Ethics & Society Newsfeed: February 3, 2017

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Politics

Betsy DeVos’s ethics review raises further questions for Democrats and watchdogs
Betsy DeVos, Trump’s nominee to lead the Education Department, promised to divest from more than 100 entities to avoid potential conflicts of interest with her new job. Questions left unanswered.

Donald Trump warned over ‘unprecedented’ plan to appoint cabinet without ethics office checks, emails reveal
Disclosed emails from the head of the ethics office warn President aides staffing a cabinet with robust oversight is a ‘tradition evolved as a result of hard lessons’

South Dakota Governor Signs Measure Reversing Voter Ethics
Governor of South Dakota signed a bill Thursday overturning an anti-corruption measure passed by a majority of voters in November, to the consternation of government watchdog groups.

Trump And His Organization Lawyer Up For The Ethics War Ahead
President Trump and the Trump Organization are beefing up their legal teams against an expected surge of conflict-of-interest allegations.

Teaching Ethics In The Trump Era
Graduate-level professor asks how to tell students ethics is important when “nothing around them feels ethical” re: Trump administration and conflicts of interest.

Bioethics

Human-pig hybrids might be unsettling. But they could save lives.
A new study out of California unsettled a lot of people last week after revealing that scientists had, for the first time, made part-human, part-pig embryos — referred to as “chimeras.” Raises ethical questions.

Could changing the way doctors are paid help narrow health disparities?
A study suggests that changing the way doctors and hospitals are paid could narrow some of the health disparities between poorer and wealthier patients.

Trump’s Supreme Court Pick Could Shape Bioethics for Generations
Neil Gorsuch, nominee for the US Supreme Court, has spent his career weighing matters of life and death. His views on life—that it is sacred and “intrinsically valuable”—are likely to shape court decisions in areas from abortion to assisted suicide for decades to come.

Continue reading “Ethics & Society Newsfeed: February 3, 2017”

The National Transgender Study is a Start – But More is Needed to Protect the Sexual Health of Transgender Teens

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On Thursday, December 9th, the largest survey of transgender people ever conducted was published by The National Center for Transgender Equality. The anonymous online survey had nearly 28,000 participants and found transgender people are twice as likely to live in poverty and three times more likely to be unemployed, according to an article in TIME Magazine. Other findings included that one-third of respondents reported issues in finding healthcare and 42%  reported higher rates of mistreatment by health care providers.

Fordham University Center for Ethics Education Director, Celia B. Fisher, Ph.D., lauded the recent national study highlighting the healthcare needs of transgender people in the United States. “More is needed on the health care experiences of transgender adolescents, especially their experiences with family physicians who often do not have the training to provide necessary gender affirming care,” she noted.

Fisher’s research with colleagues from Northwestern University, supported by the National Institute on Minority Health and Health Disparities (NIMHD), has highlighted the critical need for physicians who are trained and open to providing gender minority youth with not only transitioning information, but also gender and sexual orientation specific sexual health information and services to prevent HIV and related STIs.

Continue reading “The National Transgender Study is a Start – But More is Needed to Protect the Sexual Health of Transgender Teens”

Fordham Study Addresses Health Care of Bisexual Adolescent Girls

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For bisexual female adolescents,  proper sexual healthcare is difficult to obtain due to healthcare providers’ judgmental attitudes and assumptions of patient heterosexuality, and lack of opportunities for HIV and sexually transmitted infections (STI) testing. Additionally, youth openness with healthcare providers is restricted due to stigma experienced within families of bisexual teen girls and concerns of confidentiality. These findings were published in LGBT Health, a Mary Ann Liebert, Inc. publication

Principle investigators of this NIH-funded study, Dr. Celia B. Fisher, Director of the Fordham University Center for Ethics Education and Dr. Brian Mustanski, Director of the Institute for Sexual and Gender Minority Health and Wellbeing, along with Drs. Miriam Arbeit and Kathryn Macapagal, describe these health care disparities in the article, Bisexual Invisibility and the Sexual Health Needs of Adolescent GirlsThe study analyzed bisexual female adolescents’ perspectives on their access to health information and services provided by health care professionals.

In addition to attitudes and assumptions of healthcare providers and stigma within families, the findings also included limited school-based sexual health education as an important factor contributing to insufficient health care for bisexual adolescent girls.

“The findings from our study are consistent with the unfortunate fact that sexual health care of adolescent girls has largely been absent or focused primarily on birth control tools that do not prevent risk of HIV and other STI – especially if male partners refuse to use condoms,” notes Fisher, Director of Fordham Center for Ethics Education, “and this problem is exacerbated for bisexual girls who may be unprepared for sexual experiences with male partners or who engage in such experiences to avoid social stigma.”

The researchers concluded that practitioners must improve standard sexual health practices involving female youth by integrating nonjudgmental questions regarding bisexuality. According to Fisher, the study “underscores the need for additional training of family physicians and gynecologists to engage in patient centered discussions that help to overcome bisexual invisibility and fears of medical discrimination that are barriers to bisexual girls sexual health.” In a recent article about the study, William Byne, MD, PhD of LGBT Health, adds, “Knowledge of a patient’s sexuality is essential to the biopsychosocial model of clinical practice.”

According to the study, other forms of support of bisexual health among adolescent girls include addressing stigma, increasing sensitivity to privacy and expansion of school-based sexual health education.

Read more about this research in the News Medical Life Sciences article as well as in LGBT Health.

Ethics & Society Newsfeed: October 14, 2016

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Health Care and Bioethics

DNA database highlights need for new medical privacy protections
Creation of a national repository of genetic information is seen by some as crucial to reducing medical costs and improving people’s healthcare.

‘Big data’ could mean big problems for people’s healthcare privacy
Public and private insurers are spending millions of dollars on systems that can predict people’s future healthcare needs.

Colorado Wrestles With Ethics Of Aid In Dying As Vote Looms
Colorado man says he would like the option to end his life rather than face a painful death and advocates for Colorado’s Proposition 106  or “death with dignity.”

The NIH needs to review the ethics of research on primates
Congress asked the National Institutes of Health to review “its ethical policies and processes” on nonhuman primate research “to ensure it has appropriate justification for animal research protocols.”

Breast Cancer Death Rates Are Down, But Racial Disparities Persist
Women are less likely to die of breast cancer than they were a decade ago, but not all women are benefiting from that trend.

Continue reading “Ethics & Society Newsfeed: October 14, 2016”

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

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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.

Medical Training for Transgender Patients Needs to Include Sensitivity to Social Stigmas for both Gender and Sexual Orientation

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The recently published article on doctor’s lack of expertise in treating transgender patients in The Guardian is an important step forward in highlighting current disparities in healthcare services for this population.  The study, based on interviews with sample of 23 physicians and psychologists who chose to work with transgender patients, focused on current challenges in providing gender affirming care for individuals who are seeking medically supported transitioning treatments, such as hormonal replacement therapies (HRT).

A recently completed study by Celia B. Fisher, Ph.D. and her colleagues, funded by the National Institute for Minority Health and Health Disparities (NIMHD) confirms the need for greater medical training, based on the reports of 228 transgender males, females and gender non-conforming youth ages 14 – 21.  “Fear of stigmatization is a significant barrier to healthcare among these youth,” notes Fisher, Director of Fordham University’s Center for Ethics Education, “and in our study, 51% reported they did not discuss their transgender identity with their primary health care providers out of fear that the provider would not be accepting.”

Continue reading “Medical Training for Transgender Patients Needs to Include Sensitivity to Social Stigmas for both Gender and Sexual Orientation”

Fordham RETI Fellow Addresses Stigma for HIV-Positive Gay and Bisexual Men

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Dr. Jonathon Rendina, Hunter College, CUNY

The minority stress theory suggests that health disparities experienced by gay and bisexual men (GBM) and other sexual minorities can be explained in terms of stigma-related stressors such as discrimination at work, school, religious institutions, communities and families. The unique stressors of an HIV-positive status experienced by GBM, however, has been overlooked within research on minority stress.

Fordham University Center for Ethics Education HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI) Fellow Dr. Jon Rendina, an Assistant Professor in the Department of Psychology and Faculty Investigator and Director of Quantitative Methods at The Center for HIV Educational Studies & Training (CHEST) of Hunter College, CUNY, recently addressed this issue within a paper published in Annals of Behavioral Medicine.

Dr. Rendina has been conducting HIV research with GBM for more than ten years. He explained the need to thoroughly test “the role of internalized stigma about sexual orientation, or internalized homophobia, and internalized HIV stigma within a unified model to see whether one or both have an impact on HIV-positive gay or bisexual men.” Although it is already established that GBM are negatively impacted by internalized sexual minority stigma, the purpose of this study was to further explore the impact of HIV-related stressors on the health of GBM.

Continue reading “Fordham RETI Fellow Addresses Stigma for HIV-Positive Gay and Bisexual Men”