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PubMedDate not supplied

Animals, science, and ethics -- Preface; introduction: the troubled middle in medias res; future directions.

This is a report from The Hastings Center project, "The Ethics of Animal Experimentation and Research." As project members, we wanted to take a fresh look at the complex ethical issues that arise in the scientific use of animals in a non-adversarial and non-ideological forum. We were convinced that these issues required a genuinely interdisciplinary approach. This meant including laboratory and field scientific researchers; veterinarians; philosophers, lawyers, and scientists particularly interested in animal welfare issues; and physicians and philosophers with long-standing bioethical interests but who previously had not confronted the ethics of the human use of animals. This Special Supplement to the Hastings Center Report is the outcome of two years of deliberation.

Animal Care Committees↗
PubMed1992

PA reports on Hastings Center ethics fellowship.

Physicians Assistants are faced with ethical dilemmas every day in the course of their medical practice. The author studied current ethical dilemmas facing PAs at the Hastings Center, a bioethics research institute in New York. A description of this institute and a discussion of the researcher's findings are detailed.

Academies and Institutes↗
PubMed1986

How the Report made a difference: reflections on a 15th anniversary.

To mark the 15th anniversary of the Hasting Center Report, six authors who have written for the Report since its beginning comment briefly on an article or a theme from the Report that has had an impact on their thinking or on the way that bioethics has developed as a discipline. The titles of the commentaries are as follows: "In praise of William May's 'attitudes'" (A.M. Capron); "On opening human experimentation to moral debate" (S. Bok); "Learning from Ramsey" (R.A. McCormick); "Toward a science of particulars" (E.J. Cassell); "Challenging the power of codes" (R.M. Veatch); and "Relating moral principles and moral behavior" (D. Callahan).

Academies and Institutes↗
PubMed2005

Ethical dilemmas in the care of the most premature infants: the waters are murkier than ever.

PURPOSE OF REVIEW: Summarize the literature relevant to ethical issues surrounding decisions to provide intensive care to extremely premature newborns. RECENT FINDINGS: A Texas Supreme Court decision and a position paper are noteworthy for health professionals participating in management decisions with families at risk for extremely preterm delivery. SUMMARY: In Miller v HCA, the Millers sued the Hospital Corporation of America for resuscitating their approximately 23-week gestation daughter against their wishes. The baby survived with severe neurodevelopmental disabilities. They were awarded $59.9 million in a jury trial. However, the judgment was reversed by the court of appeals, which ruled that parents have no right to withhold urgently needed life-sustaining medical treatment from children with non-terminal impairments, deformities, or disabilities, regardless of their severity. The Supreme Court of Texas upheld that ruling, but reasoned that parents have no right to refuse resuscitation of extremely premature infants prior to birth because they cannot be fully evaluated until birth; therefore, decisions before birth could not be fully informed. Robertson (Hasting Center Report 2004) supports precluding parental refusal of resuscitation before birth. He argues that parents have a right to withhold or withdraw medical treatment from a non-terminally ill child, but only if the child will lack capacity for symbolic interaction. Such severe limitation of quality of life concerns in decision making for extremely premature newborns is inconsistent with current published guidelines, the positions of noted bioethicists, and the practice of many neonatologists. Further, the additional information attained by initiating intensive care in the most premature infants does not justify doing so without parental consent.

Female↗
PubMed2006

Empirical research in bioethical journals. A quantitative analysis.

OBJECTIVES: The objective of this research is to analyse the evolution and nature of published empirical research in the fields of medical ethics and bioethics. DESIGN: Retrospective quantitative study of nine peer reviewed journals in the field of bioethics and medical ethics (Bioethics, Cambridge Quarterly of Healthcare Ethics, Hastings Center Report, Journal of Clinical Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics). RESULTS: In total, 4029 articles published between 1990 and 2003 were retrieved from the journals studied. Over this period, 435 (10.8%) studies used an empirical design. The highest percentage of empirical research articles appeared in Nursing Ethics (n = 145, 39.5%), followed by the Journal of Medical Ethics (n = 128, 16.8%) and the Journal of Clinical Ethics (n = 93, 15.4%). These three journals account for 84.1% of all empirical research in bioethics published in this period. The results of the chi2 test for two independent samples for the entire dataset indicate that the period 1997-2003 presented a higher number of empirical studies (n = 309) than did the period 1990-1996 (n = 126). This increase is statistically significant (chi2 = 49.0264, p < .0001). Most empirical studies employed a quantitative paradigm (64.6%, n = 281). The main topic of research was prolongation of life and euthanasia (n = 68). CONCLUSIONS: We conclude that the proportion of empirical research in the nine journals increased steadily from 5.4% in 1990 to 15.4% in 2003. It is likely that the importance of empirical methods in medical ethics and bioethics will continue to increase.

Bioethics↗
PubMed2006

How international is bioethics? A quantitative retrospective study.

BACKGROUND: Studying the contribution of individual countries to leading journals in a specific discipline can highlight which countries have the most impact on that discipline and whether a geographic bias exists. This article aims to examine the international distribution of publications in the field of bioethics. METHODS: Retrospective quantitative study of nine peer reviewed journals in the field of bioethics and medical ethics (Bioethics, Cambridge Quarterly of Healthcare Ethics, Hastings Center Report, Journal of Clinical Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics). RESULTS: In total, 4,029 articles published between 1990 and 2003 were retrieved from the nine bioethical journals under study. The United States (59.3%, n = 2390), the United Kingdom (13.5%, n = 544), Canada (4%, n = 160) and Australia (3.8%, n = 154) had the highest number of publications in terms of absolute number of publications. When normalized to population size, smaller affluent countries, such as New Zealand, Finland and Sweden were more productive than the United States. The number of studies originating from the USA was decreasing in the period between 1990 and 2003. CONCLUSION: While a lot of peer reviewed journals in the field of bioethics profile themselves as international journals, they certainly do not live up to what one would expect from an "international" journal. The fact that English speaking countries, and to a larger extent American authors, dominate the international journals in the field of bioethics is a clear geographic bias towards the bioethical discussions that are going on in these journals.

Bioethics↗
PubMedDate not supplied

Theology, religious traditions, and bioethics.

The social and medical ethos within which bioethics emerged in the late 1960s and early 1970s was constituted in part by religious questions and religious thinkers. However, this identifiably religious influence on bioethics subsequently seemed to decline. How has this diminished impact come about, and what significance, if any, does it hold for the ways we now do bioethics? What difference, finally, do religious perspectives make for bioethics? These were the overarching questions that led the Hastings Center to initiate a research project on the relation of Religion and Bioethics, culminating in this special supplement to the Hastings Center Report.

Bioethics↗
PubMed2004

Error reduction, patient safety and institutional ethics committees.

Institutional ethics committees remain largely absent from the literature on error reduction and patient safety. In this paper, the author endeavors to fill the gap. As noted in the Hastings Center's recent report, "Promoting Patient Safety," the occurrence of medical error involves complex web of multiple factors. Human misstep is certainly one such factor, but not the only one. This paper builds on the Hastings Center's report in arguing that institutional ethics committees ought to play an integral role in the transformation of a "culture of blame" to a "culture of safety" in healthcare delivery.

Ethics Committees, Research↗
PubMed2005

Lessons in conflict of interest: the construction of the martyrdom of David Healy and the dilemma of bioethics.

Bioethics journals have lagged behind medical and science journals in exploring the threat of conflict of interest (COI) to the integrity of publications. Some recent discussions of COI that have occurred in the bioethics literature are reviewed. Discussions of what has been termed the "Healy affair" unintentionally demonstrate that the direct and indirect influence of undisclosed COI may come from those who call for protection from the undue influence of industry. Paradoxically, the nature and tone of current discussions may serve to dull sensitivities to what is indeed a serious set of issues facing bioethics. Some proposals are presented to address COI and other challenges to the integrity of bioethics and its journals. COI is too important a topic to be left to ideologues, and there is no substitute for readers' caution and skepticism as tools in dealing with the full range of biases that exist in published papers.

Academies and Institutes↗
PubMed1997

Duty to die?

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Aged↗
PubMedDate not supplied

Meeting at Maastricht.

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Editorial Policies↗
PubMed1999

Religious voices in biotechnology: the case of gene patenting.

On 18 May 1995, nearly 200 religious leaders joined with leading biotechnology critic Jeremy Rifkin in a press conference named the "Joint Appeal against Human and Animal Patenting," a move that many within the biotechnology industry could only interpret as seeking to inhibit biotechnological advance. What moral and religious concerns motivated this challenge to patenting? How could the biotechnology industry understand and respectfully attend to these concerns? What values were at play in the debates that followed the joint appeal? What lessons for future dialogue can be learned from attempts at conversation between the opposing positions? This essay is a report from a Hastings Center research project that accepted the task of addressing these questions. Specifically, the project focused on the patenting of human genetic material, a subset of the issues raised by the joint appeal.

Base Sequence↗
PubMedDate not supplied

AIDS, ethics, and the blood supply. A report of a conference of the American Blood Commission and the Hastings Center, Institute of Society, Ethics and the Life Sciences, January 29 and 30, 1985.

Although the conference was not held to determine policy, certain issues emerged which should be of interest to all involved with the initiation of anti-HTLV-III testing. First, there was a consensus that an implementation period during which donors will not be notified of the test results is essential. During this period, test proficiency, data confidentiality safeguards, and positive donor counseling procedures can be established. Also, during this period alternative test sites can be established; this was considered a critical step to maintain the safety of the blood supply. Second, there was a perceived need for legislation to protect the confidentiality of sensitive test data, whether in the laboratory or as part of a deferral list system, from subpoena. Third, there was not agreement about whether inventory should be tested; donors who provided that inventory did not know it was to be tested, and might not have consented if the implications of testing had been known. But, inventory testing is clearly in the interest of the recipient. Finally, there was an awareness in the blood banking community of their new role in monitoring a public health menace, and a beginning acceptance of this role emerged.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The ethics of home care: autonomy and accommodation.

The following report offers an initial exploration of home care and its distinctive ethical problems, particularly in the area of autonomy and allocation, and specifically with regard to the frail elderly...The principal source of the report was a...research project of The Hastings Center and the Division of Legal and Ethical Issues in Health Care at Montefiore Medical Center. This project was part of a...program in which the Retirement Research Foundation supported...research projects on the autonomy of the elderly in long term care... Additional material...comes from a Hastings Center project... This earlier project involved a comparative study of home care for the elderly and community-based care of the mentally ill. It provided an initial exploration of many of the ethical issues crucial to this report....

Aged↗