Tuesday, January 27, 2009

HFCS Contains Mercury

About six months ago, give or take, I started seeing these commercials on television advertising how high fructose corn syrup is just fine for you. My first thought, on seeing them, was that obviously Michael Pollan has had a huge impact on the food industry, or at least HFCS consumption! The advertisements, for those who have managed to miss them, are sponsored by the Corn Refiners Association, basically shows someone offering another person something made with HFCS, the second person freaking out, and the first person talking them into it by saying that it's perfectly fine for you. (Implying, of course, that people who opt not to consume HFCS haven't done their research and are just parroting everyone else.)

Here's the first commercial produced, so those of you who haven't seen it can get an idea for what the commercials are like:

I wonder if they're going to keep airing those advertisements, now that a new study has shown that many products containing HFCS contain mercury, and another study suggests that it's the corn itself that's contaminated.
-Kelly Hills

Friday, January 23, 2009

Obama Repeals Global Gag Rule

One of the clearest things I remember about my time working at Planned Parenthood was the rejoicing that happened when Clinton repealed Bush, Sr's global gag rule order. Although I was no longer working for Planned Parenthood by the time W. re-enacted his father's gag order, I despaired at the number of women worldwide who were going to have their access to safe and legal information about abortion restricted or completely taken away.

Checking the news before bed tonight, I actually scared my cats reacting to the news that Obama has overturned the Mexico City Policy.

I realize that there are people in the reading audience who will be disappointed by this news, and will work to continue having it placed back into effect. And personally, my concern was never so much about the abortions being provided (or not), as it was my issue with the fact that NGO's were forced to choose between discussing the full range of care options for a pregnant woman or losing their funding from the US government. I haven't been where these NGOs work, and I can't even pretend to know what they see, daily, in the lives of the women they treat. But I know that medical abortions are necessary around the world, and I know that there are situations and reasons for choosing abortion in these countries that I might never fully comprehend. A woman should have the right to a full and open, honest discussion of all of her options with her health care provider, regardless of where she lives in the world. That honesty should not be a privilege only granted to those lucky enough to live in a first world country.
-Kelly Hills

Monday, January 19, 2009

Noteworthy News in Bioethics this past week

- National Human Genome Research Institute (NHGRI) has set aside $3.9M in funding for 2010 to create several cross-disciplinary centers to study the ethical, legal, and social implications of genomics technologies. (Might sound like a lot, but does that money go quickly!)

- Personal genomics continues to grow and commodify, but is it accurate, is it wise? The average consumer can order up tests via the Internet, but what to make of the results? Once the information is known, what about one’s insurability in this era of tricky health care coverage?

- Transfusion-free medical facilities avoid the need for blood transfusions during surgery by using technology to conserve and re-infuse the patient’s own blood. The technique eliminates all sorts of risks and expenses.

- Emergency planners seek to help home-based life-support users in major outages, etc. All the various ice storms have been taking a toll, and sometimes the outages are so long that even those individuals prepared with backup plans aren’t adequately covered.

- Meta-analysis confirms value of risk reducing salpingo-oophorectomy for women with BRCA mutations.

- Injected biomaterial allows new blood vessels to grow by creating a “smart scaffold.”

- Life as we know it nearly created in lab. Primordial stuff, but haven't we heard this before?

- InNexus primate study clears way for human trials on non-Hodgkins lymphoma tumors.

- Government relaunches site for Web-based family tree of medical history. Touts it as a way to keep the complete family history in one place, so it’s more accurate for doctors to use.

- The “Malthusian Spectre” and American Health Care (a transcript of a discussion of health care costs and what could be done).

- Democrats seek $1B to compare effectiveness of medical treatments, part of efforts to lower health care costs.

- Both sides claim victory in patent battle over new type of heart valve. Both sides? How often does *that* happen? Actually, it makes sense when read in light of patent law.

- Government investigators report that the FDA is lax on requiring—and following up on—financial conflicts of doctors who conduct clinical trials of drugs and medical devices in human subjects. Ah, one of those comforting stories. Not.

- FDA promises openness in approval process for drugs and food from genetically engineered animals. Scrutiny by independent advisors at public meetings (hmmm….does that include spidergoats and glow-in-the-dark pigs?)

- USDA unable to weed out unapproved modified foods . Oh good, even if we shore up our own regs on this, we can’t keep the engineered plants and animals out of our food supply anyway. Not hopeful news.

- FDA lets drugmakers advise doctors on unapproved uses of medications, per FDA’s new guidelines on the matter. (Why does the image of foxes and henhouses come to mind?)

- People who sleep less than 7 hours per night are 3 times more likely to catch a cold. So get some rest!

[Thank you to Lisa von Biela, JD candidate, 2009, UMN, Editor of the BioBlurb, from which this content is partially taken and edited. BioBlurb is a weekly electronic publication of the American Bar Association's Committee on Biotechnology, Section of Science & Technology Law. Archived issues of the BioBlurb, as well as further information about the Committee on Biotechnology, are available here.]

Sunday, January 18, 2009

11th Hour Legislation Facing Legal Challenge

In a not at all surprising move, the so-called Conscience Rule passed at the last possible minute by the Bush Administration, has been legally challenged. Connecticut's attorney general, Richard Blumenthal, filed suit on behalf of his state, as well as California, Illinois, Massachusetts, New Jersey, Oregon and Rhode Island. Separate suits have already been filed by Planned Parenthood and the ACLU.

For those that missed the ruling, which went into effect in December, the Conscience Rule
stops federal funding to any health organization -- public or private -- if it doesn't allow health professionals the right to refuse to perform or take part in any health care services they consider objectionable on ethical, moral or religious grounds.
This includes things as diverse as providing abortions, filling prescriptions, to working on any research you're hired to do, yet find objectionable.

Health and Human Services has said that they will fight this lawsuit, and believe that they are in the right with the Conscience Rule.
-Kelly Hills

Wednesday, January 14, 2009

What long lashes you have!

Wish you had longer, fuller eyelashes? Tired of raccoon eyes from mascara that won't stay where you put it? You might be tempted to check out Latisse, a glaucoma drug that has just been granted FDA approval for lash-lengthening.

The folks at Allergan, the manufacturer of Latisse, are (not coincidentally) the same people who brought you Botox (which also started its life as a drug for medical, rather than cosmetic, use). They'll charge slightly more for Latisse than for Lumigan (the version of the drug it sells for glaucoma).

Like all drugs, Latisse/Lumigan carries the risk of side effects. In clinical trials, 15 to 45% of patients experienced red eyes (conjunctival hyperemia) and/or itchiness. Other side effects include changes in eye or eyelid color, vision disturbances, foreign-body sensation, and systemic effects (mainly upper respiratory infections). Latisse is applied with an applicator, and just to the eyelid, and the dose is less--but still, these side effects aren't uncommon, and some of them are contrary to the goal of having more attractive eyes. Then again, compared with the risks associated with cosmetic surgery and other procedures (including Botox and other kinds of cosmetic injections), they're not so substantial.

For my part, I'm not all that interested in the ethical implications involved in women's decisions to use Latisse; I mean, in our current autonomy-centered age, how could it possibly be anyone's business if a woman wants to pay money to slop this stuff on her eyelids? Sure, there needs to be disclosure of the side effects, but they're not exactly life-threatening.

The re-release of Latisse raises other questions, though, about the commercial nature of drug development and the regulatory environment. In the current economic downturn, pharmaceutical companies--like everybody else--are needing to make hard cuts. What does it say about that industry when effort is devoted to cosmetic "treatments" rather than medical ones? And what does it say about us ("the market") if this really is the smarter investment for those businesses? Additionally, when there are consumer groups (rightly) up in arms about the tortoise pace of FDA review, why are we prioritizing Latisse over drugs that actually treat medical problems?

One more proof, as if we needed it, of how broken the US healthcare system really is.

Friday, January 09, 2009

"Cancer-free" baby born in UK: what's wrong with this picture?

So: today's news reports that the first "cancer-free" baby has been born.

"What's this?" you ask. "Isn't it awfully rare for babies to have cancer?" Yep. Especially breast cancer, which is more common in older women. But the genetic test to identify known breast-cancer-causing mutations has been around for some time. Now, for the first time, it has been used as a prenatal test--technically, in this case, through preimplantation genetic diagnosis (PGD), which is testing embryos conceived through IVF prior to their being implanted in the uterus.

Certain rare BRCA mutations greatly increase a woman's risk of breast cancer and ovarian cancer--so much so that some women with these mutations decide on prophylactic surgery to remove their breasts and ovaries. However, because these really bad mutations are rare, experts recommend that only women with a strong family history of breast cancer pursue testing. The news story doesn't say whether the couple had such concerns, though presumably this is the case.

Stories like this one don't help the general public understand what genetic testing can and can't do. Even BRCA results are probabilistic: not everyone who has a positive result will go on to develop breast cancer. And there are prophylactic and curative treatments available for breast cancer (though they are, obviously, pretty awful). And who knows what the state of medicine and oncology will be by the time the BRCA mutation carrier born today is old enough to worry about breast cancer?

The opposite set of concerns plays in here too; the fact that this fetus happens not to have any of the mutations that have been shown to increase breast cancer risk does not guarantee that she won't get breast cancer anyway -- presumably there are causal factors we don't know anything about yet, since the vast majority of breast cancer is not due to one of these familial syndromes -- or any of the other zillions of cancers that afflict humankind. "Cancer-free" may be a misnomer in this case.

And finally, isn't there a morally relevant difference between choosing to terminate a pregnancy because of a positive diagnostic result (eg, Tay-Sachs, Down syndrome) and choosing to do so based on a measure of susceptibility? And no hate mail please: I don't mean to imply that the former sort of case is necessarily the right thing to do...only that some such choices might be more easily justified than others.

Art Caplan: And now for the dumbest divorce claim of 2009

Sounds like the start of a corny joke: your money or your wife? When I was a trial attorney (in a previous life), I had my fair share of rancorous divorce cases, but this one takes the cake:

According to a Newsday article,when Dr. Richard Batista's wife needed a kidney, he gave her one of his (how lucky they were a match!) -- and now that Mrs. Batista has filed for divorce, he says he it wants it back -- either that or $1.5 million -- the supposedly value of the kidney transplant.

Aside from the fact that you probably can get a kidney transplant for a lot less, thanks to medical tourism (not that I am advocating it) in China or India, medical ethicists, Art Caplan and Robert Veatch are saying it's just not argument that is going anywhere.

It is just such a shame that the show Boston Legal was canceled ~ they would have had so much fun with this case. (E.g. -- Episode 1 of Season 3 "Can't we all just get a lung?", starring Michael Fox)