Bioethics @ TIU

All We Need is (Unconditional) Love

Posted April 26th, 2017 by Chris Ralston

On March 24, 2017, Joe Gibes posted an entry on this blog, entitled “A ‘disabled’ person speaks out against a particular form of discrimination.”[1] That post featured links to several stories about Kathleen Humberstone, a young woman with Down Syndrome who spoke at a recent UN event commemorating World Down Syndrome Day, which was observed on March 21. After reading through Joe’s post and the… // Read More »

The Gift of Finitude

Posted March 1st, 2017 by Chris Ralston

I’ve been thinking a lot lately about finitude. About limits. Incompleteness. Even failure. Like the friend of a friend who is dying and has just been admitted to hospice, whose young teenaged daughter is facing the prospect of a life without her mother. Like the colleague who is grieving the loss of both a spouse and a parent within a month of each other. Like… // Read More »

Advance Care Planning and its Detractors

Posted February 18th, 2017 by Joe Gibes

The default mode of our technologically advanced medicine is to use our technology. Nowhere is this more true than close to the end of life. And our technology is really impressive; with it, we can keep chests going up and down and hearts beating for a long, long time. The troubling thing is that there are many people who would rather not have lots of… // Read More »

The surprisingly small benefit of some very (expensive) Big Ideas

Posted August 5th, 2016 by Joe Gibes

Last week, JAMA published online a Viewpoint provocatively titled, “What Happens When Underperforming Big Ideas in Research Become Entrenched?” The overarching Big Idea to which the article refers is the “narrative positing that a combination of ever-deeper knowledge of subcellular biology, especially genetics, coupled with information technology will lead to transformative improvements in health care and human health.” The article highlights three technologies that are… // Read More »

The End of Meaningful Use: A Meaningful Opportunity

Posted January 15th, 2016 by Joe Gibes

The Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andy Slavitt said Monday that 2016 would likely see the end of the meaningful use program. Meaningful use is a carrot-and-stick government program designed to get medical providers to use electronic health records (EHRs) and to set standards for using them. The carrot: medical providers who show compliance with meaningful use regulations get incentive payments… // Read More »

Technique and Eugenics: my response to the question Jon Holmlund asks about gene editing

Posted May 9th, 2015 by Joe Gibes

Jon Holmlund has asked in this blog whether germ-line modification for the purpose of eliminating genetic diseases (NOT for enhancement), if it could be done safely and equitably, would be ethically acceptable. I argue no, for at least three reasons: we humans are virtually incapable of limiting our use of technology, the technology of gene editing is inescapably eugenic, and we humans are incorrigibly eugenic…. // Read More »

Great (if Unrealistic) Expectations

Posted January 2nd, 2015 by Joe Gibes

Good ethics begins with good facts. Right decisions and truly informed consent require correct information — or, at the least, the best information we have — and accurate expectations. A review recently published in JAMA Internal Medicine online suggests that this most basic condition for making good decisions is, in many instances of medical decision-making, lacking. The article reviews studies that evaluated patients’ expectations about the… // Read More »

An Ethics of Complexity

Posted September 30th, 2014 by Tom Garigan

As a long-time member of the military medical community, this article caught my eye: “1 in 5 Army hospital leaders suspended in 2 years: What’s behind the discipline?” The reasons for these suspensions are known only at the highest level of command, and I suspect that there they will remain. But such a circumstance is significant, and we must ask for the reasons, to determine… // Read More »

Meaningful Use and Justice

Posted June 20th, 2014 by Joe Gibes

As part of the 2009 economic stimulus bill, Congress passed the Health Information Technology for Economic and Clinical Health (HITECH) Act. Among other things, this act sought to increase the adoption of Electronic Health Records (EHRs) by providing financial incentives to adopters of certified EHRs who met certain benchmarks by a certain timeline. These benchmarks are known as “Meaningful Use.” To receive the financial incentives… // Read More »

What Makes Doctors Happy

Posted March 29th, 2014 by Joe Gibes

The Rand Corporation recently published a study of determinants of physician professional satisfaction, and their implications for patient care. One of the “most novel and important findings” related to electronic health records (EHRs). The study found that EHRs affected physician satisfaction both positively and negatively. Physicians like the idea of EHRs, and appreciate their “promise” to improve patient care and thus professional satisfaction. However, the current… // Read More »