The Hastings Center Report delves into the impact of patient-satisfaction surveys on healthcare quality, arguing they may compromise care and raise costs. The issue also examines the role of courage in healthcare, highlighting its limitations in certain contexts.
The Hastings Center Report explores how the term 'rationing' has been replaced by 'value' in discussions about controlling health care costs. The report also examines the structure of clinical translation and its impact on patient care.
After 40 years of work, experts conclude that securing individual rights, improving caregiving relationships, and reforming healthcare systems are crucial to advancing end-of-life care. Strategies include training clinicians in communication skills, designing systemic improvements, and enacting financing reforms.
The Hastings Center Report explores the controversy surrounding the Surfactant, Positive Pressure, and Oxygenation Randomized Trial (SUPPORT), a study that gauged risks and benefits of blood oxygen levels in premature infants. The debate highlights concerns over informed consent and the ethics of comparative effectiveness research.
A new report by The Hastings Center calls on bioethics to help redress injustices faced by lesbian, gay, bisexual, and transgender individuals. The report highlights the need for bioethics to examine its role in shaping laws and medical practices that impact LGBT populations.
The Hastings Center and the Presidential Commission for the Study of Bioethical Issues have published a series of essays on bioethics education, highlighting gaps in knowledge and best practices. The papers focus on clinical ethics training for nurses, doctors, and medical students, emphasizing the importance of moral agency, reproduct...
The war on terror is incorporating medicine into warfare, undermining population health and exacerbating global health inequities. Humanitarian and health workers face profound moral distress due to being treated as tools in the war on terror.
A group of experts examines whether people with advanced dementia have the right to use advance directives to stop receiving food and water by mouth, despite lacking decision-making capacity. Key findings include the potential benefits and harms of such directives, as well as proposed guidelines for implementation.
Research finds that fertility treatments increase the risk of multiple births and prematurity, leading to health complications and significant healthcare costs. Experts propose six policy changes to mitigate these risks, including expanding insurance coverage for IVF and improving doctor-patient communication.
The Hastings Center special report examines the capabilities and limitations of neuroimages in biomedical research, medicine, and courtrooms. Key findings include concerns about overinterpretation, misapplication, and the lack of direct neural activity shown by neuroimaging techniques.
The Hastings Center President Emeritus Thomas H. Murray calls for a national conversation about the discretion parents should have in choosing their child's traits. The FDA is considering human testing of mitochondrial manipulation, which could prevent rare diseases and address female infertility, raising concerns about safety and ethics.
A new commentary highlights the devastating impact of sequestration on the Indian Health Service, perpetuating longstanding health care disparities. Funding cuts lead to rationing of services, contributing to a 4.1-year gap in life expectancy compared to mainstream Americans, with alarming rates of alcoholism, diabetes, and mortality.
The emergence of fertility loans has raised ethical concerns as doctors market them to patients with potential financial ties to lenders. Experts argue that this practice may exacerbate the anguish of infertility by promoting unsuccessful interventions.
Lawrence O. Gostin praises Bloomberg's policies addressing obesity epidemic, disease surveillance, and tobacco control, citing successes in trans fat limits and tobacco reduction. He argues that Bloomberg's approach is a necessary response to lifestyle-related diseases, demonstrating creativity and courage in public health advocacy.
The American Society for Bioethics and Humanities (ASBH) has proposed a method for assessing the knowledge, skills, and practice of clinical ethicists. A two-step process evaluates candidates based on their portfolio and oral examination.
The Hastings Center has released a new set of guidelines for good care near the end of life, aiming to improve communication, pain management, and treatment decisions. The guidelines clarify what is ethically permissible in the US regarding life-sustaining technologies and provide practical guidance for healthcare professionals.
A new report from The Hastings Center highlights the need to integrate undocumented immigrants into the US healthcare system, as they lack insurance and are ineligible for most federal programs. The report recommends addressing this issue in immigration reform proposals to improve population health, particularly among children and Hisp...
The Hastings Center has released a special report on the evolving landscape of animal research ethics, citing examples of changes improving animal welfare and replacing animal testing. Alternative models, such as human cell-based toxicity testing, are gaining traction.
A new ethical framework is needed to balance patient protection with data collection for learning health care systems, say experts. The proposed framework outlines seven obligations to ensure patients' rights and dignity while fostering clinical learning.
Daniel Callahan proposes a controversial approach to fighting obesity by stigmatizing overweight individuals in a way that minimizes the risk of discrimination. He suggests that 'stigmatization lite' could be an effective strategy, as people who are overweight consider the threat of discrimination as a danger to be avoided.
An international advisory group argues that female genital surgeries are poorly understood and unfairly characterized, citing medical research and cultural complexities. The practice is often misconstrued as mutilation and a violation of human rights, but experts argue it's an aesthetic enhancement in many societies.
Genomic medicine provides pharmacogenomic information to forecast therapy responses and genomic susceptibility testing to predict disease risks. However, this added knowledge may pressure patients to comply with doctors' recommendations and shift responsibility for health care decisions from doctor to patient.
The widespread adoption of prenatal whole genome sequencing could lead to increased anxiety in parents, altering societal views on normalcy and potentially influencing reproductive decisions. Additionally, the technology may impact child-rearing practices and the interests of children themselves.
A recent article in the Hastings Center Report raises questions about the AMA's policy on prescribing placebos, arguing that it may not be the best way to protect or benefit patients. The article suggests that some bioethicists argue that an undisclosed placebo is sometimes the best available treatment for certain patients.
The article proposes an ethical framework to guide coverage decisions for expensive orphan drugs, considering the tension between saving lives and avoiding unfair advantages to identifiable patients. It suggests evaluating potential health gains in context and weighing opportunity costs to determine acceptable expenditure.
A new project by The Hastings Center explores the medical safety net for undocumented immigrants in the US, highlighting the challenges of providing care to those without insurance. The project aims to clarify policy choices and identify consequences for patients, healthcare professionals, and organizations.
The article explores the ethics of gallows humor in medicine, with author Katie Watson arguing that some joking between medical professionals can be beneficial. She suggests that the key to deciding when gallows humor is okay lies in understanding the intent and impact of jokes on patients and power dynamics.
The Hastings Center Report examines the social challenges of synthetic biology, including ethical considerations and regulatory implications. Experts discuss guidelines for emerging technologies, highlighting the need for responsible stewardship and balanced analysis.
The Hastings Center will use the grant to develop educational resources on ethical issues in biomedical research, including alternatives to animal models. The project aims to promote nuanced thinking on animal welfare and medical progress.
Decertification of physicians participating in lethal injections by professional certifying organizations goes too far, argue Lawrence Nelson and Brandon Ashby. The authors examine the role of physicians in lethal injections and find that they can reduce risk while not advancing or harming ethical medicine principles.
Physicians may be complicit in torture if they care for patients at the request of their torturers, but refusing treatment can abandon a patient in need. Guidelines suggest minimizing complicity by assessing consequences and following patient requests to mitigate or prevent acts of torture.
Experts warn that disclosing quantitative data to patients can backfire due to numeracy problems and biases in interpreting data. Studies show that decision aids increase patient knowledge but may not always lead to informed decisions. Researchers advocate for further research on presenting risk information to aid decision-making.
A report from The Hastings Center finds that many children with problematic moods and behaviors receive inadequate care due to systemic and cultural pressures. Experts agree that diagnoses have unclear boundaries, leading to disagreements about treatment, but also conclude that environments contribute to problematic behaviors.
A new study found that 72% of patients in early-phase cancer trials accurately understood the trial purpose, but exhibited unrealistic optimism in response to specific questions. This bias may interfere with applying information realistically and compromise informed consent.
New research reveals that high-end hospital design features like private rooms and natural light can reduce healthcare-acquired infections and costs. Two case studies demonstrate the benefits of evidence-based design in hospitals and community health centers.
The Hastings Center has issued recommendations on growth attenuation, a controversial procedure used to restrict the growth of profoundly disabled children. The guidelines prioritize parental autonomy while establishing safeguards to ensure the child's well-being.
The Hastings Center Report has published four essays on the next generation of bioethics, exploring new areas such as pharmaceutical industry ethics, public health, and regenerative medicine. These essays propose broadening the approach to dying and creating a framework for teaching an aging population to prepare for death.
The Hastings Center researchers and coauthors examine the challenges of providing health services to detainees in drug detention centers. They argue that leaders of health-related organizations should assess whether their programs promote health or exacerbate conditions.
A series of essays examines the challenges in determining effective treatments, benefits and drawbacks for patients, as well as consumers' right to their genetic information. The articles discuss controversies surrounding direct-to-consumer tests, genetically customized drug treatments and biospecimen use.
A legal analysis by Lawrence O. Gostin asserts the health insurance mandate is constitutional due to federal powers regulating interstate commerce and taxation. The mandate's tax penalty is seen as essential for expanding healthcare access and correcting market failures, making it a key component of health reform.
A recent survey found that most Oregon hospices have limited participation in the Death with Dignity Act, which allows terminally ill patients to request physician-assisted death. Hospices' role is largely confined to providing neutral information about the law, leaving patients to seek assistance from physicians themselves.
This special edition of The Hastings Center Report examines the promise and pitfalls of personalized medicine, from direct-to-consumer genetic testing to hospice care. Key findings include the need for thousands of human biospecimens for genetic studies, as well as debates over individual mandates in healthcare reform.
A recent Hastings Center workshop examined the moral implications of synthetic biology, raising questions about humanity's relationship with nature. The project aims to address pressing ethical concerns in emerging technology, involving experts from various fields.
A new pediatric DSM category, Temper Dysregulation Disorder with Dysphoria (TDD), aims to better reflect symptoms of children currently diagnosed with bipolar disorder. However, the authors argue that this change alone is not enough to promote flourishing in troubled children and may even lead to increased medication use.
Neuroimaging research suggests that patients in a persistent vegetative state may not be conscious, raising questions about end-of-life care. The Hastings Center Report explores these issues, including the use of palliative sedation and organ donation after cardiac death protocols.
The Hastings Center Report examines the ethics of sports enhancement, including gene doping, sex typing, and biological passports. Athletes, ethicists, and former athletes share their perspectives on the pressures to cheat in elite sports.
Troubled children diagnosed with bipolar disorder may benefit from alternative diagnoses like Severe Mood Dysregulation or Temper Dysregulation Disorder. The Hastings Center researchers recommend reframing the diagnosis and treatment approach to address family and social contexts.