This paper explores the notions of hope and how individual patient autonomy can trump carefully reasoned ethical concerns and policies intended to regulate stem cell transplants. We argue that the same limits of knowledge that inform arguments to restrain and regulate unproven treatments might also undermine our ability to comprehensively dismiss or condemn them. Incautiously or indiscriminately reasoned policies and attitudes may drive critical information and data underground, impel patients away from working with clinical researchers, and tread needlessly on hope, (...) the essential motivator of patients, advocates and researchers alike. We offer recommendations to clinicians and health care providers to help balance the discourse with individuals seeking treatment while guarding against fraud, misconception, and patient harm. (shrink)

Hank Greely’s target article, “Human Brain Surrogates Research: The Onrushing Ethical Dilemma” reviews the manifold scientific and ethical questions surrounding models of human brains used i...

In the coming decades, highly treated wastewater, known as reclaimed water, is slated to be a major element of municipal water supplies. In particular, planners propose supplementing drinking water with reclaimed water as a sustainable solution to the growing challenge of urban water scarcity. Public opposition is currently considered the primary barrier to implementing successful potable water reuse projects; nonetheless, public responses to reclaimed water are not well understood. Based on a survey of over 250 residents of Tucson, Arizona, this (...) article assesses the relationship between trust in the professional institutions responsible for municipal water development and willingness to drink reclaimed water. Results demonstrate that public acceptance of potable reuse is contingent on trust in the authorities who influence design of sociotechnical systems for water supply and reuse—including water and wastewater utilities, regulators, consultants, academics, and elected local officials. Findings emphasize the highly interdependent social and political factors that inform personal decisions to support or reject potable reuse. The authors suggest that achieving greater acceptance of potable reuse will require bringing local and regional water policy in line with public values, as well as finding ways to incorporate these values into the planning process. (shrink)

The social ecological model (SEM) is a conceptual framework that recognizes individuals function within multiple interactive systems and contextual environments that influence their health. Medical Legal Partnerships (MLPs) address the social determinants of health through partnerships between health providers and civil legal services. This paper explores how the conceptual framework of SEM can be applied to the MLP model, which also uses a multidimensional approach to address an individual’s social determinants of health.

Background Forward-looking, democratically oriented governance is needed to ensure that human genome editing serves rather than undercuts public values. Scientific, policy, and ethics communities have recognized this necessity but have demonstrated limited understanding of how to fulfill it. The field of bioethics has long attempted to grapple with the unintended consequences of emerging technologies, but too often such foresight has lacked adequate scientific grounding, overemphasized regulation to the exclusion of examining underlying values, and failed to adequately engage the public. Methods (...) This research investigates the application of scenario planning, a tool developed in the high-stakes, uncertainty-ridden world of corporate strategy, for the equally high-stakes and uncertain world of the governance of emerging technologies. The scenario planning methodology is non-predictive, looking instead at a spread of plausible futures which diverge in their implications for different communities’ needs, cares, and desires. Results In this article we share how the scenario development process can further understandings of the complex and dynamic systems which generate and shape new biomedical technologies and provide opportunities to re-examine and re-think questions of governance, ethics and values. We detail the results of a year-long scenario planning study that engaged experts from the biological sciences, bioethics, social sciences, law, policy, private industry, and civic organizations to articulate alternative futures of human genome editing. Conclusions Through sharing and critiquing our methodological approach and results of this study, we advance understandings of anticipatory methods deployed in bioethics, demonstrating how this approach provides unique insights and helps to derive better research questions and policy strategies. (shrink)

This paper explores the notions of hope and how individual patient autonomy can trump carefully reasoned ethical concerns and policies intended to regulate stem cell transplants. We argue that the same limits of knowledge that inform arguments to restrain and regulate unproven treatments might also undermine our ability to comprehensively dismiss or condemn them. Incautiously or indiscriminately reasoned policies and attitudes may drive critical information and data underground, impel patients away from working with clinical researchers, and tread needlessly on hope, (...) the essential motivator of patients, advocates and researchers alike. We offer recommendations to clinicians and health care providers to help balance the discourse with individuals seeking treatment while guarding against fraud, misconception, and patient harm. (shrink)

Traditional methods of instruction can fail to produce enduring ways of learning, especially in rapidly changing disciplines in the life sciences. Educators and funding agencies are thus calling for new, integrated teaching approaches to address the life sciences. Hierarchical frameworks are being proposed as ways to tackle curricula with large numbers of concepts. Comparing lecture‐based and interactive formats by measuring performance with pre‐ and post‐tests indicated significantly higher learning gains and better conceptual understanding in the more interactive course. Other work (...) has examined how the history of biology can be used to infuse relevance into the biology curriculum. In this paper, I describe a project at Stanford to create, implement, and evaluate an integrated curriculum in undergraduate stem cell education comprised of scientific, laboratory, and ELSI topics. (shrink)