Friday, November 30, 2007

Too young to die for religion?

A recent case in the Seattle area of a 14 yr old boy with leukemia who refused a blood transfusion because of his adherence to the doctrine of Jehovah's Witnesses has raised questions about whether a juvenile is sufficiently competent to refuse lifesaving medical treatment due to religious beliefs.

To add more to the story, the boy was living with his aunt, who is a devout Jehovah's Witness, not with his biological parents, who are not.

A lot of the bloggers at ScienceBlogs are commenting on this tragedy to varying degrees, some questioning the patient's age, some considering undue influence from the aunt. Given current laws regarding medical treatment, protection of minors, and indeed, refusal of elective procedures like tubal ligation for competent adult women, this ruling will force us all to rethink our own standards on what is considered sufficiently competent in a patient, to what extent parents and guardians ought to be held accountable to harm that comes to those in their care because of beliefs they enforce, and which reasons are applicable enough to use to choose something as permanent as death.

(Of note: there have been other incidents recently involving Jehovah's Witnesses refusing lifesaving medical treatment, such as a woman who chose to die after giving birth to twins.)

Intergenerational PTSD: Epigenetics may hold explanation

Corpus Callosum blogs about the study, "Transgenerational Transmission of Cortisol and PTSD Risk" by Rachel Yehuda and Linda M. Bierer, which discovered that lower cortisol levels were observed in the offspring of Holocaust survivors, suggesting a link between parental experiences of PTSD and an increased risk of their children experiencing PTSD.

Epigenetics is still a new field, but there appears to be great potential for epigenetic models to explain intergenerational changes in genetic expression, an idea that challenges the traditional rejection of acquired traits being transmissible to later offspring. It is possible that the paradigmatic shifts inspired by epigenetics could be to genetics what Einsteinan physics was to Newtonian physics.

In light of this, it is reasonable to predict that in the next twenty years, we will see a wave of new medical and psychological conditions as the children of Iraq War veterans are born and grow up. Perhaps by then we will not only understand why they are affected as they are, but we will be developing treatments and cures to mitigate these impacts.

For a quick introduction to epigenetics, I strongly recommmend Survival of the Sickest, by Sharon Moalem. I am currently reading Evolution in Four Dimensions: Genetic, Epigenetic, Behavioral, and Symbolic Variation in the History of Life, by Eva Jablonka and Marion J. Lamb, and while I have not yet gotten to the part on epigenetics, it is a good book for discussing the paradigms and ideas behind the theories of genetics that were developed.

Thursday, November 29, 2007

So, Which Side Was That Again, Eh…? The Horror of Wrong-Sided Surgery

You’re having surgery. All the authorizations have been given—all the forms signed…and preparations made.

You trust your surgeon’s credentials, education and expertise in providing you with the care you need. You have every confidence in the nursing staff.

Yet, you can’t arrive at the hospital before stopping at an art store to pick up…permanent markers—just as a precaution. “X” marks the spot, right?

You want to make sure there’s no question WHICH side of your body the surgery is to be performed on.

Sound wacky? Not when you consider that tales of doctors operating on the wrong side of a patient’s body—or removing the wrong organ or limb—happen with frightening frequency in hospitals across the country. The most recent case, involving an 82-year old Rhode Island patient, resulted in a $50,000 fine being levied against the hospital.

While the overall percentages are low, so-called “wrong-site surgery” occurs more often than is being reported, and has prompted a review of procedures and implementation of guidelines for hospitals to follow to prevent occurrences. Review the article and relate your own opinion on what can or should be done.

On Cloning Monkeys: Quote of the Day

From the Onion this morning: " "I'd better hold my praise until some opinionated monk calls himself a bioethicist and weighs in." For more opinions on cloning monkeys, click here.

Tuesday, November 27, 2007

Call for contest submissions: The Method in Bioethics Research

"'Tis madness, but there's method in't."

But is there?

There are many different ways of doing bioethics. It is a point of pride and of truth that bioethics is a multidisciplinary and sometimes an interdisciplinary activity. All of the constituent disciplines doubtless have their methods, but in the case of theoretical bioethics, thought of by philosophers or by those with a philosophical turn of mind as philosophical bioethics, there is a problem. What do we answer when asked what is our methodology? Or what methods will we use to address and answer the questions we ask or those of which are asked of us?
-John Harris, Cambridge Quarterly of Healthcare Ethics

And thus begins the article introducing a multi-journal competition to answer the question "what are the methods of theoretical bioethics?" In something of a first, the winning entries will be published simultaneously in the following journals: AJOB, Bioethics, Cambridge Quarterly of Healthcare Ethics, Journal of Medical Ethics, Kennedy Institute of Ethics Journal, Nursing Ethics, and Theoretical Medicine and Bioethics. You can read the full details of the competition over at AJOB's blog.

"GM Beets" make a comeback - is that an industrial band?

A second attempt to start growing genetically modified beets in America has started. (NYT)
Seven years ago, beet breeders were on the verge of introducing Roundup-resistant seeds. But they had to pull back after sugar-using food companies like Hershey and Mars, fearing consumer resistance, balked at the idea of biotech beets. Now, though, sensing that those concerns have subsided, many processors have cleared their growers to plant the Roundup-resistant beets next spring.

It would be the first new type of genetically engineered food crop widely grown since the 1990s, when biotech soybeans, corn and a few other crops entered the market.

“Basically, we have not run into resistance,” said David Berg, president of American Crystal Sugar, the nation’s largest sugar beet processor. “We really think that consumer attitudes have come to accept food from biotechnology.”

A Kellogg spokeswoman, Kris Charles, said her company “would not have any issues” buying such sugar for products sold in the United States, where she said “most consumers are not concerned about biotech.”

If some other big food companies are now open to genetically modified sugar, though, they are not talking about it. Both Hershey and Mars declined to comment. “There’s just nothing we have to say on the topic,” a Mars spokeswoman said.

Quick summary: Monsanto has created a genetically modified variety of beets that can withstand its highly toxic "Roundup" herbicide; farmers who grow these "Roundup Ready" beets can spray their fields with this herbicide to kill all weeds, leaving the resistant beets unscathed. This beet was refused several years ago, but now, since there is not significant protest, it is being reintroduced.

While this is only one type of GM crop, many of the concerns here extended to other types of GM crops, including those that produce Bt toxin and display other cross-genera traits - namely, economic/corporate concerns, legal issues, and an undermining of consumer and farmer choice.

Below is a copy of what I posted as a comment to this article. I don't address specific issues with "Roundup Ready" because it should be apparent that modifying a crop so we can use even more toxic herbicides on the land it is grown on is kind of an icky thing.

While GM crops may hold promise for the future, the way they are being blithely introduced into the American industrial agricultural and food production systems with absolutely no checks (like transparent labeling or point-of-origin tracking) is foolish and dangerous. Note in the article the conveyed attitude of assuming the GM crops are safe because the industry said so, not because comprehensive safety testing was performed. Unlike chemistry or physics, we still do not understand the multi-level dynamics of biological systems, especially given new breakthroughs in epigenetics, which produce intergenerational expression or suppression of genes depending on environmental factors like nutrition and exposure to chemicals. This means that our conventional tests for food safety may not be enough to really ascertain the dangers in these products, and even those few tests supposedly performed by industry are suspect because they were not overseen by the FDA or other regulatory bodies. In fact, there is currently confusion over which regulatory body should regulate GMOs – the FDA or the USDA – because their characteristics cross categories – a GM crop that produces a toxin (ex. Bt Corn) is not just a crop because of the toxin, but is not just a toxin because it is a crop. Thus, it falls through the cracks because neither regulatory body takes responsibility for it. We must change our paradigm of safety testing and regulation to one that can accommodate the new conceptual levels invoked by genetic modification.

The biotech industry is undermining farmers by removing their ability to choose their crops. Cases of GM canola cross-pollination in Canada show that biotech companies still have no way of assuring us their products cannot be safely contained when used on an industrial scale outside a laboratory. This means that even if these products are safe, we may not be able to control their spread, and they will become, at best, an invasive organism that overruns any other native or traditional crops. And when cross-contamination occurs, as in the Monsanto v. Schmeiser case, the corporation, with extensive genetic testing resources and high-powered lawyers, are able to prosecute non-GM farmers for "theft" even if the farmer had nothing to do with GM seed blowing into their field or cross-pollinating with their conventional crops (and had no way of testing to make sure their field was free of GM crops). This power imbalance enforces a monopoly by the biotech industry that weeds out farmers who choose not to purchase these products. In a society that was built on and that still cherishes its farmers, this is wrong.

By letting industry and economic interests decide what is "safe enough", we are incorrectly placing the burden of proof on the consumer, who has no way of making a personal, responsible, informed decision and no way of bringing grievances should an adverse effect occur. Additionally, as we can see from current regulations regarding labeling of rBGH-free dairy products, while producers who do not use growth hormones are free to label their products as such, they are forced to include the disclaimer: "no significant difference has been shown between milk derived from rBST-treated and non-rBST-treated cows." Why the label? Because conventional dairy producers are afraid that consumers will be "scared away" from buying their products; this is an economic interest, not a public safety interest. It was recently decided that there was no reason to label cloned meat when it is added to the market. We are currently consuming GM crops in our processed food, which is not obligated to list such information. This attitude does not only pervade the food industry; recently, it was revealed that an FAA survey showing that airplane travel was less safe than the public thought was withheld from release to the public because of the fear that people would not want to fly anymore. Today, consumer confidence in food safety is at an all-time low; how does shirking transparent, truthful labeling inspired not by desire for economic gain, but for public safety, help remedy this? Not only do people deserve the right to choose what they eat (whether for religious, cultural, or personal reasons), but in the event of an adverse reaction (ex. Starlink corn), public health entities have no way of tracing the foods people consumed to determine if there is a common link. This means that future crises cannot be averted due to the inability of food security bodies to induce a recall of contaminated food; considering the high number of recalls of meat, produce, and processed foods in the past year, where would we be if there had been no way to trace health risks back to these? We need accurate labeling that promotes public safety and consumer choice, not labeling that feeds protectionism for the industry.

Thus, both consumer and farmer choice and safety is undermined by the industry – farmers cannot choose to grow non-GM crops, and consumers cannot choose to not consume GM products. Eliminating such choice in a free nation like America is inexcusable. We should continue to study genetic modification because of the potential promise it holds, but the American public and our farmers should not be the guinea pigs sacrificed in the industry's test studies for profit.

For further reading, I recommend The Omnivore's Dilemma by Michael Pollan, Food Politics and What to Eat by Marion Nestle.

There is also a great podcast called "Deconstructing Dinner" by Kootenay Co-op Radio in British Columbia that covers a wide variety of sustainability and food security issues.

Monday, November 26, 2007

Home Genetic Test-kits: the new "gotta have it" holiday gift?

Remember home chemistry sets? Well, they're now officially passe since you can get your very own personal genome sequence from one of several fine establishments and do a paternity test in the comfort of your own home.

Beyond simple worries about fraud, there are a number of concerns brought up at DigitalBio, including privacy, liability and legality. I offer up the possibility of overriding GINA (or similar laws, should they ever get passed), and a question: when does information stop being information and just becomes an overload of data that a person does not know how to actually use or parse?

So "what is" Tiger Woods anyway? (and should we care?)

Gene Expression discusses race and appearance, pointing to people disagreeing about whether Tiger Woods looks "Black" or "Asian." Not only is there a good discussion of the involved genetic dynamics, but the larger question of "why do we still focus on race?" is touched on.

Being of mixed descent myself, my appearance and behavior has confounded many people who have tried to "pin me down" as a certain race or ethnicity, much to my amusement (some have been wildly off) - I grew up always being asked the question, "So what are you?" And I wonder now, does it serve any purpose beyond satisfying curiosity to try to ascertain a person's race when so many other factors, like culture and nationality, contribute to a person's identity and perspective when interacting in the world? Many have speculated on the future of race, that we will lose the need for such distinctions because more people will claim mixed heritage (as shown by the 2000 U.S. Census) and will grow up with a cosmopolitan appreciation of all cultures, making attempts to reify race and ethnicity superfluous and inaccurate.

Speaking as someone who eats everything from sushi, kimchee and curry to gyros, crawdad boil, and stroganoff, I have to agree.

Addendum: Beyond aesthetic considerations, attempts to classify race and ethnicity can have very real economic impacts.

Sunday, November 25, 2007

Weekend in Review

Hope everyone enjoyed their Thanksgiving weekend and found something for which to be grateful. (After all, we all know that expressing gratitude heightens well-being and that a conscious focus on blessings may have emotional and interpersonal benefits). While we were taking a well-deserved break and counting our blessings, some notable stories with a bioethics theme came out over the last few days:

Our colleague, Paul Root Wolpe, has some interesting bioethical questions about manned space travel -- here's a sampling:

* What would we do if a crewmember became violent because of a
traumatic brain injury or mental illness?
* Do we include a straitjacket as standard issue on the craft?
* How much medical training is adequate for the crew as a whole?
* What if the designated physician gets sick?
* What level of treatment is enough?
*If a crewmember is disabled in space, who becomes their surrogate
decision maker? Their spouse? NASA physicians? Other crewmembers on the
The full article can be seen here.

The latest on deep brain stimulation for treatment of brain disorders, courtesy of PBS, Wired Science and YouTube.

From the NY Times, "Are Scientists Playing God? It Depends on Your Religion."

And, also from the Old Grey Lady, a psychiatrist examines how taking money from pharma can cloud your judgment, despite going into the deal with eyes wide open -- the article, Dr. Drug Rep.

Happy reading and remember, as the Washington Post suggests, if you start feeling too stressed out from the end of semester crunch or the holidays, take a deep breath and practice going "Om for the Holidays."

Tuesday, November 20, 2007

Induced Pluripotent stem cell lines

It is amazing to see how the Catholic Church and George Bush can hold us all in thrall regarding human embryonic stem cell research. Because of the opposition to deriving stem cells from human embryos which destroys the embryo, eminent scientists are now reduced to attempting to find stem cell alternatives and have done so - by creating induced pluripotent stem cell lines derived from human somatic cells, an advance (?) which is being heralded today in the NY Times. In other words, we can regress human skin cells to an embryonic state by introducing retroviruses including c-Myc (cancer cells) to do so. The only problem with this is that it also creates tertomas which are nasty little creatures - effectively a germ cell tumor which may contain hair, teeth, bones, eyeballs, torsos and hands. Yuk, as Leon Kass would say. Here's an idea: instead of trying to create human embryonic stem cells from someone's nose or foreskin, let us do the research on embryos as nature intended.

I prefer "geek," not "geekette"

Sciencewoman shares a few experiences with lingering sexism against women in science.

I can't help but remember my experience in preschool, where in response to my expressed interest in becoming a doctor, I was told that I "had to be a nurse" because I was a GIRL. I ended up not pursuing medicine for other reasons, but I still proudly identify as a geek through my interests in new technologies, sci-fi, and gaming, and am grateful that I had parents who bought me a microscope and chemistry set instead of the "typical girl fare".

While I am still guaranteed a large amount of (questionable) attention at any gathering of geeks, to my relief it has declined with time as more women push into scientific fields. Any wagers on how long it will be until it's no longer considered unusual for women to be geeky?

(and are there any other lady geeks out there?)

Update on the Genetic Nondiscrimination Bill

One of the things that both conservative and progressive bioethicists have agreed on is the merit of GINA ((the Genetic Non-discrimination Act). And there was great hope when it passed the House easily and may of us saw it as a potential solution to the injustice of genetic discrimination. So what's happening with the bill? Seems it has been stalled in the Senate, single-handedly by Sen. Tom Coburn (R-Oklahama). The scoop, according to Wired, is that Coburn is saying that it could place too much strain on businesses.

Where's the outrage on this?

The Model of a Psychopharmacologist

(A quick and dirty driveby post) For those of us who love Neuroethics and Gilbert & Sullivan, here is the youtube video for the day. Created by Stephen M Stahl, MD, PhD, of Neurosciences Education Institute. Enjoy!

Great Non-fiction Read: Liberation Biology

A year ago, the Women’s Bioethics Project launched a bioethics book club designed to help people understand the direct and profound implications of emerging biotechnologies. Over the past year, we’ve featured popular works of fiction from best selling authors including Jodi Picoult, Kazuo Ishiguro, Margaret Atwood and Michael Crichton to stimulate discussion and reflection.

As is the nature of fiction, these authors have focused on the perils rather than the promise of biotechnology in order to create compelling story lines and adequate narrative tension. Based on feedback from our readers, we are launching a new program featuring a selection of non-fiction works on biotechnology to provide a more balanced perspective.

For our first selection, our panel choose Ronald Bailey’s book “Liberation Biology: The Scientific and Moral Case for the Biotech Revolution” because it provides an engaging, straight forward, and ethically compelling way for readers to consider the policy implications of decisions to ban or limit access to technological advances.

I spoke with Ron, who is an award-winning journalist, science correspondent for Reason Magazine, a former television producer and author of numerous books on the environment. You can listen to our interview here. It touches on a few of the issues covered in his book, provides an important perspective to consider and will likely provoke controversy (I can already imagine the blog postings from people who prefer that we not ask hard questions and critically examine preconceived notions) but we can’t let ideological bullies stop us from engaging, educating, and empowering people to think and reflect on these critical issues.

Monday, November 19, 2007

Training Tomorrow's Peter Parkers

A New York Times article describes new efforts to teach biotech to students in high schools.

MORE than a decade ago, after George Cachianes, a former researcher at Genentech, decided to become a teacher, he started a biotechnology course at Lincoln High School in San Francisco. He saw the class as way of marrying basic biotechnology principles with modern lab practices — and insights into how business harvests biotech innovations for profit.

If you’re interested in seeing the future of biotechnology education, you might want to visit one of George Cachianes’s classrooms. “Students are motivated by understanding the relationships between research, creativity and making money,” he says. [emphasis mine]

Lincoln has five biotech classes, each with about 30 students. Four other public high schools in San Francisco offer the course, drawing on Mr. Cachianes’s syllabus. Mr. Cachianes, who still teaches at Lincoln, divides his classes into teams of five students; each team “adopts” an actual biotech company.

The students write annual reports, correspond with company officials and learn about products in the pipeline. Students also learn the latest lab techniques. They cut DNA. And recombine it. They transfer jellyfish genes into bacteria. They purify proteins. They even sequence their own cheek-cell DNA.

While I am a strong proponent of stronger science education in our high schools, I am concerned that we are teaching skills without teaching wisdom. Yes, the new advances in biotech are fascinating (I wouldn't be doing this if it weren't), but, to quote Uncle Ben, "With great power comes great responsibility." And I worry that while we are encouraging our youth to pursue the incredible power of biotechnological and other advances, we are not teaching them that such power also bestows deep responsibilities - to their employers, their customers, and to society as a whole.

Some may argue that high school students do not have the cognitive capabilities to engage in such moral/ethical discussion, but at least some of them do, as evidenced by the thriving sport of high school Speech and Forensics (aka Debate) where policy and philosophy are routinely utilized on an undergrad level to address current events and issues. Perhaps not everyone does, but a student who is able to handle complicated genetic manipulation ought to be able to absorb at least a little social awareness on the side.

Of course, it will be more difficult to find someone versed in ethical philosophy who is sufficiently motivated to work in the high schools (as there are no "Ethical Philosophy" corporations to give backing), and it is probably not wise to create an adversarial binary environment (ethicists vs. corporate interests) but some type of engagement must occur, lest we allow today's youth (tomorrow's leaders) to develop motivations based solely on personal achievement and profitability, and not built at least partly on a sense of responsibility to society.

When Quacks Attack

How one man's invention is part of a growing worldwide scam that snares the desperately ill (Seattle Times)

A Seattle Times investigation has uncovered a global network of manufacturers who sell unproven devices, and practitioners who prey on unsuspecting patients.

Capitalizing on weak government oversight, they have used these devices — some illegal, others potentially dangerous — to drain patients' bank accounts, misdiagnose diseases, and divert critically ill people from life-saving care.

These victims are casualties in the growing field called "energy medicine" — alternative therapies based on the belief that the body has energy fields that can be manipulated to improve health. Energy devices range from handheld machines the size of television remotes to behemoth machines that weigh hundreds of pounds, with costs ranging from $1,200 to $55,000.

Unfortunately, many people turn to these and other treatments, loosely termed "alternative therapies" (to include herbal supplements and holistic remedies) and the price they pay can range from thousands of dollars to their lives, whether as a direct result of the treatment or because they neglected to see real medical care for a serious condition. The reasons people turn to these practices range from a distrust of establishments like the medical community to bad experiences with previous medical treatments to a distorted perception of financial costs and expected gains.

I will be the first to admit that I do take vitamin C supplements and indulge in yoga and Shiatsu for my health because I feel that the potential gains outweigh the risks (both of which I have researched to a good extent). But I draw the line for myself and friends at expensive price tags or risky procedures; while there may be some benefit to be had, further research needs to be performed before alternative therapies are introduced freely to the public, who has a reasonable expectation of safety and efficacy.

There are many angles to a story like this – new medical technologies, public misinformation, cultural and social tendencies to believe in quack treatments – and there is no easy answer, especially when a vehement denial of the efficacy of alternative therapies by medical professionals could only exacerbate the existing atmosphere of distrust and suspicion that feeds this problem in the first place. While rational engagement by professionals and skeptics is important, a sincere and sensitive discussion on a cultural level will yield more progress in this issue.

Saturday, November 17, 2007

A new take on Descartes' "I think, therefore..."

If you could use a little chuckle this morning, check out the new philosophy of 'unidentalism'. [Hat tip to Jay Hughes of IEET for this one].

Wednesday, November 14, 2007

Colorado Supreme Court OKs Ballot Initiative to give Personhood to Embryos

[Hat tip to Terry Tomsick for this story]

From the Denver Post:

The Colorado Supreme Court on Tuesday gave the go-ahead to proponents of a ballot initiative seeking to amend the state constitution in 2008 to define personhood as a fertilized egg.

Opponents to the measure, which would lay the foundation to make abortion illegal in the state, challenged the ballot title as misleading to voters.

The court ruled in a 7-0 decision that it is clear and meets the state requirement for a single-subject ballot question.

"Proponents of this initiative have publicly stated that the goal is to make all abortion illegal, but nothing in the language of the initiative or its title even mentions abortion," said Kathryn Wittenben, executive director of NARAL Pro-Choice Colorado.

"If that's not misleading, I don't know what is," Wittenben said.

The amendment, if approved by voters, would extend constitutional protections from the moment of conception, guaranteeing every fertilized egg the right to life, liberty, equality of justice and due process of law.

The initiative's 20-year-old proponent, Kristi Burton, founder of Colorado for Equal Rights, announced the court's decision Tuesday afternoon to loud applause at the Pro-Life Leaders Summit at the Timbers Hotel in Denver.

"This is a very simple petition. That's all we need," Burton said. "The people of Colorado will support protecting human life at every stage. More than that, we have God. And he is enough."

The rest of the article can be found here.

Story of the Week: Primate Cloning

A few years ago, a Korean scientist defrauded the world and scientific community by claiming to have cloned human embryos -- but this week, researchers in Oregon say that they have cloned the embryos of macaque monkeys to derive embryonic stem cells. Listen to the NPR story here and then take a look at what our colleague Art Caplan had to say about it on MSNBC:

"For quite some time many important and influential people have been freaking out over the prospect of cloning a human being. When Dolly the cloned sheep’s existence was revealed to the world 10 years ago, panic ensued. World leaders — including the president, the pope and numerous prime ministers — condemned Dolly’s creation as a regrettable and dangerous step toward cloning a human being. " Read the rest of the commentary here.

Intersecting Human Rights Crises: Organ Transplantation and Organ Trafficking

Seen the Movie "Dirty Pretty Things?"
Some Things Are Too Dangerous
To Keep Secret Like…
Organ Trafficking and Transplant Tourism!

Come to the IHEU-Appignani Center for
Bioethics Panel!

Intersecting Human Rights Crises:
Organ Transplantation and Organ Trafficking

Who: IHEU Appignani Center for Bioethics
What: Panel discussion on organ trafficking and transplantation
Where: 2nd floor, 777 UN Plaza, New York, NY 10017
When: Tuesday, December 11, 2007, 5:30-7:30 PM
Cost: Pay at door: $35 General Public | $20 Students
RSVP: by Dec. 3, 2007
Contact: 212-687-3324 (tel) | 212-661-4188 (fax) |

The speakers will explore the ethical issues of organ trafficking with a focus on shortage of organs for transplantation, lack of organ donors, 'black-market' organ trafficking, some problems
with organ transplantation such as possible immune rejection and keeping organs alive outside the body, among others. The panel will feature keynote addresses by leading bioethicist Art Caplan, and Rachel Mayanja, UN Assistant Secretary-General, Special Adviser on Gender Issues and the Advancement of Women. The panel will also include medical doctors, experts in gender issues at the United Nations and the Council of Europe as well as the director of New York Organ Donor Network.

Over at the Business Ethics Blog: Sexism in Coffee Shops

Thanks to Chris MacDonald over at the Business Ethics Blog for posting this interesting tidbit about Waiting for Good Joe: Do coffee shops discriminate against women? Who would have thunk it? You can read the full post here.

"Every Month Contains a Miracle" part two - The Podcast Interview with Cryo-Cell

We had posted about the new product C'elle earlier this month and we had a chance last week to interview scientist and vice president of research and development Julie Allickson and vice president of marketing Rob Doll. The interview is now available via podcast at We discussed how the project came into existence, the potential, the costs, and a few other things.
Give a listen and let us know what you think -- are there any follow-up questions you would like us to ask?

Thursday, November 08, 2007

So what does a pharmacist do anyway?

U.S. District Court Judge files injunction against Washington State's requirement for pharmacists to fill prescriptions. (namely Plan B)

A federal judge has suspended Washington state's requirement that pharmacists sell "morning-after" birth control pills, a victory for druggists who claim their moral objections to the drug are being bulldozed by the government.

In an injunction signed Thursday, U.S. District Judge Ronald Leighton said pharmacists can refuse to sell the morning-after pill if they refer the customer to another nearby source. Pharmacists' employers also are protected by the order.

I have to ask whether there is a proximity and availability guarantee in this injunction - if the nearest pharmacy is fifty miles away and it is not established whether they will provide Plan B, then this is an unjust and unfair exemption.

"On the issue of free exercise of religion alone, the evidence before the court convinces it that plaintiffs ... have demonstrated both a likelihood of success on the merits and the possibility of irreparable injury," Leighton wrote in reply.

"Irreparable injury" - yes, they seem to be referring to a person's personal religious status and how protecting that is more important than, say, a person being allowed to fill a legal and valid prescription for medication that affects their health. Note that while this specific case affects Plan B, the door is open to refuse any prescription; I have friends who were refused their birth control pills because they were unmarried... they took them for hormonal imbalances, not for contraception. That said, I don't think we will see refusals for other medications that could encourage "immoral behavior" (ED medication, anyone?) anytime soon. Yet again, women are being forced into a position where we have to justify our decisions and prove that we deserve to be treated with a basic level of respect and professionalism.

The issue I would like to see resolved here is the problem with false advertising and deceptive practices. We need to clarify (and if necessary, redefine) the professional label of "pharmacist" and "pharmacy" and require complete transparency in what services are reasonably assumed to be provided and which will be prima facie rejected for personal beliefs. I propose that we make it a requirement that these businesses must explicitly state through a disclaimer that they do not provide all services and will refuse to fill prescriptions for certain medications (which will be specifically listed) in any place they call themselves a pharmacy - signs, advertisements, brochures, commercials, etc. Additionally, such a pseudo-pharmacy should not be allowed to be placed in a remote location where they would be the only pharmacy within a reasonable radius; they cannot be counted on to serve as a real pharmacy and people should not be deceived into thinking they can count on them to dispense legal and valid prescriptions.

Or why don't we reduce the government red tape and let the state of Washington, the only one that, to my knowledge, provides free contraception for anyone of low income who asks (Take Charge) because we recognize the value in people having the power to decide for themselves what is best for their health, their families, and their lives, decide what is best for Washington State?

Addendum: Additionally, I urge everyone to reject the comparison of this passive-aggressive act of refusal to civil disobedience, as it does not fulfill the requirements for this honored course of action in response to unjust laws in a democracy.

John Rawls describes civil disobedience as "a public, nonviolent, and conscientious act contrary to law" and urges that the disobeyer accept arrest and punishment as meted out by officials to demonstrate respect for legal procedures. Thus, Henry David Thoreau accepted his punishment of being jailed for refusing to pay taxes that would support a war; to him, acting within the bounds of his pacifist conscience was more important that staying out of jail. Additionally, nonviolence is a commonly accepted requirement of proper civil disobedience, which could extend to allowing harm to come to another through negligence of duty.

Consequently, we see that prescription refusers act covertly (they do not make it clear ahead of time to the public and authorities), allow harm to befall patients seeking their aid (through the ability to deny any prescription), attempt to circumvent the laws and obligations concerning their profession, and demand protection from legal consequences of their breach of the law. Additionally, their situation more closely matches the concept of "Rule Departure," where an official charged with specific duties refuses to fulfill those duties due to a conflict of conscience; with pharmacists, there is an expectation that they will dispense medications for any legal and valid prescription in a timely fashion, and by refusing to dispense, they violate their vested duties.

Addendum 2 (11/14): I am so excited that people are reading this blog and sharing their own opinions. But I would love to see a reasonable argument engaging the standards I have proposed rather than the usual retreat to ad hominems and overly simplistic moral doctrines. Let's come up with a solution by finding answers.

Stem Cells May Reverse Alzheimers' symptoms

From the UK's Daily Mail in London, November 7 : Scientists at the University of California in Irvine have for the first time used stem cells to reverse memory problems associated with strokes, Alzheimer's, and degenerative brain disease in mice. The researchers say that the cells repaired damaged parts of the brain and restored lost memory. They believe that their technique may also work on humans. Full article here.

Good news, but I am curious as to why the scientists used newborns' neuronal stem cells as opposed to embryonic or adult stem cells?

Setback in AIDS vaccine

More on the setback in the AIDS vaccine that we mentioned earlier.

The link between weight and likely cause of death

As our bloggers have commented several times before, the science of obesity is contested, uncertain, and as Medical Humanities Blogger Daniel Goldberg said, 'heavy with value-laden beliefs'. Confirming this uncertainty, today, Gina Kolata of the NY Times reports that an article in the Journal of the American Medical Association shows overweight people are much less likely to die from diseases such as Alzheimer’s, Parkinson’s, infections, and lung disease, and that the lower risk is not counteracted by increased risks of dying from any other disease, including cancer, diabetes or heart disease.

Of course, the study cannot speak to cause and effect -- but it certainly underscores that science has a lot to learn when it comes to studying optimal weight.

Tuesday, November 06, 2007

Two very different views of the future

The upcoming BBC series "Visions of the Future" has evoked two very different responses: One site, in the Women's Section of the UK TimesOnline hails "Welcome to the New Body Shop" and presents a fairly positive outlook on what science and technology will be able to contribute to the future. The other article, in the UK Telegraph, "And we will have the power of gods" presents a cautionary-beware-of-hubris outlook.
Is this merely a difference in reporting styles between the newspapers or representative of how different people look at the same news and see different things?

[Addendum, November 15, 2007: FutureNerd Steve Witham has some interesting things to say about ways of thinking about the future. Check his blog(s) at
and the IS Group].

Thursday, November 01, 2007

Eulogies For Washoe and Alex -- Invitations to Enlarge Our Moral Universe

Washoe, the first chimpanzee ever taught American Sign Language, passed away on Tuesday night. An amazing creature, she was born in 1965 in West Africa, where she was captured by the Air Force. She was brought to the United States, initially for research use in the space program, but after less than a year in the program, she took up residence with two scientists, Allen and Beatrix Gardner, who raised and treated her as a deaf human child; during her lifetime, she mastered the use of more than 250 signs and taught them to other chimpanzees. The NY Times said "by age 5 she had mastered enough signs to capture the world’s attention and set off a debate over nonhuman primates’ ability to learn human language that continues to this day." She died in bed at age 42, of natural causes, surrounded by staff members and other primates who had been close to her. More details about her life and tributes can be seen at the Friends of Washoe website.

Just several weeks ago, the world also lost another star, Alex, the talking grey parrot. Alex, who served as an inspirational model for the character "Gerard" in Michael Crichton's novel Next, was able to identify 50 different objects, 7 colors, 5 shapes, quantities up to and including 6 and a zero-like concept. Below is a video interview with Dr. Irene Pepperberg, the scientist who trained and studied him for three decades. More details about Alex's life and tributes can be seen at The Alex Foundation website.

What both Washoe and Alex did for us in the field of biomedical ethics was to force us re-examine our attitudes towards our selves and towards the other inhabitants of the planet that we share. Washoe and Alex helped us recognize that the lines between 'human' and 'nonhuman' are not so brightly drawn -- that we are interconnected and interdependent and that drawing these separations is an illusion. In the words of Buddhist monk, Thich Nhat Hanh:

If you are a poet, you will see clearly that there is a cloud floating in this sheet of paper. Without a cloud, there will be no rain; without rain, the trees cannot grow, and without trees we cannot make paper. The cloud is essential for the paper to exist. If the cloud is not here, the sheet of paper cannot be here either...

If we look into this sheet of paper even more deeply, we can see the sunshine in it. If the sunshine is not there, the tree cannot grow. In fact, nothing can grow. Even we cannot grow without sunshine. And so, we know that the sunshine is also in this sheet of paper. The paper and the sunshine inter-are. And if we continue to look, we can see the logger who cut the tree and brought it to the mill to be transformed into paper. And we see the wheat. We know that the logger cannot exist without his daily bread, and therefore the wheat that became his bread is also in this sheet of paper. And the logger's father and mother are in it too...

You cannot point out one thing that is not here -- time, space, the earth, the rain, the minerals in the soil, the sunshine, the cloud, the river, the heat. Everything co-exists with this sheet of paper... As thin as this sheet of paper is, it contains everything in the universe in it.

[From The Heart of Understanding Berkeley, CA: Parallax Press, 1988, pages 3-5.]

Alex and Washoe, by virtue of who they were, extended invitations to those of us in the human sphere to enlarge our moral universes -- An invitation which many of us have gratefully accepted. May they Rest In Peace.

"Every Month Contains a Miracle"

Today, Cryo-Cell announced its discovery of a new, unique type of stem cell found in menstrual blood that may one day have the potential to treat a number of diseases. With the slogan, "Every Month Contains a Miracle", Cryo-Cell also launched an exclusive and proprietary new service, called C’elle, to enable women to collect and cryopreserve their menstrual stem cells. Some more info from the media press kit:

Menstrual Stem Cells

  • Cryo-Cell has discovered unique stem cells in menstrual blood that express multipotent markers of both adult and embryonic stem cells. These menstrual stem cells multiply quickly and can differentiate into other types of cells, including heart, nerve, bone, cartilage and fat, according to early research.
  • The menstrual stem cells appear to have characteristics similar to those derived from the uterus (human endometrial stem cells), but they can be easily harvested in a non-invasive manner from menstrual fluid.
  • This is the first time researchers have found an adult stem cell that is highly prolific and multipotent (able to differentiate into other cell types), and can also be easily harvested in a painless, non-invasive manner as compared to other stem cell sources such as bone marrow, fat or adult peripheral blood.
  • Several leading stem cell researchers have launched preclinical studies to evaluate the potential of these unique menstrual stem cells to treat heart disease, Type 1 diabetes and spinal cord injury.
  • Researchers believe that these menstrual stem cells could someday be used treat other serious illnesses, such as osteoporosis, stroke, Alzheimer’s and Parkinson’s disease, and that the cells may even be used for customized anti-aging or sports medicine treatments. However, current research is very preliminary and it may take years to develop widely available clinical therapies.
  • Menstrual stem cells’ unique properties, combined with their ease of collection and isolation, mean they could become a breakthrough source of multipotent cells. The need for regenerative therapies incorporating cells that have the ability to engraft and differentiate is vast. The ideal cell would also have the ability to be used in an allogeneic manner, meaning it could be used to treat others with whom there is a genetic match. These cells appear to have all of these properties.
  • A summary of research related to the menstrual stem cell can be found at
We've contacted Cryo-Cell to arrange for an interview with one of their experts about the ethical implications, and hope to hear back from them shortly. Stay tuned!