Faculty Bibliography

Picking on someone as being "not religious enough" for high office or on a religion as being insufficiently pious to produce a viable candidate for any office -- from county sheriff to president -- is intolerant bias, simply out of bounds in American political discourse

Ethical issues are present at each stage in the vaccine product life cycle, the period extending from the earliest stages of research through the eventual design and implementation of global vaccination programs. Recent developments highlight fundamental principles of vaccine ethics and raise unique issues for ongoing vaccination activities worldwide. These include the 2009-10 H1N1 pandemic influenza vaccination campaign, renewed attention to the potential global eradication of polio, and the ongoing evaluation of vaccine risk controversies, most notably the alleged link between childhood vaccines and autism. These cases present ethical challenges for public health policy-makers, scientists, physicians, and other stakeholders in their efforts to improve the health of individuals, communities, and nations through vaccination.

The movement to try to close the ever-widening gap between demand and supply of organs has recently arrived at the prison gate. While there is enthusiasm for using executed prisoners as sources of organs, there are both practical barriers and moral concerns that make it unlikely that proposals to use prisoners will or should gain traction. Prisoners are generally not healthy enough to be a safe source of organs, execution makes the procurement of viable organs difficult, and organ donation post-execution ties the medical profession too closely to the act of execution.

Caplan relates the story of a pregnant woman who attempted to kill herself by swallowing a rat poison. Her life was saved but it resulted to the death of the baby after she gave birth. She was arrested , charged with murder and attempted feticide, and sent to jail. Prosecutors called her a "cold-blooded" murderer. If convicted, she will get a minimum sentence of forty-five years. The death penalty or life in prison without parole are also possibilities. This story is disturbing not just because it is unconscionable to prosecute as a murderer a pregnant woman who tried to kill herself, but because it is likely that the case was brought to make a point in the ongoing national battle over abortion

Some forms of stem cell research involving the use of embryos require embryo destruction to extract a stem cell. Others, involving cloning, require transferring a full set of genes from an adult cell into an egg. Both procedures have received heavy criticism from those opposed to embryo destruction or embryo creation by a technique other than sex. While there's a good deal of focus on the problems generated by the power of money in generating bias in science and medicine, the battle over stem cell research makes very clear that religious views can also be a huge source of distortion and bias. Here, Caplan talks about the ongoing debate about stem cell research in the US

The term evidence-based medicine is overused, abused, and is beginning to ring hollow. It is not that evidence (or at least of what most people in biomedicine think evidence-based medicine should strive to be) is a bad thing. Rather, there is more rhetoric about evidence than there is actual evidence to support the degree of talk.

BACKGROUND: Transmission of human immunodeficiency virus and hepatitis C to transplant recipients has drawn attention of the use of allografts from seronegative donors at increased risk for blood-borne viral infection (DIRVI). METHODS: We performed a cohort study of 7803 kidney transplant recipients whose kidneys were recovered through one of two organ procurement organizations from 1996 to 2007. Detailed organ procurement organization data on donor risk factors were linked to recipient data from the Organ Procurement and Transplantation Network. RESULTS: Median recipient follow-up was 3.9 years. Three hundred sixty-eight (5%) patients received DIRVI kidneys, a third of which were procured from donors with a history of injection drug use or commercial sex work. Compared with standard criteria kidney recipients, DIRVI kidney recipients were more likely to be human immunodeficiency virus positive or black. In multivariable Cox regression, using DIRVI recipients as the reference, recipients of standard criteria donor kidneys had lower mortality (hazard ratio [HR] 0.71, P<0.01) and no difference in death-censored allograft failure (HR 1.09, P=0.62), whereas recipients of expanded criteria donor kidneys had no significant difference in mortality (HR 0.98, P=0.83) but a higher allograft failure rate (HR 1.93, P<0.01). High-quality data on posttransplant recipient viral testing were not available. CONCLUSIONS: DIRVI kidney recipients experienced higher mortality than standard criteria kidney recipients. This finding could be explained if sicker patients received DIRVI kidneys (i.e., residual confounding) or the less likely possibility of undetected transmission of viral infections. Given the limitations of registry data used in this analysis, prospective studies are needed to further elucidate these findings.