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.]

Better Schooling Through Biology

Nancy Kalish, in a NYT Op-Ed advocates using biological research to provide guidance in reforming our education system in light of data that show adolescents would benefit from a high school schedule that started later.

Excerpt:

Research shows that teenagers’ body clocks are set to a schedule that is different from that of younger children or adults. This prevents adolescents from dropping off until around 11 p.m., when they produce the sleep-inducing hormone melatonin, and waking up much before 8 a.m. when their bodies stop producing melatonin. The result is that the first class of the morning is often a waste, with as many as 28 percent of students falling asleep, according to a National Sleep Foundation poll. Some are so sleepy they don’t even show up, contributing to failure and dropout rates.

Moving the start time of high school back by one hour showed significant benefits, both specific to education and in peripheral gains, like student safety:

In 2002, high schools in Jessamine County in Kentucky pushed back the first bell to 8:40 a.m., from 7:30 a.m. Attendance immediately went up, as did scores on standardized tests, which have continued to rise each year. Districts in Virginia and Connecticut have achieved similar success. In Minneapolis and Edina, Minn., which instituted high school start times of 8:40 a.m. and 8:30 a.m. respectively in 1997, students’ grades rose slightly and lateness, behavioral problems and dropout rates decreased.

Later is also safer. When high schools in Fayette County in Kentucky delayed their start times to 8:30 a.m., the number of teenagers involved in car crashes dropped, even as they rose in the state.

This is but one example of how science can constructively inform policy and provide a directed goal to which we can strive as we reform conventional methods that were influenced not by anticipated benefits, but from mere logistical necessity. With the significant shifts in lifestyle following the departure from an agrarian industry base and the advent of the Internet and other telecommunications technologies, there is no reason why we cannot come up with a system that is not just feasible, but beneficial to groups said policy seeks to benefit.

Jumping Rope with Abe Lincoln and a Groundhog

We've all seen the commercials and print ads for Rozerem, and you must admit how clever you think they are. Also, we've probably all encountered difficulty with sleeping, sometimes days-sometimes a few weeks at a time. I would be hard pressed to ever consider taking any sort of sleeping aid, prescription or OTC (with the exception of an occasional dose of Nyquil), but I have definetely experienced those bouts of poor sleeping. As our lives become increasingly busy and hectic, I think perhaps cutting back on caffeine and engaging in more physical activity (two things which are beneficial in more ways than just as sleep aids) are more healthy and desirable alternatives to help get to sleep at night.

But I did appreciate how some may feel inclined to take a sleep aid. Until now. The New Times published an article this week reporting that sleeping pills are really just mildly effective, that the newer drugs tested cut the time it took to fall asleep by only 12.8 minutes, and increased total sleep time by only 11.4 minutes. Is taking a prescription and ingesting more chemicals worth that? I don't think so.

And that is not all. The same article also reports that older prescription sleep aids such as Halcion and Restoril accounted for signicantly better results than the newer drugs. Yet another case of unneccessary "Me-too" drugs being overly marketed and preying on people who may be in a vulnerable state, in this case, sleep-deprived. As I mentioned above, most people find the Rozerem ads charming; they may march into the doctor's office and specifically request Rozerem. Note the Times article reports Americans spent $4.5 billion dollars on sleep aids last year.

Basically, sleeping pills don't really work, or rather, just aren't as effective as the American consumer is led to believe, according to the analysis. Pharmaceutical companies are latching onto our weaknesses and trying to tell us once again that it can all be solved in a little pill. And if Americans are spending that much money every year on sleeping pills, then it appears physicians are also throwing in the proverbial tower by prescribing these pills. Too bad these physicians can't be like the doctor in Fight Club who tells Tyler Durdan to "get more exercise and chew some valerium root, " instead of prescribing sleeping pills.