The intellectual and moral integrity of bioethics: response to commentaries on A case study in unethical transgressive bioethics: \u27Letter of concern from bioethicists\u27 about the prenatal administration of dexamethasone .

In our target article we showed that the Letter of Concern (LoC) fails to meet accepted standards for presenting empirical data for the purpose of supplementing a normative claim and for argument-based normative ethics. The LoC fails to meet the standards of evidence-based reasoning by making false claims, failing to reference data that undermine its key premises, and misrepresenting and misinterpreting the scientific publications it selectively references. The LoC fails to meet the standards of argument-based reasoning by treating as settled matters what are, instead, ongoing controversies, offering “mere opinion” as a substitute for argument, and making contradictory claims. The LoC is methodologically defective and thus a case study in unethical transgressive bioethics. Not withdrawing the LoC will damage the field of bioethics, making this case study in unethical transgressive bioethics important for the entire field

The perils of the imperfect expectation of the perfect baby.

Advances in modern medicine invite the assumption that medicine can control human biology. There is a perilous logic that leads from expectations of medicine\u27s control over reproductive biology to the expectation of having a perfect baby. This article proposes that obstetricians should take a preventive ethics approach to the care of pregnant women with expectations for a perfect baby. We use Nathaniel Hawthorne\u27s classic short story, The Birthmark, to illustrate the perils of the logic of control and perfection through science and then identify possible contemporary sources of the expectation of the perfect baby. We propose that the informed consent process should be used as a preventive ethics tool throughout the course of pregnancy to educate pregnant women about the inherent errors of human reproduction, the highly variable clinical outcomes of these errors, the limited capacity of medicine to detect these errors, and the even more limited capacity to correct them

Forgiveness, forbearance, and time: The temporal unfolding of transgression-related interpersonal motivations.

The investigators proposed that transgression-related interpersonal motivations result from 3 psycholog-ical parameters: forbearance (abstinence from avoidance and revenge motivations, and maintenance of benevolence), trend forgiveness (reductions in avoidance and revenge, and increases in benevolence), and temporary forgiveness (transient reductions in avoidance and revenge, and transient increases in benev-olence). In 2 studies, the investigators examined this 3-parameter model. Initial ratings of transgression severity and empathy were directly related to forbearance but not trend forgiveness. Initial responsibility attributions were inversely related to forbearance but directly related to trend forgiveness. When people experienced high empathy and low responsibility attributions, they also tended to experience temporary forgiveness. The distinctiveness of each of these 3 parameters underscores the importance of studying forgiveness temporally. The concept of forgiveness has long been a focus of the world’s religions (McCullough & Worthington, 1999; Rye et al., 2000), but only during the last decade did psychologists develop a sus-tained interest in the topic. Recent work has shed light on the social–psychological precursors to forgiveness (Exline &amp

Ethical Dimensions of Human Immunodeficiency Virus Infection During Pregnancy

Physicians encounter complex and sensitive ethical challenges in the medical care of pregnant women with human immunodeficiency virus (HIV) infection. This paper identifies those ethical challenges and provides concrete clinical guidance for how they should be addressed in obstetric care. The paper begins with a brief historical review, to highlight and to call into question the civil rights model of the ethics of HIV infection that has dominated the literature, clinical practice, and public policy. The authors propose an alternative ethical framework. This framework begins by underscoring the public health obligations of both physicians and pregnant women with HIV infection. The framework is based on a clinical ethics that appeals to both beneficence-based and autonomy-based obligations of the physician to the pregnant woman and the beneficence-based obligations of both the physician and the pregnant woman to the fetal patient. This framework is then deployed in a clinical ethical analysis of termination of pregnancy and contraception, partner notification, disclosure and confidentiality of her serostatus by the patient to the health care team, disclosure and confidentiality of her serostatus to other health care professionals, prevention of vertical transmission, and advance directives

Roundtable The Islandmagee Witches 1711 Creative and Digital Project

In March and September of 1711, in Carrickfergus, County Antrim, Ireland’s last witch trials took place. Eighteen-year-old educated gentlewoman Mary Dunbar accused eight Presbyterian women and one man from Islandmagee and the surrounding areas of using witchcraft to attack her in spectral or spirit form and to summon demons to possess her body. The women were tried on 31 March 1711 at the Spring Session of Carrickfergus County Assize Court. Despite pleading not guilty, they were convicted under the 1586 Irish Witchcraft Act and sentenced to one year’s imprisonment and four stints in the pillory. Unlike most demonically-possessed persons, the incarceration of the convicted witches did not improve Dunbar’s health. Dunbar now claimed that William Sellor, husband and father to two of the convicted women, had begun bewitching her. William was convicted of witchcraft at the Summer Assizes in September 1711. Mary Dunbar however had died a few weeks earlier, just after the first trial, turning William’s original offence into a capital crime for which he was probably executed: he was thus one of a possible two people executed in Ireland under a witchcraft Act. The story of the trial is told in Andrew Sneddon’s book Possessed by the Devil: The Real History of The Islandmagee Witches and Ireland’s Only Mass Witchcraft Trial (History Press, 2013). Along with Victoria McCollum, Sneddon now heads the Islandmagee Witches 1711 Project (w1711.org). The following discussion outlines the origins, aims and outputs of the project

A case study in unethical transgressive bioethics: Letter of concern from bioethicists about the prenatal administration of dexamethasone.

On February 3, 2010, a Letter of Concern from Bioethicists, organized by fetaldex.org, was sent to report suspected violations of the ethics of human subjects research in the off-label use of dexamethasone during pregnancy by Dr. Maria New. Copies of this letter were submitted to the FDA Office of Pediatric Therapeutics, the Department of Health and Human Services (DHHS) Office for Human Research Protections, and three universities where Dr. New has held or holds appointments. We provide a critical appraisal of the Letter of Concern and show that it makes false claims, misrepresents scientific publications and websites, fails to meet standards of evidence-based reasoning, makes undocumented claims, treats as settled matters what are, instead, ongoing controversies, offers mere opinion as a substitute for argument, and makes contradictory claims. The Letter of Concern is a case study in unethical transgressive bioethics. We call on fetaldex.org to withdraw the letter and for co-signatories to withdraw their approval of it

The professonal responsibility model of obstetrical ethics: Avoiding the perils of clashing rights

Obstetric ethics is sometimes represented by polarized views. One extreme asserts the rights of the fetus as the overwhelming ethical consideration. Both assertions are overly simplistic. Such oversimplification is called reductionism. This article explains the fallacy of rights-based reductionism and 2 models of obstetric ethics based on it and explains why the fetal rights reductionism model and the pregnant woman\u27s rights reductionism model result in conceptual and clinical failure and therefore should be abandoned. The article argues for the professional responsibility model of obstetric ethics, which emphasizes the importance of medical science and compassionate clinical care of both the pregnant and fetal patient. The result is that responsible medical care overrides the extremes of clashing rights

Training Materials Developed for Latino Entrepreneurs

This article describes the materials and training program that Extension created to assist current and potential Latino immigrant entrepreneurs in starting businesses in Arkansas. The content-based educational materials describe the process for starting a new business, government regulatory requirements, start-up costs and considerations, and how to organize important documents. All items were designed with the ultimate goal of providing business owners with worksheets and an organizational system that can be used to write a business plan