Americans Remain Pessimistic About State of Moral Values

by Justin McCarthy
Gallup: Social Issues
MAY 25, 2016

Story Highlights

• Majority continues to say state of morals getting worse
• Americans most likely to describe morals in U.S. as "poor"
• Republicans, GOP leaners most negative on state of morals

Americans remain far more likely to say the state of moral values in the U.S. is getting worse (73%) than to say it is getting better (20%). Over a 15-year trend, solid majorities have consistently viewed the direction of the country's values negatively, ranging from 67% in 2002 and 2003 to 82% in 2007.

The article is here.

Scientists debate effort to build a human genome

By Andrew Joseph
STAT
Originally posted  on June 4, 2016

Here is an excerpt:

Church said the core science of assembling a human genome from basic molecular ingredients dates back to at least 2009. And he noted that scientists have been grappling with related ethical questions for more than a decade, since the early days of synthetic biology opened the door to the idea of someone being able to build a pathogen from basic genetic components.

He said that although the project has no intention of spawning actual humans, the project’s leaders would not ignore the “ethical, social, legal” issues that inherently materialize given where the project could lead.

The article is here.

The Ethics of Large-Scale Genomic Research

Benjamin E. Berkman, Zachary E. Shapiro, Lisa Eckstein, Elizabeth R. Pike
Chapter in Ethical Reasoning in Big Data
Part of the series Computational Social Sciences pp 53-69

Abstract

The potential for big data to advance our understanding of human disease has been particularly heralded in the field of genomics. Recent technological advances have accelerated the massive data generation capabilities of genomic research, which has allowed researchers to undertake larger scale genomic research, with significantly more participants, further spurring the generation of massive amounts of data. The advance of technology has also triggered a significant reduction in cost, allowing large-scale genomic research to be increasingly feasible, even for smaller research sites. The rise of genetic research has triggered the creation of many large-scale genomic repositories (LSGRs) some of which contain the genomic information of millions of research participants. While LSGRs have genuine potential, they also have raised a number of ethical concerns. Most prominently, commentators have raised questions about the privacy implications of LSGRs, given that all genomic data is theoretically re-identifiable. Privacy can be further threatened by the possibility of aggregation of data sets, which can give rise to unexpected, and potentially sensitive, information. Beyond privacy concerns, LSGRs also raise questions about participant autonomy, public trust in research, and justice. In this chapter, we explore these ethical challenges, with the goal of elucidating which ones require closer scrutiny and perhaps policy action. Our analysis suggests that caution is warranted before any major policies are implemented. Much attention has been directed at privacy concerns raised by LSGRs, but perhaps for the wrong reasons, and perhaps at the expense of other relevant concerns. We do not think that there is yet sufficient evidence to motivate enactment of major policy changes in order to safeguard welfare interests, although there might be some stronger reasons to worry about subjects’ non-welfare interests. We also believe that LSGRs raise genuine concerns about autonomy and justice. Big data research, and LSGRs in particular, have the potential to radically advance our understanding of human disease. While these new research resources raise important ethical concerns, any policies implemented concerning LSGRs should be carefully tailored to ensure that research is not unduly burdened.

The abstract to the book chapter is here.

You may want to contact the author for a copy for personal use.

The New Era of Informed Consent

Getting to a Reasonable-Patient Standard Through Shared Decision Making

Erica S. Spatz, Harlan M. Krumholz, MD, Benjamin W. Moulton
JAMA. 2016; 315(19):2063-2064. doi:10.1001/jama.2016.3070.

Here is an excerpt:

Informed consent discussions are often devoid of details about the material risks, benefits, and alternatives that are critical to meaningful patient decision making. Informed consent documents for procedures, surgery, and medical treatments with material risks (eg, radiation therapy) tend to be generic, containing information intended to protect the physician or hospital from litigation. These documents are often written at a high reading level and sometimes presented in nonlegible print, putting a premium on health literacy and proactive information-seeking behavior. Moreover, informed consent documents are often signed minutes before the start of a procedure, a time when patients are most vulnerable and least likely to ask questions—hardly consistent with what a reasonable patient would deem acceptable. In the United States, with the exception of 1 state, Washington, that explicitly recognizes shared decision making as an alternative to the traditional informed consent process, the law has yet to promote a process that truly supports a reasonable-patient–centered standard through shared decision making.

The article is here.

Vignette 34: A Dreadful Voicemail

Dr. Vanessa Ives works in a solo private practice. She has been working with Mr. Dorian Gray for several months for signs and symptoms of depression. Mr. Gray comes to some sessions as emotionally intense, and high strung.  Dr. Ives has considered the possibility that Mr. Gray suffers with some type of cyclic mood disorder.

As part of treatment, Mr. Gray admitted to experiencing anger management problems, to the point where he described physically intimidating his wife and pushing her down. They worked on anger management skills. Mr. Gray reported progress in this area.

Dr. Ives receives a phone message from Mr. Gray’s wife.  In the voicemail, Mrs. Gray reports that Mr. Gray has become more physically intimidating and has starting to push her around.  The voicemail indicated he has not caused her any significant harm.  She requested a session to see Dr. Ives to explain what is happening between them.  Dr. Ives only met Mrs. Gray informally while she sat in the waiting room before and after several sessions.

Dr. Ives wants to be helpful, but she is struggling with whether she should even return Mrs. Gray’s phone call.  Dr. Ives has a personal history of being involved in a physically abusive relationship herself and is concerned about both the clinical and ethical issues involved regarding calling Mrs. Gray back.

Feeling uncomfortable about what is happening with this patient and his wife, Dr. Ives calls you for a professional consultation.  She wants to make an appointment to talk with you candidly about her history as well as the dynamics of the current case.

What are the ethical issues involved in this case?

What are the pertinent clinical issues in this case?

How would you help Dr. Ives deal with her emotions related to this situation, given how her history relates to this patient and his wife?

Would you recommend Dr. Ives return the call or not?

What are some possible options should Dr. Ives return the phone call?

How much transparency would you suggest to Dr. Ives with Mr. Gray about the phone message?

The Corporate Joust with Morality

by Caroline Kaeb And David Scheffer
Opino Juris
Originally posted June 6, 2016

Here is the end:

This duel between corporate responsibility and corporate deceit and culpability is no small matter.  The fate of human society and of the earth increasingly falls on the shoulders of corporate executives who either embrace society’s challenges and, if necessary, counterattack for worthy aims or they succumb to dangerous gambits for inflated profits, whatever the impact on society.

The fulcrum of risk management must be forged with sophisticated strategies that propel corporations into the great policy debates of our times in order to promote social responsibility and thus strengthen the long-term viability of corporate operations.  We believe that task must begin in business schools and in corporate boardrooms where decisions that shape the world are made every day.

The article is here.

The End of Absolutes: America's New Moral Code

The BARNA Group
Research Releases in Culture & Media
Originally published on May 25, 2016

Christian morality is being ushered out of American social structures and off the cultural main stage, leaving a vacuum in its place—and the broader culture is attempting to fill the void. New research from Barna reveals growing concern about the moral condition of the nation, even as many American adults admit they are uncertain about how to determine right from wrong. So what do Americans believe? Is truth relative or absolute? And do Christians see truth and morality in radically different ways from the broader public, or are they equally influenced by the growing tide of secularism and religious skepticism?

A majority of American adults across age group, ethnicity, gender, socioeconomic status and political ideology expresses concern about the nation’s moral condition—eight in 10 overall (80%). The proportion is closer to nine in 10 among Elders (89%) and Boomers (87%), while about three-quarters of Gen-Xers (75%) and Millennials (74%) report concern. Similarly, practicing Christians (90%) are more likely than adults of no faith (67%) or those who identify with a religious faith other than Christianity (72%) to say they are concerned about the moral condition of the nation. Though measurable differences exist between population segments, moral concern is widespread across the demographic board.

The article and survey can be found here.

Netherlands to grow human embryos for research

By www.rt.com
Originally posted May 26, 2016

The Dutch government will allow labs to grow human embryos to be used for research in a limited number of fields, it announced on Friday. Currently scientists have to rely on a limited supply of leftover embryos from in vitro fertilization patients.

The ban on the cultivation of embryos [has] hampered research which could help with the treatment of diseases on the short to medium-long term," the government said in a statement, justifying the ethically controversial move.

The new regulations would not change the so-called “14-day rule”, which demands that any human embryo kept in a lab be destroyed no later than two weeks after fertilization.

The article is here.

There’s Argument, and there’s Disputation

by Iain Brassington
British Medical Journal Blogs
Originally posted June 6, 2016

Here is an excerpt:

Basically, the problem is this: that the model for debating contests is, presumably, based around the idea that debate is an effective way to whittle bad ideas away from good; if each participant is a doughty falsificationist, and equally able in debate as his opponent, then at the end of a process of debate, we’ll be closer to the truth of the matter than we were at the start.  So far, so good.  But there’s a handful of fairly obvious problems with that model.  First, that doesn’t lend itself to the idea that there is a winner and a loser in any particular debate.  Second, a shoddy argument presented by a good speaker might win a competitive debate over a good argument presented by a diffident speaker.  We might hope that a competent judge would account for that, but it’d be better if there wasn’t any need to solve what looks to be a structural problem to begin with.  Third – which is related, but probably more importantly when it comes to ethics – someone with a good understanding of the moral arguments and who is a decent orator might stand a fair chance of winning an argument; but it doesn’t follow that a good orator who’s won an argument has any particular understanding of the moral arguments.  Debating contests reward people for being good at debate; but that’s presumably not the true end of ethics education.  Fourth, this kind of strategy is possibly OK in politics, in which the point of oratory is to persuade people to adopt a certain cause; and so debating competitions might provide training for that.  (I suspect that that’s something like the rationale behind things like the IofI’s competition in schools: it’s directed at developing a certain set of skills, with one eye on a vivacious public debate.  Whatever my private suspicions of the IofI generally, that doesn’t seem like a bad idea.)  But ethical debate is qualitatively different.  It isn’t really about winning converts.  Or, at least: one might hope that a convincing argument would have moral gravity and attract agreement, but the mood of the thing is different.

The article is here.