Ruth Macklin, PhD

Ruth Macklin is a professor, department of epidemiology and population health, Albert Einstein College of Medicine, Bronx, NY. She blogs at the Doctor’s Tablet.

Is the National Institutes of Health stifling academic freedom?

Ruth Macklin, PhD

Physician

September 4, 2019

An episode pitting top administrators at the National Institutes of Health (NIH) against senior scientists at the organization serves as a vital reminder of the importance of academic freedom and the need to communicate and express concerns about scientific research.

NIH administrators prohibited two of its senior scientists from speaking out about a research study the scientists claim has serious flaws (Crystalloid Liberal or Vasopressors Early Resuscitation in …

How can we fix the research bias from industry sponsorship?

Ruth Macklin, PhD

Policy

April 18, 2019

Late last year the New York Times reported that Dr. José Baselga, the chief medical officer of Memorial Sloan Kettering Cancer Center, had resigned for failing to disclose his conflicts of interest at professional meetings and in scientific and medical journals. The Times report says that Dr. Baselga — who also served as physician-in-chief at the center — “had failed to disclose millions of dollars in payments from health care companies in …

The erosion of informed consent in medical research

Ruth Macklin, PhD

Conditions

August 21, 2018

The bedrock requirement to obtain informed consent before patients may be enrolled in research has been eroding. I’ve documented the different ways and different reasons for this several times over the years (“Informed Consent for Babies: When Experts Disagree,” “Informed Consent in Infant Research: Ethical Problems Remain,” “Informed Consent in Comparative Effectiveness Research,” and “The Erosion of Informed Consent in Medical Research”). The latest example is a clinical trial of …

Why a study of medical resident hours was unethical

Ruth Macklin, PhD

Education

April 30, 2016

In a recent post, I wrote about the iCOMPARE research study that is comparing the effects of increasing medical residents’ consecutive duty hours with observing the currently prescribed limits on their shifts. According to the study protocol, the primary hypothesis of the research addresses the safety of patients: that mortality under the increased residents’ duty hours will not significantly exceed patient mortality under the current mandated standard for medical residents on …

Editing the genes of human embryos: A line that should not be crossed

Ruth Macklin, PhD

Conditions

May 14, 2015

In my work as a bioethicist, I have very rarely taken an “absolutist” position regarding the use of a biomedical technology. But when I read an article titled “Chinese Scientists Edit Genes of Human Embryos, Raising Concerns,” my reaction was that this should not be done. I am not alone.

The technique mentioned enables genes to be altered in every cell …

The time to regulate e-cigarettes is now

Ruth Macklin, PhD

Meds

January 25, 2015

A new revelation has added to the ongoing controversy over the health risks of e-cigarettes. Some commentators have viewed the use of this electronic delivery system for nicotine as a way for smokers to cut down on tobacco cigarettes or quit the habit altogether. Others have contended that e-cigarettes can be a “gateway” to smoking and may actually increase …

Forced chemotherapy in a teen: Exploring the ethics

Ruth Macklin, PhD

Conditions

January 16, 2015

The case of Cassandra C., a 17-year-old in Connecticut who refused to continue receiving chemotherapy to treat her Hodgkin’s lymphoma, poses a genuine ethical dilemma. The dilemma stems from a conflict between two leading ethical principles. One principle, respect for autonomy, calls for respecting individuals’ right to self-determination. In the medical context, that means allowing people to refuse medical treatment, even lifesaving therapy. The other ethical principle, beneficence, directs physicians and hospitals to …

The ethics of researching Ebola

Ruth Macklin, PhD

Conditions

November 12, 2014

As we learn of new suspected cases of Ebola infection in the United States, causing worries among the population and renewed efforts by the Centers for Disease Control and Prevention to contain the epidemic.

A student in the postgraduate course in research ethics that I teach at Albert Einstein College of Medicine recently asked whether we could discuss the Ebola epidemic in class. Because I had prepared the syllabus for the course months ago, I hadn’t …

Read more…

The ethics of researching Ebola

Curb the soaring costs of vaccines

Ruth Macklin, PhD

Meds

September 30, 2014

Few medical interventions have been as successful as vaccines in improving public health.

Whether they are childhood vaccinations, vaccines to prevent healthy adults from contracting influenza or the more recent HPV vaccine for adolescents, these preventive methods have resulted in dramatic benefits for individuals and the public. We have only to think of the eradication of smallpox and the virtual eradication of poliomyelitis to see the enormous benefits vaccines can bring. …

Read more…

Curb the soaring costs of vaccines

Hospitals should not control the decisions of pregnant women

Ruth Macklin, PhD

Policy

September 5, 2014

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Doctors, hospitals and judges have over the years attempted to control the decisions of pregnant women. In a recent Florida case, it’s not clear whether the controllers sought to protect the fetus, the woman or both. They may have wanted to protect the hospital from potential liability.

The case involved a 39-week-pregnant woman.

According to a press release issued by the National Advocates for …

Conducting research without the consent of the research subject

Ruth Macklin, PhD

Education

July 16, 2014

A new study poses one of the most vexing ethical questions concerning research with human beings: When is it acceptable to conduct research without the consent of the research subject?

In emergency situations, patients often arrive at the hospital unconscious or with severely impaired decision-making capacity. Progress in medical practice depends on results from carefully designed research; yet in these emergency cases such patients are unable to fulfill one of the …

The advance directive impact of PET scans in vegetative states

Ruth Macklin, PhD

Physician

June 13, 2014

One typically thinks of advances in medical science and technology as having unalloyed benefits. The ability to cure illness, the mitigation of pain and the possibility of making diagnoses that are more accurate are some of the uncontroversial results of medical progress. Yet as a new study of vegetative states demonstrates, such advances can raise ethical quandaries for physicians and the families of patients diagnosed as vegetative.

After the botched execution: It’s time to lift the veil of secrecy

Ruth Macklin, PhD

Physician

May 19, 2014

With new revelations emerging every day about the botched execution of a prisoner in Oklahoma, even those who favor the death penalty (I am a strong opponent) may have some reservations about the way it is carried out. Despite the uproar from both sides, I believe there are some major ethical considerations that have been overlooked in this case.

Setting aside for a …

E-cigarettes lack scientifically based guidance

Ruth Macklin, PhD

Meds

April 17, 2014

The debate over e-cigarettes has been heating up. Are the smokeless, battery-powered, nicotine-dispensing devices a gateway to smoking for young people or a helpful way for smokers to quit? Public health experts can be found on both sides of the debate.

An article in the New York Times cited two leading figures, Dr. Michael Siegler from Boston University and Dr. Stanton A. Glantz from the University of California, San …

The wishes of the patient and family versus fetal rights

Ruth Macklin, PhD

Physician

January 19, 2014

Numerous strategies by antiabortion groups to curb women’s constitutional right to abortion are frequently reported in the news, and come as no surprise. However, a recent development illustrates novel circumstances in which people are using legal maneuvers to conspire to restrict medical decisions by patients and their families even when the right to abortion is not at issue.

On January 8, 2014, a front-page story in the New York Times Read more…

The wishes of the patient and family versus fetal rights

How should personal genetic tests be regulated?

Ruth Macklin, PhD

Conditions

December 26, 2013

Many people have heard of the company 23andMe; hundreds of thousands throughout the world have used the company’s Personal Genome Service (PGS), which provides a report that offers detailed information about an individual’s DNA. For $99, a consumer receives a test-tube kit from the company, fills the tube with saliva and sends it back. The company then performs a DNA analysis and provides information about the person’s health risks, ancestry …

The ethics of paying living kidney donors

Ruth Macklin, PhD

Conditions

November 20, 2013

The very idea of living individuals selling body parts prompts revulsion in some people, while others may ask whether the price is right.

A recent nbcnews.com article reported on an organ-transplant study conducted by Canadian researchers. It began with this finding: “Paying living kidney donors $10,000 to give up their organs would save money over the current system based solely on altruism—even if it only boosts donations by a conservative 5 percent.”

Actually, the …

Is the use of gestational surrogates in India ethical?

Ruth Macklin, PhD

Physician

October 22, 2013

The use of gestational surrogates in India is a booming business, but is it ethical?

This growing practice involves individuals and couples from countries in Western Europe, North America, Israel, Japan and elsewhere who work through brokers to have their genetically related offspring carried through pregnancy and birth by Indian women.

An estimated $500 million to $2.3 billion (U.S.) changes hands among commissioning couples, infertility clinics, brokers and Indian women who choose this way …

Ruth Macklin, PhD

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