Autonomy Suspended: Autonomy Suspended: Using Female Patients to Teach Intimate Exams Without Their Knowledge or Consent

 

Recent reports of medical students performing pelvic exams for training purposes on anesthetized women without their consent have produced a firestorm of controversy and calls for greater regulation. Despite periodic efforts to reform the practice, such unauthorized practice is neither a recent...

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The Death of Jesse Gelsinger: New Evidence of the Influence of Money and Prestige in Human Research

 

Ten years ago, Jesse Gelsinger died while participating in a human gene therapy trial at the University of Pennsylvania (“Penn”). His death came to signify the corrosive influence of financial interests in human subjects research. After Jesse's death, the media reported that one researcher. Dr. James Wilson, held shares in a... 

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Emergency Contraceptives or "Abortion-Inducing" Drugs? Empowering Women to Make Informed Decisions

The Obama Administration’s (Adminstration) mandate under the Patient Protection and Affordable Care Act (ACA) that nearly all employers cover certain contraceptive drugs and devices in any employee health plan (the Mandate) opened a new front in the American abortion debate. Religious objectors charge that...

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Estate of Gelsinger v. Trustees of University of Pennsylvania: Money, Prestige, and Conflicts of Interest in Human Research

Jesse Gelsinger was an adult by the narrowest of margins, merely three months past his 18th birthday, when he died on September 17, 1999. Jesse was the first person reported to die in a human gene-therapy trial, although sadly not the last. The Food and Drug Administration (FDA) charged that a cascade of...

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Enlarging the Regulation of Shrinking Cosmetics and Sunscreens

Although one is hard-pressed to name an industry that has not jumped on the nanotechnology bandwagon, the makers of cosmetics and sunscreens have capitalized on nanotechnology more aggressively than any other. Already by 2006, 5% of all cosmetic products contained nanoparticles (NPs), whereas more than 300...

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Medicare: Where is the Common Sense? A Review of Medicare Meets Mephistopheles

In his deliciously funny book, Medicare Meets Mephistopheles, Professor David Hyman argues that Medicare corrupts our most base impulses. It urges us, for example, to grab for more than our fair share of benefets while offering providers “the prospect of staggering amounts of money – even as...actuaries were ...

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Nanotechnology: The Challenge of Regulating Known Unknowns

Nanotechnology is a subject about which we know less than we should, but probably more than we think we do at first glance. Like Defense Secretary Donald Rumsfeld’s “known unknowns,” we have learned enough to know what we should be concerned with. Glimmers of risk cropped up recently when German authorities...

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Realizing Informed Consent in Times of Controversy

The elegantly simple idea — that consent to medical treatment or participation in human research must be “informed” to be valid — is being tested anew today. The high cost of medical care, as well as a desire for quantifiable improvements in treatment, has precipitated an emphasis on evidence-based medicine...

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The Promise of Informed Consent

Some ideas are elegantly simple—deceptively so. In 1914, Justice Cardozo famously observed that “[e]very human being of adult years and sound mind has a right to determine what shall be done with his body.” Although it took nearly half a century before patients could sue to enforce that right, patients today are...

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Using Tort Law to Secure Patient Dignity

To the surprise of many people and the consternation of some medical school faculty and students, a media firestorm erupted last year over teaching hospitals’ practice of allowing medical students to perform pelvic exams on anesthetized patients without their express consent. This practice, common since the late 1800s...

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Demystifying Hobby Lobby

The Unites States Supreme Court's controversial decision in Burwell v. Hobby Lobby Stores ('Hobby Lobby') has caused great consternation for many and elation for others. As badly misunderstood outside the United States as it is within, the decision interprets the federal Religious Freedom Restoration Act (RFRA)...

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Religious Liberty After Hobby Lobby: A Panel of the 2014 Federalist Society National Lawyers Convention

The following remarks were given on November 14, 2014 during a panel of the 2014 Federalist Society National Lawyers Convention. The focus of the discussion revolved around the recent Supreme Court decision in Burwell v. Hobby Lobby. The discussion included such topics as the impact that Hobby Lobby...

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The Calculus of Accommodation: 
Contraception, Abortion, Same-Sex Marriage, and Other Clashes Between Religion and the State

This Article considers a burning issue in society today—whether, and under what circumstances, religious groups and individuals should be exempted from the dictates of civil law. The "political maelstrom: over the Obama administration's sterilization and contraceptive coverage mandate is just one of many clashes between...

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The Overlooked Costs of Religious Deference

In March of 2007, Der Spiegel reported that a German divorce court judge denied a fast-track divorce based on hardship to a German citizen of Moroccan origin who has been the victim of domestic violence and death threats from her spurned husband. In rejecting the...

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When Governments Insulate Dissenters from Social Change: What Hobby Lobby and Abortion Conscience Clauses Teach About Specific Exemptions

After the U.S. Supreme Court's decision in Burwell v. Hobby Lobby Stores, Inc., two great civil rights battles of our time — the extension of marriage to same-sex couples and women's access to reproductive services — are firmly linked in the public's mind. In Hobby Lobby...

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Unpacking the Relationship Between Conscience and Access

Many people reflexively accept or reject healthcare conscience protections. Those prizing religious freedom argue that conscience protections ensure that religious believers can both take jobs in medicine and act consonant with their faith. This group sometimes gives short shrift to concerns about access to needed...

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Trumpcare: Expect the Phoenix to Rise from the Ashes

On the first day of the Trump presidency, 1/6 the of the U.S. economy, or $3.2 trillion, revolved around healthcare. Twenty million people gained healthcare coverage after the Patient Protection and Affordable Care Act (“ACA” or “Obamacare” to opponents)—roughly half the number of uninsured that the...

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‘Unauthorized Practice’: Regulating the Use of Anesthetized, Recently Deceased, and Conscious Patients in Medical Teaching

News that anesthetized women are used to teach pelvic exams to medical students without their permission' has turned a white-hot spot-light on consent practices in medical teaching. Yet, educational pelvic exams represent just one way in which patients are used for medical training. Recently deceased patients in the... 

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Rethinking the Shield of Immunity: Should Ethics Committees Be Accountable for Their Mistakes?

This article focuses on the role of healthcare ethics committees in resolving difficult ethical questions in patient care and the repercussion of shielding their actions from society's view. Although the societal importance of ethics committees actions seem obvious, in many jurisdictions the records of committee... 

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Unauthorized Practice: Teaching Pelvic Examination on Women Under Anesthesia

Recent reports of medical students performing gynecological exams on anesthetized women without their knowledge or consent have generated a firestorm of controversy and prompted calls for greater regulation. This Commentary examines studies spanning three decades showing that such... 

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Hospital Ethics Committees as the Forum of Last Resort: An Idea Whose Time Has Not Come

Hospital Ethics Committees have become a fixture in American medicine and are poised to become the forum of last resort for end-of-life decisions as a result of state statutes giving committees immunity and privilege. The effect of such legislation is to transform ethics committees from an adjunct to the...

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Uncovering the Rationale for Requiring Infertility in Surrogacy Arrangements

With little explanation, state legislatures have limited surrogate parenting arrangements to couples in which the intended mother is infertile or unable to bear a child without unreasonable risk. This requirement stands in stark contrast to the diminishing importance of infertility to adoption agencies...

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When States Regulate Emergency Contraceptives Like Abortion, What Should Guide Disclosure?

State law efforts to regulate abortions have accelerated. Between 2011 and 2013, state legislatures enacted 205 abortion laws — 16 more than in the entire decade before.1 Most laws take direct aim at surgical abortions, although some also target chemical abortions that use drugs like RU-486, a common chemical abortifacient...

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