Noteworthy News in Bioethics this past week

1. Australia issues first license to clone human embryos. Uh-oh.

2. Army still using physicians in interrogations, ignoring recommendations.

3. New law requires country-of-origin labels on meat. How about a little
check box whether the cow was a downer or not?

4. Drug-tainted drinking water a more widespread problem than previously
reported. The good news keeps on comin’.

5. Breast cancer vaccine helps body fight tumors.

6. “1 hit” event provides new opportunity for colon cancer prevention.

7. Clostridium difficile (C. diff), a dangerous and especially virulent superbug, especially in long term care facilities. Apparently, this little gem thrives when antibiotics are used, and is not killed by alcohol-based hand washing gels! Story here.

8. Free drug samples may end up costing uninsured more in the long run. File
this under “you just can’t win.”

9. Genetically modified cotton assists neighboring crops in pest resistance.
And what else does it spread?

10. St. Petersburg Declaration on Gene-Doping (from international meeting organized by the World Anti-Doping Agency).

11. Speaking Truth to Power – The Need for, and Perils of, Health Policy Expertise in the White House. From New England Journal of Medicine.

12. Six Easy Pieces. A Cheat Sheet for the Next Administration on Science &
Tech Policy.

13. Teach the Controversy. Why “Intelligent Design” Endangers Our National
Security.

14. Drive-through flu shots for seniors in Florida. Dog biscuits included.

15. Gene tests create undue stress, thereby potentially causing disease. Well,
that’s just great, isn’t it? See story here on the problem with conflicting
results. Talk about making one’s head spin. And for a price.

[Thank you to Lisa von Biela, JD candidate, 2009, UMN, Editor of the BioBlurb, from which this content is taken. 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.]

For My Son

It's time for the world to see you
So look around and tell me what you want to be
There are endless possibilities
Through your eyes I can see
And let me break the bonds and set you free
It is time for the world to watch and see
What you can be.

Phat Friday News: The Fat Hormone that could keep you thin.

With obesity rapidly approaching epidemic proportions, researchers at the School of Public Health at Harvard stumbled across a newly discovered hormone produced by fat cells -- palmitoleate. The researchers report in Cell that that if they can increase its production, they may be able to stave off metabolic diseases such as diabetes, heart disease (caused by hardening of the arteries) and so-called fatty liver, an often asymptomatic disease that can lead to damage of the organ as well as cancer. They speculate that it may also aid in weight loss.

Full article reported in Scientific American, accessible here.

GLOBAL CATASTROPHIC RISKS: Building a Resilient Civilization and Convergence 08

Date: November 14, 2008
Place: Computer History Museum, Mountain View, CA

Organized by: Institute for Ethics and Emerging Technologies and the Center for Responsible Nanotechnology.

A day-long seminar on threats to the future of humanity, natural and man-made, and the pro-active steps we can take to reduce these risks and build a more resilient civilization. Seminar participants are strongly encouraged to pre-order and read the Global Catastrophic Risks volume edited by Nick Bostrom and Milan Cirkovic, and contributed to by some of the faculty for this seminar.

This seminar will precede the futurist mega-gathering Convergence 08, November 15-16 at the same venue, which is co-sponsored by the IEET, Humanity Plus (World Transhumanist Association), the Singularity Institute for Artificial Intelligence, the Immortality Institute, the Foresight Institute, the Long Now Foundation, the Methuselah Foundation, the Millenium Project, Reason Foundation and the Accelerating Studies Foundation.

SEMINAR FACULTY

- Nick Bostrom Ph.D., Director, Future of Humanity Institute, Oxford University
- Jamais Cascio, research affiliate, Institute for the Future
- James J. Hughes Ph.D., Exec. Director, Institute for Ethics and Emerging Technologies
- Mike Treder, Executive Director, Center for Responsible Nanotechnology
- Eliezer Yudkowsky, Research Associate. Singularity Institute for Artificial Intelligence
- William Potter Ph.D., Director, James Martin Center for Nonproliferation Studies

For more info and to register, click here for Catastrophic Risks and click here for Convergence 08.

Bioethics from a Gerontological Perspective

[Thank you to HR Moody for compiling and contributing this great collection of news items and stories from a bioethics and gerontological perspective]:

*********************************

ARE YOU FEELING OLD YET?
    
 What are they letting children learn in college these days?  One of the great things for gerontologists who teach college students is that we get to feel old ourselves all the time.

 Consider the latest points about this year's freshmen, the Class of 2012, as reported by Beloit College's well-known "Mind Set" compendium.  For our freshmen this year:

 -GPS satellite navigation systems have always been available

 -"WWW" has never stood for World Wide Wrestling

 -The Warsaw Pact is as hazy for them as the League of Nations was for their parents

 -IBM has never made typewriters

 -Lenin's name has never been on a major city in Russia

 -Off-shore oil drilling in the United States has always been prohibited

 Are you feeling old yet?  For lots more about the class of
2012 and how they're different from us oldsters, click here.

********************************************************

   CAREGIVER TRAINING IN COMMUNITY COLLEGES

 Twelve innovative in-home caregiver training programs are being awarded up to $25,000 through the 2008 Community College Caregiver Training Initiative of the International
Longevity Center-USA's Caregiving Project for Older Americans, supported by MetLife Foundation. Winners of the competition are:

 -Brookhaven College (Farmers Branch, TX) for two new training programs for Home Health Care and Hospice Aides and the Family Caregiver.

 -Capital Community College (Hartford, CT) for a new home care training program volunteers to provide home care to veterans.

 -Cincinnati State Technical and Community College for training Home Health Aides to sit for state examinations.

 -GateWay Community College (Phoenix, AZ) for recruitment efforts and bilingual programs addressed to the Hispanic population.

 -Harford Community College (Bel Air, MD) for a training focused on caregiving and end-of-life issues, in collaboration with hospitals and hospice organizations.

 -Johnson County Community College (Overland Park, KS) for an Advanced Dementia Care Certificate Program

 -Kapiolani Community College (Honolulu, Hawaii) to expand its gerontology program for entry level paraprofessional training

 -Madison Area Technical College (Madison, WI) to expand the College's Certified Nursing Assistant program

 -Union County College (Cranford, NJ) to introduce an eldercare initiative providing job-related basic education and educational assessment and counseling

 -Southeastern Community College (Whiteville, NC) to enhance its In-Home Aide and Certificated Nursing Assistant Programs

 -Southwestern Oregon Community College (Coos Bay, OR) to launch an initiative including a "train-the-trainers" component and scholarships for low-income caregivers.

 -Tulsa Community College (Tulsa, OK) to implement a Certified Home Health Aide program in its existing Certified Nurse Aide program.

  For more about the Caregiving Project for Older Americans, click here.


************************************************************

HELPING STUDENTS LEARN TO CARE FOR OLDER ADULTS

 According to the Centers for Disease Control and Prevention, people over 65 account for over half of all hospital visits and 60% of primary care visits.  In recognition of these facts, nursing programs are now adding even more gerontological  content into their curricula.

  A notable innovation here is the "Longitudinal Elder Initiative," a Baccalaureate of Science in Nursing  program which pairs students with older persons in the community. The Initiative leaders believe that this pairing will help the student understand the health needs and care
of older adults and give students concrete knowledge of how social, financial and health issues affect older persons over time.  For details, click here.

*******************************************************

           AGING BEGINS IN THE WOMB

  We have become accustomed to hearing that osteoporosis is a disease with onset in adolescence and  manifestation in later life.  But the basic point may be true for other diseases as well. The life-course perspective and the idea of "cumulative advantage and disadvantage"
means we need to see long-range consequences of early life events.  In short, teaching about aging means teaching about more than later life.

 Could the origin of other disabilities of later life in fact be found in early life?  That's the core idea of the  so-called Barker's Hypothesis, named for British researcher Dr. David Barker at the University of Southampton who published his idea more than a decade ago.  Barker looked at epidemiological  data around the world and became convinced that what happens in the womb can have long-lasting effects in later life.  His point is that fetal events-such as food deprivation or other adverse events-can show up as susceptibility to chronic conditions such as heart disease or diabetes.

 For more on the Barker Hypothesis, click here or here.

*******************************************************
                   AGELINE

 Are you and your students using AgeLine?  AgeLine is a free, searchable bibliographic database containing abstracts from both academic gerontology and popular publications.
Abstracts summarize both journal articles and books, as well as research reports and dissertations.  AgeLine current offers more than 90,000 citations.  For an overview of AgeLine, visit here.

 For tips on how to use AgeLine in your teaching read "Using AgeLine in the Classroom" by Dr. Donna Konradi, Associate Professor, School of Nursing and Center for Aging and Community, University of Indianapolis.      

More evidence for a mandate?: FDA approves Gardasil For Prevention Of Vulvar, Vaginal Cancers

We and other blogger friends have blogged about Gardasil before here and there -- and in a quick and dirty drive-by post, we thought we'd update you on the latest developments:

The AP press reports that federal health officials approved expanding the use of Gardasil, the cervical cancer vaccine, to prevent cancers of the vagina and vulva:

"The Food and Drug Administration first approved Gardasil in 2006 for the prevention of cervical cancer in girls and women ages 9 to 26. The vaccine works by protecting against strains of the human papillomavirus, or HPV, that cause about 70 percent of cervical cancers. The HPV virus, transmitted by sexual contact, causes genital warts that sometimes develop into cancer.

'There is now strong evidence showing that this vaccine can help prevent vulvar and vaginal cancers due to the same virus for which it also helps protect against cervical cancer' said Dr. Jesse Goodman, director of the FDA center that oversees vaccines."

Full Story can be accessed here.

Will you be in Phoenix on Tuesday?

If the answer to that question is yes, come hear WBP Founding Director and Board President Kathryn Hinsch speak at the Women's Empowerment Luncheon sponsored by the Maricopa County YWCA. More information is available in this article from the Arizona Republic's website, or from this post--and you can register online here. The luncheon will be held at the Arizona Biltmore from 11:30 - 1:30 on September 16.

We're nonpartisan here on the blog, but the role of women in governance and policymaking, as well as how policies in healthcare, research, and social services affect women and families, is something we should all be thinking about as we roll toward November.

Kathryn's remarks are sure to provide food for thought, regardless of your political leanings. We hope you can join us!

Fill in the blank: ____ is NOT a priority for most men.

Alright, it's not strictly a bioethics issue or controversy, but it is an article in a medical journal and the article did grab my attention:

The Journal of Sexual Medicine interviewed 28,000 men in Europe and the Americas and found, when assessing their priorities, that males between the ages of 20 and 75 ranked "honor" and "getting respect from their peers" ahead of having sex.

According to the FoxNews article, "About one-third of respondents said being healthy was the most important factor, 26 percent valued a happy family and 19 percent said they most valued being in a good relationship. Only 2 percent placed a satisfying sex life as their top priority."

Stories of note this week

[Thank you to Lisa von Biela, JD candidate, 2009, UMN, for compiling this for ABAnet Biotech]

1. Malaysia:  Genetic fingerprinting bill under flak.  Yes, “fingerprinting” in the sense of use by police.

2.  Coalition for Genetic Fairness unveils Genetic Information Nondiscrimination Act (GINA) resource.

3.  Federal appeals court rules that employers must compensate employees for travel expense and non-work time spent receiving treatment for blood-borne diseases while on the job.  Seems fair to me, and perhaps an incentive to work to minimize the potential for such exposures.

3.  Court reinstates investor suit against Merck.  Yep, more Vioxx woes for Merck.

4.  AHA pushes for standardized patient wristband colors (allergies, fall risk,  and “do not resuscitate” orders).  Especially interesting for those of us who reviewed the “POLST” resolution this summer.  And interesting in light of the story last week about attempts to standardize these colors within a state.

5.  70,000 may suffer post-9/11 stress disorder.

6.  Virus for roseola passed from parent to child in DNA, not via blood.  Great, a new way to acquire a congenital infection.

7.  Special dyes and lighting kill MRSA.  Something about this headline conjures up images of 60s discos, but whatever works, I say.

8. Combined stem cell bank, research center to open in U.K.

9.  Bacteria glue points to superbug vaccine.  Nasty mental image, but again, whatever works.

10.  Cancer Genome Atlas reports first results of comprehensive study of brain tumors.

11.  23andMe slashes price on personal genetics test.  For a mere $399 . . .

12.  Blood-boosting drug used by athletic cheats helps increase memory.  Well, every cloud has its silver lining, doesn’t it?

13.  Report from the Center for Progressive Reform proposes 9 reforms of the legal system to help eliminate special interest interference with the work of researchers.

14.  Sen. Grassley urges NIH to revoke grants awarded to universities that don’t disclose financial ties to drug makers.  Pharma fingers are everywhere.

15.  Landmark study reports breakdown in biotech patent system.

16.  FDA fast-tracks eye implants to fight progressive blindness.

17.  FDA panel endorses Pfizer’s Fablyn (or the treatment of osteoporosis in women at increased risk of fractures), with reservations.

18.  Walking is good for the brain, not just the muscles . . .wow, so all this sitting and studying is not only wrecking my muscle condition, but my very brain?  Eeek.

19.  Medical training mannequins do it all:  breathe, blink, have a pulse, bleed, excrete and vomit.  Well, they sound kinda messy to me.

Testimony Before the President's Council on Bioethics: Protecting Patients' Rights

Testimony Before the President's Council on Bioethics: Protecting Patients' Rights | Reproductive Health | RHRealityCheck.org:

Proposed HHS regulations seek to protect provider conscience -- at the expense of patient access to care. Testimony submitted to the President's Council on Bioethics examines the harmful ramifications these regulations could have.

Posted using ShareThis.

Nature vs Nurture -- Shaped by Social and Economic Conditions?

[Hat tip to Salon's Broadsheet, who brought this story to my attention]

According to a study by Dr. Schmitt et al., a psychologist at Bradley University in Illinois and the director of the International Sexuality Description Project (how that for a cocktail party conversation starter?), the more men and women have equal rights and similar jobs, the more intense the gender differences and the more strictly defined their roles become. Article in the NY Times here. Schmitt et al's paper Why Can’t a Man Be More Like a Woman? Sex Differences in Big Five Personality Traits Across 55 Cultures can be found its entirety here.

Counterintuitive, isn't it?

Does the magnitude of sex differences in personality traits demonstrate some sort of gene–environment interaction? Or does this simply suggest that despite innate differences that males and females can equally enter the soul-crunching dog-eat-dog, stress-and-disease-inducing race to wealth, fame, power or status?

Thoughts, anyone?

Call for Articles: Interdisciplinary work welcome

For those of you writing on health law and policy issues, please consider submitting your work to the Saint Louis University Journal of Health Law & Policy for publication in Spring 2009.

The Journal is published twice annually by the Center for Health Law Studies and a student editorial board. It features articles that provide in-depth analysis of topical and developing issues in health law and policy. The fall issue is devoted to the publication of the proceedings of the Center for Health Law Studies annual Symposium, and the spring issue is devoted to coverage of emerging issues within health law and policy. Students and faculty are involved in the selection process.

The Journal is accepting submissions for the Spring 2009 issue until January 1. If you are interested, please send your work by email to slu_jhlp_articles@yahoo.com or by mail to:

Saint Louis University Journal of Health Law & Policy
Attn: Editor-in-Chief
3700 Lindell Blvd.
St. Louis, MO 63108

The Journal also accepts electronic submissions through ExpressO. The Journal staff will confirm receipt of each article and perform an expedited review.

Iron-Jawed Angels: A Reminder of the Hard-Fought Right to Vote

We are a non-partisan blog, and so we cannot comment on individual political candidates' stances -- However, we can remind our readers about the issues at stake and remind everyone about why women should vote. Re-posted in part from the social networking site Gather.com, Deloris Wright poignantly explains why:

This is the story of our Grandmothers, and Great-grandmothers, as they lived only 90 years ago. It was not until 1920 that women were granted the right to go to the poles and vote. The women were innocent and defenseless. And by the end of the night, they were barely alive. Forty prison guards wielding clubs and their warden's blessing went on a rampage against the 33 women wrongly convicted of 'obstructing sidewalk traffic.'

They beat Lucy Burn, chained her hands to the cell bars above her head and left her hanging for the night, bleeding and gasping for air. They hurled Dora Lewis into a dark cell, smashed her head against an iron bed and knocked her out cold. Her cellmate, Alice Cosu, thought Lewis was dead and suffered a heart attack. Additional affidavits describe the guards grabbing, dragging, beating, choking, slamming, pinching, twisting and kicking the women.

Thus unfolded the 'Night of Terror' on Nov. 15, 1917, when the warden at the Occoquan Workhouse in Virginia ordered his guards to teach a lesson to the suffragists imprisoned there because they dared to picket Woodrow Wilson's White House for the right to vote.

For weeks, the women's only water came from an open pail. Their food--all of it colorless slop--was infested with worms. When one of the leaders, Alice Paul, embarked on a hunger strike, they tied her to a chair, forced a tube down her throat and poured liquid into her until she vomited. She was tortured like this for weeks until word was smuggled out to the press.

So, refresh my memory. Some women won't vote this year because--why, exactly? We have carpool duties? We have to get to work? Our vote doesn't matter? It's raining?

Last week, I went to a sparsely attended screening of HBO's movie 'Iron Jawed Angels.' It is a graphic depiction of the battle these women waged so that I could pull the curtain at the polling booth and have my say. I am ashamed to say I needed the reminder...




HBO released the movie on video and DVD. I wish all history; social studies and government teachers would include the movie in their curriculum. I want it shown anywhere else women gather. I realize this isn't our usual idea of socializing, but we are not voting in the numbers that we should be, and I think a little shock therapy is in order.

It is jarring to watch Woodrow Wilson and his cronies try to persuade a psychiatrist to declare Alice Paul insane so that she could be permanently institutionalized. And it is inspiring to watch the doctor refuse. Alice Paul was strong, he said, and brave. That didn't make her crazy.

The doctor admonished the men: 'Courage in women is often mistaken for insanity.'

Please, if you are so inclined, pass this on to all the women you know.

We need to get out and vote and use this right that was fought so hard for by these very courageous women. Whether you vote democratic, republican or independent party - remember to vote.

History is being made.

[The full post can be found here.]

Reproduction of 1998 Wakefield Study Finds NO MMR/Autism Link

It's pretty commonly known that Andrew Wakefield's 1998 Lancet paper on the link between autism and the MMR vaccine has been the source of considered controversy over vaccinations and autism, even after the majority of the paper authors removed their names and the journal retracted the paper. Wakefield's unethical conduct, the leaps of logic, and the small sample size itself, all contributed to reasons the paper was ultimately discredited.

Unfortunately, that sort of discrediting might hold weight in academic spheres, but doesn't necessarily take hold in the public sphere. It's much more entertaining to write scare-tactic headlines touting fears of vaccines and the rise of autism than it is to say "woops", let alone "woops, we maybe made something worse... sorry about that, please go vaccinate your kids before measles skyrockets to new epidemic proportions."

Hopefully the news that a reproduction of the Wakefield study shows absolutely no link between autism and the MMR vaccine will gain foothold in the media at large, and go a long way towards convincing parents that vaccinating their children is not only a socially responsible action that contributes to the common good (via herd immunity), but is the responsible action as a parent taking care of their child's health.

Like Wakefield's study, the new study looked for evidence of potential links between MMR vaccinations, autism and the digestive (gastrointestinal, or GI) problems sometimes seen in autistic children.

"If in fact you want to implicate a factor in the causation of an illness, it must be present before the illness," said W. Ian Lipkin, a professor of epidemiology, neurology and pathology at Columbia University, explaining the idea behind the study. "In the event MMR was responsible for autism, the MMR must precede the onset of autism. There was no evidence . . . MMR preceded either autism or GI problems" in the children studied, he said.

In the first eight months of this year, there have been almost 140 cases of measles alone. The vast majority of these cases have occurred in unvaccinated children - cases of measles that could have easily been prevented.

Let's hope that this is the final nail in the coffin of the link between the MMR vaccine and autism, and that while research into causes, origins and cures for autism continue, our vaccination rate also goes back up to healthy levels for the entire population.

-Kelly Hills

Happiness is a Warm Gun

[Hat tip to the Neurocritic] Here at the Women's Bioethics Blog, we like to write about the newest findings in neuroethics, so it is with some bemusement that I read this post from one of Neuro blogs:

Wrigley-Funded Study Finds Chewing Gum May Help Reduce Stress

In other news, a study funded by Smith & Wesson finds shooting guns may help reduce stress.




















Full post here.

Any thoughts on why the correlation? Weird.

A Wholistic Approach -- Treating Women as more than reproductive conduits

I was surprised to see that many readers of the NY Times well blog felt that their doctors too often treated as "only as a breeding machine who should be regarded as 'pre-pregnant' at all times." Perhaps I've been lucky, but even before I was a bioethicist, I felt my doctors treated me more holistically -- but then again, I've been a lawyer a lot longer than I've been a bioethicist, and maybe that played a role.

I also spotted a phrase that I had not encountered before -- "bikini medicine' -- a phrase describing the treatment for women between the ages of 14 and 54, when medical care is reduced to looking at our breasts and reproductive organs and forgetting the rest of us (except, of course, in making sure one looks passable in a bikini). Sounds somewhat denigrating to both to doctors and women.

What do you think? Take our poll and let us know!

Quantity vs. Quality of Life

Reading the article The Artificial Heart: Not Just a Pump in Scientific American raised the issue of quality of life vs. quantity of life.

I knew that in the early 1980s an artificial heart, the Jarvik-7, had been successfully implanted into a man who would have died without the device beause of his own failing heart. What I hadn't realized before reading this article was what kind of quality of life Mr. Clark (the patient) had after receiving the artificial heart.

We all have this image in a heads, probably most from television shows, of a patients who undergoes a heart transplant and receives a donor heart, which gives him or her a second chance. The leave the hospital looking healthy and happy and go onto to live for 5, 10, 15 years, or more.

Unfortunately, this wasn't the case for Mr. Clark. He was never able to leave the hospital after the artifical heart was implanted. In fact, the compressor that powered the artificial heart was the size of a refrigerator and Mr. Clark was tethered to this compressor the entire time. During the 112 days that he survived after the surgery, he suffered convulsions, cognitive problems, kidney failure, and then died of massive organ failure. Because of the scientific and medical implications of this procedure, the press followed the story closely. The public watched Mr. Clark's progress and then his decline. His quality of life during this time was so poor that many Americans were turned against the idea of artificial hearts for the next decade.

While researchers would probably argue that every patient who undergoes a procedure such as this one furthers scientific and medical progress, what does it do for the patient himself? In the end, was it worth it to Mr. Clark? Would his quality of life at the end been better if he'd spent his final days with his family, rather than undergoing surgery and hooked up to so much medical equipment? Should researchers wait longer before performing such procedures on humans? At what point is the quantify of life worth the quality? Should a patient with terminal cancer be encouraged to try yet one more treatment, even if the chances of it improving their outcome are minimal, or should they go home and spend their final moments with their loved ones? These are sensitive issues and often best decided by the patients and families themselves.

Drug Ads vs. Scare Tactics

In The Wall Street Journal this week, there was an article titled Glaxo's HIV-Drug Ads Draw Critics that raised the notion that pharmaceutical companies might be using scare tactics to convince patients to stay on their current medications.

On the surface, this might not sound too bad. After all, scare tactics have been used in other health-related commercials. We all remember the screen with the frying pan and the cracked egg, and the voiceover that said, "This is your brain on drugs." Then there were ads in the 1980s and 1990s aimed at convincing teenagers of the dangers of having unprotected sex and contracting the human immunodeficiency virus (HIV).

However, the concern with these new ads, such as the ones from Glaxo featured in the article, is that they seem aimed more at convincing patients not to try new medications. For example, one Glaxo ad showed shark-infected waters and included the message, "Don't take a chance--stick with the HIV medicine that's working for you." Although the ads don't mention a specific medication by name, they do carry the Glaxo logo.

A patient's decisions about medical treatment should be an informed decision and ideally should be made after consultation with his or her own healthcare provider. The treatment regimen that might be right for one patient, might be totally wrong for another. As new treatment options are approved by the Food and Drug Administration and are made available to patients, they should be considered. Pharmaceutical companies shouldn't be trying to scare patients into staying on their own marketed drugs to avoid having them switch to a competitor's drugs. If the competitor's drugs are really better, then perhaps the pharmaceutical company tempted to run scare ads should focus more on their research and development and coming out with newer, better drugs of their own.

Many individuals are afraid to seek medical treatment, afraid to learn the truth about their condition, and afraid to hear the prognosis. They don't need to have more fear instilled in them about the actual treatment for their condition.

Access to Too Much Information

A recent article in The Wall Street Journal, Increase in Cases of Measles Tied to Fears Over Vaccine, reported a significant increase in the number of measles cases in the United States, the highest level in more than a decade. The increase appears to be associated with an increase in the number of patients refusing to having their children vaccinated.

For children attending state-supported public school, a clearly defined set of vaccinations must be completed and documentation provided before the child can be enrolled in school. However, for children who are home schooled, their parents can refuse vaccinations and there is no enforcement. Parents of children in public school can also seek an exemption to vaccination for religious reasons.

There have been 131 reported cases of measles so far this year; 122 of those children had not been vaccinated or their vaccination status was unknown. Although not perfect, the measles vaccine is considered to be highly effective at preventing measles.

Why are parents refusing to have their children vaccinated? Primarily due to fears of that autism is caused by measles shots, other childhood vaccinations, or a mercury-based preservative that used to be in most vaccines. There is no scientific evidence that autism is caused by any of these and in fact, the preservative has not been used in any vaccinations since 2001. However, news stories, law suits, and less official sources of information available on the internet have made parents aware that some fear a link between vaccination and autism. Some parents are making their decisions out of fear and possibly putting their children at risk. Of the 131 reported cases of measles this year, no children died, however, 15 of them did have to be hospitalized.

To counteract the potentially misleading information available online, pediatricians and the Centers for Disease Control and Prevention (CDC) are endeavoring to make more evidence-based information available to parents.