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Entries in Ethics (3)

Monday
Feb272012

Are Rich People Unethical?

Rubberball/Mike Kemp(LOS ANGELES) -- A new study published in the Proceedings of the National Academy of Sciences found that wealthier people were more apt to behave unethically than those who had less money.

Scientists at the University of California at Berkeley analyzed a person’s rank in society (measured by wealth, occupational prestige and education) and found that those who were richer were more likely to cheat, lie and break the law than those who were poorer.

“We found that it is much more prevalent for people in the higher ranks of society to see greed and self-interest…as good pursuits,” said Paul Piff, lead author of the study and a doctoral candidate at Berkeley. “This resonates with a lot of current events these days.”

In the first of two studies, researchers found that those who drove more expensive cars were more likely to cut off other cars and pedestrians at a busy San Francisco four-way intersection than those who drove older, less-expensive vehicles.

In other experiments, wealthier study participants were more likely to admit they would behave unethically in a variety of situations and lie during negotiations. In another, researchers found wealthier people were more likely to cheat in an online game to win a $50 prize.

Greed is a “robust” determinant of unethical behavior, according to the study.

“This has some pretty clear implications,” said Piff. “Inequality is very much on Americans’ minds, and the potential effects of severe inequality on individual levels of behavior are major.”

Large sums of money may give people greater feelings of entitlement, causing those people to be the most averse to wealth distribution, Piff continued.  Poorer people may be less likely to cheat, because they are more dependent on their community at large, he said. In other words, they don’t want to rock the boat.

“People in power who are more inclined to behave unethically in the service of gains and self-interest can have great effects on society as a whole,” said Piff.

And it’s difficult to say whether richer people get to the top because of their unethical behavior or whether wealth causes people to become this way. “It seems like a vicious cycle,” he said.

Nevertheless, Piff said these results obviously don’t apply to all wealthy people. He noted that Bill Gates and Warren Buffett were among the wealthiest people in the world and also the most philanthropic. He also pointed to high rates of violent crime in the poorest neighborhoods in the country that counteract the study’s findings.

Piff said he hoped to further his research by figuring out ways to curb these patterns of behavior among wealthier individuals.

“What it comes down to, really, is that money creates more of a self-focus, which may account for larger feelings of entitlement,” said Piff.  “We hope to further study how we can curb these patterns and how that will affect our social environment.”

Copyright 2012 ABC News Radio

Wednesday
Oct052011

Conjoined Twins: Doctors Debate Ethics of Separation Surgery

Jupiterimages/Thinkstock(CLEVELAND) -- The decision to separate conjoined twins would be easy if it guaranteed a better life for both babies.  But the possibility of one or both twins dying or becoming severely disabled because of the surgery or the separation's effects weighs heavily on parents and doctors, according to a new report.

Two-year-old twins joined at the head were the focus of the report on the bioethics of separation surgery.  The girls, who were unnamed, shared kidneys and veins that drain blood from their brains, making separation surgery a risky undertaking unlikely to benefit both of them equally.  But leaving them joined could also threaten their health, not to mention their independence.

"In this case, every ethical principle is sort of turned on its head," said Dr. Devra Becker, a plastic surgeon at UH Case Medical Center in Cleveland and senior author of the report published Monday in the Plastic and Reconstructive Surgery journal.  Those principles, including informed consent, the duty of doctors to heal and avoid harm, and the tenet that health care resources should be distributed fairly, form the framework of Becker's report.

The girls traveled with their parents to Rainbow Babies and Children's Hospital in Cleveland from Italy for separation surgery.  They are craniopagus twins -- the rarest form of conjunction affecting one in 2.5 million births.  Based on published cases, the odds of both twins surviving separation surgery are 33 percent -- the same odds for both twins dying.

"Few will debate the benefit of separation if the surgical risk is [zero].  Similarly, few will advocate for separation if the procedure guarantees the deaths of the twins," Becker and colleagues wrote in the report.  "The ethics of separation becomes more complex when the morbidity of separation lies between [zero] and 100 percent or if one twin will benefit more from the separation than the other."

Following the risky, not to mention expensive procedure, the larger twin would need a kidney transplant or lifelong dialysis to live.  The smaller twin would be at risk for brain damage.  But left together, the girls were at risk for kidney failure and cardiovascular disease.

The procedure could also give both twins the chance for a normal life.

After thoroughly weighing the risks and benefits, the Italian twins' parents and the medical team decided to move forward with the procedure.  The larger twin, who would be left without kidneys, would go on dialysis until she was strong enough for a transplant.  And the risk of brain damage in the smaller twin would be minimized by doing the procedure in stages.  The benefits of separation for both twins, both medical and otherwise, outweighed the risks.

But during the procedure, the surgeons noticed the layer of tissue covering the twins' brains was dangerously tight -- a twist that tipped the risk-benefit scale.  The surgery was aborted, and both twins recovered.

Copyright 2011 ABC News Radio

Thursday
Oct212010

Blood Doping for Clinical Trial Eligibility?

Photo Caption - Getty Images(NEW YORK) -- Ethical and safety concerns have been raised by a Canadian group over cancer patients that have received blood transfusions for the sole purpose of meeting eligibility requirements.

Three such instances were reported in advanced cancer patients over a one-year period by Dr. Jeannie L. Callum and colleagues at Sunnybrook Health Sciences Center in Toronto, reports MedPage Today.

"We caution against this practice, given the risks of transfusion," they wrote in a letter to the editor that appeared in the Oct. 21 issue of the New England Journal of Medicine.

All three cases they reported involved patients trying to get into trials of novel chemotherapy agents by taking transfusions.

In one case, a physician of a patient ordered transfusion of a unit of red cells to raise her hemoglobin level from 8.3 g/dL to the required 9.0 g/dL for trial enrollment. These cases could have been handled differently, said Callum's group.

Clinicians should try to correct the underlying laboratory value through other treatments first, such as treating anemia, they urged.  Other options may include looking for trials at other institutions for patients who don't meet eligibility criteria.

"Patient safety must trump all decisions for such patients," the group said.  "There should be few situations, if any, in which a patient receives a transfusion solely for the purpose of temporarily altering a laboratory value to gain admittance to a clinical trial."

The group added that such ethical dilemmas could be avoided if researchers and institutional review boards were aware of laboratory values that could be manipulated by transfusions.

Copyright 2010 ABC News Radio