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Mary B Mahowald

Publications and source records attributed to Mary B Mahowald.

18 recordsLinked to original sources
PubMed2005

The President's Council on Bioethics 2002-2004: an overview.

The President's Council on Bioethics, headed by Leon Kass, was created by President George W. Bush to advise the President on issues of ethical import raised by advances in biomedical science. Between 2002 and 2004, members of the Council from diverse disciplines addressed topics such as human cloning, stem cell research, assisted reproduction, and medical interventions intended to enhance human capability or appearance. This article provides background on the Council and reviews its published reports. It also considers key definitions and distinctions, specific recommendations of the Council, and positions articulated by members who contributed to the development of its reports.

Advisory Committees↗
PubMed2004

Self-preservation: an argument for therapeutic cloning, and a strategy for fostering respect for moral integrity.

The issues of human cloning and stem cell retrieval are inseparable in circumstances in which the rationale of self-preservation may be invoked as a negative right. I apply this rationale to a hypothetical case in which cloning is necessary to preserve the bodily integrity or life of an individual. Self-preservation as moral integrity is examined in a narrower context, i.e., as applicable to those for whom deliberate termination of embryonic life is morally-problematic. This issue is addressed through comparison with two paradigms commonly used in support of clinical practice: the distinction between letting die and killing, and the permissibility of vital organ retrieval after death. Although these paradigms are questionable in their own right, they offer a rationale by which scientists and clinicians may respect the negative right to moral integrity of those with whom they disagree.

Beginning of Human Life↗
PubMed2003

Maternal-fetal surgery for treatment of myelomeningocele.

Maternal-fetal surgery for repair of fetal MMC is experimental treatment for which ethically justified clinical trials are not yet possible because equipoise is not established on medical or nonmedical grounds. We have focused here on only two of the important questions raised by this surgery. At least three others might have been considered. First is the question of access to the surgery. MMC is available only to those who can afford it. Given its poor results, that may be a good thing. However, if it were ever proved successful, it should be covered for the poor and affluent women who desire it. Second is the question of the autonomy of the women who seek the procedure. Although the women who undergo the surgery at Vanderbilt are counseled extensively by bioethicists, the autonomy of their decisions may be compromised by pressures from partners or others who think that any risk for the sake of a potential child is fully warranted. Third is the issue of potential discrimination against people with disabilities. Seeking or providing surgery that introduces the risk of fetal demise, a risk that could be avoided by postponing the surgery until after birth, suggests that life with disability is regarded as worse than death. Each of these questions deserves careful, critical analysis in its own right. Along with those addressed in this article, these issues are applicable to other ethical issues in perinatology, including those examined by other contributors to this issue.

Female↗
PubMed2003

Refusal of treatment during pregnancy.

A survey of maternal-fetal medicine fellowship directors in the 1980s found that many supported coercive treatment of pregnant women for the sake of their potential children. To examine whether legal, social, and medical developments since then have led to changes in practice or attitudes about this issue, we surveyed current directors of maternal-fetal medicine fellowship programs. Our data show that the number of requests for court orders in such cases has declined, but some practioners and judges still support them. In this article we offer an update on pertinent legal rulings, describe the method and results of our study, and discuss ethical aspects of the issue.

Civil Rights↗
PubMed1993

Futility and unilateral decision making: a different view.

... Resuscitation of PVS patients is futile if the goal is to restore the patient to a cognitive or conscious state but not if the goal is restoration of respiratory function. The judgment of futility in either case is based on nonmedical (as well as medical) values or criteria, i.e., the value of cognitive life vs. the value of noncognitive life. If all of the affected parties concur that noncognitive recovery is a goal not worth achieving, a DNR order should be written. Lacking such concurrence, justification for a DNR order might be found in societal assessment of the burdens and benefits to others (besides the patient) of providing treatment in such circumstances. This is not a decision to be made unilaterally by a single physician, whose values are not necessarily reflective of those of the patient, family members, other physicians, or society at large.

Decision Making↗