Monday, July 31, 2006
News from NYT here.
Here's an FAQ from FDA for those who missed the earlier stories about this one.
Hat tip to R. Alta Charo for bringing this story to our attention: Stem Cells -- The Hope and the Hype. The debate is so politically loaded that it's tough to tell who's being straight about the real areas of progress and how breakthroughs can be achieved. TIME magazine summarizes the issues.
On an animal-breeding farm in Siberia are cages housing two colonies of rats. In one colony, the rats have been bred for tameness in the hope of mimicking the mysterious process by which Neolithic farmers first domesticated an animal still kept today. When a visitor enters the room where the tame rats are kept, they poke their snouts through the bars to be petted.
The other colony of rats has been bred from exactly the same stock, but for aggressiveness instead. These animals are ferocious. When a visitor appears, the rats hurl themselves screaming toward their bars.
“Imagine the most evil supervillain and the nicest, sweetest cartoon animal, and that’s what these two strains of rat are like,” said Tecumseh Fitch, an animal behavior expert at the University of St. Andrews in Scotland who several years ago visited the rats at the farm, about six miles from Akademgorodok, near the Siberian city of Novosibirsk. Frank Albert, a graduate student at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany, is working with both the tame and the hyperaggressive Siberian strains in the hope of understanding the genetic basis of their behavioral differences.The two strains of rat are part of a remarkable experiment started in the former Soviet Union in 1959 by Dmitri K. Belyaev and his brother, who were geneticists who believed in Mendelian theory.
But implications go far beyond issues in animal domestication: The genes, if Mr. Albert finds them, would be of great interest because they are presumably the same in all species of domesticated mammal, maybe even including humans. Richard Wrangham, a primatologist at Harvard, has proposed that people are a domesticated form of ape, the domestication having been self-administered as human societies penalized or ostracized individuals who were too aggressive.
Human self-domestication, if it occurred, would probably not have exactly the same genetic basis as tameness in animals. But Mr. Albert said that if he could pinpoint the genetic difference between the tame and ferocious rats, he would compare the chimp genome and the human genome to see if they showed a similar difference.
One possibility is that a handful of genes — perhaps even just one — underlie all the changes seen in domestication. A structure in the embryo of all vertebrates, known as the neural crest, is the source of cells that constitute much of the face, skull and pigment cells, and many parts of the peripheral nervous system and endocrine system. If the genes in the neural crest cells were delayed just a little in coming into action, a whole range of tissues could be affected, including the maturation of the adrenal glands that underlies the first fear response of young animals, Dr. Fitch has written.
Friday, July 28, 2006
Why should the general public care about conflict of interest in professional medical and scientific publishing? Because this one of the main sources (other than online databases) postgraduate physicians use to get information about what's the best way to treat patients. So if an author recommends a certain medication or treatment on the basis of his own financial gain--rather than on what's best for patients--your doctor may (unknowingly, trustingly) recommend that treatment for you or for a family member. (Btw, both of these studies are about treatment for depression--and one includes data on treating depression in children. High-stakes stuff.)
In related news, have you seen the new ads for Lipitor (a cholesterol-lowering medication) featuring Dr. Robert Jarvik? Yes, that's Dr. Jarvik, as in the artificial heart. You can hear ethicist Katie Watson's NPR piece about it here, and read about it here.
And don't get me started on Hwang Woo-Suk. I predict his next blame-deflecting move will be to claim alien abduction.
Thursday, July 27, 2006
Here'e the full article:
NewsTarget.com printable article, Originally published July 25 2006
In health freedom fight, Abraham Cherrix to refuse court-ordered chemotherapy sentence
(NewsTarget) Abraham Cherrix -- the Virginia teen who has been court-ordered to undergo chemotherapy for his Hodgkin's Disease after opting to treat his condition with an herbal diet -- says he will defy the court's order and refuse chemotherapy.
Cherrix says he refuses to subject himself to chemotherapy, which he tried after his initial diagnosis. The chemo made him feel sick, though his cancer briefly went into remission before returning earlier this year. If Cherrix were to submit to the court order, the radiation level for his chemo would be increased.
"I think it's my body. I can choose what's best for my body," says Cherrix. "If I don't have the right to do that, then I don't have any rights at all anyway." Cherrix has been seeing American doctors based in Mexico for five months for guidance with his herbal diet, with the blessing of his parents. Cherrix says, "I feel good. I believe that in my heart, the treatment will cure me."
The Cherrix family's attorneys have filed a motion to stay and are fighting for a new trial in the Circuit Court.
Last Friday, a judge for the Accomack County Juvenile and Domestic Relations Court ruled that Cherrix must resume chemotherapy, and also found his parents guilty of child neglect. If the Circuit Court upholds the lower court's decision, Cherrix's father says he is prepared to face possible jail time. "I'm not going to be an obstacle to my son. If a judge wants to throw me in jail, then he's going to have to do that."
Critics of conventional medicine say Cherrix's situation could bring about an end to health freedom and the ability of every U.S. citizen to choose their own method of healing. Cherrix says his ongoing legal battle to keep his right to naturally treat his cancer is distracting him from healing: "I should be concentrating on my recovery. This case is taking me away from that."
"With this stand against the tyranny of modern medicine, Cherrix has squarely positioned himself as a champion of health freedom," said Mike Adams, health freedom supporter and critic of conventional cancer treatments. "Cherrix's move is brilliant. By refusing to comply with the court order, the court must either back down and recognize his right to refuse chemotherapy, or it must stick a gun in his face, handcuff him and force deadly chemicals into his veins in a Guantanamo-style torture scene.
Either way, Cherrix wins. He either regains his freedom or single-handedly exposes the true tyranny and destructive intentions of conventional medicine. The public backlash against such images would be unprecedented." Adams also added, "My advice to Cherrix and his family is that they document everything. Record audio, take pictures and film whatever happens. Faced with the prospect of daylight, these cancer industry evildoers will be forced to back down. The Judge who ordered the chemotherapy, by the way, should be charged with attempted murder."
Monday, July 24, 2006
Many states have adopted or are considering 'apology laws' that exempt expressions of regret, sympathy or compassion from being considered as admissions of liability in medical malpractice lawsuits. The intent is to encourage physicians and other healthcare providers to apologize to patients when a medical error, accident or unanticipated outcome occurs without the apology being taken as an admission of guilt. The consensus is that healthcare providers have become reluctant to explain to patients and their families what happened when procedures go wrong because they fear the information will be used against them in court. Many healthcare providers have struggled with their desire to explain and apologize to their patient, but have often been strongly advised against such open discussions by their defense attorneys.
And I love being here in Vermont ~ we're proposing legislation that Sorry! Works says is a true road map for every other state in the union.
Researchers at Columbia University are combining the processing power of the human brain with computer vision to develop a novel device that will allow people to search through images ten times faster than they can on their own.
The technology would allow hours of footage to be very quickly processed, so security officers could identify terrorists or other criminals caught on surveillance video much more efficiently.
The "cortically coupled computer vision system," known as C3 Vision, is the brainchild of professor Paul Sajda, director of the Laboratory for Intelligent Imaging and Neural Computing at Columbia University. He received a one-year, $758,000 grant from Darpa for the project in late 2005.
The system harnesses the brain's well-known ability to recognize an image much faster than the person can identify it.
"Our human visual system is the ultimate visual processor," says Sajda. "We are just trying to couple that with computer vision techniques to make searching through large volumes of imagery more efficient."
The brain emits a signal as soon as it sees something interesting, and that "aha" signal can be detected by an electroencephalogram, or EEG cap. While users sift through streaming images or video footage, the technology tags the images that elicit a signal, and ranks them in order of the strength of the neural signatures. Afterwards, the user can examine only the information that their brains identified as important, instead of wading through thousands of images.
Thursday, July 20, 2006
Legal, Medical, and Ethical Questions raised about the charges against healthcare providers during Katrina
In interviews, several experts said that although they did not know the details of the case, they suspected that it had to be more complicated than the “plain and simple homicide” asserted by the attorney general, Charles C. Foti.
One possibility is that the patients were suffering and the only way to keep them comfortable was with high drug doses that may, incidentally, have hastened their deaths. It is not known, though, how much the patients were suffering.
Charo, a professor of law and bioethics at the University of Wisconsin, said: “The real dilemma here is in getting at the very precise facts of the case. I can say that, as a general matter, if you have a patient who is in distress and who needs pain relief and if the only level of painkillers that will relieve the pain also poses a high risk of death then it is permissible to give the pain relievers, provided the patient has consented to the risk of death.”
Even if the patient can no longer give consent, Professor Charo said, it is still ethical for doctors to treat the pain if they believe it is what the patient would want.
“If that was the case, then this is not simple homicide, and I can only hope the investigators were attentive to this,” she said.
Wednesday, July 19, 2006
For Caplan, No. 1 on his list is whether suffering was involved. "So I want happy chickens, no veal, no foie gras. After that comes environmental impact, and then labor. I have an ethical guide in my head that helps me through the store."
He also points out that, in a way, we should be grateful we are even considering all these ethical questions. "These are the dilemmas of abundance," he says. "If we were living in Darfur, the only answer to 'what to eat?' would be 'anything I can find.' "
Researchers at the École Polytechnique Fédérale de Lausanne in Lausanne, Switzerland, are building large-scale computer models to study how the brain works; they have used an I.B.M. parallel supercomputer to create the most detailed three-dimensional model to date of a column of 10,000 neurons in the neocortex -- it is known as the "Blue Brain" Project. (Anybody ever read The Footprints of God?)
Blue Brain researchers say they believe the simulation will provide fundamental insights that can be applied by scientists who are trying to simulate brain functions. Researcher Robert Hecht-Nielsen is seeking to build an electronic butler called Chancellor that would be able to listen, speak and provide in-home concierge services. He contends that with adequate resources, he could create such a machine within five years. (ooh, wouldn't you like one of those?)
Attempts in Congress to override the veto, which would require a two-thirds vote, were expected to fail.According to the Christian Science Monitor, analysts agree that President Bush's veto was risky but unavoidable. Since the issue of stem-cell research arose early in his presidency, when Mr. Bush approved federal funding of preexisting stem-cell lines, he has remained adamant that no federal monies be used on newer cell colonies. The president believes the killing of human embryos, from which stem cells are harvested, is murder, says press secretary Tony Snow.
But an editorial from the Washington Post this morning poses an interesting argument: "We understand that people can in good faith disagree on this question. But we don't understand the logic of Mr. Bush's position. If using discarded embryos to extract stem cells is murder, how can he permit it to proceed with private funding?" (or IVF research to continue for that matter?)
From R. Alta Charo just off the presses:
Rumor has it that the president's veto of the stem cell bill will take
place around 2 pm today.
To express either support or opposition to this action, you may call the
white house at comment line at 202-456-1111. other white house numbers are:
Catfish beignets, curly fries smothered in cheese, pierogies with sour cream, beer-battered artichoke hearts, and fried dough buried in berry sauce and whipped cream -- all part of the traditional Taste of Chicago and all contributing to Chicago's reputation for being one of the 'fattest' cities in the US. And if Edward M. Burke, Chicago City Councilman since 1969, has his way it will be illegal for restaurants to use oils that contain trans fats, which have been tied to a string of health problems, including clogged arteries and heart attacks.
But even Mayor Richard M. Daley, who often promotes bicycle riding and who not long ago appointed a city health commissioner who announced he was creating health “report cards” for the mayor and the aldermen, has balked at a trans-fat prohibition as one rule too many.
What do you think? I love Chicago, it's my favorite city, and I'll like to see it be more healthy -- but does this go overboard? Or is it in the same category as banning smoking in public places? It brings up a host of legal and ethical questions, what role does government play in regulating lifestyle? And if I consciously choose to smoke or eat trans fats, can I really expect society to pay for my care? I'd love to hear your thoughts on this matter...
Tuesday, July 18, 2006
By KIMBERLY HEFLING, Associated Press Writer
WASHINGTON (AP) -- Sen. Rick Santorum, a conservative struggling to win reelection, suffered a political setback late Tuesday when the House rejected his bill to encourage adult stem cell research. The 273-154 vote fell 12 votes short of the two-thirds majority required under the rules. Opponents, mostly Democrats, said the bill would have given the Republican Santorum and other anti-abortion lawmakers political cover for opposing a related bill that instead would fund embryonic stem cell research. The bill had passed the Senate unanimously earlier in the day. Santorum likens embryonic stem cell research to abortion because a days-old embryo is destroyed in the process of extracting stem cells.
A spokesman for Santorum did not respond to requests for comment.
In a statement today, June Walker, National President of Hadassah, appealed directly to Senator Bill Frist, Senate Majority Leader, who visited Hadassah Medical Center in May 2005, to do all he can to ensure Senate passage (of HR 810). “By passing this legislation, the Senate will definitively demonstrate that stem cell research is not an issue that divides Americans by political party or faith. This bill would affirm the sanctity of both human life and the spirit of free inquiry-two tenets of America’s spiritual and political life behind which the vast majority of Americans proudly stand. It is immoral for our families, neighbors and friends to suffer while Washington politics hold hostage treatments within our scientific grasp. A presidential veto would not reflect the American people’s political will.”
Now that's what I call being "pro-life". You can read the full statement at: Hadassah News.
Sunday, July 16, 2006
I don’t usually share my personal woes on the WBP blog. But I’m doing so because it gives me the opportunity to point out that the most important achievement of Glenn McGee’s historic conference is that it clearly demonstrated that bioethics is neither a collection of sideshow issues (Schiavo, Baby Doe, or media issue du jour) nor merely a sub-specialty of philosophy.
As many of the speakers (Charo, Zoloth, Cohen, Moreno, Smith, Doerflinger, Cameron, Wolpe – wow, what a line-up) powerfully indicated, at the core of this politicized bioethics, is the ultimate power struggle for the control of life (and death) and our sense of ourselves as human beings. And this, my friends, is worthy of devoting ones life too. Congratulations to Glenn and the other scholars who participated for an excellent conference.
PS. WBP board member Linda MacDonald Glenn spent much of the conference interviewing all sides of this debate and will be posting a series of fascinating podcasts. Thanks to Linda for her commitment to bring the conference to a broader audience.
I was also able to capture two of the lectures from the conferences, those of R. Alta Charo and Edmund Pellegrino, although the sound quality on those is not as good as those of the interviews, at least until I can figure out how to sound edit them.
Look for pictures from the conference to be posted shortly ~ In the meanwhile, happy listening!
Thursday, July 13, 2006
Fellow blogger Alison McCook had this to say about the conference:
The Bioethics & Politics conference hosted by the Albany Medical College got off to a bang today, not a whimper. As participants trickled in, networking and finding old friends, another, uninvited group calmly filed in, parked in front of the room, and started shouting at the tops of their lungs.
The protesters, around 30 or so, were from Not Dead Yet, a disability rights group that is against legalized euthanasia and other forms of "medical killing," as they call it. The meeting hall became quickly filled with cries of "nothing about us without us." Members quickly distributed fliers to participants that explained they were upset that conference organizers had gathered people from both sides of the political spectrum, but failed to include advocates of the disabled.
Huh? I’m all about pluralism, but the conference is about politics, and with only a day and a half at our disposal, it makes sense to focus the discussion. However, the director of the AMC’s Alden March Bioethics Institute, Glenn McGee, to his credit, took the microphone and said the organizers had decided to give Not Dead Yet a chance to speak. (Glenn even managed to open with a joke: "As you can see, everything is going according to plan.") Representative Stephen Drake spoke for 10 minutes about how politics is not important to people at the front lines of hot button issues ("We live in a world where partisan lines aren’t that important"), and received as much applause as any pre-planned speaker did the rest of the day. After his speech, he and his colleagues left, and it was all very civil.
The experience clued me in to the fact that bioethicists are, by the nature of their purview, adept at handling heated debates and, hopefully, finding a compromise many people can live with. If only other discussions had such a happy ending as this one.
Tuesday, July 11, 2006
But how's this for a novel approach?: Sens. Hillary Clinton and Barack Obama also want to save on health care, but rather than capping jury awards, they hope to cut the number of medical malpractice cases by reducing medical errors, as they explain in the New England Journal of Medicine.
Supporting this approach is a recent study out of the Harvard School of Public Health that showed that the legal system does a good job of weeding out claims without merit.
Friday, July 07, 2006
The judge agreed that the remark was uncalled for, but said that the physician had a right to speak bluntly, writing, "It is nonetheless important ... to ensure that physicians and patients are free to discuss matters relating to health without fear of government reprisal, even if such discussions may sometimes be harsh, rude or offensive to the listener."
Sure, sure--docs have free speech rights the same as the rest of us. But it seems neither professional nor kind. . . . which I think are characteristics we'd like to see in our physicians, no? One hopes that some professional organization will have something more to say to the doc in question.
Thursday, July 06, 2006
Can anyone say "genetic idolatry"? Aren't we more than the sum of our genes? Or are we mere 'meatbots'?
Wallis showed few outward signs of consciousness, but his brain was methodically rebuilding the white-matter infrastructure necessary for him to interact with the outside world, researchers reported yesterday in the Journal of Clinical Investigation.
``I believe it's a very, very slow self-healing process of the brain," said Henning Voss, lead author of the study and a physicist at Weill Cornell Medical College's
Wallis emerged from a minimally conscious state in 2003 at the age of 39 and uttered his first word since Ronald W. Reagan was in the White House: ``Mom." Since then, the onetime mechanic from Big Flat, Ark., has regained the ability to form sentences and recovered some use of his limbs, though he still can't walk or feed himself.
Using both PETscans (Positron Emission Tomography scans) and an advanced imaging technique called diffusion tensor imaging, the researchers examined Wallis's brain after he regained full consciousness, and found that cells in the relatively undamaged areas had formed new axons, the long nerve fibers that transmit messages between neurons.``In essence, Terry's brain may have been seeking out new pathways to reestablish functional connections to areas involved in speech and motor control -- to compensate for those lost due to damage," said the study's senior author, Dr. Nicholas Schiff, a neurologist at the Weill Cornell Medical College in New York.