essay draft

Draft 1, Choose one of the Essay topic below write one paragraph (1/2 page) describing three important moments from history of topic, 1960+.

· Possible topics for the research paper include,

1.Human tissue. Who owns bone, sinew, corneas, and other saleable body parts? Who can consent to its post-mortem removal? What do state statutes say about the nonconsensual removal of human tissue? Why does federal law prohibit the sale of solid organs but permit the sale of other human tissue (and blood, sperm, and ova)? Do the rules that govern these activities sufficiently protect the interests that need to be protected? Or do they go too far and discourage an efficient market?

2.Physician-assisted suicide (PAS).Oregon is the only state to have legalized the practice. The Supreme Court has ruled that considerations of neither due process nor equal protection compel states to allow the practice and that the Department of Justice may not prosecute Oregon physicians who participate in PAS. Your paper can go in lots of different directions. Should other states follow Oregon’s lead? Is there an equal-protection argument that once a state has legalized PAS, it must also legalize active euthanasia? What can we learn from the practices of other countries?

3.Patentatibility of genetic code. Should genetic researchers be able to obtain patents on “raw” genetic code? What should the Patent and Trademark Office’s policy be on demonstrating “utility” in order to obtain a patent for a snippet of DNA?

4. Is “brain dead” really dead? All 50 states and the District of Columbia have rules that define death in terms of the irreversible cessation of all neurological functioning. This notion of “brain death” has been around since 1968, when the Harvard Medical School Report on “irreversible coma” (now regarded as something of a misnomer) was issued. Yet, just as soon as we as a nation seem to have become comfortable (more or less) with the concept, it is coming under increasing scrutiny and criticism. Is it internally inconsistent? Is it a snow job by the transplant community? Are the NY and NJ variations the way of the future? Is neocortical death preferable to whole-brain criteria for determining when death occurs?

5.Charity Care. Texas requires its not-for-profit hospitals to provide charity care as a quid pro quo for tax-exempt status. A dozen or more states do the same, and more states are jumping on the charity- care bandwagon every month. The federal government used to require charity care as a prerequisite for tax-exempt status, but it dropped that requirement in 1968. Should it resurrect the charity-care requirement? If so, what should it look like? What are the pitfalls illustrated by various state experiments in this field? Is there a better way to deal with the problems of providing health care for the indigent and uninsured?

6. Anecephalic newborns. Medical texts usually refer to anencephaly as a condition that is “incompatible with life” or to anencephalic newborns as “born dying.” Despite this, a few yearsa go, the Florida Supreme Court said the organs of a baby born with no neo-cortical hemispheres could not be donated because the baby was still alive under Florida law. (The AMA once opined that anencephalics should be regarded as an exception to the requirement that organ donors be dead and then turned around at its next session and revoked its own ruling.) A few years later, the 4th Circuit Court of Appeals said that a Virginia emergency room had an obligation under federal Medicare law to treat the respiratory distress of an anencephalic infant who was brought to the ER from a local nursing home. Do we need to rethink the law’s response to anencephaly? Or are anencephalic newborns entitled to the same level of protection as any other member of

society?

7. Demands for futile treatment. Surrogate decision makers often ask that “everything be done” for a patient. Sometimes they are more specific. Occasionally this request is for treatment deemed by the medical team to be “futile.” Should physicians be able to withhold or withdraw nonbeneficial interventions? If so, under what circumstances? What process values should be respected?

8. Should the U.S. Congress ban all human cloning (“reproductive” and “therapeutic” cloning)? The distinction between types of cloning activity is driven by the desire of many to create new sources of embryonic stem cells by creating new embryos. What are the arguments for and against both types of cloning? Which do you find persuasive and why? Note: the President’s Commission on Bioethics has weighed in on this topic with its first report.

9. Ethics of third-world drug research. Drug companies have been accused of running drug-testing protocols in third-world countries that would be unethical and impossible to run in the U.S. Other times, they have been criticized for testing drugs that will eventually be marketed at a price the third-world countries won’t be able to afford. What should the rules be for such research?

10. Medical decision making for minors. What should the standards be for reviewing and overruling parental medical choices? You might focus on one set of such decisions (end-of-life decisions,decisions by Christian Scientists, etc.) for your analysis.

11. Sex selection (and other genetic manipulations). What limits, if any, should be placed on the ability of prospective parents to guide or alter the genetic makeup of their offspring?

12. Medicine and capital punishment. Should physicians be allowed to medicate prisoners to make them competent for trial? For execution? The AMA has opinions on this; are they correct? Are they even coherent? And are they on a collision course with the Eighth Amendment’s prohibition of cruel and unusual punishment?

13. Human tissue. Who owns bone, sinew, corneas, and other saleable body parts? Who can consent to its post-mortem removal? What do state statutes say about the nonconsensual removal of human tissue? Why does federal law prohibit the sale of solid organs but permit the sale of other human tissue (and blood, sperm, and ova)? Do the rules that govern these activities sufficiently protect the interests that need to be protected? Or do they go too far and discourage an efficient market?

14. Access to experimental drugs. Do terminally ill patients have a constitutional right to get access to experimental drugs without enrolling in a clinical trial? A divided panel of the DC Circuit said yes in a May 2, 2006, opinion. In fact, they concluded that the constitutional right is fundamental and that the appropriate test of any rule limiting access is strict scrutiny. This is an opinion of potentially far-reaching consequences for patients, health care providers, payors, and the future of clinical drug trials in this country