As an ethicist trained in narrative, I wondered what I could offer Dr. Darcy at this point, two weeks after the events he described. And what might I have offered those involved if they had called an ethics consult at the time? One of this physician's implicit questions was, “How might this have unfolded in a better way?”When difficult choices must be made, how can a narrative approach help? A narrativist focuses less on principles, rules, and law than would a (...) philosopher or a lawyer. This is not to say that we ignore the law or are unaware of bioethical principles. But where do we go from there? Narrative offers a mode of engagement that asks different kinds of questions than those that law or philosophy might ask about moral agency, context, and values. (shrink)

The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

The Hastings Center addresses fundamental ethical issues in the areas of health, medicine, and the environment as they affect individuals, communities, and societies. With a small staff of senior researchers at the Center and drawing upon national and international experts, The Hastings Center pursues interdisciplinary research and education that includes both theory and practice. Founded in 1969 by philosopher Daniel Callahan and psychoanalyst Willard Gaylin, The Hastings Center is the oldest independent, nonpartisan, interdisciplinary research institute of its kind in the (...) world. From its earliest days The Hastings Center has understood that the moral problems arising from rapid advances in medicine and biology are set within a broad intellectual and social context. The Center's collaborations with policy-makers, in the private as well as the public sphere, assist them in analyzing the ethical dimensions of their work. (shrink)

Reality medical television, an increasingly popular genre, depicts private medical moments between patients and healthcare providers. Journalists aim to educate and inform the public, while the participants in their documentaries—providers and patients—seek to heal and be healed. When journalists and healthcare providers work together at the bedside, moral problems precipitate. During the summer of 2010, ABC aired a documentary, Boston Med, featuring several Boston hospitals. We examine the ethical issues that arise when journalism and medicine intersect. We provide a framework (...) for evaluating the potential benefits and harms of reality medical television, highlighting critical issues such as informed consent, confidentiality, and privacy. (shrink)

Beginning with this issue, the "Review Essays" section of the journal has been renamed "Critical Assessments." The new name more accurately describes not only the content of the section but also the journal's methods of assessment. Submissions to the section are peer reviewed; published essays are catalogued and indexed like the rest of the content of Perspectives in Biology and Medicine.Where many journals publish reviews on the assets and liabilities of newly published books, the Critical Assessments section of Perspectives in (...) Biology and Medicine aims for robust, engaging essays, written in an informal style about important new books, and also about important new articles. Books are a typical means of publishing... (shrink)

In 1957, D. J. Ingle, the first editor of Perspectives in Biology and Medicine, explained why he thought a new journal was needed for scientists and physicians already inundated by publications. With professional journals increasingly focused on smaller and smaller systems and preoccupied with publishing data, he decided that readers needed a forum in which there was space for leisurely interpretation, speculation, and exploration of new ideas. Ingle intended for the journal to reach into all fields of biology and medicine. (...) The journal would welcome scholarly writing from any discipline that could offer new insight and informed thinking to “take stock” of the results and implications of current research. He.. (shrink)

In the summer of 2017, much of the world was riveted by the case of Charlie Gard, a baby in London whose parents wanted an experimental treatment and whose doctors thought that further treatment would be futile. The case worked its way through the British courts and, eventually, was even heard by the European Court of Human Rights. Pope Francis and President Trump weighed in. If nothing else, the case revealed how controversial the issues around medical futility and shared decision-making (...) still are. Many ethical issues resolve over time. Discussions about disagreements lead to discovery of common ground. That doesn’t seem to be the case with the issue of medical futility and, particularly, with... (shrink)

If you travel through airports, you can’t help but notice it. Jodi Picoult’s novels are everywhere. From Charlotte to Kansas City to Los Angeles, airport bookstores are consistently stocked with three or four or more of her most recent heavy volumes of fiction. Read one and you might mutter that it seems designed for a relatively mindless flight from one coast to the other. Read several and you might agree with National Public Radio’s disparaging view that the books are “lurid (...) tales of family strife . . . garnished heavily with medical jargon, legalese, and a punitive finger pointed at a mother.” It’s not hard to find negative comments about Picoult’s novels. Janet Maslin, writing for the New York .. (shrink)

We are sad to say that Advisory Board member Renée Fox died on September 23rd. Renée was an extraordinary friend of Perspectives in Biology and Medicine, celebrating and contributing to its uniqueness over many years.Renée was a pioneer in medical sociology who spent most of her career at the University of Pennsylvania. Her research used participant-observation to explore the work of physicians. In Experiment Perilous, she examined troubling practices of doctors who conducted research on their own patients at the Peter (...) Bent Brigham Hospital in Boston. In The Courage to Fail, written with Judith Swazey, she focused on dangers to patients as their physicians used them as experimental subjects to develop... (shrink)