Yale Institution for Social and Policy Studies

Greetings from Stephen Latham, Bioethics Center Director


This was a busy week—a lot of visiting speakers, a bit of shoveling, and all the madness that is Shopping Period at Yale. The coming week, in contrast, is relaxing: nothing for your calendars!

Congratulations to Bioethics Center member and End-of-Life group stalwart Veronica Tomasic on two recent publications: “Statutes Do Injustice to Conserved People In End-of-Life Situations" ran in the  CT Law Tribune Opinion section on December 12, 2013, and "Commentary on Kathrin, a portrait by Thomas Eakins" ran in the Medicine and the Arts section of Academic Medicine, Vol. 89, No. 1, January 2014. In the latter essay, Veronica writes, “by way of discussing an Eakins painting in the Yale Art Gallery collection and Henry James' Isabel Archer, I remember a client of mine who died at YNHH.”

Congratulations to Bioethics Center Executive Committee chair Bob Levine, who has completed his service as a member of the National Research Council’s Committee on Revisions to the Common Rule for the Protection of Human Subjects in Research in the Behavioral and Social Sciences. The “advance copy” of its book-length report, Proposed Revisions to the Common Rule for the Protection of Human Subjects in the Behavioral and Biomedical Sciences was issued on January 9, 2014. The final version will be made available to the public on January 30 through the National Academies Press. Bob believes that this report will facilitate some long-overdue revisions to the federal regulations for the protection of human subjects (the Common Rule) in biomedical as well as in social and behavioral research.

Visit my bioethics blog! And if you have anything you’d like to see included in this newsletter—events, milestones, publications, calls for papers—email me at Stephen.Latham@Yale.edu with the word “Frimail” in your subject-line.

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Updates from the Summer Institute

From Associate Director Carol Pollard

*The 2014 Summer Institute class members have been chosen, and in a few weeks I’ll be attaching this list to our section of the Friday Newsletter.  Again, this is an amazing group of students – like yourselves!  Please think about coming back for a visit during the summer and to the end-of-term Banquet (Friday, July 25th, in the Peabody Museum Dinosaur Room) and staying for the weekend symposium.

*Americans just celebrated Martin Luther King Day this past Monday.  Here are some quotes taken from Reverend King’s lectures/sermons that I thought of particular interest to bioethics students:
"Of all forms of injustice, inequality in health care is the most shocking and inhumane."
"Life's most persistent and urgent question is: what are you doing for others?"
"Our lives begin to end the day we are silent about things that matter."
“True compassion is more than flinging a coin to a beggar; it is not haphazard and superficial.  It comes to see that an edifice that produces beggars needs restructuring.”
"Human salvation lies in the hands of the creatively maladjusted."

*If you are in the New Haven area April 12 – 13, the annual Global Health & Innovation Conference, sponsored by Unite for Sight, is taking place at Yale.  It annually convenes more than two thousand leaders, change-makers, students, and professionals from all fields of global health, international development, and social entrepreneurship.  For more information see: http://www.uniteforsight.org/conference

*Prya Murad writes: “I'm sure you’re totally excited to hear about my glamorous life as a 2L.  I'm halfway through law school (Loyola).  Barring anything life changing, I've committed to applying for jobs as an assistant public defender after law school.  I'm currently clerking with the office in the domestic advocacy unit and really love it.  I'm eligible for my 711 license this semester (The IL equivalent of a student license; we can practice under the supervision of a practicing attorney), so I'll will have the opportunity to approach the bench and hopefully contribute to some trials while I'm in law school.  I took a Wrongful Convictions weekend seminar over break.  Loyola has this wonderful clinic called "Life After Innocence."  It's really one of the few of its kind in the country.  It's focused on after-care for exonerees.  I had the opportunity to meet two exonerees and learn more about how wrongful convictions play into the criminal justice system.  I'll be working at the Life After Innocence project over the summer (along with the Public Defender’s office) and hopefully will continue that throughout my 3L year as well.  They do everything from helping individual clients secure social security cards and housing, to filing for Certificates of Innocence, to participating in policy-making. Mock trial takes up most of my semester.  The spring competitions are a bit more competitive, so now we have to practice extra hard and really work with everything we've learned from last semester to push ourselves those extra million miles and bring home some national titles!  My team and the coaches are amazing.  Our current case involves medical malpractice, so that should be pretty interesting!   Chicago is a great city but very, very cold.”  (Good Luck Prya!)

*Rachel Teo writes: “I'm just about to go back to Melbourne for work on my Masters in Bioethics.  I'm quite excited to go back.  Theodora (Kwok) and I had the honour of providing administrative assistance to Nancy Berlinger, Jacob Moses, and Michael Gusmano of the Hastings Center while they were visiting here at the National University of Singapore’s Center for Biomedical Ethics!  We also met Dr Michael Dunn from the Ethox Centre in Oxford as well; he collaborated with Centre for Biomedical Ethics folks on an ethics casebook project.  Right now I'm thinking about what I should write for my thesis – maybe something involving culture and perhaps issues of immigration or maybe something more philosophical, like how culture impacts subjective sense of self and medical decision-making.  But I'm also interested in the nondisclosure of medical information for young persons.  Time will tell!” (Good Luck Rachel and Theo!)

*Aileen Walsh writes: “I’m in a new position working with the Royal College of Nursing as their education adviser.  It’s a job that seeks to respond to the Francis report, where serious shortcomings in medical and nursing care were identified in Staffordshire - you may have heard about it.  I'm going to have the chance to do some applied ethics with the production of policy and educational documents; it is something I'm really keen to do.  Had I not had “the Yale experience” I don't think I would have ever applied for the job.”  (Congratulations Aileen, and I hope you will consider coming back in a future summer to teach again!)

*Articles of Possible Interest:
Womb Transplants Successful for Nine Women
Spotless mind: Epigenetic drug wipes clean fear memories
Guy Hoffman: Robots with ‘soul’

-Carol

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This Week on Campus

Monday, January 27

School of Forestry Lecture
Time: 12 PM
Location: 10 Sachem St, room 105
Speaker: Nico Sternsdorff-Cisterna, PhD student, Harvard University
Topic: Food after Fukushima: Measuring risk and radiation in Japan

John B. Pierce Laboratory Seminar
Time: 12 PM
Location: 290 Congress Ave, Pierce Lab, Gordon Memorial Library
Speaker: Harold W. (Bill) Kohl, III, PhD, Professor of Epidemiology and Kinesiology, University of Texas Health Science Center-Houston, and University of Texas, Austin
Topic: The Global Pandemic of Physical Inactivity: An Urgent Public Health Priority

History of Medicine Lecture
Time: 4:30 PM
Location: 333 Cedar St, L215
Speaker: Laurence Monnais, PhD
Topic: Colonial Medicines: An Alternative History of Medicine and Health in Vietnam

Tuesday, January 28

Child Study Center Schwartz Rounds
Time: 1 PM
Location: 230 S Frontage Rd, Cohen Auditorium
Speakers: Akashdeep Aujia, MD; Michelle Durham, MD, MPH; Robert Sinkewicz, LCSW; and Jeffrey Carter, of Solnit Children's Center, South
Topic: The Hangover: In the Aftermath of a Patient's Brush with Death

Wednesday, January 29

Schell Center Lecture
Time: 12 PM
Location: 127 Wall St, Faculty Lounge
Speaker: Michael Reed Hurtado, Coca Cola World Fund Faculty Fellow & Senior Lecturer
Topic: Transitional Justice in Colombia: When the Means Trump the Ends

Thursday, January 30

Humanities in Medicine Lecture
Time: 5 PM
Location: 300 Cedar St, Anlyan Auditorium
Speaker: Louise Aronson, MD, Associate Professor of Clinical Medicine; & Author, University of California San Francisco
Topic: A History of the Present Illness: Telling the Stories of Doctors, Patients, and Medicine Today

Friday, January 31

Agrarian Studies Colloquium
Time: 11 AM
Location: 77 Prospect St, room B012
Speaker: Andrew Matthews, Anthropology, University of California Santa Cruz
Topic: Plant Politics: Linking Mexican and Italian Forests to Climate Change

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Conferences & Off Campus Events

Lecture at Southern CT State: Virtue Ethics and Signed Language Interpreting
Teresa Blankmeyer Burke, Ph.D. is an Assistant Professor in the Philosophy and Religion
Department of Gallaudet University. She is currently the only living signing deaf philosopher with a doctorate in the world. Dr. Burke's research interests are in ethics and applied ethics, including bioethics and interpreting ethics.  She will present at 4:45 PM in EN D227.  For more information contact lockwoodh1@southernct.edu.

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Health Insurance Exchange Implementation: Early Challenges and Opportunities
Saturday, February 8, 2014 - 8:30 am to 5:15 pm
Join health policy and law experts from around the country in a one-day conference on the current status of health insurance exchange implementation. Panelists will discuss the history behind health insurance exchanges, what’s going right and wrong so far, and how to balance state and federal roles in exchange implementation and operation. For more information, click here. For a Schedule of Events, click here.

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New Directions for Food Safety: The Food Safety Modernization Act and Beyond
February 21, 2014, 9:00am to 4:30pm
Austin Hall, Ames Courtroom (200), Harvard Law School, 1515 Massachusetts Ave.
This conference is free and open to the public, but space is limited and registration is required. For more information, including the conference agenda and registration links, please visit the conference website:  http://petrieflom.law.harvard.edu/events/details/new-directions-for-food-safety.
Cosponsored by the Petrie-Flom Center; the  Center for Health Law and Policy Innovation, Food Law and Policy Division; and the Food Law Lab at Harvard Law School, with support from the Top University Strategic Alliance at Harvard University.  

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Grants, Fellowships, & Jobs

The Petrie-Flom Center will hire a new Project Coordinator in connection with our work on the Regulatory Foundations, Ethics, and Law Program of Harvard Catalyst | The Harvard Clinical and Translational Center. Reporting to the Petrie-Flom Center's Executive Director and working closely with the Center's Administrative Director, Faculty Co-Directors, and other staff, the Project Coordinator will support the Center's work on the Harvard Catalyst Regulatory Foundations, Ethics, and Law Program (40% effort), as well as the Center's core administrative needs (20% effort).  The position has four major areas of responsibility: (1) meeting and event support; (2) financial and compliance support; (3) other administrative support, including communications; and (4) special projects. For a full description and to apply click here.  For questions, please contact petrie-flom@law.harvard.edu.

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Yale Climate & Energy Institute supports post-doctoral fellowships at Yale in all disciplines related to the YCEI mission, from natural sciences and engineering to social sciences and humanities. A limited number of fellowships are available for successful candidates who can take up residence at Yale between July 1 and September 1, 2014. There is a new process for applications in 2014. Applicants must be nominated and applications submitted (via e-mail) by a current Yale faculty member.  Further details can be found on the YCEI website: http://climate.yale.edu/grants-fellowships/postdoctoral-fellowships. The deadline for applications in February 28, 2014.

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Articles of Interest

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In the News


Featured Article

Dennis, Brady. FDA’s ‘Safe and Effective’ Drug Approvals Based on Widely Varied Data, Study Finds. The Washington Post. 21 January 2014.
The Food and Drug Administration must bless any new drugs as “safe and effective” before they wind up in pharmacy aisles or prescribed to patients. But the ways in which the agency arrives at those approvals “vary widely in their thoroughness,” according to an analysis by researchers at Yale University’s School of Medicine. “Not all FDA approvals are created equally,” said Nicholas Downing, lead author of the study, which examined nearly 200 new drug approvals between 2005 and 2012. Continue reading...

Environment

Wong, Edward. China Exports Pollution to U.S., Study Finds. The New York Times. 20 January 2014.
Filthy emissions from China’s export industries are carried across the Pacific Ocean and contribute to air pollution in the Western United States, according to a paper published Monday by a prominent American science journal. The research is the first to quantify how air pollution in the United States is affected by China’s production of goods for export and by global consumer demand for those goods, the study’s authors say. Continue reading...

Wakatsuki, Yoko and Madison Park. Japan Officials Defend Dolphin Hunting At Taiji Cove. CNN. 21 January 2014.
The slaughter of bottlenose dolphins in an infamous Japanese cove took place on Tuesday. About 500 dolphins were driven into the cove this year, a larger number than usual, according to the local Taiji fishermen's union. The yearly event is a focal point of the Taiji community's dolphin hunting season, which many in the community in southwest Japan view as a long-held tradition. But the hunt is heavily scrutinized by environmental activists, who have been monitoring activities and livestreaming and tweeting about the latest developments. Continue reading...

Davenport, Coral. Industry Awakens To Threat of Climate Change. The New York Times. 23 January 2014.
Coca-Cola has always been more focused on its economic bottom line than on global warming, but when the company lost a lucrative operating license in India because of a serious water shortage there in 2004, things began to change. Today, after a decade of increasing damage to Coke’s balance sheet as global droughts dried up the water needed to produce its soda, the company has embraced the idea of climate change as an economically disruptive force. Continue reading...

Food

Barclay, Eliza. Whole Foods Bans Produce Grown With Sludge But Who Wins? NPR. 21 January 2014.
Whole Foods recently decided it would not buy produce from farmers who used treated sewage sludge, also known as biosolids, on their fields. But scientists say this is a mistake — the material is safe and benefits the environment in lots of different ways. Continue reading...

Health and Medicine

Yu, Alan. Western Scientists Look To Chinese Medicine For Fresh Leads. NPR. 18 January 2014.
In the quest for new treatments, U.S. researchers are looking to traditional Chinese medicines, some of the oldest remedies in the world. A recent discovery resulted in a better treatment for a type of leukemia that strikes about 1 in 250,000 people in the U.S. Another study found a potential new painkiller in China's medicine chest. Other researchers are studying a traditional medicinal plant called "thunder god vine" for its anti-cancer properties. The approach has already had some success. The Chinese herbal medicine artemisinin, for instance, has gone on to become the most potent anti-malarial drug available. Not all the leads have panned out, of course. But the old field has shown enough potential to keep interest high. Continue reading...

Bakalar, Nicholas. Pain Relievers May Amplify Flu Spread. The New York Times. 22 January 2014.
Taking drugs like aspirin, acetaminophen or ibuprofen when you have the flu reduces fever and makes you feel better, but it may have unintended consequences. A new study using mathematical projections has concluded that the use of anti-fever drugs during flu epidemics increases disease transmission, both by raising the amount of flu virus shed and increasing the interaction that flu sufferers have with uninfected people. Continue reading...

Andrews, Michelle. Preventative Medical Care Can Come With Unexpected Costs. NPR. 21 January 2014.
Preventive health care services are supposed to be covered under the Affordable Care Act so that people don't have to pay out of pocket to get recommended screening tests. But some people are discovering that these supposedly free services can be costly. Continue reading...

Mental Health

Graham, Judith. When They Don’t Know They Are Ill. The New York Times. 22 January 2014.
Soon after his wife was diagnosed with frontotemporal dementia, Bill Floyd consulted a neurologist who had been a member of his church. People with this illness don’t know they have it, the doctor warned. They don’t understand that anything is wrong. This little-known yet common consequence of this kind of dementia, Alzheimer’s disease and other brain disorders is called anosognosia, and it leaves people unaware that they are compromised by illness. Continue reading...

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In the Journals

Holmes, David. New IVF techniques put mitochondrial diseases in focus. The Lancet Neurology. January 2014.
The recent decision by the UK Government to press ahead with plans to allow the tightly regulated use of pioneering in-vitro fertilization techniques to prevent the transmission of a group of rare and devastating mitochondrial diseases has brought a fascinating set of ethical questions into the public eye. In this paper, the author examines the scientific and ethical issues raised by these techniques. Continue reading…

Kraemer, Felicitas. Authenticity or autonomy? When deep brain stimulation causes a dilemma. Journal of Medical Ethics. December 2013.
Lynoe and Leijonhufvud contend that particular modifications should be made to the existing Swedish regulatory regime in order to secure what they refer to as 'physician safety'- that is, protection against unnecessary lawsuits that may well endanger a doctor's reputation and career. Undoubtedly, many things went wrong at the Astrid Lindgren Children's Hospital. As the authors acknowledge, there occurred the initial botched delivery, the overdose of sodium chloride as well as the unrecorded administration of a toxic level of thiopental to the patient either by the defendant or by another doctor. The only thing the authors regard as unproblematic within this series of events is the determination by the Swedish Board of Health and Welfare that the doctor-defendant's behavior 'accords with good clinical practice' that serves as the principal assumption upon which they contend that the system, ra ther than the doctors' behavior, is to be faulted. It would be easier to sympathize with the authors' position had they explained more fully the basis of the Swedish Board's determination. To successfully defend any change to the status quo, the authors must demonstrate that the case gives rise to an insuperable injustice to the doctor that cannot be remedied by some lesser modification. For this, the case must be straightforward and exhibit enough typicality that we may infer other cases will ensue if the proposed alteration is not made. However, the case is not straightforward: the authors assert, 'thiopental was not needed and therefore not given' but also admit that 'at least one (other) physician had treated the child with thiopental shortly before the life sustaining treatment was withdrawn' [emphasis added]. It is the current author's stance that Lynoe & Leijonhufvud have not demonstrated the need for any change in law. Continue reading…

Levvis, Gay. Increasing physician protection against prosecution: unjustified and unwise. Journal of Medical Ethics. 2013.
This paper pertains to the alleged euthanising of a 3-month-old infant at Sweden's Astrid Lindgren Children’s Hospital in September 2008 and the subsequent effects upon the doctor who was charged with, but eventually acquitted of, violating Sweden's anti-euthanasia law. Lynøe and Leijonhufvud1 contend that particular modifications should be made to the existing Swedish regulatory regime in order to secure what they refer to as ‘physician safety’—that is, protection against unnecessary lawsuits that may well endanger a doctor's reputation and career. Undoubtedly, many things went wrong at the Astrid Lindgren Children's Hospital. As the authors acknowledge, there occurred the initial botched delivery, the overdose of sodium chloride as well as the unrecorded administration of a toxic level of thiopental to the patient either by the defendant or by another doctor. The only thing the authors regard as unproblematic within this series of events is the determination by the Swedish Board of Health and Welfare that the doctor-defendant's behaviour ‘accords with good clinical practice’ that serves as the principal assumption upon which they contend that the system, rather than the doctors’ behaviour, is to be faulted. Continue reading…

Wilkerson, Abby. I Want to Hold Your Hand: Abstinence Curricula, Bioethics, and the Silencing of Desire. Journal of Medical Humanities. June 2013.
The abstinence approach to sex education remains influential despite its demonstrated ineffectiveness. One bill forbids the “promotion” of “gateway sexual activity,” while requiring outright condemnation of “non-abstinence,” defined so loosely as to plausibly include handholding. Bioethics seldom (if ever) contributes to sex-ed debates, yet exploring the pivotal role of medical discourse reveals the need for bioethical intervention. Sex-ed debates revolve around a theory of human flourishing based on heteronormative temporality, a developmental teleology ensuring the transmission of various supposed social goods through heterosexual marriage (Halberstam, 2005). Heteronormative temporality also constitutes a moralized discourse in which the values of health and presumed certainties of medicine serve to justify conservative religious dictates that otherwise would appear controversial as the basis for public policy. Overall, this analysis explores how moralized medical discourses compound existing injustices, while suggesting bioethics’ potential contributions to moral and political analysis of sex-ed policies. Continue reading…

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