Thursday, July 31, 2008

Obese because your grandparents were in a famine?

Epigenetics, a very hot topic in bioethics and public health, may provide an explanation for the current obesity epidemic. Epigenetics deals with how gene activity is regulated within a cell - which genes are switched on or off, which are dimmed and how, and the transgenerational effect -- the implications for public health could be huge.

In this clip from the NOVA special, the Ghost in Your Genes, researcher Marcus Pembrey of the Institute of Child Health at University College London and his colleagues analyzed records from an isolated community in northern Sweden and found that men whose paternal grandfathers had suffered a famine between the ages of 9 and 12 lived longer than their peers; they also found that the mother's nutrition might affect a child's risk of obesity, too -- women in the Netherlands who were in the first two trimesters of pregnancy during a famine in 1944 and 1945 gave birth to boys who, at 19, were much more likely to be obese. The implication is that extended periods of feast or famine might trigger a switch to a pattern of gene expression that results in different metabolic states for future generations.



The realization that individuals can acquire characteristics through interaction with their environment and then pass these on to future generations of offspring will likely forcue us to rethink evolutionary theories such as Dawkins' selfish gene theory.

Sunday, July 27, 2008

I WANT TO BELIEVE...In Altruistic Kidneys

*Spoiler Warning!*
(Photo courtesy of 20th Century Fox - Free download.)

By Emily Stephens

Okay, yeah, I admit it. I’m an X-Phile. So, after seeing The X-Files movie this weekend, I was delighted there were medical ethics raised within the film—just so I could blog about them.
The “freak of the week” themed storyline brought back my two favorite FBI agents…well, ex-FBI agents, whose lives are still so fascinating that Mulder and Scully could’ve picked their noses on the big screen for two hours and ten minutes and I’d still be riveted. The daring duo didn’t suffer from
Rhinotillexomania, however. They were plagued with a bad case of “I want to believe.”

The movie explores some interesting questions about the lengths we go to in order to keep ourselves alive. *There are two characters dying within the film: a Russian “mad scientist” willing to harvest organs and body parts from the living in order to prolong his life (he’s dying of lung cancer) and a young boy Scully goes to great lengths to save who suffers from a rare, almost incurable disease. Scully uses contentious “stem cells” to help the boy—an act made even more controversial by the fact that she works in a Catholic hospital. Scully was torn whether or not to try an experimental, extremely painful stem cell treatment on her patient. The other doctors at her hospital were convinced the boy’s health should be left to God’s will. Scully wanted to believe her will was aligned with God’s, but she couldn’t help wonder on the most basic level how her attempts to stall death were all that different from the mad scientist’s.*

Although disturbing, these storylines aren’t too far off base. People are living longer, there are less traffic fatalities, improved ER care keeps people alive who would’ve died’n’donored in the past, and not enough people are signed up as cadaver organ donors in the first place. Black market organs are a hot topic. Stem cell research stirs up heated debate.

Some organs are only available at the donor’s death, e.g. heart, eye balls, etc. Interestingly, kidneys don’t fall into this category. In fact, most of us could continue living absolutely normal lives without one of our kidneys.

Some current facts about
kidney organ donation:

· Over 95,000 U.S. patients are currently waiting for an organ transplant; nearly 4,000 new patients are added to the waiting list each month.

· Every day, 17 people die while waiting for a transplant of a vital organ, such as a heart, liver, kidney, pancreas, lung or bone marrow.

· Because of the lack of available donors in this country, 3,916 kidney patients, 1,570 liver patients, 356 heart patients and 245 lung patients died in 2006 while waiting for life-saving organ transplants.

· The organ graft survival rate for patients with organ grafts from live donors is greater than those who received grafts from a cadaveric donor.

Due to America’s alarming organ donor shortage, Al Roth of Harvard designed an online kidney exchange program. He proposed a place where potential donors and patients needing transplants could converse and negotiate costs, incentives, and other benefits such as lifetime health care, a college education, or pocketfuls of cash for the donors. The idea resulted in NEPKE, or the New England Program for Kidney Exchange, which formed a few years ago. NEPKE connects living kidney donors who are willing to donate but incompatible with their loved one, with other compatible recipients and donors in hopes that more people will benefit from a larger multi-compatible database. There have been
31 NEPKE transplants to date.

The black market for organs has created a violent surge in third world countries, where poorer people’s organs are valued more than their lives. What does this all mean? There is and will continue to be a growing market for organs. How should we handle this exchange? A New York Times article entitled ‘
Flesh Trade’ reads:

“If it's hard to get people to give up their organs upon death, consider how much harder it is to persuade a living person to donate a kidney. (From a medical perspective, a kidney from a living donor is far more valuable than a cadaver kidney.) Even though most people can live safely on one kidney, there is still a price to be paid in discomfort, risk, fear and lost wages. But the United States, like pretty much every other country in the world, forbids a donor to collect on that price, or any other.

It is hard to find an economist who agrees with this policy. Gary Becker and Julio Jorge Elias argued in a recent paper that ‘monetary incentives would increase the supply of organs for transplant sufficiently to eliminate the very large queues in organ markets, and the suffering and deaths of many of those waiting, without increasing the total cost of transplant surgery by more than 12 percent.’”

In Europe, organs are harvested after death. There’s no donor card. It is assumed all their citizens will give. If people are willing to sell their “living donations,” why are we stopping them? Would you donate a kidney to save a loved one’s life? What about donating one to someone you didn’t know? Would you altruistically donate an organ to someone in need? If not altruistically, would you do so for a price? Would you feel cheapened if a monetary price was affixed to your organ?

The Voice of the Last Lecture Silenced


Randy Pausch, the professor whose “last lecture” we had posted about earlier this year, passed away Friday, at his home in Chesapeake, Va at the age of 47. He spoke eloquently about his mortality, the meaning of his life, what legacy he wanted to leave behind. Battling with pancreatic cancer, he lived five months longer than the six months doctors gave him.

May he rest in peace; a Carnegie Mellon campus memorial service is being planned with details to be announced at a later date. In the meanwhile, Tributes.com has created a memorial page for those who have been touched by Randy's story and would like to learn more about his inspirational journey.

A Fun Read: Seven Reasons People Hate Reason

Some of you may remember R. Alta Charo's talk from the ASBH and politics conference a couple of years ago (podcast available here), where she explores the tension between reason, politics, culture, and bioethics -- In a similar vein, an article in New Scientist magazine (subscription may be needed) explores the seven reason people shun reason:

"From religious fundamentalism to pseudoscience, it seems that forces are attacking the Enlightenment world view – characterised by rational, scientific thinking – from all sides. The debate seems black and white: you’re either with reason, or you’re against it. But is it so simple? In a series of special essays, our contributors look more carefully at some of the most provocative charges against reason. The results suggest that for all the Enlightenment has achieved, we still have a lot of work to do.

Editorial: How to make reason more reasonable

How humans dared to know

The 21st-century passion for "Enlightenment values" owes a lot to the 18th century. Philosopher A. C. Grayling discusses where those values come from and what they mean today

1: Reason stands against values and morals

Shaping a moral and humane world requires more than reason, says Archbishop Rowan Williams

2: No one actually uses reason

If we had to think logically about everything we did, we’d never do anything at all, says neuroscientist Chris Frith. Watch a related video

3: I hear "reason", I see lies

Science is routinely co-opted by governments and corporations to subvert people’s ability to make their own decisions, say sociologist David Miller and linguist Noam Chomsky. Watch a related video.

4: Reason excludes creativity and intuition

Reason is lost without art, says Turner prizewinner Keith Tyson. Watch a related video.

5: Whose reason is it anyway?

Real people don’t live their lives according to cold rationality, says bioethicist Tom Shakespeare. Watch a related video.

6: Reason destroys itself

Even in formal mathematics, reason breaks its own rules, says mathematician Roger Penrose. Watch a related video.

7: Reason is just another faith

Unconditional reliance on a single authority is never sensible, says philosopher Mary Midgley."

Saturday, July 26, 2008

Psychiatric Drugs: Not Just for Humans Any More

By Randy Hendrickson

Do animals have thoughts and feelings that are similar to our own? Do they experience anxiety, depression, or cognitive dysfunction? According to the New York Times (“Pill-Popping Pets” July 13, 2008), pharmaceutical companies are now formulating human drugs for use in companion dogs and cats. These include behavior modification and lifestyle drugs to treat conditions such as cognitive dysfunction, separation anxiety, depression, mood and behavior disorders, and even obesity. One such drug, Clomicalm® (Novartis), is chemically identical to clomipramine (Anafranil®), the tricyclic antidepressant for humans, however, it was packaged with a picture of a happy, smiling yellow lab on the box. It is approved by the FDA for separation anxiety, but also prescribed off-label for canine compulsive disorders. Another drug, Anipryl® (Pfizer) is used to treat cognitive dysfunction and help the animal with memory loss. Similarly, Reconcile® (Eli Lilly), which is used for separation anxiety, is the same chemical compound as Prozac®, except it is beef flavored and chewable. Currently, most of the major pharmaceutical manufacturers have a companion animal division. It is a very lucrative income stream considering that $15 million was spent on behavior modification drugs in the United States in 2005 alone.

According to Melanie Berson from the FDA Center for Veterinary Medicine, “as people are seeing more complex and sophisticated drugs for themselves, they want the same quality for their pets.” There is a growing desire to use behavior-modifying medications in order to have more obedient pets and to control their dogs so they don’t act like dogs. “Owners want their pets to be more like little well-behaved children.”

But this issue is more complicated than merely wanting well-behaved, socially adjusted pets. Behavioral pharmacology advocates maintain that the combination of new drug therapies along with progressive training techniques can solve behavioral problems that in the past usually resulted in euthanasia. Aggression in dogs, for example, is a serious problem. It is the primary reason dogs are brought to clinics, taken to shelters, and often even euthanized. Treatment with psychoactive medications is a good alternative to putting down these animals. Dr. Nicholas Dodman from the Tufts University Animal Behavior Clinic explains, “Prozac, a selective-serotonin reuptake inhibitor (SSRI), prolongs the effects of that neurotransmitter to reduce impulsivity, stabilize moods and lower anxiety.”

Separation anxiety is also a troublesome problem for many dogs. At least 14% of all American dogs have separation anxiety, and it often results in destruction of the home, whining, frantic barking, inappropriate chewing, or sometimes even injury to itself. Dodman claims that although separation-anxiety is believed to have genetic origins, the unnatural lives that people lead and subject their animals to trigger these problems. “A dog that lived on a farm and ran around chasing rabbits all day would be more prone to being stable than a dog living in an apartment in Manhattan.”

But is pharmacological treatment more for the health and well-being of the dog or for the convenience of owners? “A lot of ‘behavior problems’ are actually normal behaviors for the animal. Food guarding and aggression toward strangers boost a dog’s survival rate in the wild but don’t cut it in the living room.” Not everyone, however, believes that drugs are the solution to companion animal behavior problems. According to animal behaviorist Dr. Ian Dunbar, although pharmacologic aids may be helpful in some very extreme situations, most cases behavior modification alone is enough. “The rush to the medicine bottle for easily resolved problems . . . shows a disturbing parallel to the human approach to health care. We lead an unhealthy lifestyle and then rely on drugs to correct it.”

The use of psychiatric medicines in treating mood and behavior issues, however, is prompting new questions concerning what exactly separates mankind from animals. What does animal behavioral pharmacology teach us about not only animal minds, but also our own? Is it a coincidence that animal mental illnesses are mirroring those of humans? The causes of behavioral problems and mood disorders are similar for both pets and people—genetics and environment. “Whether cubicle- or cage-bound, we get too little exercise; we don’t hunt, run or play enough to produce naturally mood-elevating neurochemicals. . . . All of the behavioral issues that we have created in ourselves, we are now creating in our pets because they live in the same unhealthy environments that we do. That’s why there is a market for these drugs.”

Quote of the Day

)If you need a practical example of virtue ethics in action) "The world is never saved in grand messianic gestures, but in the simple accumulation of gentle, soft, almost invisible acts of compassion, everyday acts of compassion." Chris Abani 's talk about how the best way for us to be human is to reflect our humanity back at one another. See the whole lecture here.

Thursday, July 24, 2008

Little Miss Sunshine Meet Little Miss Melanoma

by Leane Scoz

Awwww, summertime! Whether at the beach, the pool, the park, or backyard, you are bound to come in contact with Earth's big, round, yellow friend in the sky...the sun. But, the way the encounter is handled varies greatly from person to person.

Some people welcome the warm rays from the sun and choose to apply little or no sunscreen at all. Others are deathly afraid of the consequences of the powerful rays and head to the store for a floppy hat and SPF 60. Many others choose to have their cake and eat it too by applying a mid-range SPF in hopes of tanning instead of burning. However, new research should make everyone want to run toward the nearest shade.

According to a recent article in the Washington Post, government cancer statistics revealed the rate of new melanoma cases among younger women jumped 50 percent since 1980. The American Cancer Society reports about 62,000 melanoma cases are diagnosed each year in the United States, with more than 8,400 people dying from the disease. What has caused such a large increase?

National Cancer Institute researchers who led the analysis believe a number of risk factors have contributed to the rise in cases. Stronger rays from the sun are a direct result from the thinning ozone layer and increase in greenhouse gas emissions. People are spending a lot more time outdoors and are not protecting themselves against ultraviolet radiation. Young women are frequently engaging in indoor tanning (tanning bed) use in larger numbers. Researchers also noted that increased awareness, public education campaigns, and better diagnosis may have also played a role in the larger number of reported cases.

So, what's a pale-skinned gal to do? First, remember that ultraviolet radiation is dangerous and a carcinogen. Limit the amount of time spent in the sun. Always use sunscreen (SPF 15 or greater). Get your skin checked at least once a year. And, lastly feel good knowing that you will look much younger and wrinkle-free in your golden years than your sunbathing beauty counterparts who will have acquired leathery skin that matches their handbags and more wrinkles than a Shar-pei puppy.

A Face Only a Mother Could Love

A Face Only a Mother Could Love

By Michael Leshinski

The undeniable bond between mother and child has just gotten scientific proof to back what some of us have already known. A recent study published by the American Academy of Pediatrics revealed strong brain activity for first time mothers when there were shown a picture of their own child’s face. The study, as first reported in the NY Times, compared pictures of the mother’s own and another random newborn with similar features. It was found that the mother’s brain, upon seeing the photo of her own child’s face, underwent extensive activation specifically in the emotion processing, cognition, and motor/behavioral output sections. When photos of the random, unknown newborn were presented, the mother’s brain did not show the same levels of activation.

Throughout the study, MRI technology was used to monitor the brain activation levels in the participants. The study also found that certain neurotransmitters, such as Dopamine, were released specifically when the mother was shown the picture of her own smiling baby. Dopamine has been linked directly to areas of the brain that process feelings of reward. When the mother recognized a picture of her baby with a sad expression, the same levels of dopamine were not present. In short, there’s no reward for a crying baby. I can confirm this with my own personal experience since my brother and his wife have recently had their first child. I’ve also taken away two major realizations from the publication of this study. The first involves the scientific implications of these new findings. Maybe it is possible to use this new information to treat unfortunate conditions such as Postpartum Depression. Secondly, the study tested only first time mothers, but I believe that the bond between mother and child lasts a lifetime, even if I am the youngest of three boys.

Wednesday, July 23, 2008

Upcoming Event: The Black Woman & Family & Health Care Disparities

Tonight, Wednesday, July 23, 9 p.m. ET, CNN anchor Soledad O'Brien explores the varied experiences of black women and families and investigates the reasons behind the disturbing statistics on single parenthood, health care disparities, and the devastating toll of HIV/AIDS.

Primum non Nocere - Army physicians serve bureaucracy instead of veterans

It has become common knowledge that veterans of the current military actions overseas have been regularly cheated out of the benefits due them by contract.

What is disturbing is that physicians are serving as a vehicle for this shameful practice.

BrokenSoldier relates his personal experiences being classified in his disability rating by bureaucratic interests acting through physicians. For example, migraines are a common result of concussions, and were able to be classified as "50% disability" if they met the frequency of twice per month and the pain was classified as "prostrating". However, when large numbers of soldiers ended up qualifying for this, the Army physicians were instructed to re-define "prostrating" as requiring that the servicemember sought immediate medical attention, which is a little difficult to do if you are forced prostrate from pain.

While it is certainly good to have some skepticism about these claims, I see a very good cause for investigating this both on a Congressional level and in the venue of the medical profession.

Tuesday, July 22, 2008

Women are so sensitive

A 51 year old "board certified" orthopedic surgeon in New Jersey is offended that a woman who went in for back surgery and discovered a temporary rose tatoo at her pantyline, on the side of her body opposite her back, has brought suit against him because, according to the surgeon's lawyer, her suit " suggests something he did was intended to be prurient, and nothing could be further from the truth," Rather, "It was intended just to make the patient feel better." Apparently, this was something the surgeon did frequently to "lift spirits" and no one had ever complained.
http://www.abajournal.com/news/new_jersey_woman_sues_surgeon_over_temporary_rose_tattoo/

Art Caplan was called in. While of course what he said is exactly right, "You cannot do something like this even as a joke,'' it is horrifying that in 2008 it was necessary to get a comment from a professional ethicist to say this is wrong. Also, although I know to some of you a 51 one year old can be excused because "times were different" when he was raised I am only five years younger than he is and believe me this is not so.

[Editor's note: for non-lawyers, this doctor could be held liable for battery, for unauthorized touching (i.e., beyond the original informed consent, with no implied consent because it wasn't medically necessary). Given that the patient was under anesthesia, and the location of the tattoo, he could also be held liable for intentional infliction of emotional distress, which could warrant punitive damages.]

Monday, July 21, 2008

Parents Want Alternatives

by Leane Scoz
Autism is a developmental disorder defined by impairment in social interaction and communication, and the presence of repetitive or unusual behavior and interests. The Center for Disease Control and Prevention (CDC) reports that 1 in 150 children under the age of 8 have an autism spectrum disorder (ASD). With a cure yet to be found, parents of autistic children are seeking alternative treatments over the limited conventional treatments currently available.

Chelation is one alternative therapy gaining rapid popularity among the autistic population. The unproven treatment, which removes heavy metals from the body, is believed to help children with autism by removing levels of mercury from the body. According to a recent CBS News article, the theory behind the treatment stems from the believe that mercury in vaccines triggers autism.

Since this theory has never been scientifically proven and mercury (thimerosal) has been discontinued in childhood vaccines since 2001, scientists believe the proposed government study to test chelation treatment on autistic children is unethical and dangerous. Many parents of autistic children disagree and are even resorting to using chelation without results from a study to prove whether it is beneficial or not. In fact, CBS News reports the proposed study is on hold due to safety concerns after an animal study linked the treatment to lasting brain problems in rats.

The concerns are certainly not without merit since a 5-year-old autistic boy died after undergoing chelation therapy in 2005 and hundreds of lawsuits are currently underway because of the effects of chelation therapy. However, parents of autistic children are not deterred. An estimated 3,000 autistic children in the United States participate in chelation treatment at any given time. Some children are under the care of a physician during treatment and others under the care of their parents since chelation therapy can be done with a variety of over-the-counter dietary supplements.

Parents of autistic children simply want answers. They want their children to live a normal life, free of a developmental disorder. If regulated medicine can not provide them with the answers they are seeking, they have not choice but to resort to alternative treatments, such as chelation. But, at what cost? Is it really worth putting your child's health and well-being in danger in the hopes of possibly finding an answer? It is an ethical question autistic parents will struggle with until a cure for autism is discovered.

Noteworthy News Briefs

While our bloggers have been churning away blog posts, the news stream just keeps throwing more information our way, giving plenty of food for thought -- here are a just a few summaries and links to noteworthy stories of ethical, legal, and/or societal import:

~ Empowerment enhances cognition (or the flip side, why kicking someone when they are down keeps them down). From the Economist, a study shows that simply putting someone into a weak social position impairs his/her cognitive function. Conversely, “empowering” him or her, sharpens up his mind. Full story here.

~ Most study participants understand research goals. From Reuters: People who take part in clinical trials often do so out of a desire to advance scientific knowledge and to help others, a new international study demonstrates. Access full article here.

~ Some doctors are worried that the early findings regarding a drug that seems to restore speech in Alzheimers' patients will raise premature hopes in patients and their families. More on the story here.

~ Hello, Mr. Roboto -- Do we think that machines can think? From Science Daily, the question of why and under what circumstances we attribute human-like properties to machines and how such processes manifest on a cortical level was investigated. Article accessible here.

~ Creationism rears its ugly head. Again.

~ A Blow to Genetic/Biological Idolatry: Families with Children Without A Genetic Or Gestational Link To Their Parents Do Well. Story here.

~ Good News: We've Seen the Future and We May Not Be Doomed. The story on the UN Report of the Future, here and a link to the Executive Summary here.

~ The American Medical Association, long considered to be the voice of American doctors., formally apologized for more than a century of policies that excluded blacks from the group. Article here.

~ In the category of 'keepin' em barefoot and pregnant': The draft proposal from the Department of Health and Human Services (HHS) would withhold government funds from health-care providers and organizations that don't hire people who refuse to perform abortions or provide certain types of birth control. Story here. Worthy commentary here.

~ The Future of Babies: Artificial Wombs and Pregnant Grandmas. From LiveScience, artificial wombs and experiments on human embryos grown in the lab will be commonplace and no big deal ethically in 30 years, several scientists predict.

Mercy in Timor Leste

You may remember that I had posted a blog entry previously about my adventures in Timor Leste; it is a poor but beautiful country, just beginning to flourish after being freed from 20+ years of brutal Indonesian occupation. I've just returned from a 3 week trip there again this past month and this time, I had the opportunity to witness a floating hospital at work: the U.S. Navy Hospital Ship USNS Mercy, one of the U.S.'s largest portable trauma facilities. Anchored in the harbor for several days every few months, Mercy's crew provides humanitarian assistance and medical care to the citizens of Timor Leste, focusing on public health, preventive medicine, reproductive health, dental treatment, primary care, and health education. They even have a spay-neuter clinic where citizens can bring their pets to control overpopulation.

This is a wonderful idea; it is an inspiring picture of humanity at its best. It also raises a question in my mind -- if we are willing to do this for other countries (and I think we should), why are we not able to provide basic health care for our own in need in this country?

Sunday, July 20, 2008

The "Despair-ity" of Personal Ethics

By Emily Stephens

Where Is the Justice?

Last week, a close friend/co-worker of mine was accused of timecard fraud at my office. The charge came as a total shock. I caught her in the parking lot as she left our building in tears. She explained the situation to me, and dispite my outrage, she asked I keep the matter private. I obeyed. Unfortunately, the investigation was discussed openly by management at our office, and to my friend’s detriment, the news spread like wildfire. To credit my friend’s bravery, she remained at work in silent protest of the wrongfulness of these charges, and despite the fact that her personal integrity was under public scrutiny.

Over the course of the week, I watched her battle complete humiliation. This private, embarrassing situation was discussed by all. Her boss, thinking he was doing the right thing, refused to come to her aid. Friday she was notified by HR that she’d been exonerated of all charges. Furthermore, HR ruled there wasn’t enough evidence for an investigation in the first place. Nevertheless, the damage is done. Relationships are in ruins. Trust between co-workers is flushed down the toilet.

Dr. Johnson


A few years ago, I had the honor of serving on a jury during the case of Dr. Johnson v. California State Prison system. Johnson served as one of the supervisory doctors who cared for the health of hardened criminals. Younger doctors who worked beneath him vied for his position. Although it didn’t seem premeditated, they accused Johnson of dementia and tried to force him into retirement. The charges were serious enough to warrant an official investigation into his well-being. He was forced to leave, and his license was revoked until the allegations were disproven. The stress of the situation took a tremendous toll on his health. In order to pay for his defense, he lost his home, cashed out his 401K, and said good-bye to his savings.

By the time his license was returned to him—he was found not guilty of the mental defect charges—he was no longer in a physical condition to return to work. A few years later, he testified before the jury, a sickly, weary, and hopeless man. Although we awarded him justice, his aggressors won. The damage was done, and no amount of money could give him back his faith, hope, and life.


Larry and Brandon

Newsweek’s current Top Story, entitled “Young, Gay and Murdered” describes the complicated tragedy of two 15-year-old boys, Larry and Brandon, whose relationship ended in bloodshed. Larry was flamboyant and troubled. Whether he was homosexual or not is still very much in question, as he had never had a relationship with anyone male or female, and how he dangerously and openly sought negative attention. In no way, shape, or form do I condone in the least degree his tragic murder, but the fact that he harrassed his killer cannot be neglected when examining the situation. The controversy over how schools can best deal with young teens caught up in adult issues of gender, identity, and sexuality is a difficult one. How do we fairly approach Brandon’s trial? How can we find the most appropriate justice for Larry when so much damage has already been done?

My Conclusion

I think everyone wants to do what is right. But, these events have taught me that ethics are far from simple. Although a form of justice can be given on this earth, it will always be lacking. With it comes loss, pain, anger, and confusion--things we cannot fix nor replace. True healing is beyond our power to award. As a civilization, we will continue to do our best to find mercy, justice, and healing. But as I grow older, the more I recognize there is only One who can truly “lift up the hands that hang down, and strengthen the feeble knees.”

All Those Bugs at the Gym, Oh My!

By: Jenny Walters

A recent article on Cnn.com entitled Germ warfare moves to the gym by Linda Saether dealt with the ever increases germs that are present at gyms around the U.S.

According to Dr. Brian Adams, director of University of Cincinnati Sports Dermatology Clinic, “Gyms are great for fitness, but like fun in the sun, you just have to be careful.”[1]

The main microorganisms present at gyms include bacteria, fungi, and viruses. Germs are able to travel to and from many gym –goers’ due to the number of people who share equipment, exercise mats, lockers, and showers. In addition, the activities that gym-goers’ take part in also put them at risk.

Dr. Adams stated: “The first several layers of skin are like a castle wall protecting the athlete from outside marauders. Abrasions from mats and weigh equipment, blisters from constant rubbing while running or using weight equipment both help to break down the castle wall and allow microorganisms to enter the skin.”

Sweating is also another way that germs can enter the body at a gym. According to Dr. Adams: “Sweating super-hydrates the skin and makes the athletes more likely to develop blisters. Sweating by itself may alter the castle and allow penetration of the bugs.”

Bugs that can cause problems include fungi, which can cause athlete’s foot, to viruses that can cause herpes or potentially deadly infections known as MRSA, or methicillin-resistant staphylococcus aureus.

A first line of defense for the gym-goer is disinfectant. Before an individual uses any piece of equipment, he/she needs to wipe down the equipment with disinfectant wipes. The disinfectant wipes will kill any germs that were present on the gym equipment.

One gym-goer has her germ-fighting weapons all contained in her “ultrabreathable, pink, Nike backpack.” Her backpack contains a clean water bottle, plastic bags, workout gear, a clean towel, flip-flops for the shower, a fresh bag of wipes and “everyone’s weapon of choice, the don’t-leave-home-without-it pocket hand sanitizer.”

Due to news of MRSA spreading in gyms, germ fighting has been taken “up a notch.” Gyms today are offering hand sanitizers located throughout the gym and many other germ fighting products.

This article brings light to the age of being vigilant about germs. For me, a nurse a mother, I have the word vigilant about germs embedded into my brain. My husband thinks I go a little overboard, but I would rather be safe than worry about the germs my daughter has been exposed to throughout the day. However, as my pediatrician says, germs are everywhere and it’s good to be exposed to some now and than.

[1] Saether L. Germ warfare moves to the gym. July 2008. Available at: http://www.cnn.com/2008/HEALTH/07/10/hfh.fighting.germs/index.html. Accessed on July 18, 2008.

Could Coral Reefs Really Be In Danger?

By: Jenny Walters

A recent featured report on National Public Radio (NPR) entitled Study: Global Coral Crisis Is In Full Bloom, by John Nielsen dealt with the increasing loss of coral reefs around the world.

According to Nielsen, “coral reefs around the world are in bad shape these days.”[1] A recently published paper by Kent Carpenter, a reef expert at Virginia’s Old Dominion University, reported, “as much as a third of the world’s coral species may now be headed toward extinction, thanks to problems ranging from destructive fishing boats to ocean waters warmed by global climate change.”

Carpenter went on to state “problems faced by these important ecosystems may be worse than a lot of experts think they are…A third of the world’s coral species are now declining toward extinction, partly owing to increased outbreaks of coral diseases…This is a whole ecosystem that we could potentially be losing.”1

Carpenter’s paper was prepared with the aid of the coral researchers affiliated with the International Union for Conservation of Nature, a nonprofit conservation group whose scientific work is widely thought to be definitive.1 The coral researchers put together the “‘red list’ that concludes that a third of the world’s coral species may be declining toward extinction.” The researchers also found some evidence of “a link between coral-killing diseases and warming ocean waters.”

Carpenter warns if emission of global warming gases is not reduced soon; even bigger problems will emerge.1 Currently, ocean waters are more acidic as they soak up carbon dioxide, the main global warming gas. Although there is some evidence that coral reefs can adapt to warming waters, such as reefs in some parts of the far Pacific are now thriving in the warming waters, there is no proof they can cope with the more acidic oceans.

Carpenter concluded by saying, “Obviously the overarching problem that has to be solved is the [buildup of man-made] carbon dioxide in the atmosphere.”1

To help solve the problem, wounded reefs such as the Great Barrier Reef have been put off limits to commercial fishermen.1 According to Philip Munday, a reef expert at Australia’s James Cook University reported, following the restriction of commercial fishermen, a large number of big fish have filled the area over a few years. Munday went on to state: “That gives us enormous hope that these populations…can rebound in they’re given the chance to do so. However, these programs won’t protect coral reef problems causes buy global warming, but they might help buy the reefs a little extra time.”

This article shed light on the overwhelming effects that global warming has on our planet. Global warming affects every aspect of our planet. It is everyone’s responsibility to help fight the effects of global warming.

[1] Nielson J. Study: global coral crisis is in full bloom. July 2008. Available at: http://www.npr.org/templates/story/story.php?storyId=92432491. Accessed on July 13, 2008.

How to keep our children pain-free

By: Jenny Walters

A recent article on Cnn.com entitled How to keep your kids pain-free by Elizabeth Cohen, dealt with 5 ways that a parent can use to help alleviate a child’s pain.

Dr. Jodi Greenwald, a pediatrician in Roswell, Georgia, uses a “secret weapon” for pediatric pain relief, a pinwheel. Dr. Greenwald stated: “Tell them to blow the pinwheel to make it turn, and you’re accomplishing two things…It distracts the child while they’re getting a shot and it makes them take deep breaths, which helps them relax.”[1]

Following giving birth to her son, Jennifer Crain discovered an anti-pain weapon too; a pacifier dipped in sucrose water. Nurses used this during her son’s circumcision. Researchers believe that sucking on sugar water changes the neurochemicals in the brain of the neonate.

Pediatric pain experts report that “sadly, too many children aren’t getting any pain relief, even something as simple as a pinwheel or sugar water.” A recent study in the Journal of American Medical Association, found that “four out of five babies in the neonatal intensive are unit received no pain relief when they had to undergo painful procedures.”

A study in France also found that U.S. doctors do not give pain relief to babies and children as often as they should. According to Dr. Brenda McClain, director of pediatric pain management at Yale-New Haven Children’s Hospital in Connecticut: “We may not see children’s pain as that severe. But pediatric pain needs to be taken seriously. However, most of the time I don’t think we see it that way.”

Below are five techniques that a parent can use to help alleviate a child’s pain:

1. For babies, ask about a pacifier dipped in sucrose water: Doctors say this works wonders in babies. If your pediatrician does not have sucrose water, you can make your own by dipping a pacifier into a mixture of one teaspoon table sugar and four teaspoons water. You can give your baby the pacifier about 30 minutes before a shot or procedure.

2. Ask for a topical pain cream: Creams can help take the sting out of a needle stuck. However, many doctors don’t use the topical creams, because they complain they take too long to work and they have to “sit there and wait until the cream takes effect.” You can ask your doctor for a prescription and apply the cream before you arrive at the doctor’s office. The cream needs to be applied 30 minutes to two hours before the procedure or shot.

3. Distract your child: Talking to your child about anything, but what is going on. Parents make the mistake of saying things like “We’ll get ice cream when it’s over” or “I know it hurts.” Instead it is better to talk to your child about good memories. For example, “Remember the time we went to Disney and you got to meet Mickey Mouse.”

4. Ask about alternative treatments: Acupuncture, music therapy, and hypnosis have all been used to treat children’s pain.

5. Don’t be afraid of opiates: According to pediatric pain experts, opiates can help a child in sever pain, and the risks are small. “It is very rare for children to get more pain medicine than they need or to get addicted to pain medicine” according to pain management program at the Seattle Cancer Care Alliance.

Overall, if your child is not getting enough pain relief, you, as the parent, may have to step in.

This article was not only important to me as a parent, but also as a neonatal intensive care nurse. In the neonatal intensive care unit (NICU), we used a specific pain scales designed specifically for the neonates, and we used sugar water and various pain medications to help alleviate the neonate’s pain.

I have to disagree somewhat with the research findings of “four out of five babies in the neonatal intensive are unit received no pain relief when they had to undergo painful procedures.” Pain was one the biggest concerns in the NICU. We were adamant about preventing and managing the neonate’s pain. Although there are and will always be a hand full of nurses and doctors who do not make pain management their priority, the majority of nurses and doctors are very much so concerned with pain management for neonates and children alike.

[1] Cohen E. How to keep your kids pain-free. July 2008. Available at: http://us.cnn.com/2008/HEALTH/07/10/ep.child.pain/index.html. Accessed on July 18, 2008.

Sunday, July 13, 2008

Slipping Through the Cracks

by Emily Stephens

Mike was an Army private stationed in Afganistan when it happened. TJ was in the Air Force, stationed stateside. Both soldiers were on the clock, working for their country when two acts of gross negligence changed their lives forever. Inhaling aircraft exhaust and other toxic fumes destroyed both men’s normal capacity to breathe.

TJ’s story happened almost eight years ago. Now he works as an Information Technology specialist for a research company who contracts with the government. A life once full of football, jogging, and motocross has been replaced by a face mask, nebulizer, and daily inhalations of the most powerful asmtha drugs on the market. That’s to say nothing about the pain. Nor the fact that at any minute he could lose the last 25% of his remaining lung capacity and, if lucky, wake up in an emergency room.

Every day is a struggle, especially during the spring when pollen pollutes Albuquerque’s usually clean air, thus making breathing unbearable. Has anyone ever apologized or even acknowledged the wrong-doing that led to his illness? Does the government subsidize TJ’s consistent loss of income when he is too ill to work? Does the military provide resources that will allow him to pick up the pieces of his life? The government “takes care” of TJ by offering him free medical care at the local veteran’s hospital. The buck stops there.

Mike’s story is disturbingly similar. He was subjected to unbearable amounts of toxic smoke without a mask. It wasn’t while he was fighting, or even out patroling the war-torn cities of Afganastan, but during his training. Army doctors insist he ‘developed asthma.’ It wasn’t until he visited a private practicioner that he learned he had lost almost 50% of his lung capacity. Now his days are spent with Albuterol close at hand and the constant fear that his inhaler simply won’t help. Last week, he and his wife spent 11 hours in the emergency room after steriods and his nebulizer failed.

These are just two individuals I met by sheer happenstance. It makes me wonder how big a problem there truly is about the gross negligence for the welfare of our soldiers. It bothers me that the military views human beings as “assets”. Words like “troops”, “soldiers”, and “warfighters” dehumanize these people. Body counts on the evening news have become almost meaningless, especially if photos and/or thoughts from their family aren’t included— anything to make them real now that they are gone.

According to the Seattle Post Intelligencer, “About 15 soldiers are wounded for every fatality in Iraq, compared with 2.6 in Vietnam and 2.8 in Korea. With those saved soldiers comes a financial price - one veterans groups and others claim the government is unwilling to pay. The Pentagon keeps 2 sets of books on injured GIs, and the VA will not request enough resources to care for the troops.”

CBS published an interview with Brig. Gen. Gary Cheek a few days ago (July 11, 2008). Cheek is responsible for organizing “Warrior Transition Units” or medical rehabilitation hospitals on various bases throughout the United States dedicated to treating wounded warriors so they can return home or back to the frontlines. After the government came under fire last year following the poor conditions exposed at the Walter Reed Army Medical Center, the Army is going to great bounds to improve its overpopulated outpatient program. However, Cheek admits many soldiers aren't receiving the treatment they were promised. Much of the problem has to do with the sheer number of injured soldiers.

"About 12 percent were wounded in either Iraq or Afghanistan," Brig. Gen. Gary Cheek said. [Nonetheless], if you include those whose injuries could be called combat-related - a stressed-out soldier in a car accident after returning from Iraq, for instance - the percentage goes up to 48 percent. The rest have injuries or illnesses which have nothing to do with combat. As a result, the number of soldiers in Warrior Transition Units exploded from 6,000 to 12,000 - even as casualties in Iraq were going down. With the number of soldiers in transition units increasing by about 600 a month, the Army can't hire health care workers fast enough.

"By the time we got the ratio up to where it needed to be, we were probably 30-to-60 days behind what the population had already grown to," Cheek said. Last week the Army tightened the medical conditions that qualify a solider for a Warrior Transition Unit. And a new order requires all units to be fully staffed by Monday, but some aren't going to make it.


I hope the loyalty, which no longer seems to exist within the white and blue collar workplaces of today, is at least prevalent within our armed forces. Soldiers give their lives to organizations whose overall intent is noble, but something gets lost along the way, and so many slip through the cracks. Why must veterans fight for the care, respect, and benefits they have already earned? What happened to our loyalty and gratitude for their sacrifice?

Most absurd is the fact that TJ and Mike have no recourse. TJ admitted to signing his life away when he joined the Air Force. He agreed to never sue them. Never in his wildest dreams did he think he would ever need to. Like all enlisted soldiers, TJ believed the Air Force would take care of him. He believed they valued his life, and that he wouldn’t be viewed as an expendable ‘asset’. He never thought the meaningless orders to stand in an airplane hangar without a mask would destroy his hopes and dreams.

“I’m lucky,” he explains with persistant optimism. “I have an understanding employer. They are patient with me when I call in sick two or three times every week, or when I have to work from home.” There is concern in his voice, however. Every employer, no matter how kind, has limits to their flexibility, and his employer has been stretched thin on many occasions. “They try to understand, but I never stop worrying,” says TJ. “I could lose my job at any time, and they’d have every right to fire me.”

Saturday, July 12, 2008

Fungi Makes for Fun Guys

by Leane Scoz

Psilocybin mushrooms, a.k.a. shrooms, magic mushrooms, boomers, can be traced back a million years, originating in East Africa. The fungi have been widely eaten by Europeans and Native Americans in Central and South America since the late 18th century. Psychedelic mushrooms eventually made their way to the United States and became a popular recreational drug during the 1960s with the advent of the hippie era.

The use of psychedelic mushrooms is subjective and unpredictable. The hallucinogenic experience can produce effects that are physical, sensory, emotional, and psychological. Although their consumption is illegal in most countries, including the United States, shrooms have been the subject of several psychedelic research projects in recent years.

A 2006 press release from Johns Hopkins University outlined a rigorous scientific study involving 36 college educated men and women and showed how the mushrooms produced mystical/spiritual experiences for research subjects. According to the National Institute on Drug Abuse (NIDA), the research marked a new systematic approach to studying certain hallucinogenic compounds and showed signs of therapeutic potential and value in research into the nature of consciousness and sensory perception.

A recent Associated Press article summarized a report published on July 1, 2008 in the Journal of Pharmacology that provided follow-up to the initial study. The report showed that more than 60 percent of the research subjects reported substantial increases in life satisfaction since the psilocybin experiment. The volunteers reported feeling more creative, self-confident, flexible, and optimistic. They also indicated that they felt more sensitive, tolerant, loving and compassionate since their hallucinogenic research experience.

According to a Newsweek article related to the same research project, the study of hallucinogenic compounds is and has always been controversial despite their potential to reveal secrets of the conscious mind. This is largely due to the federal government's decision to make hallucinogenic drugs, such as psilocybin and LSD, illegal in the 1960s after heavy persuasion by the media. Psychedelic research is not easily funded or sponsored and, until these recent published findings, this type of research has been difficult to legitimize.

Why do scientists continue to pursue this avenue of research? Because of the findings in research projects such as the Johns Hopkins experiment, psilocybin has shown promise in treating conditions including Obsessive Compulsive Spectrum Disorders (OCSD), anxiety in terminally ill cancer patients, and Post-Traumatic Stress Disorder (PTSD).

A Cure fo MS: Caffeine

by Leane Scoz

Caffeine. The helper that gets people out of bed and out the door in the mornings. The best friend of college students pulling all-nighters. The co-worker that keeps the office staff awake throughout the day. The cure for multiple sclerosis (MS)?

According to a recent Web MD headline on CBS News, a new study involving mice found that large amounts of caffeine blocked key steps in the development of MS. A dose of caffeine, equivalent to six to eight cups of coffee a day, was effective in preventing the compound, adenosine, from getting into the brain and triggering the onset of the disease.

The study is the work of Oklahoma Medical Research Foundation scientist, Linda Thompson, PhD, and according to her, "the results were completely unexpected." The study's principal author, Margaret Bynoe, PhD, does not believe it is wise for people to start drinking more coffee due to these initial results. She acknowledges that caffeine has not been proven to be protective in humans yet and believes future studies may unveil other adenosine blockers that could be more useful. However, the results are still encouraging.

MS is a chronic, often disabling, autoimmune disease that attacks the central nervous system. Numerous physical and mental symptoms occur because of the disease and often progress to physical and cognitive disability. About 400,000 people in the United States have MS. These people are our family members, friends, neighbors, and co-workers. Since a cure does not currently exist for the disease, people suffering from MS rely on treatments, therapies, and research studies for hope.

It is crazy to think that a cure for MS could be in the kitchen pantries of most Americans right now. Hopefully, answers will be available in the near future since studies involving human subjects are in the planning process. Until then, let's all sit back and toast that great cup of java. Who knows...maybe Americans really do run on Dunkin!

Friday, July 11, 2008

URBAN LEGEND?

By Emily Stephens

Have you seen this YouTube video yet? It has well over a million hits.
Three adults surround a few popcorn kernels with their cell phones, then dial each phone until--POP! POP! POP! POP!

video

Can cell phones really emit enough radiation to pop popcorn?

According to Cardo Systems CEO Abraham Glezerman, the answer is no. The video is a hoax. An illusion produced by his company, which manufactures and sells blue tooth headsets.

What’s interesting, though, is it came on the heels of some disturbing research that actually starts to link cell phone radiation with cancer (see the article Electrosmog, Cell Phones, and Cancer.... Oh My! below.)

So, how in the world did they do it?

Theories run the gamut: optical illusions, CGI, mini-microwaves beneath the table... The answer to the mystery is a kitchen stove and digital editing. Kernels were erased from the scene using editing software and real popcorn was thrown onto the table to steal away our attention.

Ah, the magic of technology—hopefully no brain tumors were acquired during the process.

This internet commercial circulated across the world wide web like a virus. I received it myself and wasn’t sure what do believe. Hoax or not, I look at my cell phone a little differently now. So, although highly entertaining, was this video “commercial” effective at selling Cardo Systems, or did it just scare a lot of unsuspecting, na├»ve viewers?

Monday, July 07, 2008

That's One Fat Baby!

by Emily Stephens

According to a recent study, child care may lead to rather chunky infants. A University of Illinois study collected data on more than 8,100 nine-month old babies, who were weighed and measured repeatedly between 2001 and 2002.

Fifty-five percent of the infants received daily care from someone other than a parent. Infants in part-time care gained 0.4 more pounds over nine months that those cared for by parents, and even those cared for by relatives gained 0.35 more pounds. Researchers believe this is primarily due to lack of breast-feeding and early introduction to solid food. In fact, other studies suggest breast-feeding for the first year of life may actually instill a physical protection against obesity.

Dr. David Katz, director of Yale’s Prevention Research Center warns that the threat of obesity is a new challege in America's nurseries. "Studies show obesity emerging as a problem even in the first year of life. This, in turn, results in a higher risk of diabetes in youth, and lifelong obesity and its many consequences."

Just how many infants are placed prematurely into day care? Back in March 1970, 24% of working mothers had children under two-years old enrolled in some form of care. By March 1984 that figure jumped to 46.8%. More currently, it is estimated that only 25% of infants are cared for by a parent in their own homes. The other 75% are watched by a baby-sitter or local family day care group (most often run out of a neighbor’s home). More startling is that only 6% of infants and 12% of children under two-years-old are enrolled in licensed center-based day care (U.S. Dept. of Commerce, June 1982). Furthermore, the choice of care is most often based upon affordability and convenience rather than quality.

After reading all those statistics, you can imagine how child care obesity could become a very real problem. Low-income families don’t necessarily have their pick’o’the litter when it comes to affording day care. Quality infant rearing can understandably take a back seat to making ends meet. Some studies do show, however, that average day care can benefit low-income children by preventing the IQ drop that typically takes place between the ages of 12 and 30 months for those living at home. At least these children have some room to benefit from the situation. The bottom line, however, is that the choice of care is more often determined by cost and availability, than quality.

Food choices served at day care also play a critical role in intellectual development of children. The July issue of the Archives of Pediatrics & Adolescent Medicine reported a study where Guatemalan children were given a protein-rich enhanced nutritional supplement between 1969 and 1977, and other children received sugary beverages. Between 2002 and 2004, almost 1,500 participants were given intelligence tests. As it turns out, the adults who were given the supplement early in their youth scored better on intelligence tests regardless of how many years they spent in school.

A trio of thought-provoking articles this past week

In the U.K., Human-pig hybrid embryos given go ahead:

"A licence to create human-pig embryos to study heart disease has been issued by the fertility watchdog.

This marks the third animal-human hybrid embryo licence to be issued by Human Fertilisation and Embryology Authority and the first since the Commons voted in favour of this controversial research last month.

An HFEA spokesman said it had approved an application from the Clinical Sciences Research Institute, University of Warwick, for the creation of hybrid embryos..." Full article accessible here.

From Uganda's leading website: Genital Mutilation - Women Grapple With a Deadly Tradition - "In the scorching afternoon sunshine, Philis Yapchemusto stands in the compound of a tiny building that houses the headquarters of Reproductive, Educative and Community Health (REACH) programme. The community-based programme was established in Kapchorwa to improve reproductive health conditions and stop female genital mutilation." Full article can be read here.

From Scientific American: What is self-awareness?
"Can a lobster ever truly have any emotions? What about a beetle? Or a sophisticated computer? The only way to resolve these questions conclusively would be to engage in serious scientific inquiry—but even before studying the scientific literature, many people have pretty clear intuitions about what the answers are going to be. A person might just look at a computer and feel certain that it couldn’t possibly be feeling pleasure, pain or anything at all. That’s why we don’t mind throwing a broken computer in the trash." Rest of the story here.








Sunday, July 06, 2008

My Journey for the TMJ Miracle Cure

By Emily Stephens

Who the Heck Are You and What Did You Do With My Dentist?

The once amiable, “Good afternoon, Miss Stephens. You have no cavities. Just floss a little more, and we’ll see you in six months” has changed to:

Ew, oh, my. Have you ever considered whitening? We do that here.” (Not covered by insurance.)

People die from oral cancer. Would you like to save your life and take a ten-minute cancer screening test? It’s only $80…(Also not covered by insurance.)

And…

Has your jaw ever popped? You really need to get fitted for a $600 bite plate.” (Yup, you guessed it. Definitely not covered by insurance.)

During the last five years, I have waltzed in and out of countless dental offices dismayed by sales gimmicks. How in the world can I trust a dentist to give me responsible advice when their eyes are fixed upon my wallet and not my teeth? I’ve tolerated it, though. A good dentist is a good dentist, even if they act more like a used car salesman.

However, back in March, a neurologist at the Mayo clinic prescribed a bite guard to ease the stress endured by my TMJ, which was quite possibly triggering terrible migraines. You know, the really bad kind where you go blind, your arms and legs become numb, speaking is next to impossible, and that’s to say nothing of the pain. Unfortunately, migraines have a way of making its sufferers lose all perspective, and in desperation, sufferers will try or pay anything for a miracle cure.

A local internet search led me to Dr. Kavorkian (whose name was changed to protect his identity),a dentist specializing in TMJ disorders and migraines. His secretary scheduled a free hour-long consultation—at which point I should’ve known to run away—but after filling out a million forms and watching a 25-minute testimonial that turned Dr. Kavorkian’s occlusal treatment (bite modification) biteguards into a religious experience, I was still hopeful.

The skeptic in me was brimming with questions. How does it work? How long does it take? How much does it cost? To my surprise, it took the full hour and a few threatening staredowns to coax anything out of him. His device required weekly visits for an undetermined amount of time (for some patients it took years), and at the “meager cost” of $20,000.

Are you kidding me?

Unfortunately, I’m not. Even more regrettably, I must report that am not alone out there either:

“I have had TMJ since 1984. When I first got it, no one knew what it was. As of this date I have spent approximately $30,000 over the years having my splint adjusted.”

“I have had to stand by and watch people tell [my mother] that the pain she feels is all in her head and that it can't be that bad. I feel that I am watching her slowly give up. Now they told her she has to go through a complete joint replacement and that is going to cost at least $67,000+ and her insurance does not cover a dime if those three little letters are mentioned, ‘tmj’.”

“A dentist convinced me I needed to have all my teeth capped for $75,000 and then after that he said my teeth were perfect and I should go see a shrink and I did. She and I both couldn't figure out why if this was the problem he didn't tell me to see a shrink [during] the 3 years he was working on my teeth. Now I live my life with a bite guard on most of the time. I don't know who to trust or where to go.”

Over 10 million people suffer from poorly misunderstood TMJ diseases or disorders, characterized by severe joint and surrounding tissue pain. The temporomandibular joint (or TMJ) is the jaw joint, a highly complicated joint that allows movement up and down, side-to-side, and forward and back. TMJ is most likely not covered by medical insurance, unless the situation is so severe that the sufferer is incapable of eating, and therefore starving.

Before I left my consultation, Dr. Kavorkian added in the brief observation of how bad I looked, then finished with a story about a handicapped boy who could barely walk and who by some miracle found his way to Dr. Kavorkian’s office, received a biteguard, and is now completely healed. The dentist managed a tear.

Apparently, this life-saving, bioesthetic dentistry gadget is the newest rave in TMJ disorder treatment. Imagine fixing TMJ problems with a specially fitted bite guard that week-to-week is altered or ‘shaved down’ by the dentist until your joints fit together perfectly. Think ‘braces’, but for joints and muscles.

According to the TMJ Association:


“Bioesthetic dentistry is another name for bite modification. It is based on the idea that such diverse signs and symptoms as worn or cracked teeth, gum recession, a history of multiple root canal treatments, headache, TMJ problems, ringing in the ears, equilibrium problems, fibromyalgia, etc. are all related to a disharmony between the way the teeth meet and the correct position of the temporomandibular joint. The bioesthetic dentist has patients wear a bite appliance called a MAGO (Maxillary Anterior Guided Orthotic)…which is supposed to get the bite to match the correct jaw position. This position is then maintained by tooth grinding, bonding, crowns or braces. There is no scientific evidence to support the claims made by the bioesthetic dentists, and patients should be wary of having such irreversible changes made to their teeth and bite without such evidence. (Response by Dr. Daniel Laskin.)

The Good Ol’ FCA

False Claim Act (FCA) lawsuits are repeatedly brought against pharmaceutical companies whose marketing practices are questionable: kickbacks, artificial inflation of wholesale prices, giving doctors consultant fees, grants, and other inducements to recommend their product.

So why aren’t dentists held to the same ethical standards when it comes to marketing TMJ products? Furthermore, why aren’t TMJ disorders covered under medical insurance plans when so many suffer this debilitating problem? How do we weed through the gimmicks to determine the truth about the state of our oral health? Finally, what are the rights of TMJ disorder sufferers?

It is important to know that "
recklessness and deliberate ignorance are enough. Under the FCA, a business can be held liable for a false claim even if it did not actually know the claim was false. Because it is often difficult to differentiate between innocent mistakes and "recklessness," an FCA allegation is easy to make and difficult to disprove."

Also know that "a
lmost anyone can sue. The FCA authorizes whistle-blowers to file lawsuits for alleged violations of the FCA. As a reward, the whistle-blowers get a percentage of anything a business pays in settlement or as the result of a judgment. Aside from a few specific limitations, virtually anyone can accuse a business of violating the FCA, including disgruntled employees, former employees, and business competitors. Because of the large reward and the large number of potential plaintiffs, the risk of an FCA lawsuit is very high."

As a chronic tooth grinder, a miracle cure bite plate that guarantees restful nights and migraine-less days did sound appealing. I’ve gnawed through several flimsy $600 bite guards within months in the past and decided it would have been equally productive to stick rolled up $20 bills between my teeth at night. I must admit, the desperate part of me was ready to sink all my savings into the miracle bite guard, but after leaving Dr. Kavorikian’s office, reality caught up with me, as did anger. How can dentists, medical professionals bound by the hippocratic oath, ethically monopolize on the sick and afflicted by trying to convince them to go into incredible amounts of debt for something unproven?

Until next time, snap, crackle, pop—ouch.

Friday, July 04, 2008

Are Apes People Too?


By Jenny Walters

A recent article entitled Animal-Rights Farm: Apes rights and the myth of animal equality by William Saletan discussed a “resolution headed for passage in the Spanish parliament” that will be supporting the Great Ape Project.[1]

The Great Ape Project (GAP) is an organization whose founding declaration states apes “may not be killed” or “arbitrarily deprived of their liberty.” The Spanish proposal will treat great apes “like humans of limited capacity, such as children or those who are mentally incompetent and are afforded guardians or caretakers to represent their interests.” The passage of this proposal would, “commit the (Spanish) government to ending involuntary use of apes in circuses, TV ads, and dangerous experiments.1

Peter Singer, the co-founder of GAP, states: “There is no sound moral reason why possession of basic rights should be limited to members of a particular species.” Saletan went on to state: “To borrow Martin Luther King’s rule, you should be judged by what’s inside you, not what’s on the surface.”1

Opponents of the GAP view this proposal as “egalitarian extremism.” Spanish newspapers and citizens complain that ape rights are “distracting lawmakers from human problems.”

According to one anti-animal rights reporter: “Animal rights activist believe a rat, is a pig, is a dog, is a boy.”1 In contrast, GAP believes “great apes experience an emotional and intellectual conscience similar to that of human children.” GAP demands humans, chimps, bonobos, gorillas, and orangutans are “members of the community of equals.” Singer adds: “GAP may pave the way for the extension of rights to all primates, or all mammals, or all animals.”1

The mission statement for GAP states, “great apes are entitled to rights based on their ‘morally significant characteristics.’”1 The mission reads as follows:

The idea is founded upon undeniable scientific proof that non-human great apes share more than genetically similar DNA with their human counterparts. They enjoy a rich emotional and cultural existence in which they experience emotions such as fear, anxiety and happiness. They share the intellectual capacity to create and use tools, learn and teach other languages. They remember their past and plan for their future. It is in recognition of these and other morally significant qualities that the Great Ape Project was founded.[2]

Saletan believes the GAP mission statement appeals to discrimination, not to universal equality; as most animals can’t make tool and don’t teach languages. He went on to compare the GAP mission to a “Moral Majority for vegans.”1

In a final note in the article, Saletan used a quote from George Orwell’s Animal Farm: “All animal are equal. But some animals are more equal than others.”1

This article was interesting in pointing out both sides of the argument for great ape rights. The article reports: “We are closer genetically to a chimp than a mouse is to rat.”1 The article also describes how some animal rights activists believe “a rat, is a pig, is a dog, is a boy.” Personally, I am not sold on this of being the same as a rat. However, I do feel there should be basic rights set on place for all animals and I do support the GAP proposal.

As a pet owner, I can tell each of my dogs have their own unique personalities. To me, they are just furry humans.

[1] Saletan W. Animal-rights farm: ape rights and the myth of animal equality. July 2008. Available at: http://www.slate.com/id/2194568/. Accessed on July 3, 2008.
[2] The Great Ape Project. Mission statement. Available at: http://www.greatapeproject.org/index.php. Accessed on July 4, 2008.

Thursday, July 03, 2008

Bioethics: Finding Our Shared Moral Core


Under the direction and management of psychologist, author and founding member Valerie Tarico, Phd, the Wisdom Commons is one of the newest ethics initiatives of the Women’s Bioethics Project.

The purpose of the Wisdom Commons is to affirm, inspire, and shed light on humanity's shared moral core, meaning the convergence of our religious and secular wisdom traditions and emerging wisdom culture. Many times we define ourselves in terms of our differences. But the truth is that some of our deepest concerns and highest values transcend the boundaries of culture and tradition. Early in childhood, before we even can walk and talk, the moral emotions, empathy, shame, and guilt begin to emerge. They guide us as we take our first steps toward living in community with each other.

Around the world people recognize that the joy and pain of others are similar to their own joy and pain, and wisdom traditions express this through different forms of the golden rule. We also generally agree about what kind of qualities we seek in our friends, our leaders, and ourselves. These instincts, emotions, understandings and agreements form our moral core. This moral core in turn serves the well-being of the intricate web of life around us and, foremost, the well-being of humans within that web.

The Wisdom Commons belongs to all who use it and contribute to it. Members have the ability to create personal wisdom pages that include their favorite quotes, stories and so forth from the library. A personal wisdom page can also include content that is authored by that member. Over time, we seek to build a diverse community of stewards reflecting the various traditions of our users. These stewards will also create personal wisdom pages so that their core values are visible to our members and users.

The Wisdom Commons emerged out of two years of conversations among people who share a passion for these issues. It was catalyzed into existence by a five day event in April of 2008, Seeds of Compassion, the realization of a dream by the Venerable Tenzin Dhonden and Dan Kranzler of the Kirlin Foundation. Seeds of Compassion brought over 150,000 people together to discuss how best to nurture compassion in our children and communities. It was televised in 24 languages around the world.

It is impossible to acknowledge everyone who shaped or contributed to the project, but they include Valerie Tarico, Brian Arbogast, Jennifer Hobbs, Katherine Triandafilou, Porter Bayne, Kathryn Hinsch, Darcy Rubel, Yaffa Maritz, Lee Colleton, Clif Swiggett, Bruno Alabiso, Jonathan Mark, Kathy Washienko, Matt Lerner, Mike Mathieu, Laura Peterson, John Rae Grant, Brynn Arborico, Marley Arborico, Zuzana Nemcova, Iris Chamberlain, Jean Harrison, James Peterson, Ruth Lipscomb, and others.

The Wisdom Commons draws much inspiration and some of its structure and content from The Virtues Project International, which provides curriculum, training and inspirational materials that elevate virtues in every day life. Many thanks to Linda and Dan Popov and John Kavelin for their thoughtful, patient labor of love. The beauty and meditative feel of the Commons are the handiwork of Jody and Cynthia Baxter, who created WorldPrayers.org.

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