The Bioethics Project
At Kent Place School
Presentation by: Kate Lowry and Cecelia Reali
The COVID-19 pandemic is a national public health emergency that has dramatically exposed pre-existing pervasive health disparities in our society affecting two critical systems: healthcare and education. This presentation focuses on hospitals and schools while exploring their responsibility to provide vital care, such as life-saving technology and school-based mental health services. We discuss racial and socioeconomic barriers that restrict access to health and education resources that many consider a human right. Dramatic spikes in demand for mental health care require prioritization of funding for some disorders and raise questions about boundaries of a school as well as privacy and safety. In hospitals, some doctors must decide who gets the last ventilator, dialysis machine, or ICU bed. Hospitals and schools are making what may be life and death decisions when allocating critical resources to those they deem “most likely to benefit.” This makes it critically important to understand: How should these systems address existing inequities and provide broad access to quality support? When choices have to be made, how should these systems decide who gets scarce health and education resources? What do their priorities say about how they value human life? By engaging in this presentation, participants will both learn and ask questions about how health and education systems fulfill their responsibilities to society when health is most at risk.
Presentation by: Astrid Burns and Serena Zheng
Human challenge trials (HCT) are trials that involve the intentional infection of a human with a disease or illness in order to test a vaccine or medicine to treat it. HCTs have been a crucial part of scientific research for centuries. Another type of HCT can involve inducing a condition in a patient in order to test a therapy intended to mitigate or cure it. Because of HCTs, the overall health and quality of life has improved. However, HCTs raise several ethical questions: When is it ethical to conduct tests on humans? Is it ethical to deliberately infect an individual with a potentially lethal illness for the sake of a larger community? Does the potential benefit of a HCT (eg, identification of a safe and effective vaccine) outweigh the potential harm to the participants? In this workshop, we will examine these questions by evaluating current and historical HCTs. We will explore in depth the perspectives of stakeholders, as well as important values (including autonomy and responsibility) and the ethical principle of utilitarianism. Participants will have the opportunity to share their experiences and opinions on the topic of human testing and leave the presentation with newfound knowledge on how to analyze an ethical dilemma and the specific risks and benefits that are involved with HCTs.
Presentation by: Sophia Famular and Giordan Ismael
What do you know about pharmaceutical advertising and pricing? What is the ethical responsibility of the pharmaceutical industry when advertising and pricing products? Did you know that the FDA only requires the most common and severe side effects, but not all, of drugs to be listed in an advertisement or told to patients? Or that some treatments for rare diseases cost upwards of $1 million or even more? How can pharmaceutical advertising and pharmaceutical pricing affect human health? This workshop will explore the aspects of both pharmaceutical advertising and pharmaceutical pricing and consider the ethical responsibilities of drug companies, doctors, and the federal government in the health care system. We will also explore the impact of product advertising and pricing on patient autonomy in comparison to other industries. Furthermore, we will consider the tensions between autonomy and paternalistic beneficence, and between utilitarianism and individual need. During this interactive presentation, the audience members will be able to test and expand their knowledge of the pharmaceutical industry while exploring the ethical implications of pharmaceutical product promotion and pricing. Our goal is for the audience to walk away with more knowledge about some of the otherwise behind-the-scenes parts of the industry and show the significance these issues may have on their lives and the lives of others.
Presentation by: Alana DeVirgilio and Elizabeth Washburn
Who and what determines who receives scarce resources in a time of global need? As the COVID-19 pandemic has swept across the globe, people have been grouped into populations and those populations have been assigned different priorities. The stated policy goal has been to distribute vaccines, ventilators and access to aid to the most vulnerable and at risk — but is that really happening? This presentation will explore the extent to which elderly people and the IDD (Intellectually and/or Developmentally Disabled) community have been disproportionately affected and denied access to care over the course of the COVID-19 pandemic. Additionally, we will explore what the scoring systems for allocating resources (eg, SOFA and QALY) imply about the value placed on the lives of elderly and those with IDD. Simultaneously, as versions of a priority list for the allocation of the COVID-19 vaccine have been developed, non-essential workers with a disability have been listed as lower priority than those who are able-bodied and of the same age, if specifically listed at all. This disparity, whether implicit or explicit, highlights the injustices that the disabled community has suffered during the COVID-19 pandemic and in the medical field as a whole. Allocation of ventilators, vaccines, and other necessary but scarce resources has been known to negatively impact and discriminate against disabled communities, while the elderly community has also endured exclusion from necessary aid such as ventilator access and inclusion in clinical trials. How do these issues threaten the well-being of our most vulnerable communities, and how can we help?
Presentation by: Sofia Keri and Clara Schreibman
Advances in technology in the past half-century have made it possible to create life and to change our genetic destinies. One of these transformative technologies – in vitro fertilization (IVF) – has been available for over forty years but still is not equally accessible to infertile people of all races and socioeconomic backgrounds. Another technology, CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats), is much newer, but near-term widespread access for people of all races and socioeconomic backgrounds similarly seems unlikely. Multiple barriers prevent widespread use of these tools. This raises several ethical questions. Are these technologies ethical? Is it ethical to allow some patients to access these technologies when they are not equally available to everyone? Is there a duty to make these technologies more widely available? Who should bear that responsibility? We will discuss the values of responsibility, justice, and autonomy and consider the consequences of restricted access to these life-changing technologies. Our interactive presentation (including a Kahoot) will enable attendees to better understand some of these issues, which affect us today and will affect future generations as well.
Presentation by: Anyra Kapoor and Alexandra Sinins
Was it ethical for the CDC to withhold information regarding the pandemic in January last year? How should the United States have balanced vaccine allocation to its citizens with global needs? These are only two of the many ethical questions regarding the role of leadership and governments in a pandemic. Most people state that the primary role of governments in a health crisis is to ensure the safety of their own citizens, and therefore do not question the government’s capability to pursue this ideal. However, governments often have access to information and knowledge that the public does not, which introduces the potential for paternalism within government solely deciding what is best for the country. Additionally, on a global scale, the discussion of what it means to be a “global citizen” is occurring everywhere. Some pressing questions include: how should we address the health deficiencies in developing countries, and should this obligation to remedy them fall on the developed nations? In this interactive workshop, we will examine the various dimensions of these ethical dilemmas through case studies, and look at their implications for health rights and the safety of humanity. Using the values of safety, autonomy, justice, and responsibility to focus our discussion, we will formulate our role as global citizens, consequently developing a holistic understanding of what leadership looks like, and what it means to be a leader in a time of dire need.