The norms and practices of clinical ethics took form relative to the environment and relationships of hospital care. These practices do not easily translate into the outpatient context because the environment and relational dynamics differ. Yet, as outpatient care becomes the center of health care delivery, the experiences of ethical tension for outpatient clinicians warrant greater responses. Although a substantial body of literature on the nature of the doctor–physician relationship has been developed and could provide theoretical groundwork for an outpatient (...) ethics, this literature is not sufficient to support outpatient caregivers in practical dilemmas. For physicians who are employed by or affiliated with a larger organization, a stronger alliance between clinical ethics and organizational ethics, identity, and mission will promote expansion of ethics resources in outpatient settings and address structural constraints in outpatient clinical care. (shrink)

The ArgumentCell lines and other human-derived biological materials have since 1980 become valuable forms of patentable matter. This paper revisits the much-critiqued legal caseMoore v. Regents of the University of Cahfornia, in which John Moore claimed property rights in a patented cell line made from his spleen. Most work to date has critiqued the text of the decision and left the relevant scientific and technical literature unexamined. By mapping out the construction of discontinuity and continuity between human body and cell (...) line in this literature, this paper provides a novel critique of the Moore case regarding the source and mobilization of scientific information in the decision. At the same time, the elisions of the case are used to move to a larger set of questions. Comparative material from the history of the first widely used cell line, HeLa, and a discussion of the relation of the scientific and economic value of cell lines, are aimed at analysis of how new objects such as patented human cell lines come into existence through science and law, and what kinds of definitions and practices make them valued objects of contention in the first place. (shrink)

Over the past decade, the number of clinical trials registered with the Food and Drug Administration has increased dramatically. The business of clinical research has become more diverse, involving academic institutions, clinician-researchers in community settings, pharmaceutical companies, and contract research organizations. This growth has been accompanied by increasing concerns about the ethical conduct of research. Much of this concern has been directed to procedural issues including institutional review board review, data monitoring, and informed consent forms. However, the protection of human (...) subjects cannot be achieved by relying solely on procedural safeguards. There are more nuanced issues related to recruitment and retention of subjects, and to the process of informed consent, that are generated during the interaction between study staff and subjects. It is only through an examination of these relationships that one can more fully define and understand the challenges of protecting subjects in research. (shrink)

This article tries to show that commonplace economic, ethico-religious, anti-racist,and logical-consistency objections to public funding of abortions and abortion counseling for poor women are quite weak. By contrast, arguments appealing to basic human rights to freedom of speech, informed consent, protection from great harm, justice and equal protection under the law, strongly support public funding. Thus, refusing to provide abortions at public expense for women who cannot afford them is morally unacceptable and rationally unjustifiable, despite the opinions of former Presidents (...) Reagan and Bush, the more conservative members of the Supreme Court of the United States, the current Congress, and the majority of the American people. (shrink)

Philosophy professor Bryan Hilliard begins this unusual medical ethics textbook, composed of selections from U.S. Supreme Court cases, commentaries, and discussion questions, by addressing a questi...

Philosophy professor Bryan Hilliard begins this unusual medical ethics textbook, composed of selections from U.S. Supreme Court cases, commentaries, and discussion questions, by addressing a questi...