Thursday, June 29, 2006
We were delighted that WBP’s soon to be published whitepaper was selected to be presented at the conference. Below is the abstract:
Bioethics and Public Policy:A Competitive Analysis of Americans United for Life
How does an established, pro-life advocacy group reshape itself into a self-proclaimed “non-profit, public interest bioethics law firm” using bioethics to drive its political agenda? Bioethics and Public Policy: A Competitive Analysis of Americans United for Life examines the strategies and tactics of one of the most prolific and active conservative organizations that is working to shape bioethics public policy through legislation, pro bono legal counsel, and public opinion. Analysis of Americans United for Life’s programs—such as model state legislation on bioethical issues, whereby they provide everything a state legislator would need to draft, defend, publicize and push through legislation—illustrates how an organization’s ability to focus at a state level to promote a conservative bioethics agenda fits in to the bigger picture of conservative politics. Americans United for Life also has important connections to influential D.C. based conservative think tanks and bioethics centers. It’s a fascinating look at how political influence directly shapes bioethics in the world today.
For more information on the conference: http://politics.bioethics.net/
Wednesday, June 28, 2006
From guest blogger, Peter J. Cohen, MD, JD, Adjunct Professor of Law, Georgetown University Law Center and Chair, Physician Health Committee, Medical Society of the District of Columbia:
I breathed a profound sigh of relief when I learned that the Congress had passed legislation increasing penalties for broadcast indecency as I am now assured that my eyes will no longer be assailed by “wardrobe malfunctions.” However, I wonder when our lawmakers will see fit to deal with the far more significant indecencies—nay obscenities—which we observe in our daily newspapers and TV news broadcasts every day. Just a few examples come to mind:
- Deplorable infant mortality, a disgrace to our nation
- Our impoverished people who suffer and die every day for lack of even basic health care
- Our society—far more concerned with the “legality” of immigrants than with their humanity
- A volunteer army that allows the overwhelming majority of our population to remain completely unaffected by our wars
- A system of lobbying, campaign financing, and influence peddling that make a mockery out of the democratic process
That is enough—Time and respect for the rain forests that produce our newsprint do not permit a complete listing.
Monday, June 26, 2006
Routine HIV testing in the District of Columbia
I have often wondered if blood samples taken for laboratory tests or during hospitalization are screened for human immunodeficiency virus (HIV). One could argue that routine screening of blood samples would be a good laboratory safety precaution; or that it could help catch infections in unsuspecting individuals, allowing early treatment and slowing the spread of the disease overall. A battery of questions flows: Could it also be argued that routine lab and hospital screening is too costly to be practical? Are there a set of guidelines for when HIV screening is performed? Are HIV screenings only performed when they must be ruled out as part of an explanation for a set of symptoms? Was my blood screened for HIV when I was hospitalized? Would I have been told only if my test was positive? Would routine hospital screening for HIV be considered a violation of privacy or other rights without patient consent?
Now the city of Washington, DC, which is believed to have the highest rate of HIV infection in the country (179.2/100,000 people), is urging mandatory HIV testing as part of routine health screening for all patients between the ages of 14 and 84. The Centers for Disease Control (CDC) has been pushing for physicians to routinely screen patients, but this is the first local effort of its kind. Starting tomorrow, the city will distribute 80,000 tests to community groups, doctors' offices, emergency rooms, and STD clinics. These are oral swab tests that produce results in twenty minutes, as opposed to blood tests that can take two weeks to process. According to Jason DeParle of the New York Times, this is "significant because many people who underwent the earlier tests never returned to learn the results, meaning those with the virus remained unaware of the risk they posed to others." I would take a guess that any test that can be processed in twenty minutes is also much less costly than one that gets sent to the lab for two weeks.
While the practicality of an oral test and the idea of routine testing potentially dissolve a few barriers toward HIV detection, there are still many questions to be addressed. Firstly, in a city of more than 550,000, how far will 80,000 tests go, and what happens when they run out? Susan Levine of the Washington Post reported on Saturday that the aim is to use up that supply by the end of the year, "which would mean reaching a fifth of their key population in the next six months." Both Patricia Nalls of the Women's Collective in Northwest Washington and Walter Smith of the DC Appleseed Center for Law and Justice expressed concerns about not having heard any detail about planning for necessary counseling and follow-up care for a newly diagnosed HIV-positive population.
It is also unclear as to whether routine screening does present a privacy issue. Alan Cross reported that the "recommendation met with some resistance from privacy advocates who felt that such a testing might end up stripping HIV-positive people of their privacy and a breach of confidentiality would make it difficult for them to lead normal lives."
Sources and further reading:
Deparle, Jason, "District of Columbia Urges Routine HIV Testing." New York Times, 25 June 2006, http://www.nytimes.com/2006/06/25/us/25hiv.html.
Levine, Susan, "DC Wants HIV Testing for All Residents 14 to 84." Washington Post, 24 June 2006, A01, http://www.washingtonpost.com/wp-dyn/content/article/2006/06/23/AR2006062301685.html.
Cross, Alan, "DE's new campaign to test 14 to 84 year-olds for HIV." Earthtimes.org, 25 June 2006, http://www.earthtimes.org/articles/show/7331.html.
At a time when many are calling for more risk information in direct-to-consumer pharmaceutical ads, a new study from AstraZeneca puts a cap on the number of risks mentioned in TV spots before the consumer is overloaded.
Three is optimal. Four is good. Five is OK. Anything more than that, said the drug maker, and you start wandering into too-much-information territory.
But this runs contrary to counter to what the rest of the industry has discussed. The Food and Drug Administration has repeatedly asked for more risk information, and in remarks earlier this year the director of its drug marketing, advertising and communications division, Thomas Abrams, noted that 82% of pharmaceutical company violations in the past year were related to inadequate presentation of risk information.
Brain deposits of a small protein known as amyloid beta long have been associated with Alzheimer's. But scientists have been unable to determine whether the body begins producing too much of the protein or loses the ability to clear it away.
Now, a research team led by Dr. Randall J. Bateman at Washington University in St. Louis is poised to find that answer with a test that for the first time can monitor the protein.
An initial test of the new technique on six healthy volunteers determined that the protein is quickly produced and quickly cleared, keeping it in balance in the central nervous system, the researchers report in Monday's online issue of the journal Nature Medicine.
Drowning in credit-card debt and student loans, young women are selling their eggs for big payoffs. But can they really make the right medical and moral decisions when they're tempted with $15,000?
Saturday, June 24, 2006
Monday, June 19, 2006
In China, there are 29 goats running around on a farm with human cells coursing through their organs, a result of scientists dropping human blood cells into goat embryos.
The mixing of human and animal cells in the name of medicine has been going on for decades. People are walking around with pig valves in their hearts and scientists have routinely injected human cells into lab mice to mimic diseases.
But the research is becoming increasingly exotic as scientists work with the brains of mice, monkeys and other mammals and begin fiddling with the hot-button issue of cloning. Harvard University researchers are attempting to clone human embryonic cells in rabbit eggs.
Such work has triggered protests from social conservatives and others who fear the blurring of species lines, invoking the image of the chimera of Greek mythology, a monstrous mix of lion, goat and serpent.
During his State of the Union speech in January, President Bush called for a ban on "human cloning in all its forms" and "human-animal hybrids," labeling it one of the "most egregious abuses of medical research."
He didn't elaborate, but scientists working in the field believe that by "hybrids," the president meant creating living animals with human traits - something they say they aren't doing.
Other critics are calling for stricter regulations on the research.
Belle Weaver is flying into the nation's capital today to receive an award for saving a family member's life. Before she leaves town, she'll meet with her congressman, accept a certificate autographed by a football great and bow her head to receive a medal. Stories such as hers, of heroism and quick thinking, are always inspiring. But this one has a twist, and not just because Belle is 3 years old -- she's a beagle. And she used her owner's cellphone to call 911. Her owner, Kevin Weaver, 34, was in the throes of a diabetic seizure, lying unconscious on his kitchen floor in Ocoee, Fla., when Belle located his phone and chomped down on the keypad, triggering a call.
The only thing emergency dispatchers heard was barking, but it was enough cause to send help, they reasoned. Weaver, a former flight attendant, woke up hours later in the hospital, weak and disoriented. Belle was there by his side, having finagled a ride in the ambulance.
Thursday, June 15, 2006
Wednesday, June 14, 2006
In an effort to combat the growing rate of obesity in the U.S., the FDA recently released the Keystone Report. In a world in which all of our portions are “super-sized,” the Keystone Report offers some solutions for controlling caloric intake, especially when eating outside the home. “Americans spend approximately 46 percent of their food budget on food prepared away from home and take in 32 percent of their calories from such foods.”1
The Keystone Report offers recommendations about how to change consumers eating behaviors. Specifically, the Report suggests increasing the marketing of lower calorie foods like fruits and vegetables and providing consumers with nutritional information. Although there has been an increase in the amount of nutritional information available to consumers, more improvements are possible. Most dining establishments still do not provide such nutritional information.
I agree that the FDA and other government agencies should continue to educate the public about health and dietary issues. However, because obesity rates are still on the rise, perhaps the government should also try to promote the benefits of eating more balanced meals at home. We will not see substantial improvements in the obesity rates until more education comes from within the home. Parents have to education themselves and their children about the benefits of eating healthy and exercising. Children sitting in front of the television hearing about exercising and eating more fruits and vegetables are not going to make any changes on their own. Unless parents talk to their children and lead by example, government initiatives will not make the improvements that they could.
I read an article on CNN.com entitled “Thalidomide Approved for Cancer Treatment.” On May 25, 2006, the FDA approved the use of thalidomide in treating patients recently diagnosed with multiple myeloma. Thalidomide, in combination with dexamethasone, is to be used in treating multiple myeloma.
In the early sixties when thalidomide was used by pregnant women, it was discovered that thalidomide caused numerous birth defects. Specifically, it stunted the growth of fetal arms and legs and caused eye, ear, heart, and kidney defects. As a result, the use of thalidomide was banned worldwide in 1962.
Even today, with its FDA approval, thalidomide is being marketed under a “restricted distribution program.” Thalidomide labels display multiple warnings about the risk of birth defects. There is also a warning for male patients stating that it is unknown if thalidomide is present in semen. Due to the severe risks associated with thalidomide even the FDA provides information on its website about thalidomide and warns about the drug’s effects: “Do not take this drug if there is any possibility that you are, or may become, pregnant. Just one dose can cause severe birth defects.”
In addition to myeloma, thalidomide is also being examined in clinical trials as a treatment for a variety of solid tumors and blood cancers.
I found it interesting, and concerning, that a drug with such serious side effects will be used in hopes of prolonging the life of multiple myeloma patients. My concern is based on the CNN article’s suggestion that the success of the clinical trials is somewhat questionable and unknown. For the sake of those multiple myeloma patients that will take this medication in hopes of treating their condition, I hope that the efficacy of the drug outweighs the side effects.
Tuesday, June 13, 2006
Imagine being able to order a genetic test over the Internet -- to see if you have inherited a predisposition to cancer or whether there might be a genetic component to your infertility -- without having to get approval from your doctor, consult a genetic counselor or risk the fallout that might result from filing an insurance claim.
Now imagine sitting alone at your home computer and receiving devastating news: test results that will forever change your life -- and your family's -- in ways you never anticipated.
Those are the promises and perils of the nascent, growing and largely unregulated phenomenon of direct-to-consumer (DTC) genetic tests. For the price of a mail order test kit containing swabs to scrape cells inside the cheek, nearly a dozen companies now offer curious consumers the chance, without ever seeing a doctor, to learn whether they carry genes for cancer, blood disorders or other diseases. Some companies are marketing personalized diet or skin care recommendations based on DNA analysis using tests that are not widely accepted in the scientific community.
For more, read on...
In a manner reminiscent of "To Sail Beyond the Sunset" (both the poem of Ulysses by Alfred Tennyson and the book by science fiction author Robert Heinlein), world reknowned astrophysicist Stephen Hawking has said that the survival of the human race depends on its ability to find new homes elsewhere in the universe because there's an increasing risk that a disaster will destroy the Earth.
Humans could have a permanent base on the moon in 20 years and a colony on Mars in the next 40 years, the British scientist told a news conference. "We won't find anywhere as nice as Earth unless we go to another star system," added Hawking, who arrived in Hong Kong to a rock star's welcome Monday. Tickets for his lecture planned for Wednesday were sold out.
He added that if humans can avoid killing themselves in the next 100 years, they should have space settlements that can continue without support from Earth.
"It is important for the human race to spread out into space for the survival of the species," Hawking said. "Life on Earth is at the ever-increasing risk of being wiped out by a disaster, such as sudden global warming, nuclear war, a genetically engineered virus or other dangers we have not yet thought of."
Friday, June 09, 2006
Read more about:www.iheu.org/bioethics
I was immediately reminded of an issue I worked on when I was an advocate for artists and cultural organizations. In 2001, the United States Immigration and Naturalization Service (now the U.S. Citizenship and Immigration Services) implemented a $1000 premium processing fee for non-immigrant visa applications. This service worked in favor of businesses who could pay the fee to have the applications of new foreign employees processed in 15 days, but it significantly lengthened the time it took to process non-premium application (to as much as 120 days). As a result, the visa applications of international artists who could not pay the fee were delayed enough that some missed their own performances in the
I was a little groggy when I heard this news and I had missed the first half of the story, so I later Googled around for a matching news article with the information I missed. I didn't find an exact match, but I did find a number of other articles about the phenomenon—that is, concierge medicine or “pay-for-care” services. Concierge-style medical practices charge an annual fee of anywhere from $700 to $6000 for the patient conveniences mentioned above, and additional per-visit fees of $50 to $200 depending on the service provided. Many patients who utilize concierge medical services claim that these fee-based conveniences save them aggravation in obtaining care, provide them with better quality health care, and save them money and time in the long-run. Many of these patients also keep their regular health insurance to cover major and emergency medical needs.
I couldn't help but wonder, if I as a patient could pay the extra fees, why should I, on principle, have to pay anything on top of what I'm already shelling out for health insurance and copays, just to get decent service? Furthermore, would it not be selfish of me to opt for premium service knowing that medical care resources are limited and I would in effect be taking away a level of service from patients who can not afford extra costs?
Should a line be drawn between different kinds of services, those for which premium service is stratified by cost and those for which levels of service must be prioritized by something else? I thought to myself, it's one thing to charge extra fees for a service that does not directly infringe on the rights of an individual. I don't have a problem with the idea of stratefying cost according to speed of package delivery, as it is unlikely to affect any critical aspect of my life (like my health), and the use of premium services do not strain the resources of the delivery company. Health care services are sometimes prioritized by urgency of medical need, for example, in the emergency room, or when my physician will give me a same-day appointment because I have been running a high fever for several days. But once someone else can out-prioritize me by paying more, medical urgency goes out the window.
It then occurred to me that it may be more ethical to run a purely pay-for-service practice, as opposed to a practice that offered fee-based services for those who could afford them but still accepted patients who could not. (I'm not sure exactly how the practice on the news operated.) Some doctors who run concierge-style medical practices in fact claim that they are better able to care for their patients because they see fewer patients without sacrificing revenue and save time by not having to submit health insurance claims for patients. Declining rates of insurance reimbursements for providers was also cited as incentive to run concierge practices.
Still, the existence of a few concierge-style medical practices creates the potential for skew in who gets the better medical care and an environment of “you get what you pay for.” I can imagine that as things currently stand only a very small percentage of the population could or would be willing to pay several thousand more dollars a year for medical care. I am reminded of a conversation I had with a Philadelphia-based psychotherapist about the administrative and cost issues of insurance supplementation for mental health services: she told me that many of her colleagues had chosen to move their practices to
Some interesting news stories about concierge medicine:
and from the Miami Herald.
Maybe it's a little bit of stretch, but what does the book and the movie The DaVinci Code have to do with Women's Bioethics? How about this for arguments: "...the latest challenge to women's lowly status in religion. The female place in sacred history, according to a group of researchers, goes beyond wife, mother and follower." The pro-life movement sees it this way: 'The Da Vinci Code is a piece of propaganda which follows the same pattern as the revolution that gave us abortion and the rest of our promiscuous culture. The fallout of that revolution ... could lead to the spiritual deaths of millions more."
What are your thoughts? Does anybody else see more connections? Or is this too much of stretch?
Arthur Allen does a nice job of discussing some things we should be thinking about in his Slate article: And Now, the HPV Vaccine: Warts and all (http://www.slate.com/id/2143304/) :
"...how to get the vaccine to the women and girls who need it most—poor, uneducated women and those in the developing world. "None of us are going to be happy if the only women who get the vaccine are the same women who are already getting regular screens for cervical cancer," John Schiller, one of the vaccine's inventors, told me at his National Institutes of Health laboratory. The Vaccines for Children program, a Clinton-era entitlement, will probably make the vaccine available for free to poor children in the United States. But social conservatives like Focus on the Family leader James Dobson have opposed making vaccination mandatory, believing vaccination might lower barriers to teen sex.In a roundabout way, this prudery may keep the vaccine out of reach of poor girls. Research and experience have shown that only mandatory-vaccination laws—which typically increase vaccination rates by 10 to 15 percent—get even cheap vaccines to the poor. Given the politics, state legislatures and public health boards may shy from requiring HPV vaccine for middle-school entry."
This falls under the category of 'no big surprise' : The federal government should guarantee that all Americans have basic health insurance coverage, says a committee set up by Congress to find out what people want when it comes to health care.
"Assuring health care is a shared social responsibility," says the interim report of the Citizens' Health Care Working Group, a 14-member committee that went to 50 communities and heard from 23,000 people.
The committee describes its recommendations as a framework. The recommendations don't say who would pay for universal health coverage or how much it would cost. The concept of government-guaranteed coverage runs counter to the Bush administration's position that consumers should bear more responsibility for their initial medical expenses.
Thursday, June 08, 2006
When Camille Walters plays soccer, her normally brown eyes have a spooky red tint – that’s because of the contact lens designed to give this athlete an edge.
That's because the 15-year-old wears tinted contact lenses that block certain wavelengths of light and help athletes see better. Oh, and they look cool, too.
But does these lenses give some athletes an unfair advantage? The associations that govern high school and college sports don't think so, but they're keeping an eye on the lenses.
Jerry Diehl, assistant director of the National Federation of State High School Associations in
The federation allows the lenses and puts them in the same category as sunglasses or corrective lenses. The NCAA also allows the sports lenses because it considers them similar to sunglasses.
But Diehl said he's worried about the perception of an unfair advantage.
"If one affluent team can get this, it forces everybody else to go out and do that," Diehl said. "Is it really something that makes a difference? In this instance, at this juncture anyway, it doesn't seem to be any better or any worse than allowing what is already under the rule."
Dr. William Jones of
Tuesday, June 06, 2006
A recent posting invited progressive bioethics scholars to participate in a private briefing at the upcoming ASBH summer conference in
Do you consider yourself a progressive bioethics scholar? Are you interested in getting more politically involved? Will you be attending the ASBH Summer conference in
From Science and Theology magazine:
A priest, a rabbi, and an Islamic scholar walk into a room full of scientists …
Sound like a modern twist to a politically incorrect joke? Actually it happened in 1999 in Rockville, Md., and serves as an ideal metaphor for the growing cooperation between science and religion. The three religious leaders were among 11 experts called by the National Bioethics Advisory Commission to give religious perspectives on human stem cell research.
The witnesses agreed on little. But it was evident that a fundamental question had gone unchanged, at least since Nathaniel Hawthorne’s cautionary short story “The Birthmark” was published 163 years ago. Should scientists do something simply because they can? As biotechnology enables us to do more and more, that question becomes ever more finely parsed. From 1866 to this day, no one has looked askance at Gregor Mendel’s cross-pollination of pea pods. Yet in the spring of 1994, biotechnology firm Calgene’s genetically modified Flavr Savr tomato drew salvos from activists who charged that the company was producing “Frankenfood” that could harm human health and disrupt the food chain.
Monday, June 05, 2006
Shabaz said Wal-Mart and Medical Staffing Network accommodated Noesen's religious opposition to contraception by having other pharmacists fill prescriptions. But he said Noesen went too far by putting customers who called about birth control on hold indefinitely and refusing to get service for those who showed up in person without notifying other pharmacists.
By Rick Weiss of the Washington Post:
So you think you are the self-reliant type.
A rugged individualist.Well, give it up. You'd be nothing without the trillions of microbial minions toiling in your large intestine, performing crucial physiological functions that your highfalutin human cells wouldn't have a clue how to do.
Sunday, June 04, 2006
If you would like to participate, please email email@example.com with your name, age, gender, and geographical location. We need your demographic information to be sure we have a representative sample but all responses will be compiled without attribution. The groups will be held mid-July and the results presented to the WBP advisory committees and state legislators bioethics working group. Please consider participating in this important project. Incentive: WBP coffee mug to all participants.
[Submitted by Kathryn Hinsch]
"All the marvels and wonders of technology can amount to nothing unless it elevates humans to their highest potential" --
Today's quote is by Jacque Fresco, an inventor who I had the pleasure of meeting at a conference a few years ago. He describles himself most often as a multi-disciplinarian or “generalist” -- a student of many inter-related fields. He is a prolific inventor, having spent his entire life (he is now 89 years old) conceiving of and devising inventions on various scales which entail the use of innovative technology.
The quote comes from the film Future by Design, a documentary film by Academy Award® nominated Hollywood filmmaker William Gazecki --the film is a visually and intellectually engaging exploration of one man’s vision of a future where war is outdated, there is no shortage of any necessary resource, and our focus as a species is sustainability. But far from presenting a vision of Utopia, this documentary demonstrates a “possible future” -- with real and viable alternatives to our current paradigm of militarism and commercialism.
In the Future by Design, all systems work together. The personal, social, economic, industrial and governance arenas are all interconnected and balanced into one functional system. The Future by Design is a true participatory democracy, where each member of the society has the opportunity to input their needs, opinions and preferences into the central computer, which then assesses and analyzes all information to determine the use of resources in manufacturing distribution of goods and services. For an inspiring look at humanity's potential, check it out at futurebydesign.org.
[Models & Photos by Jacque Fresco & Roxanne Meadows]
Friday, June 02, 2006
The Board of Pharmacy's move mirrored the preference of the state pharmacy association but angered abortion- and women's-rights groups, and defied the wishes of Gov. Christine Gregoire.
Lisa Stone JD, Board member of the WBP and Executive Director of the Northwestern Women's
[Hat tip to R. Alta Charo for the great header] Under the category of "this would change everything": As bizarre as it may seem, the sample jars brimming with cloudy, reddish rainwater in Godfrey Louis's laboratory in southern India may hold, well, aliens. In April, Louis, a solid-state physicist at Mahatma Gandhi University, published a paper in the prestigious peer-reviewed journal Astrophysics and Space Science in which he hypothesizes that the samples -- water taken from the mysterious blood-colored showers that fell sporadically across Louis's home state of Kerala in the summer of 2001 -- contain microbes from outer space.
In a similar vein, Francoise Baylis gave an awesome telelecture today at the University of Vermont on "Ethical Issues in Chimera Research and Stem cell therapies for Human Neurodegenerative Disorders", an area which has been of great interest to me ever since I started researching the issue for my thesis at McGill (published here). Some articles that both she and I have written at actionbioscience.com outline the issues that scientists and researchers will be facing.
Posted by Ana Lita to Women's Bioethics Blog at 6/02/2006 12:52:00 PM
Those of us who are concerned with women's health and welfare would do well to consider this issue. Thinking about the amount of ink and anguish we spill in the US about the "mommy wars"--when this kind of thing is going on in the world--makes me crazy.