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Contents

• Letter from the Editor Michael Weintraub
  
• Bioethics in Brief
  
• The Presidential Bioethics Commission: Interview with Dr. Amy Gutmann
  

Editorials

• A Brief History of Organ Transplantation Sterling Sims
  
• “My Brain Made Me Do It”: Can Neuroimaging Undermine the Case for Criminal Punishment? Ilana Yurkiewicz
  

Articles

• Placing the Patient at the Center of Care by Mayme Marshall Read Abstract

  Modern healthcare is preoccupied with scientific information (increasing the accuracy of diagnosis and treatment protocols) as a means to improve morbidity and morality outcomes. Physicians commonly use ‘information-based’ communication during patient consultations. These interactions are informative but lack the compassion and empathy that promote a strong and trusting relationship between physicians and patients. Alternatively, ‘patient-centered’ communication emphasizes empathetic, caring and trusting physician-patient communication. In addition to answering scientific questions, this type of communication promotes patient well-being and quality of life. Studies show that patients with high levels of trust in their physicians have better health outcomes than those who do not. To maximize the potential of positive health results, physicians need to practice patient-centered communication techniques in addition to improving diagnosis and treatment. Although this type of communication is not innate for many people, it has been demonstrated that empathetic and compassionate communication can be learned. Although many medical schools promote communication education, a standard curriculum promoting patient-centered communication needs to be implemented. Placing the patient at the center of care is essential to ensure adequate care for the ‘whole’ patient—body and mind.

• The Ethics of Non-Therapeutic Neonatal Male Circumcision by Christine E. Schultheiss Read Abstract

  Circumcision of newborn males has been practiced for thousands of years. In the US, between 76 and 92% of newborn boys are circumcised. Those who support the practice claim that it carries various medical and non-medical benefits with no significant risks. However, those who are opposed to neonatal circumcision argue that the benefits of circumcision are nominal at best and the infringement on the autonomy of the infant is a significant harm. Though little attention is given to this subject, there have been some attempts in recent years to justify or condemn the practice from a bioethical standpoint. The most significant of the attempts to defend the practice comes from David Benatar and Michael Benatar in their 2003 “Between Prophylaxis and Child Abuse: The Ethics of Neonatal Male Circumcision.” This paper attempts to refute the authors’ claim that non-therapeutic neonatal male circumcision is an ethically defendable practice for the reasons they suggest.

• Xenotransplantation: Weighing the Risks and Benefits of a Controversial Procedure by Arun Sharma Read Abstract

  The widespread organ shortage is a medical dilemma that has been well documented for a number of years. Because of this problem, massive waiting lists have unfortunately become a reality, and as a result, thousands of patients die while waiting for their replacement organs. However, a unique, albeit risky, alternative to traditional transplantation procedures, known as xenotransplantation, has been proposed. Xenotransplantation is a controversial procedure involving the short-term transplantation of animal tissues into humans. Proponents of this alternative to traditional transplantation support it because xenotransplantation can serve as a temporary “bridge” for patients waiting for a long-term human replacement organ. The prospect of saving thousands of human lives cannot be underestimated. Xenotransplantation could potentially eliminate the organ shortage crisis by providing temporary organs until human replacement tissues can be procured. Understandably, however, this unique procedure raises multiple medical and ethical concerns. Traditional transplantation has been associated with terrible medical problems such as acute organ rejection, and because of xenotransplantation’s cross-species nature, these problems are only magnified through concerns such as interspecies virus transmission. From an ethical standpoint, one must also consider to what extent animal organs can be “harvested” without ultimately establishing organ farms where animals are grown only to be slaughtered for medical purposes. Taking all medical and ethical risks into consideration, xenotransplantation should still be given serious thought because of its potential to alleviate the organ shortage crisis and ultimately to improve the human condition.

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