Caplan, Arthur L.
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Publication Bioethics and the Brain(2003-06-01) Foster, Kenneth R; Wolpe, Paul Root; Caplan, Arthur L.Microelectronics and medical imaging are bringing us closer to a world where mind reading is possible and blindness banished - but we may not want to live there. New ways of imaging the human brain and new developments in microelectronics are providing unprecedented capabilities for monitoring the brain in real time and even for controlling brain function. The technologies are novel, but some of the questions that they will raise are not. Electrical activity in the brain can reveal the contents of a person's memory. New imaging techniques might allow physician to detect devastating diseases long before those diseases become clinically apparent. And researchers may one day find brain activity that correlates with behavior patterns such as tendencies toward alcoholism, aggression, pedophilia, or racism. But how reliable will the information be, how should it be used, and what will it do to our notion of privacy? Meanwhile, microelectronics is making access to the brain a two-way street. The same electrical stimulation technologies that allow some deaf people to hear could be fashioned to control behavior as well. What are the appropriate limits to the use of this technology? Ethicists are only now beginning to take note of these developments in neuroscience.Publication Protecting Subjects' Interests in Genetics Research(2002-04-01) Merz, Jon F; Magnus, David; Caplan, Arthur L.; Cho, Mildred KBiomedical researchers often assume that sponsors, subjects, families, and disease-associated advocacy groups contribute to research solely because of altruism. This view fails to capture the diverse interests of many participants in the emerging research enterprise. In the past two decades, patient groups have become increasingly active in the promotion and facilitation of genetics research. Simultaneously, a significant shift of academic biomedical science toward commercialization has occurred, spurred by U.S. federal policy changes.Publication A Proposed Ethical Framework for Vaccine Mandates: Competing Values and the Case of HPV(2008-06-01) Field, Robert I; Caplan, Arthur L.Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When applied to the HPV vaccine, this framework would support a mandate based on utilitarianism, if certain conditions are met and if herd immunity is a realistic objective.Publication Solid-Organ Transplantation in HIV-Infected Patients(2002-07-25) Halpern, Scott D; Ubel, Peter A; Caplan, Arthur L.Before the introduction of highly active antiretroviral therapy in the mid-1990s, transplantation centers were understandably reluctant to provide scarce solid organs for patients infected with the human immunodeficiency virus (HIV). However, because treated patients can now expect to live substantially longer than before, many will have end-stage organ disease long before they have life-threatening conditions related to HIV infection. It is therefore time for the transplantation community to readdress the safety, efficacy, and propriety of transplanting scarce organs in HIV-positive patients who need them. In this article, we provide ethical arguments for viewing transplantation in patients with HIV infection as analogous to transplantation in patients with other chronic illnesses. Accordingly, transplantation in HIV-positive patients should be initiated at major centers and should not be considered experimental. In addition, reimbursement for such procedures should be similar to that for transplantation in other patients, unless evidence accumulates that HIV-infected transplant recipients fare poorly.Publication The Meaning of the Holocaust for Bioethics(1989-08-01) Caplan, Arthur L.Despite the central role played by the events leading to and during the Holocaust in bioethical discourse, bioethicists have paid surprisingly little attention to examining the nature of the crimes committed in the name of medicine and science, the moral rationales used to defend these crimes, or to the specifics of history that do and do not find parallels in current public policies and moral disputes. The Center for Biomedical Ethics at the University of Minnesota convened a conference on May 17-19, 1989, to examine some of these issues. The conference focused on five major themes: What role did mainstream medicine and science play in the creation of the Nazi state; What did German scientists and physicians think about and do in the name of eugenics and euthanasia; What moral rationales were used to justify the involvement of medicine - and science with genocide, euthanasia, and racism; Should scientists and physicians make any use of information obtained from barbarous experiments conducted on innocent persons in concentration camps; and What is the appropriate use of metaphors and analogies to the Nazi era in contemporary debates in bioethics?Publication No Method, Thus Madness?(2006-04-01) Caplan, Arthur L.If you ask most medical school deans if they have a course, program, or center doing bioethics, they will enthusiastically assure you that they do. And their enthusiasm for bioethics grows exponentially in proportion to their interest in showing that they are doing something about managing research ethics issues at their institutions. The same can be said about the entire biomedical research establishment - from private companies to independent research centers to professional organizations - bioethics is on the masthead, the organizational chart, and the agenda of the annual meeting. Not to worry - medicine's got ethics.Publication The Bioethics of Chronic Illness(1988-03-01) Caplan, Arthur L.; Jennings, Bruce; Callahan, DanielThere is a specter haunting the American health care system. It is the prospect of widespread chronic illness and disability in an aging society. With it comes a daunting challenge to our health care delivery system, social welfare services, families, and communities. And it presents an equally difficult challenge to millions of us as individuals. For prolonged, slowly debilitating chronic illnesses will most likely be our companions in the twilight of our lives. At present, it is unclear whether the American health care and social service systems are prepared to cope with the challenges, both financial and ethical, that chronic illness poses to our society. Innovative policy ideas are needed, as are continuing research, extended and better coordinated social senvice programs, and educational programs that will equip health care providers to meet the special needs of persons with chronic illnesses.Publication Domestic ‘Zealotry’ and Press Discourse: Kevorkian’s Euthanasia Incident(2000-08-01) Turow, Joseph; Caplan, Arthur L; Bracken, John SThe manner in which press outlets cover the convergence of the explicitly sensational and the explicitly ideological holds political and social implications. Does a startling or shocking domestic incident that the US press labels as zealotry catalyze the nation's news outlets to explore a wide range of views about the issues involved and their public relevance? This article addresses this matter by examining print media coverage of a videotaped euthanasia that was broadcast by the popular news magazine program 60 Minutes. The findings raise questions about the ability of incidents such as these to push the mainstream press to look beyond zealotry to the social context surrounding it.Publication Right to reform(2009-09-10) Caplan, Arthur LHealth reform is not in the details. Think I am wrong? How far did we get this summer wallowing around in claims about co-ops, public plans, death panels, rationing, and cost savings? Health reform is in the ethics.Publication Embryo disposal practices in IVF clinics in the United States(2004-08-09) Gurmankin, Andrea D; Sisti, Dominic; Caplan, Arthur L.BACKGROUND. The moral status of the human embryo is particularly controversial in the United States, where one debate has centered on embryos created in excess at in vitro fertilization (IVF) clinics. Little has been known about the disposal of these embryos. METHODS.We mailed anonymous, self-administered questionnaires to directors of 341 American IVF clinics. RESULTS. 217 of 341 clinics (64 percent) responded. Nearly all (97 percent) were willing to create and cryopreserve extra embryos. Fewer, but still a majority (59 percent), were explicitly willing to avoid creating extras. When embryos did remain in excess, clinics offered various options: continual cryopreservation for a charge (96 percent) or for no charge (4 percent), donation for reproductive use by other couples (76 percent), disposal prior to (60 percent) or following (54 percent) cryopreservation, and donation for research (60 percent) or embryologist training (19 percent). Qualifications varied widely among those personnel responsible for securing couples’ consent for disposal and for conducting disposal itself. Some clinics performed a religious or quasi-religious disposal ceremony. Some clinics required a couple’s participation in disposal; some allowed but did not require it; some others discouraged or disallowed it. CONCLUSIONS. The disposal of human embryos created in excess at American IVF clinics varies in ways suggesting both moral sensitivity and ethical divergence.