Point-of-care evidence-based medicine websites allow physicians to answer clinical queries using recent evidence at the bedside. Despite significant research into the function, usability and effectiveness of these programmes, little attention has been paid to their ethical issues. As many of these sites summarise the literature and provide recommendations, we sought to assess the role of conflicts of interest in two widely used websites: UpToDate and Dynamed. We recorded all conflicts of interest for six articles detailing treatment for the following conditions: (...) erectile dysfunction, fibromyalgia, hypogonadism, psoriasis, rheumatoid arthritis and Crohn's disease. These diseases were chosen as their medical management is either controversial, or they are treated using biological drugs which are mostly available by brand name only. Thus, we hypothesised that the role of conflict of interest would be more significant in these conditions than in an illness treated with generic medications or by strict guidelines. All articles from the UpToDate articles demonstrated a conflict of interest. At times, the editor and author would have a financial relationship with a company whose drug was mentioned within the article. This is in contrast with articles on the Dynamed website, in which no author or editor had a documented conflict. We offer recommendations regarding the role of conflict of interest disclosure in these point-of-care evidence-based medicine websites. (shrink)

Increasingly widespread adoption of health information technology tools in clinical care increases interest in ethical and legal issues related to the use of these tools for public health and the effects of these uses on the clinician-patient relationship. It is argued that patients, clinicians, and society have generally uncontroversial duties to support civil society's public health mission, information technology supports this mission, and the effects of automated and computerized public health surveillance are likely to have little if any effect on (...) the clinician-patient relationship. It is also suggested, nevertheless, that electronic public health surveillance raises interesting and important ethical issues, some of which can be addressed if not resolved by empirical research, especially regarding patient preferences about secondary use of health data and their moral obligation to contribute to population- based health. (shrink)

One of the largest, oldest, and most interesting challenges in health care is the balancing act in which clinicians have generally uncontroversial duties both to individual patients and to communities. Physicians and nurses must — so we teach them — put patients first, and at the same time recognize that individuals are members of communities. Individuals affect the health of communities, and communities affect the health of individuals. Thus, the moral and professional duties that result are sometimes in conflict.Moreover, the (...) traditional, prosaic clinical encounter is evolving in an environment increasingly shaped by electronic health records, personal health records, pharmacogenomics and vast networks of data collection and storage for public health surveillance, human subjects research, health services evaluation, and comparative effectiveness research. Health information technology is changing everything. It would be perverse otherwise: imagine large amounts of data and information either ignored, missed, or collected and then ignored. (shrink)

Advanced Cell Technology's Ethics Advisory Board has been called window dressing for a corporate marketing plan. But the scientists and managers have paid attention, and the lawyers have gone along.

What is reading? In this groundbreaking book, esteemed researchers Ken Goodman, Peter Fries, and Steven Strauss, explain not only what reading really is but also why common sense makes it seem to be something quite different from that reality. How can this grand illusion be explained? That is the purpose of this book. As the authors show, unraveling the secrets of the grand illusion of reading teaches about far more than reading itself, but also about how remarkable human language is, (...) how the brain uses language to navigate the world, what it means to be human. Each author brings a different perspective, but all share a common view of the reading process. Together they provide a clear and surprising exposition of the reading process, in which they involve readers of this book in exploring the ways they themselves read and make sense of written language while their eyes fixate on fewer than 70 percent of the words in the text. In addition, the authors engage in a cross-disciplinary discussion about how readers use the brain, eyes, and language in reading. The different perspectives provide depth to the authors' description of reading. The information presented in this book will be new to many teachers, researchers, teacher educators, and the public alike. The final chapter draws on the understandings from the book to challenge the treatment of reading and writing as school subjects and offers the basis for supporting literacy development as a natural extension of oral language development. (shrink)

The intersection of ethics, computing, and genetics plots a space not yet adequately mapped, despite its importance, indeed, its rapidly growing importance. Its subdomains are well-enough known: or the study of ethical issues in genetics and genomics, is part of core curricula everywhere. Ethics and computing is an established subfield. Computing and geneticshas in little more than a decade progressed from subsubspecialty to the sine qua non of contemporary biomedical research, and it bids fair to transform clinical practice. We must (...) prepare for the complete digitization of the genomes of individual patients and the storage of millions of these genomes in very large databases. (shrink)

The American Journal of Bioethics, Volume 12, Issue 5, Page 20-22, May 2012.

Electronic mail creates special opportunities and burdens for academicians and others. This article first describes e-mail and how it works in a university setting. It then presents the transcript of an electronic exchange over the issue of multiple or repeat abortion. The debate was inspired by a case presented during "ethics rounds" for students at a university medical center. The value of e-mail in this case is considered, and the electronic medium is found to be useful for sharing ideas and (...) stimulating debate about issues in medical ethics, as well as for educational purposes. (shrink)

News media accounts of issues in bioethics gain significance to the extent that the media influence public policy and inform personal decision making. The increasingly frequent appearance of bioethics in the news thus imposes responsibilities on journalists and their sources. These responsibilities are identified and discussed, as is (i) the concept of "newsworthiness" as applied to bioethics, (ii) the variable quality of bioethics reportage and (iii) journalists' reliance on ethicists to pass judgment. Because of the potential social and other benefits (...) of high quality reporting on ethical issues, it is argued that journalists and their bioethics sources should explore and accommodate more productive relationships. An optimal journalism-ethics relationship will be one characterized by "para-ethics," in which journalistic constraints are noted but also in which issues and arguments are presented without oversimplification and credible disagreement is given appropriate attention. (shrink)

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the (...) responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades. (shrink)

To ask whether and to what extent there is an obligation to treat illegal immigrants impliesthat any duty to treat an illegal resident is different from or lesser than the duty to treat a citizen. What could be the reason for thinking that morality affords fewer benefits or rights to illegal residents?

Computer-based information and communication technologies continue to transform the delivery of health care and the conception and scientific understanding of the human body and the diseases that afflict it. While information technology has the potential to improve the quality and efficiency of patient care, it also raises important ethical and social issues. This IRIE theme issue seeks to provide a forum to identify, analyse and discuss the ethical and social issues raised by various applications of information and communication technology in (...) medicine and health care. The contributions give a flavour of the extraordinarily broad landscape shaped by the intersection of medicine, computing and ethics. In fact, their diversity suggests that much more work is needed to clarify issues and approaches, and to provide practical tools for clinicians. (shrink)

Radio Frequency Identification (RFID) systems identify and track objects, animals and, in principle, people. The ability to gather information obtained by tracking consumer goods, government documents, monetary transactions and human beings raises a number of interesting and important privacy issues. Moreover, RFID systems pose an ensemble of other ethical challenges related to appropriate uses and users of such systems. This paper reviews a number of RFID applications with the intention of identifying the technology’s benefits and possible misuses. We offer an (...) overview and discussion of the most important ethical issues concerning RFID, and describes and examine some methods of protecting privacy. (shrink)