1
|
Casper ST, Bachynski KE, Buckland ME, Comrie D, Gandy S, Gates J, Goldberg DS, Henne K, Hind K, Morrison D, Ortega F, Pearce AJ, Philpott-Jones S, Sandel E, Tatos T, Tucker S, Finkel AM. Toward Complete, Candid, and Unbiased International Consensus Statements on Concussion in Sport. J Law Med Ethics 2021; 49:372-377. [PMID: 34665101 PMCID: PMC8941977 DOI: 10.1017/jme.2021.56] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuries especially when they recur.
Collapse
|
3
|
Dubé K, Gianella S, Concha-Garcia S, Little SJ, Kaytes A, Taylor J, Mathur K, Javadi S, Nathan A, Patel H, Luter S, Philpott-Jones S, Brown B, Smith D. Ethical considerations for HIV cure-related research at the end of life. BMC Med Ethics 2018; 19:83. [PMID: 30342507 PMCID: PMC6196016 DOI: 10.1186/s12910-018-0321-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/02/2018] [Indexed: 12/25/2022] Open
Abstract
Background The U.S. National Institute of Allergies and Infectious Diseases (NIAID) and the National Institute of Mental Health (NIMH) have a new research priority: inclusion of terminally ill persons living with HIV (PLWHIV) in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego (UCSD) for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. Discussion As end-of-life (EOL) HIV cure research is relatively new, the scientific community has a timely opportunity to examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders (biomedical researchers, PLWHIV, bioethicists, and socio-behavioral scientists) and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. Conclusion EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable.
Collapse
Affiliation(s)
- Karine Dubé
- Gillings School of Global Public Health, University of North Carolina, 4108 McGavran-Greenberg Hall, Chapel Hill, North Carolina, USA.
| | - Sara Gianella
- Division of Infectious Diseases and Global Public Health, University of California San Diego, Stein Clinical Research Building, La Jolla, California, USA.,AntiViral Research Center (AVRC), University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA
| | - Susan Concha-Garcia
- Division of Infectious Diseases and Global Public Health, University of California San Diego, Stein Clinical Research Building, La Jolla, California, USA.,AntiViral Research Center (AVRC), University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA
| | - Susan J Little
- Division of Infectious Diseases and Global Public Health, University of California San Diego, Stein Clinical Research Building, La Jolla, California, USA
| | - Andy Kaytes
- AVRC Community Advisory Board, University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA
| | - Jeff Taylor
- AVRC Community Advisory Board, University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA.,HIV and Aging Research Project - Palm Springs (HARP-PS), 1775 East Palm Canyon Drive, Suite 110-349, Palm Springs, California, USA
| | - Kushagra Mathur
- AntiViral Research Center (AVRC), University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA
| | - Sogol Javadi
- AntiViral Research Center (AVRC), University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA
| | - Anshula Nathan
- Gillings School of Global Public Health, University of North Carolina, 4108 McGavran-Greenberg Hall, Chapel Hill, North Carolina, USA
| | - Hursch Patel
- Gillings School of Global Public Health, University of North Carolina, 4108 McGavran-Greenberg Hall, Chapel Hill, North Carolina, USA
| | - Stuart Luter
- Gillings School of Global Public Health, University of North Carolina, 4108 McGavran-Greenberg Hall, Chapel Hill, North Carolina, USA
| | - Sean Philpott-Jones
- Department of Bioethics, Clarkson University, 80 Nott Terrace, Schenectady, New York, USA
| | - Brandon Brown
- Center for Healthy Communities, Department of Social Medicine, Population, and Public Health, University of California Riverside School of Medicine, 3333 14th Street, Riverside, California, USA
| | - Davey Smith
- Division of Infectious Diseases and Global Public Health, University of California San Diego, Stein Clinical Research Building, La Jolla, California, USA.,AntiViral Research Center (AVRC), University of California San Diego, 220 Dickinson Street, Suite A, San Diego, California, USA
| |
Collapse
|
6
|
Fletcher F, Ingram LA, Kerr J, Buchberg M, Bogdan-Lovis L, Philpott-Jones S. "She Told Them, Oh That Bitch Got AIDS": Experiences of Multilevel HIV/AIDS-Related Stigma Among African American Women Living with HIV/AIDS in the South. AIDS Patient Care STDS 2016; 30:349-56. [PMID: 27410498 DOI: 10.1089/apc.2016.0026] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
African American women bear a disproportionate burden of HIV/AIDS in the United States. Although they constitute only 13% of the US population, African Americans account for nearly 65% of all new HIV infections among American women. In addition, this population suffers comparatively greater adverse health outcomes related to HIV status. African American women living with HIV in the South may be further burdened by HIV/AIDS stigma, which is comparatively more pronounced in this region. To further explore this burden, we used narrative data and the Social Ecological Model to explore how African American women living with HIV in the US South recount, conceptualize, and cope with HIV/AIDS stigma at interpersonal, community, and institutional levels. Our narrative analysis suggests that HIV-positive African American women living in the South are vulnerable to experiences of multilevel HIV stigma in various settings and contexts across multiple domains of life. Stigma subsequently complicated disclosure decisions and made it difficult for women to feel supported in particular social, professional and medical settings that are generally regarded as safe spaces for noninfected individuals. Findings suggest that the debilitating and compounded effect of multilevel HIV/AIDS stigma on HIV-positive African American women in the South warrants closer examination to tailor approaches that effectively address the unique needs of this population.
Collapse
Affiliation(s)
- Faith Fletcher
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, Illinois
| | - Lucy Annang Ingram
- Department of Health Promotion, Education, and Behavior, University of South Carolina Arnold School of Public Health, Columbia, South Carolina
| | - Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky
| | - Meredith Buchberg
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Libby Bogdan-Lovis
- Center for Ethics and Humanities in the Life Sciences, East Lansing, Michigan
| | | |
Collapse
|
7
|
Philpott-Jones S, Gefenas E, Macpherson CC, Strosberg MA, Hall RT. Fogarty and Charge of Moral Imperialism: A Response to Hellmann et al. Arch Med Res 2016; 47:65-6. [PMID: 26845618 DOI: 10.1016/j.arcmed.2016.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
Affiliation(s)
- Sean Philpott-Jones
- Center for Bioethics and Clinical Leadership, Union Graduate College, Schenectady, NY, USA.
| | - Eugenijus Gefenas
- Department of Medical History and Ethics, Vilnius University, Vilnius, Lithuania
| | | | - Martin A Strosberg
- Center for Bioethics and Clinical Leadership, Union Graduate College, Schenectady, NY, USA
| | - Robert T Hall
- Facultad de Filosofía, Universidad Autónoma de Querétaro, Querétaro, Mexico
| |
Collapse
|
9
|
Affiliation(s)
- Lisa B Haddad
- Assistant Professor, Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, GA, USA
| | - Sean Philpott-Jones
- Director, Center for Bioethics and Clinical Leadership, The Bioethics Program, Union Graduate College, Mount Sinai School of Medicine, New York, NY, USA
| | - Toby Schonfeld
- Director, Master of Arts in Bioethics, Center for Ethics and Professor, School of Medicine, Emory University, Atlanta, GA, USA
| |
Collapse
|