Papers by Timothy M Krahn
![Research paper thumbnail of HPV Testing for Primary Cervical Cancer Screening: A Health Technology Assessment [Internet]](https://attachments.academia-assets.com/110082270/thumbnails/1.jpg)
Dr. Yi-Sheng Chao screened and selected some of the studies; extracted, critically appraised, ana... more Dr. Yi-Sheng Chao screened and selected some of the studies; extracted, critically appraised, analyzed data, and interpreted the results; drafted the Clinical Review; revised the review based on reviewers' comments; and provided final approval to the version of the report submitted for publication. Michelle Clark contributed to the protocol development for the Clinical Review. She screened and selected studies; extracted, critically appraised, and interpreted data; contributed to the writing of the Clinical Review; revised the review based on reviewers' comments; and provided final approval to the version of the report submitted for publication. Elizabeth Carson wrote the protocol, screened and selected studies for inclusion, and reviewed early drafts of the clinical and implementation sections. Patients' Perspectives and Experiences Review Dr. Meredith Vanstone led the Patients' Perspectives and Experiences Review, wrote the protocol, supervised and participated in all work, drafted the report, oversaw all updates and revisions, and provided final approval to the version of the report submitted for publication. Umair Majid wrote and reviewed the final Patients' Perspectives and Experiences Review, coded and analyzed data for review, and undertook literature screening for inclusion into the review. Sujane Kandasamy undertook the screening of titles, abstracts, and full-text papers; reviewing screening decisions; qualitative data analysis (e.g., coding, thematic analysis, participating in team discussions, compilation of findings); and manuscript drafting, writing, and editing. Neha Arora performed qualitative descriptive analysis of data; worked on interpretation of data, discussion, and thematic analysis; contributed to designing parts of the discussion and conclusion; and drafted and revised the report. Ethical Issues Analysis Dr. Lynette Reid conceived and designed the study; with assistance from CADTH staff, acquired data and interpreted it; and formulated key messages and conclusions. She drafted the body of the Ethical Issues Analysis with the exception of the legal risk section; revised the legal risk section; and provided final approval to the version of the report submitted for publication. Timothy M. Krahn conceived, designed, and wrote the first draft, and revised and reviewed based on comments for the legal risk section of the Ethical Issues Analysis. He further reviewed the entire Ethics Issues Analysis section of the document and provided final approval to the version of the report submitted for publication. Implementation Issues Analysis Kasia Kaluzny developed the section protocol, acquired data from literature and consultative interviews, and interpreted results. She wrote the Implementation Issues Analysis section and revised it based on feedback from the project team. Further, she drafted the implementation key messages and conclusions. Research Information Science Kelly Farrah designed and executed the literature search strategies, wrote the literature search methods sections and appendix, and managed referencing for the draft report. Caitlyn Ford peer-reviewed the search strategies, managed report referencing, and approved the final version of the report submitted for publication.
Ethical concerns with PGD regulation 3 Scope, focus, and aim of thesis 4 Structure 7 Chapter 1: M... more Ethical concerns with PGD regulation 3 Scope, focus, and aim of thesis 4 Structure 7 Chapter 1: Matters of context and approach 8 Historical background: the Warnock Report 8 Motivations to redress this moral context as per feminist approaches to bioethics Clearing a space from within Chapter 2: Is PGD for Down's syndrome appropriate according to UK law and policy? 19 Chapter objectives and outline The HFEA Act (1990) and the HFEA How to determine the permissibility of any PGD application What is "serious" about a "serious genetic condition"? How to determine if PGD for Down's syndrome is appropriate according to the HFEA's standards for assessment Assessing the appropriateness of a PGD license application The views and reproductive experiences of PGD clients 27 Effective therapy 32 Intellectual impairments 35 Associated suffering from the perspective of the individual 40 Associated suffering from the perspective of the family; the impact of social supports and family circumstances of the people seeking treatment 42 Models of disability: locating the source of, and determining how best to respond to, functional limitations Summary of chapter conclusions Chapter 3: Considering some structural problems with UK regulation of PGD 59 Chapter objectives and outline Problems with the HFEA's new list of "in principle" serious conditions Reasons to expunge the list and to resist differential standards Summary of chapter conclusions Conclusion 75 References 79 I would like to acknowledge the strong support I have come to depend upon during the process of this thesis from my partner Katrina Grentz, my mother Elfrieda Krahn, my late father John Jacob Krahn, as well as all of my brothers John Edward, James, Peter, and Andrew. Françoise Baylis has been an incredibly dependable and helpful mentor through the many years that I have been developing the ideas in this thesis. Friends and colleagues, Andrew Fenton, Olga Kits, Lynette Reid, Jocelyn Downie, and Susan Sherwin have also provided me with much needed conversation and feedback along the way. Lastly, I would like to thank my co-supervisors Ian Kerr and Jennifer Chandler who have been very caring coaches and masterful teachers whose strong sense of collegiality has been inspiring and really uplifting when I needed it.
The CRISPR Journal, 2020
Discussions and debates about the governance of human germline and heritable genome editing shoul... more Discussions and debates about the governance of human germline and heritable genome editing should be informed by a clear and accurate understanding of the global policy landscape. This policy survey of 106 countries yields significant new data. A large majority of countries (96 out of 106) surveyed have policy documentslegislation, regulations, guidelines, codes, and international treaties-relevant to the use of genome editing to modify early-stage human embryos, gametes, or their precursor cells. Most of these 96 countries do not have policies that specifically address the use of genetically modified in vitro embryos in laboratory research (germline genome editing); of those that do, 23 prohibit this research and 11 explicitly permit it. Seventy-five of the 96 countries prohibit the use of genetically modified in vitro embryos to initiate a pregnancy (heritable genome editing). Five of these 75 countries provide exceptions to their prohibitions. No country explicitly permits heritable human genome editing. These data contrast markedly with previously reported findings.
Bioethics, 2019
The growth of the electronic cigarettes (e-cigarettes) market has prompted debates in the public ... more The growth of the electronic cigarettes (e-cigarettes) market has prompted debates in the public health community. Within that community, arguments for the liberalization of e-cigarettes, or rather, including them in smoke-free (restrictive) policies, are based on speculations over the current evidence base used to support them. 1 In 2015 Public Health England (PHE) concluded that 'e-cigarettes are 95% less harmful to your health than normal cigarettes'. 2 This claim has also become a key marketing message associated with promoting e-cigarettes as 'safer' than cigarettes. In this respect, some of those promoting e-cigarettes maintain that they will result in harm reduction as an alternative to smoking. Those opposed to liberalization need not be opposed to tobacco harm reduction in principle, but some may see a wider set of harms bearing down upon public health advocacy and policy making. In this latter view, opposing liberalization makes sense for resisting the normalization of e-cigarettes through markets and the attendant undermining of a spectrum of public health policies. Among the polices at risk are those containing the principles of research ethics. In this respect, while the evidence base remains disputed, there is a concern that public understanding of the potential health risks of e-cigarette use appears to be moderated by some researchers with links to tobacco and e-cigarette industries; noting that these are often one and the same corporate 1 Many of those who support liberalization emphasize its potential benefits, citing studies that suggest that e-cigarettes help smokers quit, are not commonly used among young people, and will not have serious impacts on long-term health. Those against cite
Journal of Public Health, 2017
Inspired by poet J.L. Borges's intimations on acceptance, this commentary highlights the eviction... more Inspired by poet J.L. Borges's intimations on acceptance, this commentary highlights the eviction of an older woman and her kitten from an affordable independent living facility as representing exclusionary practices and policies that compromise the ability for some lower-income older adults to age-in-place. Even as efforts to promote aging-in-place have prioritized housing as a key need, and public health evidence suggests benefits from animal companionship later in life, there is a shortage of social and other types of affordable housing in Canada and elsewhere that allows older adult tenants to reside independently with companion animals. Within the private housing market, however, companion animals may be leveraged as a marketing tactic, with 'pets' being welcomed into rental arrangements. In light of this meanspatterned discrepancy, this commentary troubles the persistent undervaluing of human-animal relationships that exists at policy and practice levels. Furthermore, banning companion animals from affordable housing subsumes an accepted yet insidious practise of regulating the lives of older adults who have not achieved idealized conceptions of responsible aging, including home ownership. We draw these two concerns together by advocating for adequate provision of affordable housing opportunities where lower-income older adults may be granted the choice to establish a home that includes a companion animal as they age-in-place.
Autism, neurodiversity and equality beyond the'normal
P49 Stem cell compliance on consent: rules and reality
Reproductive BioMedicine Online, 2010
P46 “Seriousness” and the regulation of preimplantation genetic diagnosis: the case of Down's syndrome
Reproductive BioMedicine Online, 2010
Reproductive BioMedicine Online, 2009
is a research associate working in the areas of neuroethics and assisted human reproduction with ... more is a research associate working in the areas of neuroethics and assisted human reproduction with a special focus on how new technological developments in these fields impact questions of ethics and policies for persons with disabilities. This research is informed by his previous work in moral epistemology, moral ontology, social theory and contemporary political philosophy. Timothy has also worked for years for various community agencies and public schools providing direct services to persons with developmental disabilities. Prior to this, Timothy was a full-time lecturer in the Philosophy Department at the University of Winnipeg from 1997-2000.
Medicine Studies, 2010
Purpose: With the increasing sophistication of neuroimaging technologies in medicine, new languag... more Purpose: With the increasing sophistication of neuroimaging technologies in medicine, new language is being sought to make sense of the findings. the aim of this paper is to explore whether the 'brain-reading' metaphor used to convey current medical or neurobiological findings imports unintended significations that do not necessarily reflect the genuine findings made by physicians and neuroscientists. Methods: First, the paper surveys the ambiguities of the readability metaphor, drawing from the history of science and medicine, paying special attention to the sixteenth through nineteenth centuries. next, the paper addresses more closely the issue of how metaphors may be confusing when used in medicine in general, and neuroscience in particular. the paper then explores the possible misleading effects associated with the contemporary use of the 'brain-reading' metaphor in neuroimaging research. Results: rather than breaking new ground, what we see in current scientific language is a persistence of both a constraining and expansive set of language practices forming a relatively continuous tradition linking current neuroimaging to past scientific investigations into the brain. Conclusions: the use of the readability metaphor thus carries with it both positive and negative effects. Physicians and neuroscientists must resort to the use of terms already laden with predetermined meaning(s), and often burdened by tradition, at the risk of importing through these words connotations that do not tally with the sought-after objectivity of empirical science .
Journal of Public Health, 2018
Inspired by poet J.L. Borges’s intimations on acceptance, this commentary highlights the eviction... more Inspired by poet J.L. Borges’s intimations on acceptance, this commentary highlights the eviction of an older woman and her kitten from an affordable independent living facility as representing exclusionary practices and policies that compromise the ability for some lower-income older adults to age-in-place. Even as efforts to promote aging-in-place have prioritized housing as a key need, and public health evidence suggests benefits from animal companionship later in life, there is a shortage of social and other types of affordable housing in Canada and elsewhere that allows older adult tenants to reside independently with companion animals. Within the private housing market, however, companion animals may be leveraged as a marketing tactic, with ‘pets’ being welcomed into rental arrangements. In light of this means- patterned discrepancy, this commentary troubles the persistent undervaluing of human–animal relationships that exists at policy and practice levels. Furthermore, banning companion animals from affordable housing subsumes an accepted yet insidious practise of regulating the lives of older adults who have not achieved idealized conceptions of responsible aging, including home ownership. We draw these two concerns together by advocating for adequate provision of affordable housing opportunities where lower-income older adults may be granted the choice to establish a home that includes a companion animal as they age-in-place.
JEMH · April 2009 · 4(1) | 2
Journal of Obstetrics and Gynaecology Canada, 2016
Objective: We reviewed the content of IVF consent documents (i.e., consent forms and accompanying... more Objective: We reviewed the content of IVF consent documents (i.e., consent forms and accompanying information sheets) used by Canadian IVF clinics in 1991, and 2014, paying particular attention to the inclusion of information that should be provided to patients in accordance with minimum ethical standards for disclosure.
From the time that James Thomson and colleagues (1998) fi rst announced the successful derivation... more From the time that James Thomson and colleagues (1998) fi rst announced the successful derivation of human embryonic stem cell (hESC) lines, there has been a heated debate about the ethical acceptability of hESC research because this research entails the destruction of human embryos (see Prainsack et al., 2008a). In an effort to quell this debate, governments, quasi-governmental organizations, and professional organizations around the world have sought to develop ethical standards for embryo research and hESC research, and to entrench these standards in laws or research guidelines. Together, these many and varied ethical and legal standards for embryo research and hESC research currently shape the fi eld of stem cell science. Their importance can be measured by the fact that scientists consider these standards In an effort to quell ongoing debate about the ethics of human embryonic stem cell (hESC) research, there have been concerted efforts to develop ethical standards for both emb...
Care ethics for guiding the process of multiple sclerosis diagnosis
Journal of Medical Ethics, 2013
Multiple sclerosis (MS) is a chronic neurological disorder for which there is no definitive diagn... more Multiple sclerosis (MS) is a chronic neurological disorder for which there is no definitive diagnostic test. Uncertainty characterises most of its features with diagnosis reached through a process of elimination. Coping with uncertainty has been recognised as a significant problem for MS patients. Discussions in the literature concerning the ethics of MS diagnosis have focused on an ethics of duty emphasising the rules for disclosure and healthcare professionals' obligations to provide information to patients. This narrow construal of the ethics at stake with MS diagnosis may be driven by a common misperception that diagnosis is an event, or series of events, rather than a process. Scant attention has been given to the dynamic, situated relational space between patient and physician as they journey potentially together (or apart) through the process of diagnosis. The healthcare provider cannot properly judge 'the how, what and when' of MS disclosure merely by applying rules pertaining to general professional duties to tell the truth and patients' rights to know their medical status. Proper disclosure and effective communication require the practice of flexible, caring responsibility and sustained, ongoing attention to the particular relational needs of 'this' patient in her own situational context. Accordingly, this article argues that care ethics is especially useful (but not without certain limitations) for attending to a broader swath of responsibilities (different from minimal duties) and affective components implicated in meeting patients' overall needs for care as the patient and physician cope with uncertainty through the process of establishing an MS diagnosis.
Go Now": A Popular Film Showing the Potential for "Masculinity" to Facilitate Health-Promoting Behaviours
International Journal of Men's Health, 2012
Ethical Analyses of Predictive Brain Implants Should Be Consistent With Feminist Interpretations of Autonomy
AJOB Neuroscience, 2015
Handbook of Neuroethics, 2014
This chapter takes as its focus the topic of traumatic brain injury (TBI) from the perspective of... more This chapter takes as its focus the topic of traumatic brain injury (TBI) from the perspective of "Public and Cultural Neuroethics," showing that there are deeply entrenched social and cultural barriers implicated in the trauma and injury commonly experienced by TBI survivors. The first section ("Traumatic Brain Injury (TBI) and the Situational Context for Survivors") details some basic facts about TBI and the situational context for this patient population. The second section ("Mistaken or Misattributed Beliefs About TBI") explains some of the prevalent societal misperceptions of persons living with TBIs, especially those linked to living with hidden disabilities as "the walking wounded." The third section ("Problems of Social Stigma") explains the problems of social stigma and what can be learned from on point mental illness research for making sense of societal challenges facing TBI survivors. The final section ("Educational Strategies and Using Narrative Media for Combating Stigma") concludes the chapter by examining educational strategies and the use of documentary narrative media for combating and redressing stigmas against this population.
The Patient-Physician Journey to Diagnosis
Medical Ethics and the Movies, 2011
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Papers by Timothy M Krahn