IJFAB BLOG IS BACK FROM BREAK!
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The IJFAB Blog editors have been on break to focus on family during the Northern Hemisphere’s winter holidays. We will be posting some great new content this coming week including reflections by a bioethicist obstetrician, reflections on disability and bioethics, and reflections on how an American governor’s pardon of a man convicted of child sexual assault are linked to global misinformation about women’s bodies and the concept of “virginity.”

If you ever come here and find that you miss us, seek IJFAB out on Twitter @IJFAB where we not only boost IJFAB Blog content but also new IJFAB issues and most importantly, retweet current events in bioethics and sometimes offer brief questions to get at issues that are being overlooked. This screenshot of tweets from late December 2019 gives an example of what you can expect to find.

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Climate change puts women at risk of early labor

A recent study has shown that birth rates increase by 5% on days with temperatures over 90 degrees. Additionally, the World Health Organization notes that higher air temperatures have been linked to heat stroke and higher pollen levels, which can trigger asthma.

Researchers analyzed country-level birthrates over 20 years to make their projections, and estimated that heat exposure translated into 25,000 infants born earlier than predicted each year, approximately 150,000 hours of lost gestational time.

If current climate change trends continue unabated, the researchers project that there will be 250,000 lost gestational days per year by the end of the century.

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Evidence continues to suggest that climate change poses serious threats to human health. This will disproportionately affect vulnerable people in countries with warmer climates and fewer health resources, making it a concern of both bioethics and environmental justice.

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African scientists and ethicists lead the way in developing ethical guidelines on handling data
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In case you missed it, in June of 2019, Nature covered efforts by the multinational African Academy of Sciences (AAS), founded in 1985, to develop ethical guidelines on handling data. Their goal: to make sure that Africans benefit from research done in Africa, and to protect study participants from exploitation.


While the guidance has no legal heft–just as the U.S. National Academies of Science reports are advisory–it will provide nations throughout Africa with a common resource for developing and revising legal requirements for human subject/participant research.

So what are you waiting for? Go ahead and consider all these factors so that it viagra discount india becomes easier for you to track the progress and provide guidance wherever required. generic viagra without prescriptions What we see is proof that bin Laden the Brave was not living the life of a rough and tumble world of PPC advertising. Unfortunately, such drugs often lead to inflammation and other side cialis 10 mg effects. These meetings help to deal with stress, lack of concentration, lack of buy soft cialis energy, sexual dysfunction, anxiety, depression and many other emotional conditions.

If you want to follow up, the Nature article also links to other community and national guidelines developed within Africa’s many nations and cultures. It closes with a commentary from Collet Dandara that will ring true with anyone who takes community-based participatory research seriously:

The situation is compounded by Africa’s lack of research infrastructure, including quality data repositories and equipment such as gene sequencers. Collet Dandara, a geneticist at the University of Cape Town in South Africa, largely blames African governments for failing to provide such infrastructure for genomics research, which forces the continent’s scientists to send samples abroad for analysis.

Even initiatives designed to strengthen African expertise rarely cover basic infrastructure, Dandara says. That means African scientists can’t keep studying data that they have helped to collect once the initial round of projects — on which they usually work with international partners who have the analysis capabilities — finishes. Dandara says this happened with the MalariaGEN project, which collected genomic data from malaria parasites, mosquitoes and people. Several UK and US health agencies and charities started it in 2005. “A whole lot of studies were done in Africa, but to interrogate the data is difficult for African scientists,” he says.

However the AAS committee guidelines address the practical challenges of data sharing, it’s important that they also uphold African values, says Dandara. Communities that take a group-centred approach to participation in research projects, such as the San people in southern Africa, can run into problems with the individualized approach to data ownership and benefit sharing that is common in Western science. Deciding how to proceed would involve working closely with communities that have some claim to the information being gathered, Dandara says, including asking members how they think the work should be done.

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Poland’s policy on frozen embryos violates autonomy, discriminates against single women

A recent article has brought attention to a troubling policy in Poland surrounding the use of surplus frozen embryos left over from in-vitro fertilization treatment (IVF). IVF requires fertilization of an egg outside of the womb, and embryos not used are frozen. What to do with surplus frozen embryos is a debate within bioethics: some argue they should be “adopted” for use by other couples, others argue they should be used in research. Most laws or policies on the issue, however, allow the woman or couple to make the final choice, unless they waive that right.

But under a Polish law passed in 2015, women who are separated from their husbands are then considered “anonymous donors” whose embryos can be adopted to a married couple after 20 years–without their consent.

Because Barbara is separated from her husband, as a single woman, she is now treated as an “anonymous donor” under a law passed in Poland in 2015.

“If the embryos are taken away from me physically, I know that after 20 years they will no longer be mine [they will be] taken away against my will,” Barbara says sadly.

Her embryos — with the same genetic material as her two daughters — could become babies raised by a couple she will never meet, and she may never know what becomes of them.

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When the regulations around IVF in Poland happened four years ago, putting Barbara in this situation, it was too late for single women who already had some of their embryos stored in dozens of clinics across the country.

They are no longer able to have their embryos transferred unless they have a male partner to help raise the child, Dr Magdalena Radkowska-Walkowicz says.

There are several ethical issues at stake– not only is adopting someone’s embryo to a married couple without consent a violation of one’s autonomy, but the law contains moral judgments about what the “ideal” family should be: clearly favoring married couples at the expense of the rights of single women. Further, the requirement that one must have a “male partner” in order to have access to one’s own embryos valorizes heterosexual relationships and reflects patriarchal norms.

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On this International Day to End Violence Against Women, keep the WHO mantra of “RESPECT” in mind
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Today is International Day to End Violence Against Women.

The World Health Organization has a very helpful Twitter thread on the topic. One of their tweets links to this RESPECT framework for preventing Violence Against Women. It may be valuable to keep it in mind today and all days, and to ask how medical care can help women and families do better, as well as how our governments around the world can do better to protect women and change culture.

R – Relationship skills strengthened. This refers to strategies to improve skills in interpersonal communication, conflict management and shared decision-making.

E – Empowerment of women. This refers to economic and social empowerment strategies including those that build skills in self-efficacy, assertiveness, negotiation, and self-confidence.

S – Services ensured. This refers to a range of services including health, police, legal, and social services for survivors of violence.

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P – Poverty reduced. This refers to strategies targeted to women or the household, whose primary aim is to alleviate poverty.

E – Environments made safe. This refers to efforts to create safe schools, public spaces and work environments, among others.

C – Child and adolescent abuse prevented. This includes strategies that establish nurturing family relationships.

T – Transformed attitudes, beliefs and norms. This refers to strategies that challenge harmful gender attitudes, beliefs, norms and stereotypes.

You can read more about this framework here.

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Māori Theorists Working in Bioethics and Justice Spotlighted at Australasian Association of Bioethics and Health Law and New Zealand Bioethics Conference
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Ongoing 21-23 November of 2019, the Australasian Association of Bioethics and Health Law / New Zealand Bioethics Conference is spotlighting work by Māori thinkers. IJFAB Blog readers might want to look more closely at their work, which makes important contributions to interdisciplinary bioethics and philosophical bioethics. Short bios including links to a few of their pieces of work are below each of their images.

A sturdy woman with jaw-length curly brown hair and rectangular black glasses smilles slightly toward the camera.  She is wearing a bright red blazer and black shirt. Her necklace appears to be traditional Māori carved bone art.
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The first highlighted theorist is Dr. Krushil Watene (PhD, MA) of the College of Humanities and Social Sciences at Massey University in New Zealand. Her work on how we get a very different result when we put the capability approach into cross-cultural conversation with Māori philosophies is worth taking a look at. The links provided here are only a few of Dr. Watene’s many pieces on the subject of justice, and on how Māori justice concepts can contribute to global justice theorizing. Her work also bears on environmental philosophy which has sweeping implications for health, and she works on Māori and Pasifika health and development policies.

A man with short-cut hair, dark on top and greying on the sides, smiles widely toward the camera.  He is wearing a white button down collared shirt and wearing what appears to be a traditional Māori necklace.

The second highlighted theorist is Māui Hudson of the faculty of Māori and Indigenous Studies at the University of Waikato in New Zealand. Professor Hudson works on Māori research ethics, traditional medicine, the interface of Māori knowledge-making and western traditions of inquiry, and Māori health, among other topics.

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Measles epidemics news: DR of Congo, Samoa
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So far in 2019, a measles outbreak in the DR of Congo has killed nearly 5,000 people. A September vaccination initiative by the Congolese government vaccinated an additional 800,000 people.

In Samoa, 15 people have died and the government has closed schools, instituted mandatory vaccination, and prohibited the presence of children at public gatherings.

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Earlier this year, in April of 2019, the UN reported that measles cases had quadrupled globally.

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Environmental Protection Agency will limit science used in public health regulations

 The Trump administration plans to limit the scientific and medical research that government agencies use when formulating public health policies, amidst protests from both scientists and physicians that this policy will undermine current scientific foundations for government legislation.

A new draft of the Environmental Protection Agency proposal, titled Strengthening Transparency in Regulatory Science, would require that scientists disclose all of their raw data, including confidential medical records, before the agency could consider an academic study’s conclusions. E.P.A. officials called the plan a step toward transparency and said the disclosure of raw data would allow conclusions to be verified independently.

The new regulations will make it more difficult to pass clean air and water laws because much research linking pollution to health issues relies on personal health information that is protected by confidentiality agreements with research participants. Potentially even more harmful, the new proposal could apply retroactively to current public health policies. Experts warn that studies we have relied on for decades, such as those that show mercury from power plants is harmful to brain development, may not longer be allowed as evidence once current public health regulations come up for renewal.

For instance, a groundbreaking 1993 Harvard University project that definitively linked polluted air to premature deaths, currently the foundation of the nation’s air-quality laws, could become inadmissible. When gathering data for their research, known as the Six Cities study, scientists signed confidentiality agreements to track the private medical and occupational histories of more than 22,000 people in six cities. They combined that personal data with home air-quality data to study the link between chronic exposure to air pollution and mortality.

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But the fossil fuel industry and some Republican lawmakers have long criticized the analysis and a similar study by the American Cancer Society, saying the underlying data sets of both were never made public, preventing independent analysis of the conclusions.

The change reflects the Trump Administration’s broader effort to reduce the use of scientific research in government legislation. In the recent past, senior administration official have tried to water down the testimony of government scientists, publicly censured scientists who disagree with President Trump’s positions and prohibited government researchers from presenting their work at conferences. These efforts could have profoundly detrimental effects on both our environment and public health.


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Is Sarah Franklin a Bioethicist? Bioethics Beyond Philosophy

EDITOR’S NOTE: This Guest Blog comes to us from bioethicists Dr. Nathan Emmerich and Dr. Alexis Paton in response to a flurry of discussion over Sarah Franklin’s inquiry into bioethics in a recent issue of Nature. Alexis Paton is a Lecturer of Social Science Applied to Health with the SAPPHIRE group at the University of Leicester. She is a Trustee of the Institute of Medical Ethics, and the Chair of the Royal College of Physicians’ Committee on Ethical Issues in Medicine. Nathan Emmerich is Dr Nathan Emmerich is a Research Fellow in bioethics at the ANU College of Health and Medicine.

There are two pictures side by side. One, a woman with pale skin, glasses, and long brown hair who is smiling, is labeled as Dr. Alexis Paton.  The other, a man with curly brown hair, pale skin, glasses, wearing a striped blue and white shirt, is labeled as Dr. Nathan Emmerich.
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In a recent essay for Nature, part of a series of editorials marking the journal’s 150th anniversary, Professor Sarah Franklin suggested that “[b]ioethics, once a beacon of principled pathways to policy, is increasingly lost” (p.629). The tenor of her argument is that bioethics is obsolete, and this certainly seems to be the way that some have taken it. However, it is arguably the case that such responses do little more than rush to the defense of only one facet of bioethics, a multifaceted field. Thus, they do not accept what we see as Franklin’s invitation to reflect upon the nature of bioethics, where it has come from and where it might be going. More than this, elements of these responses test the boundaries of propriety in scholarly debate, at least to our ears. Indeed, in one or two places, we had found ourselves questioning whether the same points would be made in the same way about a male author. If only for the sake of brevity we shall leave this issue to one side.

A more fruitful reading of Franklin’s essay emerges when one bears in mind that bioethics is a broader endeavor than explicitly acknowledged by Franklin or apparently presumed by those who have commented thus far. Consider the fact that, despite the initial pronouncement quoted above, Franklin seems to demur from the hardline of bioethics’ obsolescence saying that, like any other field, bioethics evolves and that:

The field no longer relies on philosophically derived mandates codified into textbook formulas. Instead, it functions as a dashboard of pragmatic instruments, and is less expert-driven, more interdisciplinary, less multipurpose and more bespoke. (p.629)

If bioethics has indeed evolved in this way and, presumably, will continue to develop, how should we take Franklin’s suggestion that it is lost? It seems that the target of Franklin’s criticism is applied philosophically-based bioethics, which roots itself solidly in the philosophical tradition. The dominance of philosophy in bioethics was preeminent from the late 1970 until the late 1990s, and philosophy remains a significant component of the field today. This approach to bioethics is a form of applied philosophy or applied ethics, and it certainly seems to be the conception of bioethics that those responding to Franklin are anxious to defend.

A screencap shows the Nature logo at the top and the headline of an article with subheading. They read "Ethical research--the long and bumpy road from shirked to shared: From all to scarce, to professionalized, the ethics of research is now everybody's business, argues Sarah Franklin in the sixth essay in a series on how the past 150 years have shaped science, marking Nature's anniversary." The byline is Sarah Franklin. There is an illustration of a naked human baby lying on top of a giant pill, half cream colored and half hot pink.  Below the pill are roots that have formed double helixes with DNA's characteristic bonds in the ladder-and-helix structure. Above the baby is a hot pink tree with branches stretching up and out. The art is credited to Señor Salme.
IMAGE CREDIT: Screenshot from Nature’s website showing Franklin’s article and art by Señor Salme

It is, however, a mistake to think that this approach—which we might call philosophical bioethics or applied bioethics—amounts to or has ever amounted to the sum total of the field, even if some of its proponents often appear to suggest that it is, or perhaps, should be the case.

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FAB CONGRESS DEADLINE EXTENDED TO MONDAY NOVEMBER 11!
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THE DEADLINE FOR ABSTRACT SUBMISSION to the Feminist Approaches to Bioethics Congress (and the World Congress of Bioethics) HAS BEEN EXTENDED TO MONDAY, NOVEMBER 11th, 11:59pm EST!

For details on formatting your abstract for FAB Congress, go to: https://iab2020.org/wp-content/uploads/2019/09/FAB_2020_CFP_August_2019_revised.pdf

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To submit your abstract, go to: https://www.abstractscorecard.com/cfp/submit/login.asp?EventKey=VGBYZXGF

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Want to review books? Here are some tips on doing a good job, and perhaps doing it for IJFAB
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I am very grateful to have recently taken on the role of Book Review Editor for the International Journal of Feminist Approaches to Bioethics. In this role, I will be frequently soliciting both books and reviewers for the journal and hope to find willing volunteers from the IJFAB audience and beyond.

This image shows the cover of the International Journal of Feminist Approaches to Bioethics
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I’m a book lover, both professionally and personally. I’m always on the look-out for a new acquisition whether it’s a second-hand gem from one of those lovely stores that have that smell (you know what I’m talking about) and a shop cat or a fresh shiny new one hot off the press. As such, I’m an avid reader of book reviews.

The book review–more than the book’s own synopsis–often provides me, a potential reader, with a viewpoint that can help decide whether it’s to go into the Jenga-like book piles scattered around my home or whether I might prioritize something else. To be clear, a negative review may not condemn the book to the “to-be-ignored” list. A good book review reveals something of the author, allowing the review-reader to assess whether the author is simpatico. Therefore, a negative review by a reviewer with whom I sense philosophical differences may well incline me towards reading a book as much as a positive review from someone with whom I feel an affinity.

This image shows a famous meme of a man sitting at a table holding a coffee cup.  Hanging from the table is a sign that says "change my mind" at the bottom.  For this meme, people insert different text above  "change my mind."  We have inserted "even negative book reviews can be useful." MEME MODIFICATION  CREDIT: Alison Reiheld

There are, I believe, at least 5 generally accepted key qualities of a good book review. These include:

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Not up for grabs: disabled folks respond to unwanted touching
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A couple of days ago the BBC’s online magazine on disability, Ouch!, published an article about the phenomenon of unwanted touching by nondisabled people that is endured by many people with disabilities. The prompt for the article was the report of a woman wheelchair user who had embellished her wheelchair with metal spikes on the handles in an attempt to stop them being grabbed by (supposed) ‘helpers’.

This screenshot of the BBC article referenced by the author of this post shows the title of the article (Spikes - and other ways disabled people combat unwanted touching) as well as a close up of the removable handle covers which appear to be purple satin or leather and have spiky studs on them which come to points, like a punk rock bracelet or collar. The image is credited to Bronwyn Berg.  The text below says "Bronwyn Berg became so fed-up with people manhandling her without asking, she put spikes on her wheelchair. And she's not alone. With a spate of disabled people reporting unwanted touching some are taking action to stop it in its tracks."
A screenshot of the BBC article mentioned by the author

The article explains very well why this physical contact, which often also includes moving the wheelchair bodily, is unwanted. Other people with disabilities added their voices, proving that blind, mobility impaired, or otherwise anomalously embodied people are also treated as literally up for grabs by the nondisabled world.

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When I posted this article on Facebook I’ve received some comments from non-disabled people, to the effect that the disabled people were either exaggerating or oversensitive, since they (the nondisabled commentators) never noticed it as a problem. Now, the only possible responses to that argument are (a) well, you wouldn’t notice it, would you; and (b) in any case, it’s not really your place to judge whether the reports are exaggerated or not. This form of epistemic injustice (it can’t actually be that bad) is experienced only too frequently by people with disabilities.

It’s certainly not confined to people with mobility or visual impairments either. As a deaf person I routinely encounter people who think that, if I don’t seem to have heard them, it’s appropriate then to shove me in one direction or another. From this experience I can say from that being manhandled like this is not just alarming: it’s an act that confirms what disabled people already suspect, that much of the world doesn’t think we are worth the consideration that is given ‘normal’ people.

Editor’s Note: there is a useful set of primers on disability etiquette you might take a look at if you want to see some ways you can ensure that you are respectful of disabled folks, regardless of whether you yourself are disabled. Those of us who are disabled may need a little help on how to interact with folks whose disabilities are different from our own, and those of us who are not presently disabled might need a little help all around. Keep in mind that no single source of advice will have all the answers!

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