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Why Bioethics Has a Race Problem

John Hoberman

For more than a decade, bioethics leaders have called for bioethics to pay closer attention to the racial dimensions of medicine. But bioethicists – and bioethics journals – have not responded. Citing disparities in clinical outcomes and "racially-motivated misconduct," Hoberman asks, "Might one argue that bioethicists had a professional obligation to do better in this regard than the vast majority of whites, including white physicians, who do not regard racial justice as an urgent problem requiring corrective action?" Hoberman is the author of Black & Blue: The Origins and Consequences of Medical Racism and a professor at the University of Texas at Austin.

Reframing Conscientious Care: Providing Abortion Care When Law and Conscience Collide

Mara Buchbinder, Dragana Lassiter, Rebecca Mercier, Amy Bryant, and Anne Drapkin Lyerly

Much of the debate on conscience in health care has addressed the ethics of refusal: the rights of providers to refuse to perform procedures to which they object and the interests of the patients who might be harmed by their refusals. But conscience can also be a positive force, grounding decisions about offering care. The article, based in an empirical investigation by the authors, discusses approaches devised by abortion providers in North Carolina who wished to mitigate the effects of the state's Woman's Right to Know Act, which stipulated that patients must be informed about the medical risks associated with abortion and of pregnancy and specified the use of language such as "unborn child." The providers sought to mitigate the effects of the forced language, for example, by emphasizing that the risks of carrying a pregnancy to term are substantially greater than the risks of an early-term abortion. The authors argue that such approaches are ethically justified when health care providers face legal or institutional policy mandates that raise possible moral conflicts.

Two "Other Voices" essays offer additional perspectives. "Conscience, Courage, and 'Consent'" argues that statutes such as the North Carolina law convey a deep-seated distrust in the integrity of physicians. "When Policy Produces Moral Distress: Reclaiming Conscience" calls for bioethics to embrace the idea of "conscience" as something affirmative.

Also in this issue:

At Law: International Health Research after Schrems v. Data Protection Commissioner

Mark A. Rothstein

Last October, the European Union's highest court invalidated the 15-year-old Safe Harbor Framework Agreement with the United States, which had permitted entities in the E.U. to send personal data to American companies – provided that the companies self-certified to the U.S. Department of Commerce that they were in compliance with the E.U.'s essential privacy protections. As a result of the decision, data sharing between researchers in the U.S. and the E.U. via cloud servers may soon come under greater legal scrutiny.

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