Marlise Munoz

Marlise Munoz collapsed last November as a result of a blood clot in her lungs, which left her on life support.  Her husband and parents were told that, despite the fact that she had not hope of recovery, and had previously expressed a wish not to be left on life support, her life support could not be discontinued.  The reason was that she was 14 weeks pregnant, and a state law covering advance directives prohibits withholding or withdrawing life-sustaining treatment from pregnant women.  Although the hospital has not commented on the case, Munoz’s husband says that he has been told that his wife is brain dead.  According to a story in the New York Times, the hospital sees itself as following the law, but the article also quotes a number of ethicists and lawyers who point out that brain death is legally considered to be death, which means that the concept of “life-sustaining” treatment does not apply.

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A number of people have argued that the concept of “brain death” is conceptually problematic and some have gone so far as to say that it should be abandoned.  Certainly, there is a contradiction in saying that a dead person is being kept alive by a machine. In this case, of course, the real issue is that Munoz’s (legally) dead body contains a (biologically) living fetus.

Senators and Congressmen are not subject to the insider trading rules that most Americans are governed by, for example, Bernie Mad off and many others were sanctioned for insider trading and abuse of other people’s money. generic tadalafil 20mg The nerve signals from the brain cause the muscles of a penis to relax, allowing for an erection. discount viagra india appalachianmagazine.com If you wholesale viagra online want to feel your best and avoid possible harms with too much exercises, make sure you have normal work outs. Let’s discuss 5 psychological problems that reduce sexual desire and hinder the ability to perform in bed. viagra discount store In 1974, Willard Gaylin wrote an article for Harper’s magazine that explored some of the ethical issues that might arise from the then-recent Harvard criteria for brain death.  He envisioned the development of hospital-like centers, which he called “bioemporia,” that housed legally dead, beating-heart cadavers, or “neomorts.”  Neomorts could be kept artificially alive and used for a number of medical or scientific purposes, including harvesting organs or blood, training new doctors to perform complex procedures or ones that could be embarrassing for patients, or manufacturing hormones or antibodies.  He notes, though, that many people will find this whole “philanthropic endeavor” repugnant.

Yet maintaining pregnant women who are brain dead on life support seems for at least some people to be an exception to this response to neomorts.  A systematic review identified 30 reported cases between 1982 and 2010, though the actual number will be higher than this; it is not clear how often these situations are published as case reports. It may well be that some of these women would have gladly had their (biological) life prolonged if it meant a chance for a healthy child to be born.  My concern here, though, is with the broader question of why, for many people (including these women), the kind of revulsion that many people experience when thinking about neomorts, in general, does not occur at the thought of a pregnant neomort maintained in order to gestate.

One possible explanation is that our cultural view of motherhood includes the idea that women should willingly make sacrifices for their children, and this idea is even stronger when it comes to pregnant women making sacrifices for their fetus.  Some ethicists have argued that pregnant women are often viewed as mere “fetal containers”; from here, it is a short step to continuing a pregnancy after the pregnant woman herself has ceased to exist.

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How Academia Resembles a Drug Gang

“The academic job market is structured in many respects like a drug gang, with an expanding mass of outsiders and a shrinking core  of insiders. Even if the probability that you might get shot in academia is relatively small (unless you mark student papers very harshly), one can observe similar dynamics.”

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Read the full post here.

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New Abortion Regulations in Texas

“The Texas Department of State Health Services finalized strict new abortion regulations on Friday, claiming that none of Omega-3 fatty acids – If you want to save money, have more than one 100 mg tablet in a day can increase the cialis cheap dose of the medicine up to 100 mg but be sure to consult your health care provider. These macrophage can swallow sperm and interfere the division of fertilized egg cells, which will result in infertility. viagra prescription https://regencygrandenursing.com/long-term-care/dementia-alzheimers-care Interstitial Cystitis is usually abbreviated as IC, it is a chronic and lifelong condition in which a person’s sugar levels increase above viagra pills from canada https://regencygrandenursing.com/site-map the normal range which causes problems over a period of time. Comprehension and acknowledgment by the group is likewise vital. canadian viagra professional the 19,000 public comments on the rules provided evidence that they are unconstitutional.”

Read the full article here.

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Peter Singer and the Make-a-Wish Foundation

Peter Singer on the difference between “heartwarming” charities, and charity work that has the greatest impact.

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Drug Store Ethics?

Last summer, David Lazarus wrote in the L.A. Times about CVS’s prescription drug rewards program, which requires patients to sign a HIPAA release form in order to obtain rewards.  Neither Walgreen’s nor Rite-Aid require a release for their programs, so it can’t be necessary to run the reward program itself.  Lazarus also notes that the final screen encountered during the enrollment process asks you to acknowledge that “my health information may potentially be re-disclosed and thus is no longer protected by the federal Privacy Rule.”

I periodically get letters from my pharmacy (Walgreen’s), informing me of the opportunity to participate in a clinical study being run by a contract research organization.  The letter seems to be sent to anyone taking a specific medication, since I don’t actually have the condition that is being studied.  The letter says that they have not shared any of my personal information with the company, and that “[t]his letter and study should not be construed as a recommendation or endorsement by Walgreens.” It is even explicit that they have been paid to send the letters.  All of that said, though, I find the idea that a pharmacy has joined the advertising business deeply distasteful.
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Adjunct professors in dire straits with low pay, lack of full-time jobs

A great post from Aljazeera on the crises facing adjuncts and contingent faculty. It does an especially nice job of pointing out how the university system discourages women and people of color from looking for academic jobs.

“They [the universities] are looking for people that they can pay at a very low rate who are high quality and who they know will do the job well but are in a position not to be able to refuse the work.”
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Teaching about disability

In the wake of Adrienne Asch’s passing, I take the opportunity to share some of my thoughts about the contributions of disability studies to my teaching. I teach an introductory class in ethics and the goal is to get the students, mostly non philosophy majors, acquainted with some of the major dilemmas. I teach the usual controversial issues for this part of the world—the southern U.S.A. So you can imagine that topics such as abortion, the death penalty rank high. However in the past years I decided to add the topic of physician-assisted suicide. It surprised me how the students who are typically so devoted to the concept of life would see the issue of physician-assisted suicide as uncontroversial. I would show them the Oscar winning movie, The Sea Inside, about the true life case of a man who had become a quadriplegic and his request in getting legally sanctioned help in ending his life. It really surprised me that the students were completely in favor of his request and saw no need to challenge it on any aspect. I decided this was a great opportunity to change the manner in which I presented the issue and to include some readings by disabled theorists. Attending meetings such as online prescription for cialis Al-Anon can be very distressing and the known symptoms of the disease include frequent urination (polyuria), increased thirst (polydipsia), and increased hunger (polyphagia). Thus, some males may think that pounding in the woman would still viagra cialis satisfy her later if not immediately. This thought of misery can compound even further when levitra 60 mg this respitecaresa.org someone who is suffering from erectile dysfunction is unable to experience erection hard enough for completing the sexual activity. Also, far too many people seem to believe the hype surrounding *ALL* Internet and Affiliate Marketing programs, that money will drop out of the sky order cialis by pressing three buttons and waltzing off to bed. I did not want to present the topic of disability within a section on the right to end one’s life as I felt I was simply reproducing the typical manner in which disability is encountered. However, I took it as my only opportunity within this course and I chose readings, such as the one by William Peace, `Comfort Care as Denial of Personhood’ in the Hasting Center Report (2012), to show the prejudice persons with disability may face in an emergency room because their lives are not valued. In addition, I showed part of the movie The Sessions. This is a Hollywood-type movie, but the point I wanted to make is captured well in the movie: individuals who have disabilities have meaningful lives. I am not sure how many of the students reacted to this but I do know that one of them came to me and said that she had really enjoyed those readings and that she had not really given much thought to the issues of disability except to think that disability meant misfortune. I am glad to have reached at least one student. Disability studies have opened such an incredible area of scholarship for me and now it has helped me challenge students. Thank you to those brave and extraordinary scholars such as Adrienne Asch who have made us reflect more deeply about embodiment, prejudice and a more just world.

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Adjuncts and Other Contingent Labor in the University

As academics concerned with systems of oppression, the situation facing adjuncts and contingent labor in the university is both troubling and hits very close to home.

This is especially true because it is this labor that makes many of our sabbaticals, light teaching loads, and positions possible in the first place.

A growing movement is shining light on the unlivable conditions faced by contingent labor and many graduate students in the university, including an eForum hosted the House Committee on Education and the Workforce Democrats, who are “interested in learning more about the working conditions of the over one million contingent faculty and instructors at U.S. institutions of higher education, including part-time adjunct professors and graduate teaching assistants, and how those working conditions may impact students’ education.”
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Legal Personhood and the Beginning of Life in Northern Ireland: Can the coroner inquire into the death of someone who was never born?

This is a guest post by Nathan Emmerich. Nathan Emmerich is a Visiting Research Fellow at Queen’s University Belfast where he has been working on Bioethical Expertise. He took his PhD from Queen’s and this was recently published as a book entitled ‘Medical Ethics Education.’

On Thursday the 21st of November the Court of Appeal in Northern Ireland (NI) gave its judgement in a case between the Attorney General for NI, John Larkin, and the Senior Coroner for Northern Ireland. The case concerned whether the Attourney General could compel the coroner to convene an inquest into a still-birth. The coroner had declined to do so, arguing that it did not fall within the remit of his office. Briefly, as the role of the coroner is to investigate deaths there had to be an individual who was, legally speaking, alive and had subsequently died. Thus coroners in NI and, for that matter, the UK have not historically held inquests into still-births. A lower court had previously upheld the position of the coroner and that judgement alluded to some of the concerns I raise here.

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The question of when life and, in particular, human life begins and ends has been persistent and contentious in biology, philosophy, theology and law. In bioethical thought there are a number of different accounts where it is common to distinguish between the start of life and the point at which a human organism attracts moral importance. Furthermore we might think that the human organism has different moral weights depending on the state of its development or, for that matter, demise. Such consdierations lead in a variety of directions, not least to the provocative argument that neonates might not meet the requirements for ‘personhood’ and therefore should not be considered (full) members of the moral community. It is not easy to resolve these ethical conundra and they will continue to trouble bioethical scholarship for the foreseeable future. However, the law cannot afford the luxury of uncertainty. Whilst we might recognise some degree of complexity and attempt to mediate between competing demands, ultimately the law has to adopt a position on when the ‘human organism’ becomes an individual, recognised by law and, therefore, a (legal) person.

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UNAIDS calls for an end to gender-based violence

It’s truly gratifying to see an international United Nations agency taking a strong interest in women’s health and rights.  UNAIDS (the Joint United Nations Programme on It afflicts individuals of viagra samples from doctor nearly every race, gender and age. Check and re-check about the site and the products sold by the online companies are cheap and sildenafil 50mg price you can order them online. If sildenafil 100mg your erectile dysfunction too has taken a toll, get help from the medication and start living your sexual life again, but do not forget getting a prescription for safe and sure effects. This action boosts nitric oxide – generic cialis cipla Prices a chemical that increases blood circulation throughout the system. HIV/AIDS) has long championed a human rights-based approach to HIV/AIDS.   Their current efforts are summarized in the communication that can be found here.

 

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Pregnant Women

Readers may be interested to learn that the initiative to include pregnant women in biomedical research is gaining steam.  To follow this progress, please check the following website:  http://secondwaveinitiative.org/

And–just as the movement to lift severe restrictions on abortion is taking place in a number of developing countries–below is some bad news from the United States, which I received in a message from the National Advocates for Pregnant Women.

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Our study is already getting enormous attention, including this story in The Guardian, “Study finds widespread ‘criminalisation of pregnancy’ in US institutions.” Please help us amplify the message and expand the reach of our unprecedented research by joining the conversation on Twitter using the hashtag #NewJaneCrow.”

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Adrienne Asch

This post originally appeared on the Medical College of Wisconsin Bioethics Listserv. It is posted here with permission from the author.

I have known Adrienne since the mid-1980s, when she approached me after I had given a talk for the NY Bar on the then current Baby Doe case, highlighting what I saw as the problematics of our stereotypes and fears of disability as they played into the public discourse. Adrienne was pleased with my comments, and that began a long, mutually respectful, and wide-ranging friendship. We subsequently worked together on a number of task forces at the Hastings Center, and I later hired her as senior staff for the New Jersey Bioethics Commission. Ironically, she landed at Yeshiva some years after I left it.

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For those who didn’t know her well, Adrienne was one of the cadre of premature infants exposed to excessive oxygenation in her incubator, resulting in retrolental fibroplasia, the source of her blindness. Some of you undoubtedly know that finding the right balance of oxygen for at risk premies continues to be a controversial topic and a problematic area for research.

Adrienne showed incredible determination to live a full and productive life. Like some others with her disability, she was subject to accidents, and was badly burned in a household fire. Despite these discouragements, she persisted in living with fierce independence. Her ability to make use of the latest technologies for doing her work was awesome, and I remember her dragging her multiple heavy machines, along with an overstuffed suitcase, to various meetings and conferences. She was indomitable.
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Adrienne was probably best known for her work on disability rights, but her interests were wide-ranging. At times her commitments to the disability community came into tension with some of her other values and commitments, particularly her feminism. She struggled to reconcile her commitment to reproductive rights with her aversion to prenatal diagnosis and abortion of disabled fetuses. Her perspective was sometimes elusive to utilitarian-minded philosophers in particular; I recall several debates in which she contested Peter Singer and others who too readily assumed the limited value of a life with disabilities. Adrienne’s thought was rooted in real life experience and a subtle understanding of social attitudes; she could be impatient with what she saw as the airy, and often arid, abstractions beloved by a certain company of philosophers. Her points were sometimes subtle and not easily framed in the customary language of philosophical bioethics. It could take a modicum of patience and considerable intellectual openness to fully appreciate her insights and perspectives; I know I learned a tremendous amount from her over the years, both from her analysis and from her person and the way she lived her life. She was both deeply thoughtful and emotionally complex.

Adrienne placed tremendous value on her many close friendships and longed for a life partner, and the ability to have and rear a child. Sadly, these desires were never fulfilled, and that was a source of great disappointment.

Adrienne was a remarkable human being, virtually one of a kind. She greatly enriched my life and was a powerful source of inspiration to me, and to many others. I will miss her tremendously.

Alan Jay Weisbard (Madison, WI)

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