As of 1992, it is probably not necessary for physicians to educate their patients about the availability of genetic tests unless there is a specific indication of genetic disease in the family. However, should a patient ask for such information or testing, today's physician would have a duty to know enough about the current status of carrier testing to be able to respond to the requests or make a proper referral. In addition, as the reliability of such tests increase and their costs decrease, physicians may arrive at a moment when some sort of patient education is required, at least for the most common disorders. The recent court decisions securing the right to abortion mean that patients will continue to have the moral and legal right to assert their privilege to plan their families and, where possible, to avoid genetic impairments in their children. Physicians will have the sensitive task of helping patients to achieve their personal goals regarding such family planning, while not overwhelming patients with confusing or frightening information.
Mandatory contraception.
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Problems in commercialized surrogate mothering.
Commercialized surrogate mothering is an unworkable arrangement for helping infertile couples to have children. The arrangement requires a woman to undergo artificial insemination, to sustain a pregnancy and to relinquish the child upon birth to the genetic father. During the course of the pregnancy, the arrangement calls for restrictions on the surrogate mother's behavior and authority to make medical decisions concerning herself and the fetus. Such restrictions are unenforceable under contract law, and the usual social mechanisms to induce compliance are absent. Due to the large sums of money involved and the growing industry of surrogate mother brokering, efforts have begun in many state legislatures to regulate the arrangements, and in particular the behavior of the surrogate mothers, in order to increase the predictability and workability of the arrangements. If passed, these state laws could set a dangerous precedent for regulating all women during pregnancy and standardizing the behavior and medical care of pregnant women. Noncommercialized surrogate mothering does not pose these same threats, and is likely to continue for many years to come.
Legislative approaches to surrogate motherhood.
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