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What Do Prospective Parents Owe to Their Children? Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Abigail Levin
I consider the question of what moral obligations prospective parents owe to their future children. It is taken as an almost axiomatic premise of a wide range of philosophical arguments that prospective parents have a moral obligation to take such steps as ensuring their own financial stability or waiting until they are emotionally mature before conceiving. This is because it is assumed that parents
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The Ethic of Accompaniment Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Laura Haupt
Taking inspiration from liberation theology and physician Paul Farmer, the lead article in the March‐April 2024 issue of the Hastings Center Report offers a “cautiously idealistic” argument for surgeons to follow the ethic of accompaniment, opening themselves to the lives of patients and communities who are poor, disabled, directly harmed by racism, and otherwise marginalized. Among other work in this
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Do Suicide Attempters Have a Right Not to Be Stabilized in an Emergency? Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Aleksy Tarasenko Struc
The standard of care in the United States favors stabilizing any adult who arrives in an emergency department after a failed suicide attempt, even if he appears decisionally capacitated and refuses life‐sustaining treatment. I challenge this ubiquitous practice. Emergency clinicians generally have a moral obligation to err on the side of stabilizing even suicide attempters who refuse such interventions
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Additional Steps for Maintaining Public Trust in the FDA Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Mitchell Berger
This letter responds to the essay “Securing the Trustworthiness of the FDA to Build Public Trust in Vaccines,” by Leah Z. Rand, Daniel P. Carpenter, Aaron S. Kesselheim, Anushka Bhaskar, Jonathan J. Darrow, and William B. Feldman, in the special report “Time to Rebuild: Essays on Trust in Health Care and Science,” in the September‐October 2023 issue of the Hastings Center Report.
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The Power of Proximity: Toward an Ethic of Accompaniment in Surgical Care Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 C. Phifer Nicholson, Monica H. Bodd, Ellery Sarosi, Martha C. Carlough, M. Therese Lysaught, Farr A. Curlin
Although the field of surgical ethics focuses primarily on informed consent, surgical decision‐making, and research ethics, some surgeons have started to consider ethical questions regarding justice and solidarity with poor and minoritized populations. To date, those calling for social justice in surgical care have emphasized increased diversity within the ranks of the surgical profession. This article
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How Seeking Transfer Often Fails to Help Define Medically Inappropriate Treatment Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Douglas B. White, Thaddeus M. Pope
On September 1, 2023, Texas made important revisions to it its decades‐old statute granting legal safe harbor immunity to physicians who withhold or withdraw life‐sustaining treatment over the objection of critically ill patients’ surrogate decision‐makers. However, lawmakers left untouched glaring flaws in a key safeguard for patients—the transfer option. The transfer option is ethically important
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The Pandemic of Invisible Victims in American Mental Health Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Jacob M. Appel
Although considerable attention has been devoted to the concepts of “visible” and “invisible” victims in general medical practice, especially in relation to resource allocation, far less consideration has been devoted to these concepts in behavioral health. Distinctive features of mental health care in the United States help explain this gap. This essay explores three specific ways in which the American
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Holding the Guardrails on Involuntary Commitment Hastings Center Rep. (IF 3.3) Pub Date : 2024-04-19 Carl H. Coleman
In response to the increasing number of mentally ill people experiencing homelessness, some policy‐makers have called for the expanded use of involuntary commitment, even for individuals who are not engaging in behaviors that are immediately life‐threatening. Yet there is no evidence that involuntary commitment offers long‐term benefits, and significant reasons to believe that expanding the practice
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Residency Requirements for Medical Aid in Dying Hastings Center Rep. (IF 3.3) Pub Date : 2024-03-15 Rebecca Dresser
In 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont
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Ethical Challenges of Advances in Vaccine Delivery Technologies Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Arthur L. Caplan, Kyle Ferguson, Anne Williamson
Strategies to address misinformation and hesitancy about vaccines, including the fear of needles, and to overcome obstacles to access, such as the refrigeration that some vaccines demand, strongly suggest the need to develop new vaccine delivery technologies. But, given widespread distrust surrounding vaccination, these new technologies must be introduced to the public with the utmost transparency
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Hidden Ethical Challenges in Health Data Infrastructure Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Nicole Contaxis
Data infrastructure includes the bureaucratic, technical, and social mechanisms that assist in actions like data management, analysis, storage, and sharing. While issues like data sharing have been addressed in depth in bioethical literature, data infrastructure presents its own ethical considerations, apart from the actions (such as data sharing and data analysis) that it enables. This essay outlines
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Neuroscience and Society: Supporting and Unsettling Public Engagement Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Gregory E. Kaebnick
Advancing neuroscience is one of many topics that pose a challenge often called “the alignment problem”—the challenge, that is, of assuring that science policy is responsive to and in some sense squares with the public's values. This issue of the Hastings Center Report launches a series of scholarly essays and articles on the ethical and social issues raised by this vast body of medical research and
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Brain Pioneers and Moral Entanglement: An Argument for Post‐trial Responsibilities in Neural‐Device Trials Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Sara Goering, Andrew I. Brown, Eran Klein
We argue that in implanted neurotechnology research, participants and researchers experience what Henry Richardson has called “moral entanglement.” Participants partially entrust researchers with access to their brains and thus to information that would otherwise be private, leading to created intimacies and special obligations of beneficence for researchers and research funding agencies. One of these
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Identity Theft, Deep Brain Stimulation, and the Primacy of Post‐trial Obligations Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Joseph J. Fins, Amanda R. Merner, Megan S. Wright, Gabriel Lázaro‐Muñoz
Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity
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Issue Information and About the Cover Art Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23
Issue Information and About the Cover Art On the cover: Neurodiversity, by Amaya Chikuni, 2022, watercolor, white charcoal, and tissue paper on poster board. Courtesy of the artist.
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Digital Humans to Combat Loneliness and Social Isolation: Ethics Concerns and Policy Recommendations Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Nancy S. Jecker, Robert Sparrow, Zohar Lederman, Anita Ho
Social isolation and loneliness are growing concerns around the globe that put people at increased risk of disease and early death. One much‐touted approach to addressing them is deploying artificially intelligent agents to serve as companions for socially isolated and lonely people. Focusing on digital humans, we consider evidence and ethical arguments for and against this approach. We set forth and
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A Coeditors' Note Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Laura Haupt, Gregory E. Kaebnick
The January‐February 2024 issue of the Hastings Center Report includes two sets of pieces concerning brain health. One is a special report on ethical challenges that emerge at various points in the care of people facing dementia. The other set launches the journal's Neuroscience and Society series. An At Law essay provides a framework for challenging discriminatory practices related to the use of algorithms
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Challenging Disability Discrimination in the Clinical Use of PDMP Algorithms Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Elizabeth Pendo, Jennifer Oliva
State prescription drug monitoring programs (PDMPs) use proprietary, predictive software platforms that deploy algorithms to determine whether a patient is at risk for drug misuse, drug diversion, doctor shopping, or substance use disorder (SUD). Clinical overreliance on PDMP algorithm‐generated information and risk scores motivates clinicians to refuse to treat—or to inappropriately treat—vulnerable
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Care or Complicity? Medical Personnel in Prisons Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-23 Rebecca L. Walker
Imprisonment may sometimes be a justified form of punishment. Yet the U.S. carceral system suffers from appalling problems of justice—in who is put into prisons, in how imprisoned people are treated, and in downstream personal and community health impacts. Medical personnel working in prisons and jails take on risky work for highly vulnerable and underserved patients. They are to be lauded for their
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Selected Publications Relevant to Topics Explored in This Special Report, with a Focus on the United States Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21
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Choice in the Context of Dementia: Emerging Issues for Health Care Practice in Aging Societies Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21 Nancy Berlinger, Emily A. Largent, Mara Buchbinder, Mildred Z. Solomon
This introduction to the special report “Facing Dementia: Clarifying End‐of‐Life Choices, Supporting Better Lives” explains why focused attention to dementia is needed in bioethics and in health care practice in a range of settings. It explains how this strongly age‐associated condition shapes individual lives over years, revealing inequities in how dementia care is financed. The introduction explains
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Related Developments and Debates in Canada: Time Line and Publications Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21
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When People Facing Dementia Choose to Hasten Death: The Landscape of Current Ethical, Legal, Medical, and Social Considerations in the United States Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21 Emily A. Largent, Jane Lowers, Thaddeus Mason Pope, Timothy E. Quill, Matthew K. Wynia
Some individuals facing dementia contemplate hastening their own death: weighing the possibility of living longer with dementia against the alternative of dying sooner but avoiding the later stages of cognitive and functional impairment. This weighing resonates with an ethical and legal consensus in the United States that individuals can voluntarily choose to forgo life‐sustaining interventions and
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Opening the Door: Rethinking “Difficult Conversations” about Living and Dying with Dementia Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21 Mara Buchbinder, Nancy Berlinger
This essay looks closely at metaphors and other figures of speech that often feature in how Americans talk about dementia, becoming part of cultural narratives: shared stories that convey ideas and values, and also worries and fears. It uses approaches from literary studies to analyze how cultural narratives about dementia may surface in conversations with family members or health care professionals
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Too Soon or Too Late: Rethinking the Significance of Six Months When Dementia Is a Primary Diagnosis Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21 Cindy L. Cain, Timothy E. Quill
Cultural narratives shape how we think about the world, including how we decide when the end of life begins. Hospice care has become an integral part of the end‐of‐life care in the United States, but as it has grown, its policies and practices have also imposed cultural narratives, like those associated with the “six‐month rule” that the majority of the end of life takes place in the final six months
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Guiding the Future: Rethinking the Role of Advance Directives in the Care of People with Dementia Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21 Barak Gaster, Thaddeus Mason Pope
When people lose capacity to make a medical decision, the standard is to assess what their preferences would have been and try to honor their wishes. Dementia raises a special case in such situations, given its long, progressive trajectory during which others must make substituted judgments. The question of how to help surrogates make better‐informed decisions has led to the development of dementia‐specific
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What Makes a Better Life for People Facing Dementia? Toward Dementia‐Friendly Health and Social Policy, Medical Care, and Community Support in the United States Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21 Barak Gaster, Emily A. Largent
Taking steps to build a more dementia‐friendly society is essential for addressing the needs of people experiencing dementia. Initiatives that improve the quality of life for those living with dementia are needed to lessen controllable factors that can negatively influence how people envision a future trajectory of dementia for themselves. Programs that provide better funding and better coordination
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About The Hastings Center and the Cover Art Hastings Center Rep. (IF 3.3) Pub Date : 2024-02-21
About The Hastings Center The Hastings Center addresses fundamental ethical and social issues in health care, science, and technology. Through our scholars’ writing and speaking, and through the work of the many other people who participate in our projects or submit articles to our publications, we shape ideas that influence key opinion leaders, including health policy-makers, regulators, lawyers,
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Shared Problems Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Gregory E. Kaebnick
Several pieces in the November-December 2023 issue of the Hastings Center Report contribute to developing an expansive vision of bioethics. In the lead article, Sean Valles calls on the field to work against the problem of mass incarceration in the United States not only by addressing “what happens to people once they are inside prisons” but also with respect to the “ripple effects” the system has
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Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Sean A. Valles
A growing body of literature has engaged with mass incarceration as a public health problem. This article reviews some of that literature, illustrating why and how bioethicists can and should engage with the problem of mass incarceration as a remediable cause of health inequities. “Mass incarceration” refers to a phenomenon that emerged in the United States fifty years ago: imprisoning a vastly larger
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The Problem Is Not (Merely) Mass Incarceration: Incarceration as a Bioethical Crisis and Abolition as a Moral Obligation Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Jennifer Elyse James
Mass incarceration is an ethical crisis. Yet it is not only the magnitude of the system that is troubling. Mass incarceration has been created and sustained by racism, classism, and ableism, and the problems of the criminal legal system will not be solved without meaningfully intervening upon these forms of oppression. Beyond that, incarceration itself—whether of one person or 2 million—represents
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Preventing Another Fifty Years of Mass Incarceration: How Bioethics Can Help Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Homer Venters
In the article “Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics,” Sean Valles provides an important reminder of the consequences of mass incarceration in the United States and identifies potential roles for bioethicists in addressing this system. My limited view—that of a physician who conducts court-ordered investigations and monitoring of health services behind bars—is that
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Clinician Moral Distress: Toward an Ethics of Agent-Regret Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Daniel T. Kim, Wayne Shelton, Megan K. Applewhite
Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the
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Making the World Safer and Fairer in Pandemics Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Lawrence O. Gostin, Kevin A. Klock, Alexandra Finch
Global health has long been characterized by injustice, with certain populations marginalized and made vulnerable by social, economic, and health disparities within and among countries. The pandemic only amplified inequalities. In response to it, the World Health Organization and the United Nations have embarked on transformative normative and financial reforms that could reimagine pandemic prevention
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Lockdowns, Bioethics, and the Public: Policy-Making in a Liberal Democracy Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 S. Andrew Schroeder
Commentaries on the ethics of Covid lockdowns nearly all focus on offering substantive guidance to policy-makers. Lockdowns, however, raise many ethical questions that admit of a range of reasonable answers. In such cases, policy-making in a liberal democracy ought to be sensitive to which reasonable views the public actually holds—a topic existing bioethical work on lockdowns has not explored in detail
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Forgotten and without Protections: Older Adults in Prison Settings Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Jalayne J. Arias, Lillian Morgado, Stephanie Grace Prost
The number of older adults incarcerated in prisons is growing significantly, and there is a great need for legal authority, processes, and resources to mitigate individual and social burdens of elder neglect and abuse within these settings. Older adults in prison may be particularly vulnerable to abuse, neglect, or exploitation. They are dependent on the carceral system for basic resources, are at
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Big Mistake: Knowing and Doing Better in Patient Engagement Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Holly Fernandez Lynch
Pushing back on policies favored by dying patients is a challenging endeavor, requiring tact, engagement, openness to bidirectional learning, and willingness to offer alternative solutions. It's easy to make missteps, especially in the age of social media. Holly Fernandez Lynch shares her experience learning with and from the amyotrophic lateral sclerosis (ALS) community, first as a caricature of an
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Feminist Bioethics: Moving Forward in Coalition Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-22 Mercer Gary
The Routledge Handbook of Feminist Bioethics, edited by Wendy A. Rogers et al., presents a thorough, contemporary understanding of feminist bioethics, linking feminist efforts to other critical approaches in the field of bioethics. A more demanding standard for feminist scholarship is set by engaging gender at its intersections with race, class, sexuality, and ability––intersections that require bioethicists
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Errata Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-07
Errata In “Editors’ Statement on the Responsible Use of Generative AI Technologies in Scholarly Journal Publishing,” by Gregory E. Kaebnick et al., in the September-October issue (Hastings Center Report 53, no. 5 [2023]: 3-6, doi: 10.1002/hast.1507), the sentence “However, to our knowledge, previous position statements have not addressed the responsibilities of reviewers to authors” should read as
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Errata Hastings Center Rep. (IF 3.3) Pub Date : 2023-12-05
Errata In the “Acknowledgment” section in the essay “The Public Performativity of Trust,” by Melissa Creary and Lynette Hammond Gerido, in the special report “Time to Rebuild: Essays on Trust in Health Care and Science” (Hastings Center Report 53, no. 5 [2023]: S76-S85, doi: 10.1002/hast.1527), Gerido's name was incorrect. The acknowledgment should say, “Lynette Hammond Gerido was supported by National
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Dependence Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Gregory E. Kaebnick
The Hastings Center Report's September-October 2023 issue is about relying on others—on loved ones, clinicians, scientists, and institutions. The lead article explores how loving relationships support and reshape the agency of people who have dementia. Authors Eran Klein and Sara Goering argue that the understanding of agency as a shared, relational capacity has implications for the development of
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Can I Hold That Thought for You? Dementia and Shared Relational Agency Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Eran Klein, Sara Goering
Agency is talked about by many as something that people living with dementia lose, once they've lost much else—autonomy, identity, and privacy, among other things. While the language of loss may capture some of what transpires in dementia, it can obscure how people living with dementia and their loved ones share agency through sharing capacities for memory, language, and decision-making. We suggest
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Hope and Exploitation in Commercial Provision of Assisted Reproductive Technologies Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Anthony Wrigley, Gabriel Watts, Wendy Lipworth, Ainsley J. Newson
Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add-on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever-increasing array of add-ons are marketed to ART patients, even when evidence to support them is
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A Path Forward—and Outward: Repositioning Bioethics to Face Future Challenges Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Vardit Ravitsky
This essay explores what the future may hold for bioethics if it continues its evolution toward a field that embraces systemic, collective-level challenges; has a global scale and focus; emphasizes human flourishing; and seeks to have increased societal impact. As The Hastings Center considers strategic priorities for its research, public engagement, and impact, this essay reflects on where we have
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The Pitfalls of Genomic Data Diversity Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Anna Jabloner, Alexis Walker
Biomedical research recruitment today focuses on including participants representative of global genetic variation—rightfully so. But ethnographic attention to practices of inclusion highlights how this agenda often transforms into “predatory inclusion,” simplistic pushes to get Black and brown people into genomic databases. As anthropologists of medicine, we argue that the question of how to get from
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Cultivating Peace and Health at Community Health Centers Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Carolyn P. Neuhaus
Founded on a commitment to social justice and health equity, community health centers in the United States provide high-quality primary care to underserved populations and address social drivers of health disparities. Through an examination of two books on the history of community health centers, Peace & Health: How a Group of Small-Town Activists and College Students Set Out to Change Healthcare,
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Past: Imperfect; Future: Tense Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Matthew K. Wynia
How should the field of bioethics grapple with a history that includes ethicists who supported eugenics, scientific racism, and even Nazi medicine and also ethicists who created the salutary policy and practice responses to those heinous aspects of medical history? Learning humility from studying historical errors is one path to improvement; finding courage from studying historical strengths is another
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Issue Information (About the Cover Art) Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14
Issue Information (About the Cover Art)! On the cover: As Ships Pass By, by Toni Luciani, 2022, oil on canvas, 24 × 48 inches. Courtesy of the artist.
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Trust in Health Care and Science: Toward Common Ground on Key Concepts Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Lauren A. Taylor, Mildred Z. Solomon, Gregory E. Kaebnick
This essay summarizes key insights across the essays in the Hastings Center Report's special report “Time to Rebuild: Essays on Trust in Health Care and Science.” These insights concern trust and trustworthiness as distinct concepts, competence as a necessary but not sufficient input to trust, trust as a reciprocal good, trust as an interpersonal as well as structural phenomena, the ethical impermissibility
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Trust in Crises and Crises of Trust Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Jonathan H. Marks
During times of crisis, institutions tend to focus on maintaining or restoring public trust, as well as on measures to insulate themselves (and their leadership) from potential legal liability. This is because institutions reflexively turn to lawyers, risk managers, crisis consultants, and public relations firms that focus on what they euphemistically call the “optics.” In this essay, I highlight the
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The Sociotechnical Construction of Distrust during the Covid-19 Pandemic Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Kenneth R. Fleischmann
What were the impacts of the Covid-19 pandemic on trust in public health information, and what can be done to rebuild trust in public health authorities? This essay synthesizes insights from science and technology studies, information studies, and bioethics to explore sociotechnical factors that may have contributed to the breakdown of trust in public health information during the Covid-19 pandemic
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When Mistakes Multiply: How Inadequate Responses to Medical Mishaps Erode Trust in American Medicine Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Mark Schlesinger, Rachel Grob
In this essay, we explore consequences of the systemic failure to track and to publicize the prevalence of patient-safety threats in American medicine. Tens of millions of Americans lose trust in medical care every year due to safety shortfalls. Because this loss of trust is long-lasting, the corrosive effects build up over time, yielding a collective maelstrom of mistrust among the American public
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Climates of Distrust in Medicine Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Laura Specker Sullivan
Trust in medicine is often conceived of on an individual level, with respect to how people rely on particular clinicians or institutions. Yet as discussions of trust during the Covid-19 pandemic highlighted, trust decisions are not always as individual or interpersonal as this conception suggests. Rather, individual instances of trusting behavior are related to social trust, which is conceived as a
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“You have to trust yourself”: The Overlooked Role of Self-Trust in Coping with Chronic Illness Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Rachel Grob, Stacy Van Gorp, Jane Alice Evered
Self-trust is essential to the well-being of people with chronic illnesses and those who care for them. In this exploratory essay, we draw on a trove of health narratives to catalyze examination of this important but often overlooked topic. We explore how self-trust is impeded at both personal and structural levels, how it can best be nourished, and how it is related to self-advocacy. Because people's
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What Patient-Experience Data Reveal about Trust Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Thomas H. Lee, Senem Guney, Deirdre E. Mylod
This essay analyzes two types of patient-experience data to broaden and deepen understanding of trust in health care. Analysis of patients’ open-ended comments shows a close connection between patients’ feelings of trust and their intent to recommend providers and provider organizations—a global measure to evaluate patients’ perceptions of care experiences. Patients’ comments also reveal the bidirectional
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Betraying, Earning, or Justifying Trust in Health Organizations Hastings Center Rep. (IF 3.3) Pub Date : 2023-11-14 Jodyn Platt, Susan Dorr Goold
Health care and public health programs increasingly rely on, and often even require, organizational action, which is facilitated, if not dependent on, trust. Case examples in this essay highlight trust, trustworthiness, and distrust in public and private organizations, providing insights into how trust in health-related organizations can be betrayed, earned, and justified and into the consequences