This Week in Bioethics

by Matthew Eppinette, CBC Executive Director on July 1, 2016

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1. Hippocratic Telemedicine?

Perhaps, like me, you have received emails from your health insurance company or seen ads on your social media letting you know about options that will allow you to “see” a health care provider by phone, email, webcam, or even text. According to the Wall Street Journal, if you haven’t received such offers yet, you probably will soon; telemedicine is growing by 30% per year. As the article highlights, there are without a doubt instances where the ability for a sick person to interact with a physician virtually is a truly valuable option (e.g., Doctors Without Borders are able to interact with patients and physicians in very remote places). However, many unanswered questions remain, particularly with respect to things like the tradeoff of convenience versus quality, what continuity of care looks like in virtual medicine, how to oversee these interactions appropriately, and the nature of a virtual doctor-patient relationship. As technology develops, so too does the practice of medicine. But these developments must be evaluated in light of medicine as a practice that is rooted in understandings that go back to Hippocrates (e.g., do no harm) rather than medicine as a service to be provided at the lowest cost.

2. Artificial Reproductive Technology Statistics

The journal Human Reproduction recently made freely available an article reporting some of the most comprehensive statistics available on artificial reproductive technologies (ART). The data covers 2008-2010, and reveals, among other things, that in those three years, “more than 4,461,309 ART cycles were initiated, resulting in an estimated 1,144,858 babies born.” The fertility industry would much prefer that the reported statistic is given as 25.7% live births per cycle started rather than as a 74.3% failure rate. For me, this raises some interesting questions: Is this the standard cultural and media narrative that we hear when it comes to ART? How might our evaluation of and choices about ART differ if the failure rate was given more attention? In my view, there are solid, principled reasons to reject artificial reproductive technologies (see, for example, “Procreation versus Reproduction” in Meilaender’s Bioethics, or O’Donovan’s Begotten or Made), but these numbers make a strong utilitarian case for great caution with respect to ART as well.

3. #LiveBoldly? They Already Do!

In early June we alerted you to the film You Before Me, which presents the false and dangerous narrative “that if you’re a disabled person, you’re better off dead.” Jennifer reviewed the film, pointing out the ways in which it relies on two dangerously mistaken ideas: radical personal autonomy and death as an answer to human suffering. At the end of the review, Jennifer cheered on those disability activists who reject these mistaken ideas and instead choose to live boldly and live well. Our friends at Not Dead Yet are a great example of just this. They were not only outspoken in their opposition to You Before Me, but organized protests of the film in multiple cities on three continents. This week they released a video celebrating all those who came out to show what it looks like to live boldly and live well. We celebrate with them. “#LiveBoldly? We already do!” Indeed!

4. Stem Cells and Baseball

The Los Angeles Angels of Anaheim are having a difficult season. They have lost nearly 60% of their games this year and are in last place in their division. Injuries are at least a partial explanation for their troubles as two of their pitchers have ulnar collateral ligament tears. The standard treatment for this injury since the 1970s has been “Tommy John” surgery, which requires 15-24 months of recovery. The Angels’ pitchers, however, have opted to be treated with adult stem cells from their own bone marrow, which—if it works—will require as little as 6-12 months of recovery. (If it does not work they will undergo surgery.) This is yet another example of the potential that adult stem cells hold, even though they do not seem to get as much media attention. We will be keeping an eye on the progress of these pitchers.

5. The Answer is Yes. Opening Assisted Dying to Psychiatric Patients is a Bad Idea.

An article on the website Medscape examines the debate in Canada over whether “nonterminally ill patients with psychiatric conditions” should be included in that country’s newly enacted assisted suicide legislation. The article’s headline asks “Opening Assisted Dying to Psychiatric Patients a Bad Idea?” To be clear, the answer is an unequivocal yes; opening assisted dying to psychiatric patients is a bad idea. The proper and compassionate approach to suicidal desire—whatever its cause—is compassionate intervention and prevention, not facilitation. For more on assisted suicide and euthanasia, see our issue overview and our one page PDF, “What’s Wrong with Physician Assisted Suicide.”

Langiappe (a little something extra)

We are extending the free viewing of Anonymous Father’s Day on YouTube through the July 4 holiday weekend! We want to make sure as many people as possible get a chance to see this film. Watch it and please help us spread the word on Facebook, Twitter, Google+, LinkedIn, etc.

This Week in Bioethics Archive

Image by peaceful-jp-scenery (CC BY-NC-ND 2.0), via flickr

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