New in the Hastings Center Report

Bioethics and Populism: How Should Our Field Respond?

Mildred Z. Solomon and Bruce Jennings

Authoritarian populism is on the rise, posing a real threat to constitutional democracies worldwide. Fueled by ethnic and nationalistic extremism, these emerging movements are highly polarized, antidemocratic and exclusionary. The field of bioethics is uniquely positioned to contribute to the rebuilding of the communal and civic foundations upon which constitutional democracy rests. This essay makes a vital case for a renewed commitment to justice and civic deliberation in the field of bioethics. Mildred Z. Solomon is president of The Hastings Center; Bruce Jennings is a senior advisor.

Enrolling in Clinical Research While Incarcerated: What Influences Participants' Decisions?

Paul P. Christopher, Lorena G. Garcia-Sampson, Michael Stein, Jennifer Johnson, Josiah Rich, and Charles Lidz

We know surprisingly little about how (and why) prisoners choose to participate in medical research. This study sought to better understand their motives. Through semistructured interviews, the study found that prisoner-participants face many of the same issues as nonincarcerated participants when determining whether or not to enroll in clinical research, but they are also subject to unique influences that may leave them vulnerable to exploitation. While none of the participants reported coercion, many described enrolling in clinical research to obtain access to better health care, which raised some concerns.

Keramet Reiter

When prisoners' basic needs are unmet, how can we be certain that their decision-making is uncoerced? In this response to "Enrolling in Clinical Research While Incarcerated," Keramet Reiter, of the School of Law at the University of California, Irvine, reconsiders the question of coercion for prisoner-participants in clinical research.

Toward an Ethically Sensitive Implementation of Noninvasive Prenatal Screening in the Global Context

Jessica Mozersky, Vardit Ravitsky, Rayna Rapp, Marsha Michie, Subhashini Chandrasekharan, and Megan Allyse

By analyzing placental DNA circulating in maternal blood, noninvasive prenatal screening using cell-free DNA can provide information about fetal chromosomal disorders without posing a risk to the fetus. The majority of the literature on this screening tool has considered it from a primarily European or North American perspective. Emerging from a four-day international workshop on the implications of expanded access to cell-free DNA screening, this article highlights eight key insights from a global context, considering ethical, legal, social, economic, clinical, and practical issues.

Also in this issue:

"Best Evidence Aside: Why Trump's Executive Order Makes America Less Healthy," "Justifying Clinical Nudges," Case Study ("Managing Opioid Withdrawal for Hospital Patients in Custody"), and In Practice ("The Clue").

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Contact Susan Gilbert, Director of Communications
The Hastings Center
845-424-4040 x244
gilberts@thehastingscenter.org