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Health policy on the town meeting agenda.

American Health Decisions, a movement that started in Oregon, has spread to several other states. Through the media and widespread public discussion, the projects aim to increase public awareness about the individual and societal dimensions of ethical choices in health care.

Advisory Committees↗

The politics of personhood.

Concepts of personhood are embedded in a political and cultural context. The persistence of moral conflicts--and advances in biological and clinical sciences accelerate their number--and the difficulties of resolving them reflect features of our political culture. In the extraordinary American tension between individual and public life, controlling the definition of what it is to be a human being becomes a fundamental basis of social and political power. Much is at stake in these persistent conflicts: freedon of individuals; authority of professionals; automony of scientists; and even the role of the church.

Beginning of Human Life↗

Personhood, medicine, and American Society.

The problems of personhood with which this conference--and our society--grapples are significantly interwoven with modern medicine, its technology, and its science. More importantly, the conceptual language and recurrect themes of personhood questions are shaped by moral philosophers and jurists: "individualism" and "connectedness" are at the core of debates. Existing institutional arrangements have been inadequate to arrive at an effective societal consensus.

Advisory Committees↗

Personhood in the bioethics literature.

Althought the literature--medical, philosophical, religious, and legal-- on personhood is vast, there is little evidence that writers on this topic are approaching a consensus on the meaning of the concept or on criteria for its application. Some writers set low, or minimal, standards for personhood - others posit higher, more normative standards. But throughout, the moral values writers antecedently embrace determine the definition they arrive at by way of conclusion. Personhood has not been a useful concept for resolving dilemmas in bioethics.

Abortion, Induced↗

Western bioethics on the Navajo reservation. Benefit or harm?

OBJECTIVE: To understand the Navajo perspective regarding the discussion of negative information and to consider the limitations of dominant Western bioethical perspectives. DESIGN: Focused ethnography. SETTING: Navajo Indian reservation in northeast Arizona. PARTICIPANTS: Thirty-four Navajo informants, including patients, biomedical health care providers, and traditional healers. RESULTS: Informants explained that patients and providers should think and speak in a positive way and avoid thinking or speaking in a negative way; 86% of those questioned considered advance care planning a dangerous violation of traditional Navajo values. These findings are consistent with hózhó, the most important concept in traditional Navajo culture, which combines the concepts of beauty, goodness, order, harmony, and everything that is positive or ideal. CONCLUSIONS: Discussing negative information conflicts with the Navajo concept hózhó and was viewed as potentially harmful by these Navajo informants. Policies complying with the Patient Self-determination Act, which are intended to expose all hospitalized Navajo patients to advance care planning, are ethically troublesome and warrant reevaluation.

Advance Care Planning↗