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ETHICS IN BIOMEDICAL

Student discussion must be a minimum of 150 – 200 original words and supported by academic, peer-reviewed references (at least 1). Whenever possible, please try to relate the course content ethics in biomedical to real-world applications from your work experience. I expect your message to reflect critical thought and an integration of the key themes and concepts from the readings.

1. The readings for this chapter discuss the importance of ethics in research. One particular issue relates to consent for participation in research. Why is consent such an important ethical principle in research?

2. The readings describe some of the ethical issues that surround organ transplantation. Utilizing the readings and the United Network Organ Sharing (UNOS) website, identify what you believe how ethical principles can be applied to ensure equal access to this service.

UNOS link
http://www.unos.org/

3. It is clear that both the organ donation and transplant process involves multiple individuals that must make difficult decisions. So…what do we base the decisions on? It is important that MDs remain objective about who gets a transplant and who doesn’t. Should the homeless person with no access to resources be given the same consideration as someone with a home, resources and a family? There is no easy answer, of course. Cherkassky (2010) states that providers “may often be torn between their moral duty to save those who are most in need, considerations of efficiency, and the battle against forming moral judgments about particular candidates”. It is easy to say MDs and transplant teams should not make moral judgments, but we understand the decision makers are human and the decisions are difficult.

When the number of organs are limited, what ethical principles should apply to the decision making process? Justice? Utilitarianism? What do you think?
Cherkassky L. (2010). Rational rejection? The ethical complication of assessing organ transplant candidates in the United Kingdom and the United States. Journal of Law and Medicine. 2010 Sep;18(1):156-68. PMID: 20977169 [PubMed – indexed for MEDLINE]

Schiano TD, Bourgoise T, Rhodes R. (2015). High Risk Liver Transplant Candidates: An ethical proposal on where to draw the line. Liver Transplant. 2015 Feb 4. doi: 10.1002/lt.24087. [Epub ahead of print] PMID: 25651102

4. Organ transplantation requires hospitals be approved by federal agencies and participate in UNOS, the United Network Organ Sharing, previously discussed. Hospitals must have transplant teams that include surgeons. An example of how these teams impact who gets organs and doesn’t was reported by the Orange County Register (2005):

“During that period, University of California, Irvine (UCI) accepted less than 10 percent of the 543 livers it was offered,” the Register reported. “At the same time, the waiting list of patients in need of livers grew as long as 171. All of the livers UCI rejected were later accepted by other hospitals for transplant candidates on their lists, as accounted for in the report” (Opinion section).

In this case, the activity of UCI physicians and leaders violated every ethical principle we’ve been discussing, including beneficence, patient autonomy and do no harm. MDs were fired, the CEO of the hospital lost his job and others were fired. But, for some individuals who waited…and waited…on the list, the ethical violations resulted in their death. This really happened…what do you think?

Reference:

Orange County Register (2005). Opinion. Did liver program mislead its patients? Dec. 29, 2005, updated August 21, 2013.

Schiano TD, Bourgoise T, Rhodes R. (2015). High Risk Liver Transplant Candidates: An ethical proposal on where to draw the line. Liver Transplant. 2015 Feb 4. doi: 10.1002/lt.24087. [Epub ahead of print] PMID: 25651102

5. Discuss Article: Empirical investigation of the ethical reasoning of physicians and molecular biologists – the importance of the four principles of biomedical ethics—- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2186350/
6. Discuss Article : Information needs and information seeking in a biomedical research setting: a study of scientists and science administrators. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2000785/
7. Discuss Article: The Federal Government and Academic Texts as Barriers to Informed Consent. http://www.jpands.org/vol13no1/lanfranchi.pdf
Question 8- Upload separate
Find a current administrative issue in a newspaper, magazine, or journal article relating to topics such as patient privacy, confidentiality, or HIPAA.
Write a 1,050- to 1,400-word paper that includes the following:
• Describe the issue and its impact on the population it affects most.
• What arguments or facts are used in the article to support the proposed solution?
• What are the ethical and legal issues reported for your administrative issue?
• Explain the managerial responsibilities related to administrative ethical issues. If none were stated, what should have been done?
• Identify any proposed solutions.
• Be prepared to discuss your findings in class.
Include at least three sources in your paper.
Format your paper consistent with APA guidelines.

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