Faculty Bibliography

There is increasing pressure for neuroscientists to communicate their research and the societal implications of their findings to the public. Communicating science is challenging, and the transformation of communication by digital and interactive media increases the complexity of the challenge. To facilitate dialogue with the public in this new media landscape, we suggest three courses of action for the neuroscience community: a cultural shift that explicitly recognizes and rewards public outreach, the identification and development of neuroscience communication experts, and ongoing empirical research on the public communication of neuroscience.

Much attention has been focused in recent years on the ethical acceptability of physicians receiving gifts from drug companies. Professional guidelines recognize industry gifts as a conflict of interest and establish thresholds prohibiting the exchange of large gifts while expressly allowing for the exchange of small gifts such as pens, note pads, and coffee. Considerable evidence from the social sciences suggests that gifts of negligible value can influence the behavior of the recipient in ways the recipient does not always realize. Policies and guidelines that rely on arbitrary value limits for gift-giving or receipt should be reevaluated.

Competing visions for health reform in the United States and renewed interest in health technology assessment (HTA) have led to fierce national debates about the appropriateness of rationing. Because of a limited supply of organs, kidney transplantation has always required rationing and overt discussion of the ethics that guide it, but the field of transplantation has also contended recently with internal calls for a new rationing system. The aim of the Life Years from Transplantation (LYFT) proposal is to allocate kidneys to patients who obtain the greatest survival benefit from transplantation, which would lengthen the lives of kidney transplant recipients but restrict the ability of older Americans to obtain a transplant. The debate around the LYFT proposal reveals the ethical and policy challenges of identifying which patients should receive a treatment based on the results of cost-effectiveness and other HTA studies. This article argues that attempts to use HTA for healthcare rationing are likely to disadvantage older patients. Guiding principles to help ensure that resources such as kidneys are justly allocated across the life span are proposed.

Chaplan comments on the latest trend of reproductive technology, where doctors put more than one embryo. No clinic should be putting more than two or three babies into even a younger patient who has already shown she can create children through success in previous rounds of in vitro fertilization. If the only way to prevent such outrageous treatment is to pass a law penalizing any doctor who implants numerous embryos under such circumstances, then let's get such a law passed

Caplan depicts a situation where conflict between parents and doctors right to determine if one of the patients or family members who was diagnosed with a highly malignant disease is dead. He further discusses whether family's religious view of death and the doctors' professional rights to declare death affects the decision of whether an individual is already dead. He explains that the determination of death is best left in the hands of doctors. The determination of when to end care that is completely and utterly futile because the patient has died is also best left to doctors. As much as death may trigger religious activity on the part of many, religion should never trump science when it comes to deciding when death has occurred in a hospital and what to do about the fact

Caplan discusses the four problems with the conclusion that the way to combat organ trafficking is to make it legal. First, there is no reason to think that most nations have the resources to regulate a market in organs effectively. After all, even the US, Britain, and Germany proved unable to regulate their banking, housing and securities sectors. Second, there are other ways to expand the availability of organs and tissue that do not involve treating human beings as commercial body-parts factories. Nations could institute presumed-consent policies, asking those who do not want to be donors to carry cards or register their objection in computer registries. When supplemented with appropriate training and resources, these systems have proven very effective in Spain, Belgium, Austria, and other nations. Third--and perhaps the greatest problem with legalizing organ and body-part markets--is that such markets prey on the grim circumstances of the poor. Fourth, they clearly violate the medical ethics of physicians and health-care workers