Category Archives: Bioethics

Fordham’s Dr. Elizabeth Yuko Address Ethics of Web Self-Diagnoses

Millions of people use websites like WebMD every day to gain insight on a range of medical issues from cancer to mental health. This practice, or “cyberchondria,” is a new digital phenomenon that has resulted from online databases of free, medical information.

With about 74 million users each month, the information on WebMD provides some with clarity for our most intimate and confusing health concerns, but for others, it could be a source of anxiety. In a recent article published in GOOD Magazine, Fordham University Center for Ethics Education Bioethicist Dr. Elizabeth Yuko addressed the “ethical gray area” of web diagnosis and online symptom checkers.

“Websites and algorithms are not held to the Hippocratic Oath. Because WebMD is a media organization, rather than an individual medical professional, it is not held to the same legal and ethical accountability as individual practitioners,” notes Dr. Yuko. Unlike WebMD, other online communities and health professionals must operate under ethics codes and guidelines designed by organizations such as American Medical Association and American Psychological Association.

As far as legal liability is concerned, Dr. Yuko explained that because WebMD’s Terms and Conditions state “This Site Does Not Provide Medical Advice,” the website is not “legally obligated to provide a worst-case scenario” while most health professionals, at least in the United States, are held accountable if they do not provide patients with complete information regarding their health conditions.

Dr. Yuko, however, is most concerned with the use of health care sites as a substitute for obtaining diagnoses because people “can’t afford in-person care.” She stated, “This in itself is an ethics issue, but one from a societal, distributive justice perspective, highlighting the fact that not everyone has access to effective, affordable health care.”

Read the full article at GOOD.

Relying on Psychological Assessments do not Right Death Penalty Wrongs for the Intellectually Disabled

Although the death penalty is on the decline in the United States, the case of James Rhodes highlights the ethical quagmire facing forensic psychiatrists and psychologists whose evaluations contribute whether persons with intellectual disabilities convicted of murder will live or die.

In addition to the increasingly familiar racial biases and legal flaws in death penalty convictions and use of lethal injection, according to Celia B. Fisher, Ph.D. Director of Fordham University’s Centerfor Ethics Education, little attention has been paid to the lack of professional consensus surrounding the validity and reliability of IQ tests in general and for racial minorities in particular, disagreement over the use of absolute cut-off scores to determine intellectual disability, and the inherent fallibility of tests to determine the probability of future violence.

“Professional evaluations are not a panacea for inconsistent, uninformed and often racially biased jury decisions,” notes Fisher, “rather than providing a fair and neutral assessment of mental ability forensic assessments are contributing to inconsistencies that lethally violate the human rights of convicted criminals in capital cases.”

For more information on the ethics of psychologists’ involvement in death penalty evaluations – particularly for defendants with mental disabilities Dr. Fisher’s 2013 article in Ethics & Behavior entitled “Human Rights and Psychologists’ Involvement in Assessments Related to Death Penalty Cases.”

Celia B. Fisher, Ph.D. is the Marie Ward Doty University Chair, Professor of Psychology, and Director of Fordham University’s Center for Ethics Education. She chaired the 2002 revision of the American Psychological Association’s Ethics Code and is the author of Decoding the Ethics Code: A Practical Guide for Psychologists, now in it’s fourth edition, from Sage Publications.

 

Fisher describes innovative approach to research involving vulnerable adolescents at OHRP conference

 

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Fordham University Center for Ethics Education Director and Marie Ward Doty University Chair in Ethics Dr. Celia B. Fisher gave the keynote address this morning at an Office for Human Research Protections (OHRP) conference, entitled “Vulnerable, Marginalized and At-Risk Participants in Research.”

In this address, Fisher describes her innovative approach to giving vulnerable adolescents and their families a voice in ensuring the responsible conduct of research. Her work illuminates the importance of fitting research ethics protections to the real world lives of LGBT teens, pediatric cancer patients, and ethnic minority youth in ways that reflect their values and merit their trust.

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#BioethicsSoWhite

 

By Celia B. Fisher, Ph.D.

In a recent article in the American Journal of Bioethics Kayhan Parsi of the Loyola University of Chicago Stritch School of Medicine exhorted bioethicists to address racism in their work. What the article did not address is why in 2016 it has taken bioethics so long to recognize a problem existing for more than 50 years since the field’s nascence.

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10 years after Vioxx scandal, pharmaceutical companies caught again misleading patients using false claims

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Pharmaceutical companies have once again used industry influence to conceal data and make false claims about a high-profile medication.

Today The New York Times reported that Johnson & Johnson and Bayer – the companies behind the anti-clotting drug Xarelto – are responsible for critical laboratory data being left out of a letter published in The New England Journal of Medicine discussing the safety of the medication. Lawyers representing patients suing the two major pharmaceutical companies claim that both corporations were complicit by remaining silent about the data concealed from the publication.

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So-called ‘female Viagra’ even less effective than suggested, not selling well

By: Elizabeth Yuko, Ph.D.

UPDATE: 2/29/16: An article published today in JAMA Internal Medicine found that Addyi — the so-called “female Viagra” —  is even less effective than initially thought, resulting in only one-half of one additional satisfying sexual experience per month for the women taking the medication.

The drug has not been selling well since it received FDA approval in August 2015. As of early January 2016, only 240-290 prescription for Addyi were written each week, according to a recent report cited in The New York Times. The report estimates that sales are currently running at a rate of around $11 million per year, far lower than the projected $100 to $150 million in revenue for this year.

For additional discussion of Addyi, the drug’s efficacy, and the ethical implications, please continue reading below.

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First Uterus Transplant in U.S. Performed at the Cleveland Clinic

Surgical team behind the first uterus transplant in the United States, via The Cleveland Clinic.

Surgical team behind the first uterus transplant in the United States, via The Cleveland Clinic.

The first uterus transplant in the United States took place yesterday at the Cleveland Clinic. The patient is currently in “stable condition,” and more details about the procedure will be released next week at a press conference.

Fordham University Center for Ethics Education Bioethicist Dr. Elizabeth Yuko discussed the ethical implications of uterus transplants in a Fordham News story predicting significant news stories of 2016, as well as in two posts on Ethics & Society in January 2014 and August 2015.

The uterus transplant that took place yesterday in Cleveland differs from those that occurred in Sweden in 2014, because the recipient received the uterus from a deceased donor. The wombs transplanted in the Swedish trial all came from living donors, which raises additional ethical questions regarding living donors undergoing serious surgery for a non-life-saving transplant.

Please read Dr. Yuko’s previous discussions of this topic for further details.