Fiester, Autumn

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Now showing 1 - 10 of 26
  • Publication
    Creating Fido's Twin: Can Pet Cloning be Ethically Justified
    (2005-08-01) Fiester, Autumn
    Taken at face value, pet cloning may seem at best a frivolous practice, costly both to the cloned pet's health and its owner's pocket. At worst, its critics say, it is misguided and unhealthy - way of exploiting grief to the detriment of the animal, its owner, and perhaps even animal welfare in general. But if the great pains we are willing to take to clone Fido raise the status of companion animals in the public eye, then the practice might be defensible.
  • Publication
    The "Difficult" Patient Reconceived: An Expanded Moral Mandate for Clinical Ethics
    (2012-05-01) Fiester, Autumn
    Between 15%-60% of patients are considered “difficult” by their treating physicians. Patient psychiatric pathology is the conventional explanation for why patients are deemed “difficult.” But the prevalence of the problem suggests the possibility of a less pathological cause. I argue that the phenomenon can be better explained as responses to problematic interactions related to healthcare delivery. If there are grounds to reconceive the “difficult” patient as reacting to the perception of ill treatment, then there is an ethical obligation to address this perception of harm. Resolution of such conflicts currently lies with the provider and patient. But the ethical stakes place these conflicts into the province of the ethics consult service. As the resource for addressing ethical dilemmas, there is a moral mandate to offer assistance in the resolution of these ethically charged conflicts that is no less pressing than the more familiar terrain of clinical ethics consultation.
  • Publication
    When It Hurts to Ask: Avoiding Moral Injury in Requests to Forgo Treatment
    (2014-03-01) Fiester, Autumn
    Clinicians commonly believe that "there is no harm in asking" patients with life-threatening illnesses if they would like to forgo aggressive therapy. In fact, many clinicians believe that the question is not only appropriate, but obligatory on grounds of patient empowerment and autonomy: Patients should be given all options, including the option to stop treatment. But in this piece, I argue that there is, indeed, serious -- and even traumatic -- harm in asking patients to forgo treatment if that request is perceived by the patient as evidence that the clinician devalues or questions the integrity of that patient's life. When such requests are perceived to imply: "Your life is not worth saving," the effect of the "ask" is insult and offense, not empowerment. I then argue how clinicians can avoid moral injury in conversations about withholding or withdrawing treatment.
  • Publication
    Why the Omega-3 Piggy Should Not Go to Market
    (2006-12-01) Fiester, Autumn
    The paper in your April issue by Lai et al. entitled "Generation of cloned transgenic pigs rich in omega-3 fatty acids" (Nat. Biotechnol. 24, 435–436, 2006) perfectly captures the fundamental problem with American biotech research. That problem is that scientists pursue their research agenda to further scientific knowledge - all well and good - but when the project succeeds they invent problems for which their research results can be marketed as a solution. This unreflective move from 'pure science' to commercialization may end up as biotech's undoing.
  • Publication
    Physicians and Strikes: Can a Walkout Over the Malpractice Crisis Be Ethically Justified?
    (2004-01-01) Fiester, Autumn
    Malpractice insurance rates have created a crisis in American medicine. Rates are rising and reimbursements are not keeping pace. In response, physicians in the states hardest hit by this crisis are feeling compelled to take political action, and the current action of choice seems to be physician strikes. While the malpractice insurance crisis is acknowledged to be severe, does it justify the extreme action of a physician walkout? Should physicians engage in this type of collective action, and what are the costs to patients and the profession when such action is taken? I will offer three related arguments against physician strikes that constitute a prima facie prohibition against such action: first, strikes are intended to cause harm to patients; second, strikes are an affront to the physician-patient relationship; and, third, strikes risk decreasing the public's respect for the medical profession. As with any prima facie obligation, there are justifying conditions that may override the moral prohibition, but I will argue that the current malpractice crisis does not rise to the level of such a justifying condition. While the malpractice crisis demands and justifies a political response on the part of the nation's physicians, strikes and slow-downs are not an ethically justified means to the legitimate end of controlling insurance costs.
  • Publication
    Commentary: The Questions We Shouldn't Ask
    (2012-01-01) Wahlert, Lance; Fiester, Autumn
  • Publication
    The Failure of the Consult Model: Why "Mediation" Should Replace "Consultation"
    (2007-02-01) Fiester, Autumn
    Ellen Fox and her colleagues (Fox, Myers and Pearlman 2007) have generated a rich set of data about ethics consultations in US hospitals that raise serious concerns about this mode of conflict resolution. Using the data they have collected, I want to highlight several issues that question the ethical legitimacy of the ethics consult service (ECS) model, and I want to argue that it may be time to replace ethics consultation with ethics mediation.
  • Publication
    Justifying a Presumption of Restraint in Animal Biotechnology Research
    (2008-06-01) Fiester, Autumn
    Articulating the public’s widespread unease about animal biotechnology has not been easy, and the first attempts have not been able to provide an effective tool for navigating the moral permissibility of this research. Because these moral intuitions have been difficult to cash out, they have been belittled as representing nothing more than fear or confusion. But there are sound philosophical reasons supporting the public’s opposition to animal biotechnology and these arguments justify a default position of resistance I call the Presumption of Restraint. The Presumption of Restraint constitutes a justificatory process that sets out the criteria for permitting or rejecting individual biotechnology projects. This Presumption of Restraint can be overridden by compelling arguments that speak to a project’s moral and scientific merit. This strategy creates a middle-of-the-road stance that can embrace particular projects, while rejecting others. The Presumption of Restraint can also serve as a model for assessing moral permissibility in other areas of technological innovation.
  • Publication
    Ethical Considerations in Treating the Horse with Laminitis
    (2004-03-01) Fiester, Autumn; Mann, Lori
    The nature of laminitis - its unpredictable course, the severe pain and disability it causes, the lengthy convalescence it requires even when cured - poses challenging ethical quandaries for the clinicians who treat it and the owners whose horses suffer from it. Unique among equine ailments, this disease places owners and clinicians in the untenable position of trying to balance considerations that are very difficult to weigh against each other: the animal's pain, the unknown disease trajectory, the questionable possibility of full recovery, the limited usefulness of the animal post-laminitis, the financial drain of treatment, the financial loss of a formerly productive horse, the expense of maintaining a "pasture potato," the animal's frustration or distress during convalescence, etc. The pressing question in every case of laminitis is: where should we draw the line? The answer to this question will not only be different in every individual case of laminitis, but different owners and clinicians will often have divergent views even regarding the same case. In an ethical terrain that is so clearly "gray," absolutes are unlikely to be found. Instead, our essay hopes to clarify the ethical considerations involved in treating a horse with laminitis to facilitate the decision-making process regarding the specific cases encountered by clinicians in the field.
  • Publication
    Ethical Issues in Animal Cloning
    (2005-06-01) Fiester, Autumn
    The issue of human reproductive cloning has recently received a great deal attention in public discourse. Bioethicists, policy makers, and the media have been quick to identify the key ethical issues involved in human reproductive cloning and to argue, almost unanimously, for an international ban on such attempts. Meanwhile, scientists have proceeded with extensive research agendas in the cloning of animals. Despite this research, there has been little public discussion of the ethical issues raised by animal cloning projects. Polling data show that the public is decidedly against the cloning of animals. To understand the public’s reaction and fill the void of reasoned debate about the issue,we need to review the possible objections to animal cloning and assess the merits of the anti–animal cloning stance. Some objections to animal cloning (e.g., the impact of cloning on the population of unwanted animals) can be easily addressed, while others (e.g., the health of cloned animals) require more serious attention by the public and policy makers.