As web instruction becomes more and more prevalent at universities across the country, instructors of ethics are being encouraged to develop online courses to meet the needs of a diverse array of students. Web instruction is often viewed as a cost-saving technique, where large numbers of students can be reached by distance education in an effort to conserve classroom and instructor resources. In practice, however, the reverse is often true: online courses require more of faculty time and effort than do (...) many traditional classes. Based on personal experience teaching an online course in health care ethics for students in the Allied Health Professions, it is evident that there are both benefits and challenges in teaching online courses, particularly in ethics. Examples of benefits are (1) the asynchronous nature of web instruction allows students to progress through the course at their own pace and at times that are convenient given their clinical responsibilities; (2) web courses allow for a standardization of content and quality of instruction over a diversity of programs; and (3) examples can be tailored to the differing experiences of students in the course. Some challenges to teaching online ethics courses include (1) the fact that online instruction benefits visual learners and disadvantages those lacking good reading comprehension or strong writing skills; (2) developing meaningful student-student and student-instructor interaction; and (3) teaching ethics involves teaching a process rather than a product. Allowing students to apply their knowledge to real-world cases in their disciplines and encouraging them to share experiences from clinical practice is an effective way to meet several of these challenges. Building an online community is another good way to increase the interaction of students and their engagement with the material. (shrink)

The reference to the vagina as “it” or “down there” is symptomatic of two larger cultural problems: not naming the vagina when speaking about the vagina, and conflating the vagina with the external female genitalia. The euphemisms and obfuscating language have implications both for lay understandings of female bodies and for the practice of health care. Granting and using a name gives both the named and the namer power and legitimacy.

Following the widespread occurrence of birth defects from the use of thalidomide to treat nausea during pregnancy in the 1960s and 1970s, the Food and Drug Administration became particularly vigilant about the use of therapeutic agents during pregnancy and in women of childbearing potential. The FDA developed a list that categorizes an agent according to the known risks to a fetus. The drug thalidomide falls into Category X: agents that have demonstrated clear risk of fetal abnormalities and whose risks outweigh (...) the benefits of use during pregnancy.Another Category X drug is isotretinoin, commonly known by its trade name Accutane. Isotretinoin is an oral medication prescribed for severe recalcitrant, nodular acne in patients who are unresponsive to conventional therapy. Isotretinoin has been available since 1982, and it remains the only effective treatment for this condition. (shrink)

The United States Food and Drug Administration , in collaboration with pharmaceutical manufacturers, have recently implemented a heavily revised risk-management program for patients on isotretinoin , a drug with known and pronounced teratogenic effects. This revised risk management plan places significant burdens on both providers and patients in the hopes of achieving its goal of reducing fetal exposure to isotretinoin. The main focus of this paper is to discuss the burdens of various aspects of the program in relationship to potential (...) corresponding benefits. In particular, we evaluate the pregnancy rates of women on isotretinoin therapy compared with that of the general population and the rate changes based on the risk management programs. Additionally, we investigate whether the benefits of the program for women have increased as the benefits have risen. We devote special attention to the ethical implications of the intent of the program and to an analysis of the ethical justification of the restrictions placed on women of childbearing potential as it compares to the risk-benefit relationship of using isotretinoin. (shrink)

This essay refutes the charge of relativism levied against religious approaches to bioethics by using Jewish bioethics as a case study. I demonstrate how an approach to ethics that includes particular spiritualities need not be essentialist but can better respect a patient's values, goals, and priorities. Recognizing the value of listening to silenced voices and showing how the identification of a nonhomogenous group can yield important insights for ethics, feminist approaches have paved the way for a reintroduction of religious approaches (...) to mainstream ethical discourse. (shrink)

For couples for whom assisted reproduction is the only way to have genetically related offspring, the donation of gametes by others makes available enhanced reproductive options. There has been an increasing demand for such services, as evidenced by the Web site launched by fashion photographer Ron Harris in the fall of 1999. Although the sale of such gametes is not new, this Web site does speak to a different set of priorities and values than has been witnessed in the context (...) of assisted reproduction: the selection of particular traits, in effect, the creation of designer babies. With the expanding demand for such services come expanded liabilities, which are the focus of this article. The author argues that this kind of commodification of gametes reinforces dubious social attitudes, leads to potential harms for the children created by this technology, and suggests a departure from traditional paradigms in medicine: a departure in an ill-advised direction. (shrink)