Perspectives in Biology and Medicine最新文献

Planet Earth and its growing human population are challenged by the health impacts of industrial policies that drive global emissions production and cause climate change. The health-care industry has capacity and responsibility to adopt environmentally sustainable policies and practices. Bioethicists have a responsibility to support environmental sustainability through their clinical, research, educational, and policy work. They communicate complex ideas to diverse stakeholders and can communicate similarly to improve understanding about emissions and the value of environmentally sustainable policy. A growing bioethics literature addresses climate change in collaboration with human and veterinary medicine and other disciplines. Pursuing environmental sustainability with the vigor that made autonomy a norm would help to reduce global emissions production in health care and make it a role model for other industries. Making environmental sustainability a health-care norm would be as significant an accomplishment as doing so for individual autonomy.

This essay argues for the importance of formalizing public engagement efforts around bioethics as something we might call "bioethics communication," and it outlines the Johns Hopkins Berman Institute of Bioethics' plans for engaging in this effort. Because science is complex and difficult to explain to nonexperts, the field of science communication has arisen to meet this need. The field involves both a practice and a subject of empirical research. Like science, bioethics is also complex and difficult to explain, which is why the world needs bioethics communication. The authors are engaged in a brand-new effort to establish the sort of public bioethics efforts that would constitute bioethics communication, through a program which they call the Dracopoulos-Bloomberg iDeas Lab. The authors invite colleagues to experiment and learn with them as they invest in the development of bioethics communicators and their products.

Of the more than 47 million people living with Alzheimer's disease or other types of dementia, an estimated one-third live alone. This essay explores the idea of the dignity of risk as it presents in the lives of people living alone with dementia, an underrepresented group in research, and considers the tension between safeguarding people with dementia from risks associated with disease progression and denying them the experience of risk as an aspect of everyday life. For individuals, risk is associated with vulnerability, choice, uncertainty, and the pursuit of goals, and may hold positive and negative connotations. This essay considers how myriad choices in the everyday lives of people living alone with dementia present some degree of risk, and how the ability to make these choices may constitute a life of dignity, replete with meaning and richness. The essay concludes with suggestions about how to reframe living alone with dementia as a way of living that can be better socially supported.

Robert Perske argued in 1972 that "there can be such a thing as human dignity in risk, and there can be a dehumanizing indignity in safety." Though Perske was referring to paternalistic care for the intellectually disabled, we can extend his counsel to the persistent attempts to impose a different kind of "safety," including efforts to enforce the gender and sex binary, as intersex surgeries were (and still are) meant to do. This article argues that when physicians surgically and hormonally alter the genitals and gonads of intersex infants, shaping their bodies to safely align with typical male and female bodies and gender roles, they unwittingly subject them to a dehumanizing indignity. Imposing the binary legislatively with anti-transgender bills is similarly harmful and can inadvertently undermine intersex care. Conservative lawmakers' tacit dismissal of young people's transgender identities parallels physicians' paternalistic, even if well-intentioned, efforts to make intersex bodies fit neatly into prescribed categories. Whether legislative or medical, these interventions promote the traditional gender and sex binary and undermine the dignity of such persons' eventual self-authorship.

While there is voluminous literature on pain in the context of medicine, pain as an aesthetic, representational, and epistemological issue remains undertheorized. The present article, after reviewing the nature of pain and surveying the emerging interdisciplinary field of graphic medicine, seeks to close-read sections of Georgia Webber's Dumb (2018) to demonstrate how the artist transforms the inexpressibility and invisibility of pain into a visual and sensate language. Webber's Dumb articulates a complex sense of pain, in which pain is conceived at once as a generative and also as a disabling force. Webber not only transforms pain into a knowable sensation but also teases out the relationship of pain with the creation of comics-artisanal labor-itself. This article also draws attention to the potential of the comics medium in visualizing and expressing pain, and it concludes by showing how pain is at once biological, cultural, and social.

Datafication has allowed us to quantify every facet of the corona-virus pandemic. A significant quantity of data sets on infection and recovery rates, mortality, comorbidities, the intensity of symptoms, region-by-region statistics, vaccination, and virus variants, among other things, has been made publicly available. However, these data sets relentlessly reduce human beings to mere numbers and graph points. The present study employs a close reading of comic panels to demonstrate how graphic medicine uses data to critique, supplement, and expose its lacunae. The article draws from graphic medical narratives and panels such as Andy Warner's "The Nib Bureau of Statistics" (2020), Sarah Firth's "State of Emergency" (2021), and Randall Munroe's "Statistics" (2020). Though data visualizations and comics are both graphical representations, their treatment of COVID-19-related issues is radically different. Graphic medicine "re-draws" data visualizations through imitation, subversion, and displacement to showcase multiple temporalities, marginal agencies, and the affective nature of human existence. Furthermore, the humanistic intervention of graphic medicine deftly reclaims individual lives and attendant stories in a world dominated by technologically mediated data. This essay does not dismiss the performative force of data; instead, it insists on humanizing and contextualizing a sensitive presentation of data to convey our entangled existence and collective states.

Over recent decades, progress in bioscience research has been remarkable, but alongside the many transformative advances is a growing concern that a surprisingly high fraction of published research cannot be reproduced by the scientific community. Though experimental and interpretive errors are unavoidable features of the scientific process, recent evidence suggests that irreproducibility is a serious issue requiring analysis, understanding, and remediation. This article reviews the meaning of research reproducibility, examines ongoing efforts to estimate its prevalence, and considers the factors that contribute to it. Two recent case studies illustrate the disparate responses that researchers may take when facing serious claims that a high-profile research finding is irreproducible and may be false. Finally, the article examines potential interventions to counter the current level of irreproducibility, aimed at increasing the efficiency and impact of society's substantial and critically important investment in bioscience research.

Hospitals have both a regulatory and an ethical mandate to craft a safe discharge plan for all patients. These plans can become a source of conflict between clinicians and patients when they have differing conceptions of safety and best interests. In bioethics principles this conflict can be characterized as the tension between the patient's right to make medical decisions in accordance with their values, or autonomy, and the clinician's obligation to provide best care to their patients, or beneficence. Employed independently, these principles can be limiting and may not accommodate the nuanced narrative of patients who lack decisional capacity but have expressed clear preferences about where they wish to live. Utilizing case-based discussion, this article explores how the inclusion of Robert Perske's dignity of risk principal in bioethics consultation can support clinicians in expanding their conceptions of beneficence and safety, providing the team with the freedom to craft discharge plans that keep the patient at the center of the narrative.