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2018, Rhetoric + Argumentation

Deaths in Phase I Drug Trials: Ethical Issues and Ways to Mitigate Risk

ANNE FREEMAN

In 2016, a healthy male volunteer received an experimental drug that had never been tested in humans, lapsed into a coma, and died. There are a number of ethical questions raised by the episode, including whether it is appropriate to conduct first-in-human tests on a healthy volunteer who has no chance of medical benefit from the drug in question. At its core, paying healthy volunteers who stand no chance of medical benefit is a coercion that violates the ethical principle of nonmaleficence, “first do no harm.” Nevertheless, phase I testing is necessary for development of novel drugs that ultimately may enormously benefit the greater population. There are ways to address this essential tension between harm to an individual versus good to society. One way is to increase transparency in the testing design. Trials should provide more information regarding the evidence that a drug is safe, both to provide more information to a participant as well as to the public in the event of an adverse outcome. Requiring companies to release details of on whom the drug was tested and how much participants received is good science and good ethics. Drug companies should acknowledge that although uncommon, terrible outcomes will occur, and may result from testing any novel drug, regardless of anticipated safety. When a participant is injured during a phase I trial, there should be a clear process for compensation to the individual or survivors.

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2018, Rhetoric + Argumentation

Trapped in Limb-o: Health, Pain, and Body Integrity Identity Disorder

RACHEL BIGGIO

In this paper, I examine the ethical dilemma present in cases of Body Integrity Identity Disorder (BIID), a condition in which sufferers do not identify with one of their limbs and subsequently seek amputation. Many medical professionals and lay people alike feel there exists a moral requirement to refuse treatment in instances of BIID, as the curative procedure requires the removal of a “healthy” limb. I, however, resist the supposition of healthfulness of the undesirable limb in instances of BIID and indeed assert that an identity conflict poses a genuine medical condition with the undesirable limb as the source of ailment. Thus, I insist that amputation in the case of BIID is permissible, and further, that the medical establishment must fundamentally reexamine its conceptions of pain, illness, and health to honor a wider range of human experience.

1st Place – Rhetoric + Argumentation

Abstract

2018, Rhetoric + Argumentation

Human Cloning: A Critique of Prevailing Arguments in Islam

HUNAIN ALI

The paper discusses the stance taken by a majority of the Muslim scholars regarding human cloning. It argues that the practice of human cloning should be permissible, through providing a critique on the prevailing arguments that exist in Muslim discourse against human cloning. The paper first argues that human cloning does not undermine God’s role nor does it weaken one’s belief in God. Second, it argues that human cloning does not necessarily result in the breakdown of lineage and kinship among society. Lastly, the paper explains that with further research, human cloning can be made safer and will not be as harmful as critics of human cloning deem it to be.

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2018, Academic Paper

The Dilemma of Life-extending Treatments

CHAIMAA BENKERMI

The subject of Islam and bioethics covers all medicinal fields in relation to religion, leading intellectuals to continuously attempt to determine one eventual conclusion that would ideally retain both teachings from the divine sources and common ethical righteousness. From abortion, organ transplantation to brain death, the practice of Islamic bioethics covers all medical matters while attempting to justify and rationalize the physician’s role along with the patient’s consent, in an Islamic point of view. The matter of death in Islam is indeed a rather overlooked one, as it triggers fear for most of the people who thus, subconsciously, desire to delay that moment when ‘their time comes.’ But life-extending treatments have actually become more popular over the past decades, and the growing use of modern biomedical technologies has triggered many debates with regards to the definition as well as the ethical aspect of the act of delaying the process of death.

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2018, Academic Paper

The Privilege of Living and Dying

HELENA BLACK

In this paper, I argue for the right of the elderly to make their own decisions about healthcare as they approach the end of their lives. Ageism and current laws are a common hindrance to the proper care of the elderly. The wishes of older patients to undergo treatment are often dismissed and, in most cases, a decision to discontinue care and end suffering with assisted suicide cannot be honored. Doctors take a paternalistic approach, determining care for their elderly patients without taking into account their circumstances, life events or belief systems. The idea that these individuals have lived their life, and that administering new or substantial treatments would put an unjustified burden on limited resources, is prevalent among many in the medical profession. To combat this problem and allow the elderly to retain autonomy, medicine must incorporate “narrative care,” an approach that uses individual stories, as well as the patient’s wishes, to create personalized treatment plans. 

Real-life accounts of experiences with end-of-life care, including those of my own grandparents, are used to highlight the importance of taking cues from patients themselves. The controversial subject of legalizing “medical aid in dying” is also extensively discussed, with arguments presented on both sides of the issue. The importance of measures to safeguard against coercion while giving the elderly the option to end their lives with dignity is also considered. Together, these narratives combine to present an argument for changing policy to facilitate individual end-of-life decision-making regarding life and death.

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2018, Academic Paper

The Legacy of Henrietta Lacks: Reconciliation and Intersectionality

MATTHEW BUCKWALD

Medical malpractices are performed daily, but what can we do to make them better? Henrietta Lacks was undergoing treatment for cervical cancer at Johns Hopkins Hospital in 1951 while doctors examined her cells from a routine biopsy. These cells held the secret to the cures and vaccines to nearly every modern medical epidemic in history. Lacks, however, being a poor black woman from inner-city Baltimore, neither gave consent for this tissue sampling, nor was compensated for the remarkable contribution her cells gave to the medical community. Johns Hopkins Hospital has created numerous programs and events to educate the public about consensual sampling and avoiding malpractices, but is this enough? This paper first explores the bioethical dilemma of Lacks’ case and establishes the moral harm done. Following, this paper analyzes the attempts that have been made by Johns Hopkins to take responsibility for their actions. I argue that their lack of intersectionality in accounting for Lacks results in the lack of desired value in their reconciliation. I suggest that Johns Hopkins should instead look to work directly with the community they hurt. Lacks may now have her own website, but her own family still does not have basic access to health care. People whose intersections hurt them in a sociopolitical arena are considered to have a parallel lower moral standing in society. Therefore, medical professionals discount the realities and experiences of this said population; as moral status decreases, so declines health standards. This is a crucial element of bioethics that is often overlooked in cases of reconciliation, including and especially in the case of Henrietta Lacks.

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2018, Academic Paper

The Role of Narrative Ethics and Autonomy in Health Care

CAMILO DIBSI

This paper presents a narrative that exemplifies several key problems that arise from the heavy-handed focus on autonomy as a moral value. It approaches a moral dilemma from a narrative ethics perspective by breaking down a real-world, documented series of events and carefully analyzing the intentions and roles of the several important actors in it. The paper argues that by ignoring narrative ethics, the medical practitioners involved in this narrative allowed their patient to acquire a level of autonomy in her decision making that was disproportionate to the level of control and self-awareness that she exercised over her own medical situation, leaving the door open to operational blunders. But where did everything go wrong and what can be done to fix this problem? This paper demonstrates that by failing to engage in active, intellectual, doctor-patient dialogue, the GPs in this example unknowingly allowed a bioethical dichotomy to form between themselves and their patient, and that the use of narrative ethics could have potentially bridged this gap. Rather than subordinating the value of patient autonomy, this paper actually highlights its importance by proving that narrative strategies are beneficial for medical practitioners to recognize when and how much “voice” they should allocate to their patients. This paper is divided into several sections: an introduction of the story, characters, and theories that are explored in the essay, a cross-sectional analysis between the actions and intentions of different actors and how these are juxtaposed with narrative ethics, and finally a brief summary of the importance that the conclusions reached in the paper have on the world of bioethics.

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2018, Academic Paper

The Ethics of a Legal Organ Market

NAOMI ZHAO

In the United States, about 75,000 people are on a waitlist for a kidney transplant, but only one in four patients will end up receiving a kidney. This large gap between supply and demand raises the question of why it is illegal to buy and sell organs. Even though a legal organ market seems incredibly far-fetched, the moral arguments for why people should not be able to sell their organs contain many inconsistencies. This essay will address ethics concerns with the legalization of an organ market using the principles of nonmaleficence, autonomy, and justice.

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2018, Rhetoric + Argumentation

Examining the Ethics of the Iranian Kidney Market

DAVID D’AMBRISI

In the sphere of organ transplantation laws, Iran stands alone. Unlike all other nations, Iran allows its citizens to sell their “extra” kidney in exchange for cash, loans, and better health insurance. This market solution has largely eliminated kidney shortages persistent in countries with no market, and in turn, the Iranian market has allowed sick patients to undergo transplant surgery before they succumb to renal disease. Although these positive attributes may exist, many observers remain unconvinced and believe that the Iranian kidney market disrespects sellers and exploits those who live in poverty in Iran.

My paper serves as a case analysis of the Iranian market and concludes that the Iranian kidney market is not only permissible but also morally imperative. I first examine the consequences of potential markets and the Iranian market and find that while negative outcomes exist, these negative results are not caused by the commodification of kidneys. Rather, the Iranian kidney market produces tremendous good by eliminating organ shortages. Next, I consider whether the Iranian market is ethical while disregarding the consequences of the market. I conclude that the Iranian market enhances the autonomy of sellers. Not only can individuals sell kidneys as they desire, but also, the Iranian market is regulated such that a combination of non-profits, the government, and physicians foster informed consent practices that would otherwise be missing in a black market. Lastly, I recommend that other countries institute regulated kidney markets similar to those in Iran.

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2018, Rhetoric + Argumentation

Direct-to-Consumer Genetic Testing: A Call for a More Interpretive Approach

ZACH SCHERER

The F.D.A. recently granted approval to the genetic testing company 23andMe to offer screenings for three mutations of the BRCA1 and BRCA2 genes that increase one’s likelihood of developing breast cancer. This controversial decision creates a conflict between the fundamental bioethical principles of autonomy and beneficence/non-maleficence. In this paper, I argue that, while provision of these test results should not be banned, the F.D.A.’s decision insufficiently considers the risks posed by relatively unfettered access to these test results. Therefore, a guarantee of the opportunity to consult a professional throughout the process and an explicit recommendation to consumers to do so is needed.

2nd Place – Rhetoric + Argumentation

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