October 2008 / Vol. 14 / No. 02

In November 2005 the University of Toronto Joint Centre for Bioethics Pandemic Influenza Working Group released a report, Stand On Guard for Thee: Ethical considerations in preparedness planning for pandemic influ-enza. This report tackled four broad issues in pandemic preparedness. A particularly noteworthy issue is health workers duty to provide care during a communicable disease outbreak. In this report we made the following recommendations on this issue:

Professional colleges and associations should provide, by way of their 1. codes of ethics, clear guidance to members in advance of a major communicable disease outbreak, such as pandemic flu. Existing mech-anisms should be identified, or means should be developed, to inform college members as to expectations and obligations regarding the duty to provide care during a communicable disease outbreak.

Angus Dawson has joined us for a year as visiting scholar at the Joint Centre for Bioethics starting this September. He will study ethical issues in public health, including some work on databanks, cancer registries, and large epidemiological studies. Angus is examining the arguments for and against our almost obsessive preoccupation with autonomous informed consent. The tension between the rights of individuals and the health of the larger society comes into sharp focus in public health ethics, a field of heightened interest at the JCB. Most public health studies could be construed as unethical when the clinical framework of informed consent is inappropriately applied. What is good clinical practice? The therapeu-tic misconception is prevalent in research; empirical evidence reveals the reality that people rarely fully understand. Training doctors, nurses and researchers in communication doesn’t seem to solve the problem. Maybe we shouldn’t expect either patients or research subjects to “get it” as autonomous informed decision-makers.

Director’s Corner

Feature: Informed Consent to Study and Improve the Public’s Health?

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In This Issue

1 Director’s Corner1 Feature: “Informed Consent to Study and Improve the Public’s Health?”4 Narrative & Bioethics5 The Art of Bioethics7 2008-09 JCB Fellows7 Fellowships 8 JCB 10-Year Report9 Seminars, Events & Conferences13 Awards & Announcements 13 Recent Publications15 Submission & Contact Information

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Director’s Corner

Governments and the health care sector should 2. ensure that: a. care providers’ safety is protected at all times, and providers are able to discharge duties and receive sufficient support throughout a period of extraordinary demands; and b. disability insurance and death benefits are available to staff and their families adversely af-fected while performing their duties.

Governments, hospitals and health regions should 3. develop human resource strategies for commu-nicable disease outbreaks that cover the diverse occupational roles, that are transparent in how individuals are assigned to roles in the manage-ment of an outbreak, and that are equitable with respect to the distribution of risk among individu-als and occupational categories.

It is interesting to reflect three years on from the report and five years on from the SARS experience in Toronto how the debate has moved forward. It is therefore instructive to see that the issue has been given a rather thorough analysis in one of the lead-ing bioethics journals. In the August 2008 issue of American Journal of Bioethics there is a target article entitled “Ethics, Pandemics, and the Duty to Treat” by Heidi Malm; Thomas May; Leslie P. Francis; Saad B. Omer; Daniel A. Salmon; Robert Hood (AJOB 2008; 8(8): 4-19; commentaries at AJOB 2008; 8(8): 20-43). One of the distinctive, innovative, and provoca-tive features of the American Journal of Bioethics is that they have target articles and then invite open peer commentaries. The Malm et al. article “Ethics, Pandemics, and the Duty to Treat” attracted no less than 14 peer commentaries, all of which make for

essential reading. The JCB group itself contributed a commentary called “The Duty to Care in a Pandemic”. I invite members of the broader healthcare commu-nity to read the target article and the commentaries as I believe that issues with respect to obligations to care in public health disasters are very much alive and require reflection in our community. I invite members of our partnership to engage in discussions on these topics of overarching importance to the health profes-sions. When one reads these articles as a collection it is clear how morally complex and nuanced these issues are, and how important it is that healthcare organizations look back to the original recommenda-tions, particularly recommendations 1 and 3, which still strike me as relevant and important. Going for-ward, these issues will wax and wane in the public’s mind but remain enduring concerns for the healthcare provider community. I welcome any thoughts from the readership on this issue.

Ross UpshurDirector, Joint Centre for Bioethics; Director, Primary Care Research Unit; Canada Research Chair in Primary Care Research; Associate Professor, Department of Family and Community Medicine, and Public Health Sci-ences, University of Toronto.

Comments on this article? Email your response to newseditor.jcb@utoronto.ca. We may publish your email in the next issue.

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Feature

The REB serves as a surrogate decision-maker, ensuring safety for research participants. Placing the responsibility for decision-making squarely and unfairly on the patient is an approach that espouses a consumerist ideal and undermines trust. Angus has taught bioethics to doctors and nurses for twelve years. He found they are thoroughly inculcated with the concept of autonomy. He encourages them to see the importance of trust in the benign paternalism that so frequently characterizes the patient-caregiver relationship.

Public health changes the focus of bioethics to include the larger society, and seeks to improve the general status of health through vaccination, fluoridation, etc. The perception of conflict between society and the individual, narrowly construed, is a reductionist simplification. Individuals have relationships -- family, team, union, town -- that are underestimated in the autonomist formulation. We are all part of the larger group and our culture influences us all. Looking at our genes narrowly as a privacy issue is unrealistic. Since we can’t get individual consent from everyone ultimately affected by genetic studies; we need to move to a socially-grounded form of ethics.

A family doctor’s recommendation of vaccination is determinative for parents. Angus will study other determinants, like misleading media reports, and pub-lic policy statements about vaccines: should they be compulsory? Semi-compulsory (ie. Required to enroll in school)? Or voluntary? Should society should set the norms for physical activity and health? Angus sees public health as a key to “the good life”.

Angus was Founding Director of the Centre for Professional Ethics at Keele University in Staffordshire, UK, where he will return after his sojourn in Toronto.

He spent the past year at the Centre for Ethics at U of T working on a book about vaccinations. He currently lives in Greektown with his wife Bev, a recovering law-yer, and children Molly, 10, and Thomas, 7, who attend Jackman School. They enjoy Toronto and the services the city offers, including the public library, skating, karate and swimming lessons. The family has also enjoyed time spent at a cottage on Georgian Bay. Angus is an ardent cyclist who rides his bike to the JCB whenever possible. He is enjoying the JCB environment, espe-cially its links to the hospitals and clinicians.

Contributed by: Martin McKneally, Professor Emeritus, Department of Surgery and the Joint Centre for Bioethics

Congratulations on your excellent newsletter. While vaca-tioning with friends in Toronto this August, my husband (an advanced practice nurse) and I read the March 2008 issue of The JCB Voice. We especially enjoyed the Feature article: “From Coffeehouse to Roundtable” by Bob Parke, bioethicist, and Community Word: “Santa IRB”, written with permission from David R. Karp. Mr. Parke’s article brings awareness to the multi-faceted issues which transect the paradigms of mental health and bioethics. Dr. Scrooge’s letter to Dr. Kringle was as thought-provoking as it was humorous. Thank you for publishing such insightful arti-cles.

E.L. Moya, Esq.Sarasota, Florida

Angus Dawson

Comments to the Editor

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Narrative & BioethicsOrgan Trade in a Civilized Country

Although I signed over a kidney as collateral for your emotional investment,I did not expect to wake disorientedand alone in a strange hotel roomwith a fresh seam in my side.

I was naive to believe our contracttranscended the literal, aspiring to the symbolic– an outmoded concept of civilization.

Morning is not this shoddy room’s best light.I see secretions encrusted on the mucky quiltas clearly as an infrared camerain a documentary I once watchedcalled Hotels Undercover.

I realize now what I should have then:this country’s only language is flesh,every thought and experience organically manifestand contained, so emotioncan only be exorcised by bloodletting

and civilized or notthe most common side effectof any exchange is rejection. But now I must thank you,for it seems you excised the very pound of fleshwhich housed all my romantic delusions.I am a little lopsided less a kidney,but finally aware that I really only needed one.

-- Julie Roorda© Julie Roorda and Guernica Editions

Just the Facts Ma’am Please, Just the Bare Facts

Date: July, 2005, mid afternoon.Location: Toronto.Exactly where? Outside, could be anywhere. What did you witness? Humid and hazy. Blindlingly bright. Near scorched skins. Short tempers. Panting dogs. Cranky vendors and cats. Faceless crowds. Wrinkled suits. Idling overheated engines. Not a hope of a cloud in sight.

July, 2005, mid afternoon. Location: Toronto. Exactly where? Inside. General Hospital. Palliative Care Room #426. What did you witness? Freezingly Cold and clammy. Grey translucent skin. Vacant blue eyes. Less pleading now, par-tial probing. A withering old man. Huge heart, no longer able to hold.

A sudden gasp. A throaty gurgle. A lean, lovingly out-stretched arm. Shiny gold ring. Fingers suspended in air. Grey translucent skin. Vacant blue eyes. No more pleading or probing. Just the upheld stance of a waywarm wrist Numbers on arm, faded, though not forgotten.Blurred and Code Auschwitz blue.

It starts to rain outside. The sky darkens. Dogs bark. Wrinkled suits run. Overheated engines race. Not a hope of sunlight in sight.

Exactly where? Inside palliative care room #426What did you witness? The sun is shining. Blue eyes and body have vanished, no where to be found. All that remains: The old man’s numbered tattoo glistening in the sun’s rays. Blindingly bright. Near scorched skins. Not a hope of another human being in sight.

-- Marcia SokolowskiClinical Ethicist, Baycrest Centre for Geriatric Care

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The Art of Bioethics

‘I had a wonderful marriage, a wonderful love, and I want to just be ready to go’, declares a matriarch in a documentary 203 Days which took us through the day to day journey of the last 203 days of her life. Issues surrounding care at home viś-a-viś nurs-ing home care were raised in this powerful portrayal of the choices and decisions made by the family and the individual. The notion of using audio visual means to bring emotional input and intellectual deliberation simultaneously to an issue was ‘experimented’ at the Arts Bioethics sessions at the 9th World Congress of Bioethics (WCB), held at Rijeka, Croatia between the 5th and the 8th of September 2008. An arts exhibition and a performance session were two major events organised by the Arts Bioethics Network (ABN), and included theatre, dance, documentaries, poetry, paint-ings, sound and ceramic installations, photographs and interactive exhibits. The Arts Bioethics Network aims to encourage critical engagement between dif-ferent disciplines by bringing together artists and non-artists. Founded in 2006, and formally launching its activities in 2008 WCB, the ABN sessions tapped into the congress theme ‘Challenge of cross cultural bio-ethics in the 21st century’, and featured a number of contributions exploring different cultures – the Eastern and the Western, the written word and the narrative, and many others.

Balance of Power, Promotional Mugs and Drugs for Healthy People explored the power balances that characterise the relationships between patients, doc-tors and the pharmaceutical industry. The medium used was ceramics, which was particularly evocative of the fragile nature of interactions. Mugs and tum-blers balanced on top of each other instantly referred the viewer to the topsy-turvy nature of the power relationships amongst the various actors. Professor Raimond Gaita from Kings College, London and

Australian Catholic University stated, after witnessing the exhibition, that it inspired ‘meditative reflection than it does deliberation’. He summed up the ethos of the exhibition and the Network when he observed that ‘ethical thought should be much more about reflecting on the meaning of what we do and what we suffering rather than just the constant preoccu-pation with principles of conduct - whether they can be rationally justified, what principles they should be and so on’. Art, to him, was a way to try and under-stand the human condition in which moral thought is embedded.

The Lake was a sound installation that converted fish fin movements to music. The mesmerizing combina-tion of rhythmic music within a darkened room gave a unique focus to the contemplation of the ethics behind the project. It compelled one to think of the art work and its impact, and the loss of such a work, if one were to conclude that the ‘unnatural’ manipula-tion of fish in order to make music were unaccept-able. The exhilaration that is obtained from using imagination and ingenuity to extract something which is otherwise inconceivable would also be lost, were such a conclusion to be reached. What might have been presented in a conventional conference paper as arguments for and against in answer to ‘how far should we go in the manipulation of other life, just because we can do it’ was presented, through this installation, in a manner memorable and affecting one’s intellect and emotion simultaneously.

Savithri a solo dance production in the Indian clas-sical style of Bharathanatyam injected cross cultural ideas from Indian philosophy and mystic traditions weaving a tale of love and life extension culminating in rumination on death and its mysteries. Without much introduction to Bharathanatyam, its method

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The Art of Bioethics

and nuances, the dancer left the audience wondering about the depth and beauty of this unique classical art form, akin to the feeling that one has when confronted with strange and different ethical frameworks which are only ever glimpsed into, but not really understood or analysed within mainstream bioethics (perhaps because they are not considered worthy enough?).

At the very least ABN events added an additional dimension to ethical debate at the congress. Perhaps, and more ambitiously, it has inspired participants and viewers to push the boundaries of interdisciplinary knowledge production into unprecedented territories.

ABN Contributors – Bailey Barash (203 Days), Gus Clutterbuck (Balance of Power, Drugs for Healthy People and Promotional Mugs), Katherine Koller (The Carousel Ride), Chamu Kuppuswamy (Quantum Gene, Savithri), Andreja Kulunčić (Closed Embryo Reality), Peter Rumney and Nettie Scriven (The Icarus Project) Julie Freeman (The Lake), Sebastien Duprat (Smile of a Stem Cell, La vie, Ma vie: c’est quoi? c’est quand?), Debora Diniz (Severina’s Story).

For more information, contact the coordinators of the network:

Dr. Chamu Kuppuswamy - c.kuppuswamy@shef.ac.uk Dr. Paul Ulhas Macneill - pmacneill@med.usyd.edu.au

Contributed by: Dr. Chamu Kuppuswamy Lecturer, University of Sheffield Co-coordinator, Arts Bioethics Network Photo by: Joy Yueyue Zhang

October 2008 / Vol. 14 / No. 02 Page: 7

2008-09 JCB Clinical & Organizational Ethics Fellows

Rebecca Bruni holds a Bach-elor of Arts in Psychology from the University of Manitoba and a Bachelor of Science in Nursing from the University of Toronto. She will be defending her PhD thesis from the University of Toronto (Medical Science and Collaborative Program in Bio-ethics) in the fall of 2008. Her

thesis focuses on public engagement and priority set-ting. She has worked as an RN in general medicine and completed an ethics internship at Baycrest.

Tom Foreman holds a Bachelors Degree in History/Secondary Ed-ucation from Eastern Mennonite University, a Masters of Public and International Af-fairs with a specializa-tions in International Economic Develop-

ment from the University of Pittsburgh Graduate School of Public and International Affairs, a Masters of Theol-

ogy with a specialization in Healthcare Ministry from Duquesne University and a Doctorate in Healthcare Ethics from Duquesne University. He has been work-ing as an End of Life care specialist in Hospice and as an applied researcher in Emergency Medicine.

Kevin Reel has a background in occupational therapy with a BSc from the University of Toronto.His subsequent practise was mainly in the UK and commu-nity based, before moving into higher education. He was Senior Lecturer, OT Field Chair and an Acting Director in the School of Health and Social Care at Oxford Brookes University. He has a PG

Cert in Teaching from Oxford Brookes, a PG Diploma in healthcare ethics from King’s College London and an MSc in medical ethics from Imperial College. He served for three years on a UK wide research ethics committee. He also worked at the College of Occupa-tional Therapists, devising their research governance arrangements, and most recently as Education Devel-opment Manager.

Fellowships

Centre for Ethics, University of TorontoDoctoral Fellowships 2009-10

The University of Toronto’s Centre for Ethics is an inter-disciplinary and interfaculty initiative aimed at promot-ing ethics research and teaching across the disciplines. We invite applications for our Doctoral Fellows Program for the 2009-10 academic year. Two or three fellow-ships will be awarded to outstanding doctoral students

who are writing and conducting research about ethics. Fellowships are open to enrolled doctoral students in the Faculty of Arts and Sciences, the Faculty of Law, the Faculty of Management, the Faculty of Medicine, or the Faculty of Education (OISE/UT). Applicants should have completed their course requirements and have received formal approval of their doctoral disser-tation proposals.

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Fellowships

The JCB is pleased to present the report “Working for an Ethical Future: The First Decade of the Uni-versity of Toronto Joint Centre for Bioethics”.

If you would like copies of the report mailed to you, please send an email request (including your mailing

address) to Beth Woods at beth.woods@utoronto.ca.

Alternatively, copies can be picked up at the JCB, 88 College Street, Toronto.

The Fellowships will provide each successful candidate with a stipend of $20,000 for the academic year (Sep-tember 1, 2009 to May 15, 2010). Fellows will have private study space within the Centre, with access to a desktop computer, a printer and photocopying facilities. Apart from making substantial progress toward comple-tion of their dissertations during their year in residence at the Centre, Doctoral Fellows are also expected to participate in a bi-weekly seminar, together with local faculty as well as the Centre’s faculty and post-doctoral fellows, and to present their work to colleagues at the Centre. Fellowships are non-renewable. Doctoral Fel-lowships will be awarded on the basis of (1) the quality of an applicant’s dissertation proposal and graduate work to date; (2) the relevance of the proposal to the goals of the Centre for Ethics; (3) the potential for completing the dissertation in a timely fashion; and (4) the likely future contribution to teaching and writing about ethics and human values. Fellows will be se-lected by an interdisciplinary faculty committee of the Centre for Ethics.

Candidates should submit the following materials in application for the Doctoral Fellowship:

Graduate Transcript; • Dissertation Proposal; • Curriculum vitae; • A scholarly paper or dissertation chapter, written • in the last year; and Three confidential letters of reference, of which • one should be from the dissertation supervisor.

All materials, including letters of reference, must be received by January 30, 2009. Send complete ap-plications to:

Professor Melissa WilliamsDirectorCentre for EthicsUniversity of Toronto6 Hoskin AvenueToronto, Ontario Canada M5S 1H8.

JCB 10-Year Report

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Seminars, Events & Conferences

JCB Bioethics Seminars This Month:

October 8, 2008Steve Joordens, PhD, Associate Professor of Psychology, Centre for Com-putational Cognitive Neuroscience, University of Toronto at Scarborough. “If Humans are Animals, We Should Treat Them the Same: An Argument Against Science’s Explicit Double-Standard with Respect to Research Ethics” 4:10-5:15 pm, Great Hall, 88 College St. (This seminar will be webcast through ePresence.)

October 15, 2008 Karima Velji, RN, PhD, CHE, Vice President, Patient Care and Chief Nursing Executive, Toronto Rehabilitation Institute. “Ethics perspectives -- Nursing Project in Afghanistan” 4:10–5:15 pm, Great Hall, 88 College St. (This seminar will be webcast through ePresence.)

October 22, 200828th Annual Philippa Harris Lecture on Bioethical Issues in Cancer Harvey Chochinov, OM, FRSC, Canada Research Chair in Palliative Care, Distinguished Professor, Department of Psychiatry, University of Manitoba. “The Essence of Medicine” 4:30 - 5:30 pm, Main Lecture Theatre, Room 604, 6th Floor, Princess Margaret Hospital, 610 University Avenue. (All are welcome, admission is free, and no registration is required.)

October 29, 2008Jonathan Breslin, PhD, Ethicist, North York General Hospital and Jennifer Gibson, PhD, Director of Partnerships and Strategy, University of Toronto Joint Centre for Bioethics. “Ethics change in health care organizations: What is our burning platform?” 4:10–5:15 pm, Great Hall, 88 College St. (This seminar will be webcast through ePresence.)

October 16, 2008Hospital for Sick Children Bioethics Grand Rounds “Team ethics” in the NICU (and beyond): Challenges and tensions”. Presenters: Connie Wil-liams, Neonatology Fellow, University of Toronto; David Edgell, BA, MHSc, CCP, CPC Cardiovascular Perfusionist, The Hospital for Sick Children; Jonathan Hell-mann, MBBCh, FCP(SA), FRCPC, MHSc Professor of Paediatrics, University of Toronto, Clinical Director, NICU. 12:00-1:00pm at the Hospital for Sick Children

ePresence Registration Instructions:

ePresence now supports both PC and Mac videostream-ing. If you are using either Windows or Mac OSX you can register to view JCB archived seminars and participate in live events. Please note that the registration process should be done at least 2 days in ad-vance of the actual event.

To register for ePresence:Go to the Centre for Glob-1. al eHealth Innovation’s ePresence website (http://epresence.ehealthinnova-tion.org/epresence).Click on the register but-2. ton (at the top blue bar) and ensure that your system meets all require-ments.Run System Check.3. Enter your information, 4. including userid and pass-word. You will need to remember your userid and password to join in future webcasts.Difficulties with register-5. ing should be reported by email to brenda.knowles@utoronto.ca.You will only need to reg-6. ister once.

October 2008 / Vol. 14 / No. 02 Page: 10

Seminars, Events & ConferencesRoom 1250 Elm Wing. The Session will be videocon-ferenced with Bloorview Kids Rehab.

October 17, 2008McGill School of Nursing hosts the Joan Gil-christ Nursing Explorations Series “Ethically Speaking - The Moral Dilemmas of Nursing Leader-ship and Practice”. Invited speakers include: Elizabeth Peter, RN, PhD, University of Toronto. To be held in Montreal, Quebec at the Holiday Inn Montreal Mid-town. For more information please visit: www.medi-cine.mcgill.ca/nursing-explorations2008.

October 17, 2008The Lupina Centre for Spirituality, Healthcare and Ethics will be holding a free public lecture entitled “Health, Justice and Social Responsibility” given by James Dwyer, State University of New York. 7:30pm at Elliott MacGuigan Hall, Regis College, 67 St. Nicholas St. Toronto. No registration is required. 416-922-5474.

October 21, 2008The Centre for Addiction and Mental Health Brown Bag Research Ethics Discussion Groups. Ms. Catherine Tansey, PhD Candidate, Institute of Medical Sciences, JCB “The Impact of SARS on Research Ethics Review: Forced to Adapt” 12:00-1:00pm Room 2062, 33 Russell St. Contact: Susan_Pilon@camh.net

October 23, 2008The Centre for International Health Dalla Lana School of Public Health, University of Toronto presents a spe-cial workshop “Integratng Traditional Chinese Medi-cine (TCM) & Western Medicine” Guest Lecturer: Dr. XU, Xu Wei, MD of Integrated Medicine (China), PhD of Traditional Chinese Medicine (China). 5:30-8:00pmRoom 100, Health Sciences Building 155 College

Street, Toronto. Fee and dinner: $20.00. Register from: uofttix.ca.

October 30 & 31, 2008“Determinants of Our Health: Toronto in a Global Vil-lage” a Sectors without Borders Symposium at Hart House, University of Toronto. Co-hosted by Toronto Public Health and the Centre for International Health, Dalla Lana School of Public Health, University of To-ronto. Registration for two days, with lunch and light breakfast, is $125. A limited number of $25 spaces are available for students/low income. Online registra-tion: www.uoftix.ca Each morning and afternoon will feature a Keynote session in the Great Hall at Hart House, followed by two concurrent workshops. The closing afternoon session will be a Town Hall on health and poverty in Toronto, followed by the rythms of a world beat concert. Presenters include: Ross Upshur, Director, University of Toronto Joint Centre for Bioethics

November 6, 2008Canadian Catholic Bioethics Institute, University of St. Michael’s College, University of Toronto. “Practical Ethics in Home-Based Care” conference 2008. Mad-den auditorium in Carr Hall, University of St. Michael’s College, 100 St. Joseph Street. Registration forms can be downloaded from: www.ccbi-utoronto.ca. Deadline is October 24. Send registration and cheque, payable to the Canadian Catholic Bioeth-ics Institute to: Canadian Catholic Bioethics Institute, 81 St. Mary Street, Toronto, ON M5S 1J4.

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Seminars, Events & ConferencesNovember 14-15, 2008MacLean Center for Clinical Medical Ethics at the University of Chicago 20th Annual Dorothy J. MacLean Fellows Conference: A Festschrift in hon-our of Mark Siegler. This conference is free of charge. However you are asked to register so they can plan meals and ensure your receipt of a reading packet. To register please see: http://medicine.uchicago.edu/centers/ccme/events.htm.

June 8-9, 2009“End of Life Decisions: Ethics in clinical practice, re-search and policy” XI Annual Swedish Symposium on Biomedicine, Ethics and Society, Seglarhotel-let, Sandhamn. Call for abstracts submission dead-line March 1, 2009. For pre-registration and abstract submission, email: crb@crb.uu.se

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Awards & Announcements

Michelle Cleghorn, a MSc graduate student (through IMS) and Collaborative Program in Bioethics student at the JCB, was awarded a $5000 University of Toronto Open Fellowship Award (IMS Entrance Award).

Dr. Barry Schwartz was awarded the University of Toronto’s prestigious Arbor Award for outstanding vol-

unteer service. Barry Schwartz is currently Vice-Chair of the Health Sciences REB, a mem-ber and executive member of the Committee for Human Subjects in Research (REPAC), a committee member of the Determinants of Community Health (DOCH) research re-view committee and a member

of the Centre for International Research by Summer Students Committee.

We are pleased to announce that The National In-stitutes of Health, Fogarty International Centre has awarded Ross Upshur a Fogarty grant in the amount of $1,053,432 over 4 years. The project “University of Toronto MHSc in Bioethics, International Stream” continues our successful international student pro-gram. We thank all who contributed to this success-ful endeavor. Special thanks to Brenda Knowles and Jason Nie.

Dr. Zaid Gabriel, a recent graduate of the MHSc program through the Joint Centre for Bioethics, has taken the position of Research Ethics Officer – Health Sciences role in the Office of Research Ethics, Univer-sity of Toronto.

Recent PublicationsBenatar SR. Introduction to section on global health ethics. In: Singer PA. Viens AM, editors. The Cam-bridge Textbook of Bioethics. Cambridge: Cambridge University Press; 2008 p. 339-340.

Benatar SR. Global health, global health ethics and cross-cultural considerations in bioethics. In: Singer PA. Viens AM, editors. The Cambridge Textbook of Bioethics. Cambridge: Cambridge University Press; 2008 p. p. 341-349.

Benatar SR. Limited resources squandered: Medical care often wasted on futile case. Op-Ed Cape Times, 2008 June 24; Sect. P:9.

Benatar SR. Transparency key in dividing health budget. Meeting infinite demands with finite means. Op-Ed Cape Times 2008 June 25 Sect. P:9.

Chavez F, Peter E, Gastaldo D. Nurses as global citizens: A global health curriculum at the University of Toronto, Canada. In: Tschudin V, Davis AJ editors. The Globalisation of Nursing. Abingdon: Radcliffe Publish-ing Ltd. 2008 p. 175-186.

Gerson AC, Harrison C, Furth SL. Psychosocial and ethical issues in children with chronic kidney disease. In: Geary DF, Schaefer F, editors. Comprehensive Pe-diatric Nephrology. Philadelphia: Saunders 2008;9:811-816.

October 2008 / Vol. 14 / No. 02 Page: 14

Recent PublicationsGordon M. Ethics: Ethicist’s role is to guide deliberation, not give answer. The Medical Post 2008 Sept. 16.

Handelman M, Parke B. The beneficial role of a judicial process when “everything” is too much? Healthcare Quarterly 2008; 11(4):46-50.

Hardy B, Seguin B, Good-said F, Jimenez-Sanchez G, Singer PA, Daar AS. The next steps for genomic medicine: Challenges and opportunities for

the developing world. Nature Reviews Genetics 2008 October; S23-S27.

Hardy B, Seguin B, Ramesar R, Singer PA, Daar AS. South Africa: From species cradle to genomic applications. Nature Reviews Genetics 2008 October; S19-S23.

Hardy B, Seguin B, Singer PA, Mukerji M, Brah-machari SK, Daar AS. From diversity to delivery: The case of the Indian Genome Variation initiative. Nature Reviews Genetics 2008 October; S9-S14.

Joska JA, Kaliski SZ, Benatar SR. Patients with se-vere mental illness: a new approach to testing for HIV. South African Medical Journal 2008; 98: 213-217.

Peter E. Seeing our way through the responsibility vs. endeavour conundrum: The code of ethics as both product and process. Canadian Journal of Nursing Leadership 2008; 21(2): 28-31.

Peter E, Watt-Watson J. Improving pain manage-

ment education. In: Rashiq S, Schopflocher D, Taen-zer P, Jonsson E editors. Chronic Pain: A Health Policy Perspective. Weinheim: WILEY-VCH Verlag GmbH & Co. KGaA. 2008 p. 255-264.

Schwartz B. Safety in human research: Past prob-lems and current challenges from a Canadian per-spective. HEC Forum 2008; 20(3): 277-290.

Schwartz B. Advertising in dentistry: Blurring the line between commercialism and professionalism. Ontario Dentist 2008; 85(10):10-13.

Seguin B, Hardy B, Singer PA, Daar AS. Universal health care, genomic medicine and Thailand: Invest-ing in today and tomorrow. Nature Reviews Genetics 2008 October; S14-S19.

Seguin B, Hardy B, Singer PA, Daar AS. Genom-ics, public health and developing countries: The case of the Mexican National Institute of Genomic Medicine (INMEGEN). Nature Reviews Genetics 2008 October; S5-S9.

Viens AM, Dawson A, Bensimon C, McDougall C, Faith K, Wilson K, Tracy S, Thompson A, Gibson J, Nie J, Kapiriri L, Robertson A, Ritvo P, Upshur R. The duty to care in a pandemic. American Journal of Bioethics 2008; 8(8): 31-3.

van Delden JJM, Ashcroft R, Dawson A, Marck-mann G, Upshur R, Verweij MF. The ethics of mandatory vaccination against influenza for health care workers. Vaccine 2008; 26: 5562-6.

Weizenbluth JS, Sokolowski M, Gordon M. The power of stories: Narrative ethics in long-term care. Annals of Long-Term Care 2008 Sept. 1; 16(9 Sept. 08).

The purpose of this newsletter is to facilitate communication among people interested in bioethics throughout the Joint Centre for Bioethics, participat-ing institutions and elsewhere. The newsletter is published and distributed by email at the beginning of each month. If you would like to receive the newslet-ter, please contact:

Editor: Adrienne GrapkoEmail: newseditor.jcb@utoronto.caFax: (416) 978-1911

Submission & Contact Information

The Joint Centre for Bioethics (JCB) is a partnership among the University of Toronto; Baycrest Centre for Geriatric Care; Bloorview Kids Rehab; Centre for Addiction and Mental Health; Centre for Clinical Ethics, a shared service of Providence Centre, St. Joseph’s Health Centre, and St. Michael’s Hospital; The Hospital for Sick Children; Humber River Regional Hospital; Mount Sinai Hospital; North York General Hospital; Ontario Genomics Institute; Sunnybrook Health Sciences Centre; Toronto Community Care Access Centre; Toronto East General Hospital; Toronto Rehabilitation Institute; Trillium Health Centre; and University Health Network.

The University of Toronto Joint Centre for Bioethics

Submissions to the newsletter must be made by the 25th of the preceding month.Previous issues of the newsletter are posted on our website at:

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Joint Centre for BioethicsUniversity of Toronto88 College StreetToronto, Ontario M5G 1L4Canada

Phone: (416) 978-2709Fax: (416) 978-1911Email: newseditor.jcb@utoronto.caWeb: http://www.jointcentreforbioethics.ca/

October 2008 / Vol. 14 / No. 02 Page: 15

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