Bioethics Publications

  • Artist’s Statement: Doctor-Patient

    Anekwe, O.N. – Student

    Academic Medicine – December 14, 2013

    Obiora Anekwe discusses his art collage, Doctor-Patient, which shows a doctor and a nurse weighing and confirming the height of a man in the Tuskegee Syphilis Study.

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  • Letter to the Editor

    Hui, K. – Student

    New York Times – October 20, 2013

    It is unsurprising that doctors fail to come clean on medical error given our society’s climate of malpractice.

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  • The Illusion of Post Hoc Autonomy

    Hui, K. – Student

    AJOB Neuroscience – September 11, 2013

    While a basic kind of autonomy may be all that is necessary for agency, unconscious influences on decision making remain a serious threat to autonomy.

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  • Political Engagement as an Element of Social Recovery: A Qualitative Study

    Bergstresser, S.M., Brown, I.S., Colesante, A. – Student

    Psychiatric Services – August 15, 2013

    Taking a qualitative approach, Sara May Bergstresser describes consumer attitudes toward political participation and the association between political engagement and social recovery.

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  • Return of secondary genomic findings vs patient autonomy: implications for medical care

    Klitzman, R., Appelbaum, P. S., & Chung, W. – Faculty

    Journal of the American Medical Association – July 31, 2013

    In April 2013, the American College of Medical Genetics (ACMG) recommended that clinical laboratories conducting whole genome sequencing (WGS) and whole exome sequencing (WES) for specific clinical indications should also analyze and report any mutations identified from a list of 57 genes considered medically actionable, regardless of whether patients wish to receive the results.1 These recommendations have sparked a heated debate with profound implications for countless physicians and their patients.

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  • The Person at the Center

    Bergstresser, S.M. – Student

    The American Journal of Bioethics – July 17, 2013

    Various theories and interventions have linked the capabilities approach to health policy, mental health services, and broader questions of social integration for consumers of mental health services.

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  • Researchers’ views on return of incidental genomic research results: qualitative and quantitative findings

    Klitzman, R., Appelbaum, P. S., Fyer, A., Martinez, J., Buquez, B., Wynn, J., ... & Chung, W. K. – Faculty

    Genetics in Medicine – June 27, 2013

    Comprehensive genomic analysis including exome and genome sequencing is increasingly being utilized in research studies, leading to the generation of incidental genetic findings. It is unclear how researchers plan to deal with incidental genetic findings.

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  • Public Safety, Mental Disorders, and Guns

    Appelbaum, P. S. – Faculty

    JAMA Psychiatry – April 3, 2013

    In the aftermath of the shooting of 20 schoolchildren and 6 teachers in Newtown, Connecticut, on December 14, 2012, attention quickly focused on the presumed link between mental disorder and violence. With no more than rumors to rely on, the media speculated wildly on the gunman's diagnosis and drew parallels to earlier shootings involving persons with mental illness. Wayne LaPierre, executive vice president of the National Rifle Association, announced at a press conference that the problem of violence was largely due to people with mental illness, “genuine monsters . . . that are so deranged, so evil, so possessed by voices and driven by demons, that no sane person can even possibly comprehend them.”

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  • Repackaging Cigarettes — Will the Courts Thwart the FDA?

    Bayer, R., Gostin, L., & Marcus-Toll, D. – Student

    The New England Journal of Medicine – November 29, 2012

    Legal and policy issues have emerged related to the proposed graphic warning labels on cigarette packaging.

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  • The ethics of research on deep brain stimulation for depression: decisional capacity and therapeutic misconception

    Fisher, C. E., Dunn, L. B., Christopher, P. P., Holtzheimer, P. E., Leykin, Y., Mayberg, H. S., ... & Appelbaum, P. S. – Faculty

    Annals of the New York Academy of Sciences – July 19, 2012

    Research on deep brain stimulation (DBS) for treatment-resistant depression appears promising, but concerns have been raised about the decisional capacity of severely depressed patients and their potential misconceptions about the research. We assessed 31 DBS research participants with the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), a well-validated capacity measure, and with a scale to measure therapeutic misconception, which occurs when subjects do not recognize key differences between treatment and clinical research. Correlations with baseline depressive symptoms were explored. Subjects’ performance on the MacCAT-CR was excellent, but therapeutic misconception was still apparent. A trend toward significance was found in the correlation between baseline depression ratings and total therapeutic misconception score. Responses to open-ended prompts revealed both reassuring and concerning statements related to expectations of risk, benefit, and individualization. Even severely depressed patients did not manifest impairments in their capacity to consent to DBS research. Therapeutic misconception, however, remained prevalent.

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