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Features – Berman Institute Bioethics Bulletin http://bioethicsbulletin.org Bioethics News & Analysis from Johns Hopkins Thu, 25 May 2017 15:02:27 +0000 en-US hourly 1 https://wordpress.org/?v=4.7.5 http://bioethicsbulletin.org/wp-content/uploads/2016/08/cropped-faviconBI-32x32.png Features – Berman Institute Bioethics Bulletin http://bioethicsbulletin.org 32 32 Johns Hopkins Celebrates http://bioethicsbulletin.org/archive/johns-hopkins-celebrates http://bioethicsbulletin.org/archive/johns-hopkins-celebrates#respond Mon, 22 May 2017 16:07:18 +0000 http://bioethicsbulletin.org/?p=36166

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A Bioethical Framework for Opioid Prescribing http://bioethicsbulletin.org/archive/a-bioethical-framework-for-opioid-prescribing http://bioethicsbulletin.org/archive/a-bioethical-framework-for-opioid-prescribing#respond Wed, 17 May 2017 18:39:01 +0000 http://bioethicsbulletin.org/?p=36134

Images via Flickr Attribution Some rights reserved by sfxeric

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Ethical Guidance for the Supermarket http://bioethicsbulletin.org/archive/ethical-guidance-for-the-supermarket http://bioethicsbulletin.org/archive/ethical-guidance-for-the-supermarket#respond Mon, 01 May 2017 20:09:17 +0000 http://bioethicsbulletin.org/?p=36032 Ethical Certification Workshop

March 2017

The US Dept. of the Interior, US Fish and Wildlife Service, National Conservation Training Center in Shepherdstown, West Virginia


Brief Summary


If free-range eggs once occupied a little part of the shelf, now the situation is completely reversed, with a dizzying array of options trumpeting eggs that are organic, or Omega-3 enriched, from hens that are cage-free, local, vegetarian fed, cage-free, or merely enjoying “outdoor access.” As it becomes increasingly complex for consumers to navigate supermarket shelves, the need for ethical guidance and information for consumers grows.


Last year, the Johns Hopkins Berman Institute of Bioethics and the Bloomberg School of Public Health embarked on a project to address this need. A key step involved bringing together a broad range of academic and industry experts to grapple with the myriad debates that emerge around trying to find ethical consensus. To ensure a lively and informed debate, we drew upon the expertise of purchasers, retailers, farmers, water conservation experts, food safety specialists, nutritionists, and academics focused on animal welfare, labor and human rights, crops and agriculture, the environment, and the evaluation of standards.


In preparation for the workshop seven academic members of the team wrote white papers to cover the core subject areas of the project: crop production; animal welfare; water utilization and impact; public health and nutrition; food safety; environmental impact; and labor and community issues. These papers provided on overview of the topic and highlighted moral issues to consider for ethical certification. In addition to providing background information on the subject matter, the white papers were also used to inform the statements of ethical concern formulated as Candidate Criteria. The Candidate Criteria laid the foundation for the workshop.


At the workshop’s end, the group managed to condense an original set of Candidate Criteria from seven categories into four categories of Critical Considerations to guide the design of an ethical certification scheme. These categories include: Environmental Impact & Resource Conservation; Labor & Smallholding Farmers; Community Well-Being; and Animal Welfare. In the end, what we have is not prescriptive, but a template for industry that details what is required for a food to be considered ethical. It will be up to industry to decide and share how they will meet those requirements in a verifiable, transparent way. We envision that industry partners will play a great role in the project’s success, and cheer the industry voices in the debate that helped keep questions of auditability and practicality at the forefront.


We are condensing and finalizing the Critical Considerations and will be sharing these in the very near future.

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Billboards and Breeding http://bioethicsbulletin.org/archive/billboards-and-breeding http://bioethicsbulletin.org/archive/billboards-and-breeding#respond Wed, 26 Apr 2017 13:59:45 +0000 http://bioethicsbulletin.org/?p=35998 Welcome To The Species Barrier… where two vegan, environmentalists question how we interact with the planet and the other animals who call it home. Prepare to have your preconceptions challenged and explore that barrier in place which separates the human animal from other species.


Included on today’s show, guest bioethicist Travis Rieder asks should we be having children in the age of climate change?



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Food Security & Nutrition in Timor-Leste http://bioethicsbulletin.org/archive/food-security-nutrition-in-timor-leste http://bioethicsbulletin.org/archive/food-security-nutrition-in-timor-leste#respond Tue, 18 Apr 2017 14:50:29 +0000 http://bioethicsbulletin.org/?p=35952 Q&A with Becky McLaren


Can you briefly describe the Timor-Leste project and your recent visit to the country?


The project is a strategic review of the food security and nutrition situation in Timor-Leste. We’re working with the World Food Programme, which has done similar work in other countries. We’re evaluating what’s been done in the past and what’s currently going on in order to make recommendations for future work. Our review is framed around the Sustainable Development Goals (SDGs), specifically SDG 2 which aims to end hunger worldwide by 2030.


Our recent trip was an opportunity to develop relationships with our different collaborators, including our main partner in the review, CEPAD; build an outline for the project’s next steps; and meet other stakeholders – government, international and local NGOs, and civil society organizations.


Can you tell us about some of the unique nutrition and food security challenges facing Timor-Leste?


Timor-Leste is a post-conflict country which is still in the window of peacebuilding and becoming more stable. The country was colonized by Portugal until 1975 and then occupied by Indonesia until the UN helped it achieve independence in 2002. There was a reemergence of conflict in 2006, and UN peacekeepers maintained a presence in Timor-Leste until 2012. At the present, the country has a unique opportunity to move beyond creating a stable government and into building food and nutrition security. The government has the chance to restructure the agriculture and food systems.


Timor-Leste also has serious nutrition challenges, with one of the highest stunting rates in the world. About 50 percent of children under five experience stunting, an indication of malnutrition that leads to decreased stature and cognitive ability, among other health effects. This issue is sometimes under-acknowledged in Timor-Leste: people think the Timorese are just shorter than others and that it is not a nutrition problem. But it is an important metric, especially for a country moving forward and developing further


What are your thoughts on the future for Timor-Leste?


I think Timor-Leste has important decisions to make about food and agriculture. Many people want food sovereignty, especially to produce enough rice that the country does not have to rely on imports. Others, especially those outside Timor-Leste, feel this is not the best strategy, as imports are relatively inexpensive, increasing rice production would require major agricultural investments, and it is not the most nutritious crop that could be produced in the country. There are other options: they could focus on horticulture or export crops, such as coffee and spices. These decisions about agriculture and nutrition are key to the country’s future stability and development. For our project, it is important to incorporate local priorities and offer our expertise in a way that supports the Timorese in making their own decisions.



Image: By Nuno_Alex_GM, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=52487512

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Toxicologist Aims To Label Ethical Standards http://bioethicsbulletin.org/archive/toxicologists-aims-to-label-rate-food-producers-ethical-standards http://bioethicsbulletin.org/archive/toxicologists-aims-to-label-rate-food-producers-ethical-standards#respond Wed, 05 Apr 2017 19:29:00 +0000 http://bioethicsbulletin.org/?p=35870

Crossposted from Johns Hopkins Magazine


Toxicologist aims to label, rate food producers’ ethical standards


Greg Rienzi / PublishedSpring 2017


Toxicologist Alan Goldberg knows what an industrial pig nursery should look and smell like. So one with no pigs, no slop, and no aroma was certainly surprising. Goldberg toured such a sanitized—and possibly staged—facility in 2006 while he was part of the 15-member Pew Commission on Industrial Farm Animal Production, tasked to examine how industry practices impact human health, animal welfare, the environment, and rural communities.


The facilities with actual animals in them told a different tale. He recalls one poultry shed in Arkansas that housed 45,000 chickens clustered on a dirt floor that had likely not been cleaned since before the last harvest. Inside, the potent mix of nitrous oxide and ammonia, a byproduct of the chicken feces and urine, made the commissioners’ eyes burn. “The word the Pew Commission used to describe the conditions we saw was ‘inhumane.’ Personally, I would say ‘cruel,'” says Goldberg, a professor of environmental health and engineering at the Bloomberg School of Public Health and the founding director of the school’s Center for Alternatives to Animal Testing.



In its 2008 landmark report, the commission condemned the state of industrial production and made sweeping recommendations, including the ban of nontherapeutic anti­biotics, improved management of food animal waste to lessen contamination of waterways, and the phasing out of intensive animal confinement. The report received wide publicity, but in the eight intervening years little has changed. “The agricultural lobby is incredibly powerful, and the industry still largely unregulated,” he says.


The slow progress drove Goldberg to look for other ways to influence industrial food production practices. One possible tactic: make the food that is ethically produced easier to identify, and let the consumer drive demand. He envisions a comprehensive ethical certification that would rate adherence to multiple criteria related to the environment, animal welfare, labor standards, water utilization and contamination, and food safety. The corresponding label could be a stylized “E” on the package, accompanied by a QR code that consumers can scan to see how the product scored in each category. The philosophy behind the label, which would be the first of its kind, is to create a template of ethical standards for the food industry and better inform consumers about their choices. Ethically produced food, after all, has become big business. The U.S organic food industry posted a record $43.3 billion in sales in 2015.


The project, funded by the Stavros Niarchos Foundation and launched in fall 2016, will first focus on finalizing a set of standards that can be adopted by the food industry. To do this, Goldberg assembled a group of faculty at the Johns Hopkins Berman Institute of Bioethics and recruited an international academic team of seven non-JHU experts in animal rights, health policy, agriculture and food production, ecology, and law. The group will identify the necessary measures to achieve this ethical certification. The trick, he says, will be to make sure they don’t overreach with standards that can’t practically be met, or ones that don’t have sufficient impact.


Ethical labels and the certification process are nothing new, but existing ones are highly specialized and typically focus on just one issue.


A quick scan of grocery store shelves verifies the ever-growing list: Certified Organic, Non-GMO, dolphin-safe, free-range, cage-free, Fair Trade, Animal Welfare Approved, American Grassfed, and so on. Many of these labels’ standards are verified by a third-party audit and require annual renewal.


As part of the project, Goldberg and his team will appraise the standards and certification processes of these existing food labels to determine best practices and flaws in the system. The result will be an online ethical label database to share with industry and consumers. “Some [labels] are very good at what they do,” he says. Others, he cautions, may not be accurate or say anything of value to the consumer.


Goldberg says the transition to more sustainable and humane food production will not necessarily require a significant cost. To go from battery-cage egg production—where hens live confined wing-to-wing in wire cages—to a facility that is still industrial but offers the chickens some freedom of movement increases the cost per egg at the retail level by roughly 1 cent, he says. He compares this relatively modest change to a turkey farmer switching from a factory farm system to pasture-raised birds that roam in open fields. “I don’t expect every company to produce every food to the highest ethical standard. There are certainly associated costs and might not be advantages,” he says. “But there are basic things we need to be concerned about, such as the overuse of pesticides, animal cruelty, and the utilization of water.”


Ethical branding has already had a significant impact on the food industry. Goldberg points to the example of “free-range,” a term that consumers increasingly look for when shopping for eggs. In the past two years, dozens of goliath companies including McDonald’s, 7-Eleven, Dunkin’ Donuts, Costco, Nestlé, and Target have committed to selling only free-range eggs by 2025. Goldberg says many of these same large companies could be early adopters of the label to woo the growing number of ethically conscious consumers.


But Johns Hopkins will not get into the business of certifying food. Goldberg says the university will likely license the intellectual property to an independent entity, which will act as the certification-granting body and perform annual audits to make sure the standards are being upheld.



Original Article

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Jeff Kahn on WYPR Midday http://bioethicsbulletin.org/archive/jeff-kahn-on-wypr-midday http://bioethicsbulletin.org/archive/jeff-kahn-on-wypr-midday#respond Mon, 03 Apr 2017 14:51:22 +0000 http://bioethicsbulletin.org/?p=35239


Jeffrey Kahn, PhD, MPH,  Andreas C. Dracopoulos Director of the Johns Hopkins Berman Institute of Bioethics, appears regularly on WYPR’s Midday show with Tom Hall to discuss pressing ethics issues related to current scientific and technological advances.


Here is an archive of Prof. Kahn’s appearances on Midday with Tom Hall:



Informed Consent and the Extraordinary Story of Baltimore’s Henrietta Lacks

April 5, 2017


Midday on Ethics: HBO and Oprah Winfrey will bring the story of Henrietta Lacks to television. The film, “The Immortal Life of Henrietta Lacks,” based on the best-selling book of the same name by Rebecca Skloot, premiers on April 22.  You may already be familiar with the story of Henrietta Lacks, who lived in southeastern Baltimore County in the early 1950s. She had cancer, and in 1951, doctors at Johns Hopkins Hospital did a routine biopsy. She died eight months later. But her cells live on, because without her consent, and without the knowledge of her family, cells taken during the biopsy were used, for decades, in medical research around the world.   In fact the HeLa cell line — H-E for Henrietta and L-A for Lacks — revolutionized medical research, and, by some accounts, has resulted in billions of dollars worth of medical breakthroughs. None of the proceeds, however, went to Ms. Lacks or to her descendants. Could the same thing happen today? We’ll try to untangle the ethical questions in this conversation about Informed Consent. How much have standards changed in the 65 years since Henrietta Lacks was a cancer patient at Hopkins? What are today’s standards?

New Report Sets Guidelines for Genome Editing

February 15, 2017


Genome editing, that is the ability to make additions, deletions, and alterations to the genome of a human or animal, is not a new. Scientists have been experimenting with it in labs for a while to better understand the way some diseases and disabilities work. But now a new report released yesterday from the National Academy of Sciences and the National Academy of Medicine sets international guidelines for genome editing. New editing tools like CRISPR have opened up the doors for more lab and clinical research projects. The scientists behind the report hope their guidelines will serve as a roadmap to help other scientists avoid the ethical concerns associated with gene editing.

Bioethics With Dr. Jeffrey Kahn: A Question Of Assisted Suicide

January 24, 2017

Some people call it “assisted suicide.” Others prefer the terms “death with dignity,” “aid to the dying,” or “the right to die.” Whatever the label, nearly 20 percent of Americans now live in places where it’s legal. Washington, DC is one of those places. Maryland is not.  Should it be?

Bioethics With Dr. Jeffrey Kahn: Autonomous Car Safety

December 15, 2016


Every scientific advancement comes with a slew of questions. Take autonomous cars, for example.   In an accident, whose lives should a driverless vehicle be programmed to protect?   Passengers in the car, or people on the street? The field of bioethics addresses the complicated ethical dilemmas that researchers and policy makers face in an ever-changing modern world.

Questions in Bioethics: Genetically Modified Animals, and Now Humans

October 13, 2016


We thought we’d start by talking about the public health issue that has dominated the headlines since this summer. The Zika virus grabbed the public health spotlight and spread like crazy in certain parts of the world, including an outbreak that has been controlled in the Miami area. One of the approaches to eliminating the virus that scientists are considering involves genetically modifying mosquitoes and then releasing them into the environment. On the surface, it may seem that changing the genetic make-up of some insects shouldn’t be cause for alarm. But like so many of the issues that Jeff Kahn and his colleagues consider, it’s not that simple.
Dr. Kahn also weighs in on the topic of babies now being born with more than two biological parents. They actually carry the genetic material of three parents. To the parents who otherwise might not have biological children, the technology that makes this possible is a blessing. But is it a good idea? What are the consequences of these new possibilities? Tom asks Dr. Kahn about framing the questions we should be asking in bioethics, to find the answers we need.

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Moral Basis for Small Families http://bioethicsbulletin.org/archive/moral-basis-for-small-families http://bioethicsbulletin.org/archive/moral-basis-for-small-families#respond Tue, 28 Mar 2017 15:48:43 +0000 http://bioethicsbulletin.org/?p=35797 Part One:

Part Two:

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Would You “Donate” Your Kidney for $1,000? http://bioethicsbulletin.org/archive/would-you-donate-your-kidney-for-1000 http://bioethicsbulletin.org/archive/would-you-donate-your-kidney-for-1000#comments Thu, 16 Mar 2017 16:27:40 +0000 http://bioethicsbulletin.org/?p=35720 Crossposted from Rising to the Challenge, The Campaign for Johns Hopkins


Nearly 100,000 Americans sit on the waiting list for kidney donations, but only about 17,000 of the organs are transplanted each year — despite the fact that living donors can provide kidneys. What could help close the gap between the need and the supply? Might providing some kind of altruistic incentives or financial compensation for donors be a step toward saving thousands of lives, and with what ethical implications?


That thorny question is one of nine that Hopkins faculty are examining with Exploration of Practical Ethics grants administered by the Berman Institute of Bioethics. Established in part by a generous gift from university trustee Andreas Dracopoulos, the program funds one-year pilot studies that address key questions in professions and scholarly disciplines, within institutions, and throughout society.


“Research institutions like Hopkins are perfect for this kind of inquiry, because we don’t just produce graduates who can go out into the world and solve these problems. We produce the thought processes that inform the way future leaders will make decisions,” says Maria Merritt, an associate professor in the Berman Institute and Bloomberg School of Public Health. Merritt is overseeing the portfolio of funded awards in her role as program officer for the Exploration of Practical Ethics effort.


Vikram Chib and Mario Macis


Informing the debate over the ethics of payments for organ donation is the goal of a project proposed by Mario Macis, an associate professor in the Carey Business School, Vikram Chib, an associate professor in the Whiting School of Engineering, and Nicola Lacetera, an associate professor at the University of Toronto.


“The discussion is essentially the same today as it was 30 years ago,” Macis says. Anti-market advocates say paying for organs is “against human dignity,” or a market would create undue coercion or pressure to donate. But, Macis says, these are assumptions based on public sentiment, not empirical evidence. Because paying for organs is illegal in the United States, a potential model to test a market for organ donation has not been tested — a circumstance Macis and his team seek to change with support from an Exploration of Practical Ethics grant.


Along with co-investigator Jeffrey Kahn, the Andreas C. Dracopoulos Director of the Berman Institute, Macis and Chib designed an experiment that simulates the ethical and economic dimensions of a market for organ donations. Participants engage in activities that will allow the investigators to examine how motivations such as altruism, personal financial gain, and tolerance for pain determine individual choices, as well as how certain areas of the brain behave when people make these decisions.


“We’d talked about this kind of approach a while ago at a symposium, but the call for proposals for this grant really helped us solidify this idea,” Chib says.


The Exploration of Practical Ethics Program, particularly its seed funding, is also important, Macis says, because external grant providers might perceive this kind of experiment – and the sensitive societal issue it addresses – to be too risky an investment.


“With this grant we’ll produce a pilot study that will essentially be our proof of concept, the foundation on which we can apply for grants to expand this research,” Macis says.


Macis, Chib, and Kahn, as well as the other Exploration of Practical Ethics grant recipients, presented their work at a January 2017 symposium at the Bloomberg School of Public Health. The other projects and their investigators are:



For more information about the how to support Exploration of Practical Ethics program the Berman Institute of Bioethics, please contact Joshua Else, associate vice president for development. Give Your Support: BERMAN INSTITUTE OF BIOETHICS



SEE ALSO: Round two: RFPs open for funding to support practical ethics activities

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An Emerging Public Health Crisis http://bioethicsbulletin.org/archive/an-emerging-public-health-crisis http://bioethicsbulletin.org/archive/an-emerging-public-health-crisis#respond Fri, 10 Mar 2017 14:15:38 +0000 http://bioethicsbulletin.org/?p=35368 The Executive Order on Refugees: An Emerging Public Health Crisis


March 10, 2017 Update:


New in The Lancet: The Revised US Refugee Ban, Health, and Security, Leonard Rubenstein and Paul Spiegel

“The new order suspending and then shrinking the refugee resettlement programme does not bring any security gains and imposes tremendous mental and physical harm on people who have suffered more than most of us can even imagine. Let them in.”


February 21, 2017 Update:


Ethics, Refugees, and the President’s Executive Order, Nancy Kass, ScD

“The values emblematic of our country are often thought to include deep commitments to individual liberties and to entrepreneurship, but also empathy for others, care for the sick, and broad interests –regardless of how we get there– in lifting the tide for all. Mogens Lykketoft, former UN General Assembly President said, “The genuine loss and pain these people are suffering should be unbearable for all of us.

This sentiment should exemplify our common morality.”



The Executive Order on Refugees: An Emerging Public Health Crisis


Please note, due to technical difficulties with sound recording, the first few minutes lack audio, audio begins at 4:15.


via Johns Hopkins HUB


The Johns Hopkins University Bloomberg School of Public Health hosted a symposium examining the consequences of President Donald Trump’s executive order suspending the U.S. refugee admission program.


The symposium, “The Executive Order on Refugees: An Emerging Public Health Crisis,” took place in the Bloomberg School’s Sommer Hall on JHU’s East Baltimore campus and was cosponsored by the Johns Hopkins Berman Institute of Bioethics.

The executive order, signed Friday, blocks entry into the U.S. (with very narrow exceptions) of individuals from seven nations—Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen—for 90 days. The order also immediately suspends, for 120 days, the U.S. Refugee Admissions Program, during which time refugees will not be admitted to the United States.


On Friday, two dozen faculty members joined Michael J. Klag, dean of the Bloomberg School, in publishing an open letter to President Trump urging against the action.


“We write as researchers and scientists, but we also share our deep concern that the proposed executive order ignores decades-long policy and law of the United States to provide a haven for people suffering persecution on account of nationality, membership in social group, political opinion or religion,” the letter states. “Instead, it prioritizes admission of refugees on the basis of religious-based persecution over the needs of people suffering from political oppression in the Middle East and throughout the world.”


The symposium featured discussions on a range of topics, including an on-the-ground perspective of the Syrian refugee crisis; the U.S. refugee resettlement program; the health of refugees and displaced people in Iraq (including Yazidis) and Syria; and public health and bioethics concerns related to the refugee crisis.


Speakers at the symposium included Zaher Sahloul, the former president of the Syrian American Medical Society; and David Rocah, a senior staff attorney with the American Civil Liberties Union of Maryland.


Johns Hopkins faculty participants included:



Image By Haeferl – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=24789650

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