Faculty Bibliography

When you get old enough as a practitioner in any field young people seek your advice about what they should do if they want to do what you do. Given that my age seems to be increasing exponentially, this has been happening to me with increasing frequency. Undergraduates, high school students, medical students, those pursuing degrees in law and nursing and even those interested in a mid-career change have been asking me what they need to do if they want to pursue a career in bioethics. I have thought about their question quite a bit. I have come to realize that the answer is not the same for everyone who presents the question. But, the core of the answer is pretty much the same: pursue masters level training in bioethics, acquire familiarity with key social science methods and tools, learn something about a particular sub-area of the health sciences or life sciences, and seek out every opportunity to fine tune your analytical and rhetorical skills by working with others on projects, research, consulting, or teaching activities. At its heart bioethics is an interdisciplinary activity and knowing how to work with others who do empirical, historical, legal and normative work is a must. I had thought that advice to be sound until I heard Zeke Emanuel's plenary address to open the most recent annual meeting of the American Society of Bioethics and the Humanities. Emanuel espoused a vision for future bioethicists that I think is narrow, misguided and wrong. Now I say that in the spirit that Emanuel himself enjoys—vigorous debate about a matter that both of us consider of the gravest importance. Zeke Emanuel, a physician with a degree in political science as well, is one of the best and brightest scholars in the field of bioethics. His writings are solid and exemplify how best to integrate empirical inquiry with normative analysis. And the 'shop' he has run at the NIH Clinical Center for many years prior to moving into the Office of Budget and Management to work on health reform has done an outstanding job training younger scholars in the ins and outs of bioethical inquiry. These facts are precisely why the recent plenary address to the American Society of Bioethics and the Humanities was so disappointing.

This paper presents a common standard for conflict of interest disclosure. The common standard was drafted by the authors, following consultation with a multi-disciplinary group of journal editors, publishers, bioethicists and other academics. It is presented here for the benefit of authors, editorial managers, journal editors and peer reviewers to stimulate discussion and to provide guidance to authors in reporting real, apparent and potential conflicts of interest. It is particularly relevant to addiction specialty journals because of the potential conflicts of interest associated with funding from the alcohol, tobacco, pharmaceutical and gambling industries. Following an appropriate period of vetting the common standard within the scientific community, it is recommended that journal editors adopt journal policies and reporting procedures that are consistent across journals.

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