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Curious Bioethics: May 15-21, 2023
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Dr. Burgart pulls the curtain aside on the House of Medicine, revealing how injustice and politics impact patients—equipping you to discuss complex issues with wit, confidence, and clarity.
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Curious Bioethics

Curious Bioethics: May 15-21, 2023

Parental grief, North Carolina's abortion law, a star poem & a stats lesson

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Alyssa Burgart, MD, MA
May 21, 2023
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Curious Bioethics: May 15-21, 2023
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Hey there, Curious Human!

Bravely engaging with difficult information is how we heal and find our way in uncertain times. I’m grateful to you for seeing pain without looking away. For being curious, even when it hurts.

In today’s curated collection, you’ll find:

  • Bioethics in the News: parental grieving after denied abortions, North Carolina’s new abortion restrictions, gun violence tormenting our kids.

  • What I’m Reading: poem Dead Stars

  • Educational Opportunities: clarifying statistics, Nazi Doctors

Thank you for reading Curious Bioethics: Curated Bioethics for Curious Humans! This post is public so feel free to share it.

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Bioethics in the News

‘The law has created torture’

The Washington Post followed Florida’s Dorbert family as they were denied an abortion, despite their fetus having Potter syndrome. In this rare and fatal condition, their baby would live hours, if he survived the pregnancy at all.

Milo Evan Dorbert drew his first and last breath on the evening of March 3. The unusual complications in his mother’s pregnancy tested the interpretation of Florida’s new abortion law.

The state’s ban on abortion after 15 weeks of gestation has an exception for fatal fetal abnormalities. But as long as their baby’s heart kept beating, the Dorberts say, doctors would not honor their request to terminate the pregnancy. The doctors would not say how they reached their decision, but the new law carries severe penalties, including prison time, for medical practitioners who run afoul of it. The hospital system declined to discuss the case.

Instead, the Dorberts would have to wait for labor to be induced at 37 weeks.

You can read more about their journey here. In addition to their parents’ grief, the story also explores the grief of their baby’s brother (a toddler) and his grandfather.

Image: Osmosis by Elsevier

North Carolina’s Abortion Shutdown

North Carolina’s Republican supermajority overrode the Democratic governor’s veto of its 12-week abortion ban. At least 88% of abortions in the state take place before 12 weeks, but the law also adds a new requirement for in-person visits for patients and significant licensing restrictions on abortion clinics - requiring them to comply with ambulatory surgical centers. These changes make it significantly harder for pregnant people in other southern states to travel to North Carolina for care. The state already has a 72-hour waiting period for abortions, but the in-person visit requirement means patients would need to be in the state for several days or make multiple trips. The law also strengthens the state’s requirement that drugs like mifepristone be taken while being observed by a physician, even though these drugs are safe to take at home.

The legislature chose these restrictions over a statewide ban because it has become increasingly apparent that abortion restrictions are unpopular among Republicans.

Gun Violence Cited as #1 Public Health Threat

A new poll by Axios/Ipsos found that access to guns and firearms is now considered one of the top threats to public health, alongside opioids and fentanyl. Since February, the number of Americans citing guns as their top concern has increased significantly.

  • Following several recent mass shootings, more than one in four (26%) believe access to guns is the #1 threat to public health at this moment, roughly tied with opioids and fentanyl (25%).

  • This represents a nearly 10 percentage point increase from earlier this year (26% now, 17% in February).

  • Access to guns tops the list among Black Americans (49% cite this as their #1 concern), Democrats (50%), and those living in urban areas (31%).

With more than 1,000 incidents since 2018 and 98% of K-12 public schools implementing active-shooter drills, it should be no surprise that gun violence torments our kids.

Dr. Katie Donnelly, a pediatric emergency medicine physician at Children's National Hospital in Washington, D.C., said that she interacts "with a lot of kids who really aren't thinking about what they want to be when they grow up because they don't have an expectation that they're going to grow up."

Data: Center for Homeland Defense and Security; Note: Includes any incident when a gun is "brandished, is fired, or a bullet hits school property for any reason." Chart: Tory Lysik/Axios Visuals

How Much Worse Are Things for Trans Folks?

Yesterday,

Erin Reed
released the May 2023 Anti-Trans Legislative Map. The map below shows the deeper, more violent divide against trans people in the US. Florida’s laws are now so restrictive that the state is now labeled “Do Not Travel.” Many of these new restrictions directly prevent children and their parents from accessing evidence-based care as recommended by physicians, nurse practitioners, and reputable professional organizations.

The emotional and psychological trauma of rejection, whether by family, friends, society, or lawmakers, can leave scars that never heal. When we fail to accept people for who they are, we pass painful judgements on them and create so much unnecessary emotional and psychological pain. 

- Moira Szilagyi, MD, PhD, FAAP

American society seems determined to bring as many children into the world as possible so that they can be shot at school or neglected/bullied out of existence.

What I’m Reading This Week

Dead Stars: Poet Laureate Ada Limón’s Stunning Love Poem to Life

Not all death talk is awful… I promise…

Everything in the known universe is made of stardust, including us humans. Maria Popover describes us as “creatures of matter, capable of seeing beauty, capable of making meaning.” Ada Limón’s poem explores this interplay of existence and meaning beautifully.

Look, we are not unspectacular things.
      We’ve come this far, survived this much. What

would happen if we decided to survive more? To love harder?

What if we stood up with our synapses and flesh and said, No.
      No, to the rising tides.

- Ada Limón

You can read the whole gorgeous poem and even listen to the poet read it to you here.

Educational Opportunities

Figures don’t lie, but liars can figure.

I’m not some statistical genius, so I really appreciate finding someone who can break down complex figures and make them digestible. Stats PhD student Kareem Carr expertly breaks down a misleading representation of race-related violence data on Twitter that I highly recommend checking out. It’s a wonderful lesson in the ways our brains can be easily tricked by the way data is presented.

SUMMARY: This is a bad use of data. - misleading format - poor organization - missing context - confounding by age, income and probably many other factors - naive use of a poor outcome measure (violent crime)

Learning about the Holocaust

I’m concerned by the number of people I talk to who haven’t learned much about the Holocaust - a continent-wide genocide. There have been many terrible genocides, the extensive German record-keeping provides a unique opportunity to examine the details and learn how to prevent its repetition.

There are so many bioethics issues today that can easily be threaded back to the Holocaust - research ethics, human dignity, and the role of physicians in supporting racist, ableist notions of human worthiness. Countless books, documentaries, feature films, podcasts, and websites are devoted to sharing the stories of the harms of white supremacy and nationalism.

The Holocaust Encyclopedia offers a well-organized site place to start. If you’re curious about the role of Nazi physicians in the Holocaust, check out this page.

That’s it!

As always, thanks for being curious. 🙏

Hit reply or comment and let me know what ethics issues you are most curious about —I’d love to hear from you! Looking for a deep dive into a particular ethics or medicine issue? Please let me know - I’m always looking for new topics to share with you.

See you next week!

Be Well & Be Curious,

Alyssa


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By Alyssa Burgart · Launched 4 years ago
Dr. Burgart pulls the curtain aside on the House of Medicine, revealing how injustice and politics impact patients—equipping you to discuss complex issues with wit, confidence, and clarity.
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