David Kaufman

In his recently rediscovered _On the Freedom from Distress_ (Περὶἀλυπίας), Galen argues for a sophisticated therapy of distress that incorporates three prominent and, in their original contexts, opposing methods of consolation. Despite their varied origins, the chapter argues that Galen integrates these distinct methods of therapy into a highly original and cogent, multi-tiered therapy of distress. Beyond its considerable interest for the ancient theory of emotional consolation, and for the ancient theory of the emotions more generally, Galen's resulting theory also illuminates several features of his philosophical methodology: most notably, his open-minded and appropriative stance towards other philosophical schools; the role of his own trained experience as a criterion for his philosophical views; and the significance that he places on the nature and upbringing of the audience of his philosophical works.

While patients have the right to control who has access to their health information and designate visitors, it is not always clear whether—when a patient lacks capacity—their surrogate also exercises such rights. States and federal laws are often vague about the limits of surrogate authority. Even where legal or institutional guidance on this issue is clear, requests by surrogates to withhold information or restrict visitation with a patient can be a source of ethical uncertainty and distress on the part of the clinical team. This paper explores the ethical issues raised by such requests. To date, there has been little exploration of this issue in the clinical ethics literature. First, we summarize the scant existing ethical and legal guidance on this issue. Second, we present two potential approaches to navigating requests from surrogates to withhold information or restrict visitation. Third, we discuss the merits and limitations of both approaches, and introduce some additional considerations that further complicate the picture. We argue for a flexible restrictive approach to information-sharing, and a constrained permissive approach to visitation. Finally, we propose several considerations that clinicians and clinical ethicists might think through in these situations to help guide their practice.

The National Institutes of Health and other federal health agencies are considering establishing a national biobank to study the roles of genes and environment in human health. A preliminary public engagement study was conducted to assess public attitudes and concerns about the proposed biobank, including the expectations for return of individual research results. A total of 141 adults of different ages, incomes, genders, ethnicities, and races participated in 16 focus groups in six locations across the country. Focus group participants voiced a strong desire to be able to access individual research results. Recognizing the wide range of possible research results from a large cohort study, they repeatedly and spontaneously suggested that cohort study participants be given ongoing choices as to which results they received.