Who Will Care for the US Elderly, continued...

Thanks again to Lisa Eckenwiler:

Employers expand elder-care benefits
Thursday, July 27, 2006
By M.P. McQueen, The Wall Street Journal

As more Americans care for elderly relatives, companies are increasingly helping employees by adding workplace benefits similar to those that have been offered for child dependents.

About a quarter of all companies currently provide some basic elder-care benefits, mainly referrals that help employees find caregivers and legal services, a recent survey showed. But other companies, such as accounting firm KPMG LLP and Unilever PLC, the consumer-products concern, are going beyond this to provide employees with additional benefits, which can include extended leaves of absence and subsidized in-home care when emergencies arise.

Who Will Care for the US Elderly if the Borders are Closed?

Thanks to Lisa Eckenwiler for bringing this article to our attention from the Wall Street Journal:
(subscription required) Who Will Care For U.S. Elderly If Border Closes?
By BARRY NEWMAN
July 26, 2006; Page B1
PHILADELPHIA -- Forty years ago, Blanca Maldonado moved to the U.S. from Puerto Rico. She married and had 13 children, 28 grandchildren and 30 great-grandchildren. Now 76 years old and bedridden with bone disease, she is cared for by Xiomara Martinez, an immigrant who arrived in 1996 from the Dominican Republic. Luis Maldonado, a 43-year-old cook, sat at his mother's bedside on a visit to her small apartment here one afternoon. "We'd all love to be with her all the time, but we have to take care of our needs," he said of his family. "But we never stop thinking of Mama." Neither does Ms. Martinez. Her own mother entered the U.S. illegally in 1978 and eventually got a green card. After a long wait, her children joined her. At 47, Ms. Martinez earns $6.65 an hour, paid through a state agency, for taking care of Ms. Maldonado's needs, from baths to rice and beans.

The article goes on to say that in the immigration fight that continues to frustrate Congress and its constituency this summer, workers such as Ms. Martinez are examples that the issue cuts into something more basic: a demographic thundercloud moving over the country as baby boomers approach old age. Immigrants, whether legal or undocumented, make up a disproportionate share of those who care for the elderly -- and the need for such workers is set to explode in the coming years. Where will the extra helpers come from?

Plan B may become available OTC after all

Almost a year after ruling that the morning-after pill could not be sold over the counter, the FDA is reconsidering. Early reports suggest that Plan B may become available to women 18 and older only (women younger than that would still need a prescription.)

News from NYT here.
Here's an FAQ from FDA for those who missed the earlier stories about this one.

Intelligent Design: Is it really all about our place in the world?

This article by Robert Lee Hotz of the LA Times pinpoints what he sees as the underlying agenda of the 'intelligent design' promoters: Darwinian evolution unseats humanity as master of a divine creation. With its emphasis on the mechanism of natural selection, it puts people on equal biological footing with barnacles and baboons.

TIME: the truth about stem cells

Hat tip to R. Alta Charo for bringing this story to our attention: Stem Cells -- The Hope and the Hype. The debate is so politically loaded that it's tough to tell who's being straight about the real areas of progress and how breakthroughs can be achieved. TIME magazine summarizes the issues.

Living Large, Part Deux

Gina Kolata asks how long can living large and healthy go on?: Longer life. Less disease. Less disability. The trends have continued for more than a century as humans have become bigger, stronger and healthier. But can they — will they — keep going? Or is there some countertrend, obesity or an overuse of medications, perhaps, that will turn the statistics around?

Nice Rats, Nasty Rats: Genes and Behavior?

Nicholas Wade of the NY Times explores the question of whether or not a single gene that affects the timing of neural crest cell development underlie the whole phenomenon of animal and human domestication? :

On an animal-breeding farm in Siberia are cages housing two colonies of rats. In one colony, the rats have been bred for tameness in the hope of mimicking the mysterious process by which Neolithic farmers first domesticated an animal still kept today. When a visitor enters the room where the tame rats are kept, they poke their snouts through the bars to be petted.

The other colony of rats has been bred from exactly the same stock, but for aggressiveness instead. These animals are ferocious. When a visitor appears, the rats hurl themselves screaming toward their bars.

“Imagine the most evil supervillain and the nicest, sweetest cartoon animal, and that’s what these two strains of rat are like,” said Tecumseh Fitch, an animal behavior expert at the University of St. Andrews in Scotland who several years ago visited the rats at the farm, about six miles from Akademgorodok, near the Siberian city of Novosibirsk. Frank Albert, a graduate student at the Max Planck Institute for Evolutionary Anthropology in Leipzig, Germany, is working with both the tame and the hyperaggressive Siberian strains in the hope of understanding the genetic basis of their behavioral differences.

The two strains of rat are part of a remarkable experiment started in the former Soviet Union in 1959 by Dmitri K. Belyaev and his brother, who were geneticists who believed in Mendelian theory.

But implications go far beyond issues in animal domestication: The genes, if Mr. Albert finds them, would be of great interest because they are presumably the same in all species of domesticated mammal, maybe even including humans. Richard Wrangham, a primatologist at Harvard, has proposed that people are a domesticated form of ape, the domestication having been self-administered as human societies penalized or ostracized individuals who were too aggressive.

Human self-domestication, if it occurred, would probably not have exactly the same genetic basis as tameness in animals. But Mr. Albert said that if he could pinpoint the genetic difference between the tame and ferocious rats, he would compare the chimp genome and the human genome to see if they showed a similar difference.

One possibility is that a handful of genes — perhaps even just one — underlie all the changes seen in domestication. A structure in the embryo of all vertebrates, known as the neural crest, is the source of cells that constitute much of the face, skull and pigment cells, and many parts of the peripheral nervous system and endocrine system. If the genes in the neural crest cells were delayed just a little in coming into action, a whole range of tissues could be affected, including the maturation of the adrenal glands that underlies the first fear response of young animals, Dr. Fitch has written.

But aren't you on the payroll, doctor?

Health researchers haven't been faring too well in the news lately. The most recent revelations about scientific misbehavior concern the failure of several prominent health researchers to disclose their financial interests in the treatments they praised in print. Info in the NYT here, here, and here.

Why should the general public care about conflict of interest in professional medical and scientific publishing? Because this one of the main sources (other than online databases) postgraduate physicians use to get information about what's the best way to treat patients. So if an author recommends a certain medication or treatment on the basis of his own financial gain--rather than on what's best for patients--your doctor may (unknowingly, trustingly) recommend that treatment for you or for a family member. (Btw, both of these studies are about treatment for depression--and one includes data on treating depression in children. High-stakes stuff.)

In related news, have you seen the new ads for Lipitor (a cholesterol-lowering medication) featuring Dr. Robert Jarvik? Yes, that's Dr. Jarvik, as in the artificial heart. You can hear ethicist Katie Watson's NPR piece about it here, and read about it here.

And don't get me started on Hwang Woo-Suk. I predict his next blame-deflecting move will be to claim alien abduction.

It's My Body and I'll Decide if I Want To - You would too if it happened to you

Should a teen be forced to undergo chemo therapy? We need to be pay close attention to cases that pit "medical necessity against the explicit wishes of a competent (albeit in this case, a minor) patient." When I read Mr. Cherrix's quote "I can choose what is best for my body....If I don't have the right to do that, I don't have any rights at all" I could not help but consider the implications for reproductive choice including forced caesareans and abortion. Ethical considerations include not just what we "ought" to do but also "who decides”.

Here'e the full article:

NewsTarget.com printable article, Originally published July 25 2006

In health freedom fight, Abraham Cherrix to refuse court-ordered chemotherapy sentence

(NewsTarget) Abraham Cherrix -- the Virginia teen who has been court-ordered to undergo chemotherapy for his Hodgkin's Disease after opting to treat his condition with an herbal diet -- says he will defy the court's order and refuse chemotherapy.
Cherrix says he refuses to subject himself to chemotherapy, which he tried after his initial diagnosis. The chemo made him feel sick, though his cancer briefly went into remission before returning earlier this year. If Cherrix were to submit to the court order, the radiation level for his chemo would be increased.

"I think it's my body. I can choose what's best for my body," says Cherrix. "If I don't have the right to do that, then I don't have any rights at all anyway." Cherrix has been seeing American doctors based in Mexico for five months for guidance with his herbal diet, with the blessing of his parents. Cherrix says, "I feel good. I believe that in my heart, the treatment will cure me."
The Cherrix family's attorneys have filed a motion to stay and are fighting for a new trial in the Circuit Court.

Last Friday, a judge for the Accomack County Juvenile and Domestic Relations Court ruled that Cherrix must resume chemotherapy, and also found his parents guilty of child neglect. If the Circuit Court upholds the lower court's decision, Cherrix's father says he is prepared to face possible jail time. "I'm not going to be an obstacle to my son. If a judge wants to throw me in jail, then he's going to have to do that."

Critics of conventional medicine say Cherrix's situation could bring about an end to health freedom and the ability of every U.S. citizen to choose their own method of healing. Cherrix says his ongoing legal battle to keep his right to naturally treat his cancer is distracting him from healing: "I should be concentrating on my recovery. This case is taking me away from that."

"With this stand against the tyranny of modern medicine, Cherrix has squarely positioned himself as a champion of health freedom," said Mike Adams, health freedom supporter and critic of conventional cancer treatments. "Cherrix's move is brilliant. By refusing to comply with the court order, the court must either back down and recognize his right to refuse chemotherapy, or it must stick a gun in his face, handcuff him and force deadly chemicals into his veins in a Guantanamo-style torture scene.

Either way, Cherrix wins. He either regains his freedom or single-handedly exposes the true tyranny and destructive intentions of conventional medicine. The public backlash against such images would be unprecedented." Adams also added, "My advice to Cherrix and his family is that they document everything. Record audio, take pictures and film whatever happens. Faced with the prospect of daylight, these cancer industry evildoers will be forced to back down. The Judge who ordered the chemotherapy, by the way, should be charged with attempted murder."
###

Searching for a 'middle ground' in the malpractice crisis

From the Sorry! Works Coalition:

Many states have adopted or are considering 'apology laws' that exempt expressions of regret, sympathy or compassion from being considered as admissions of liability in medical malpractice lawsuits. The intent is to encourage physicians and other healthcare providers to apologize to patients when a medical error, accident or unanticipated outcome occurs without the apology being taken as an admission of guilt. The consensus is that healthcare providers have become reluctant to explain to patients and their families what happened when procedures go wrong because they fear the information will be used against them in court. Many healthcare providers have struggled with their desire to explain and apologize to their patient, but have often been strongly advised against such open discussions by their defense attorneys.

And I love being here in Vermont ~ we're proposing legislation that Sorry! Works says is a true road map for every other state in the union.

This is your brain; this your brain on a computer

From Wired: DARPA (Defense Advanced Research Projects Agency) has been funding new brain-computer-interface technology could turn our brains into automatic image-identifying machines that operate faster than human consciousness.

Researchers at Columbia University are combining the processing power of the human brain with computer vision to develop a novel device that will allow people to search through images ten times faster than they can on their own.

The technology would allow hours of footage to be very quickly processed, so security officers could identify terrorists or other criminals caught on surveillance video much more efficiently.

The "cortically coupled computer vision system," known as C3 Vision, is the brainchild of professor Paul Sajda, director of the Laboratory for Intelligent Imaging and Neural Computing at Columbia University. He received a one-year, $758,000 grant from Darpa for the project in late 2005.

The system harnesses the brain's well-known ability to recognize an image much faster than the person can identify it.

"Our human visual system is the ultimate visual processor," says Sajda. "We are just trying to couple that with computer vision techniques to make searching through large volumes of imagery more efficient."

The brain emits a signal as soon as it sees something interesting, and that "aha" signal can be detected by an electroencephalogram, or EEG cap. While users sift through streaming images or video footage, the technology tags the images that elicit a signal, and ranks them in order of the strength of the neural signatures. Afterwards, the user can examine only the information that their brains identified as important, instead of wading through thousands of images.

Legal, Medical, and Ethical Questions raised about the charges against healthcare providers during Katrina

Our Board Member R. Alta Charo is cited in a NY Times articles among the experts in medicine and ethics who have many questions about the accusations, to kmade on Tuesday by Louisiana’s attorney general, that a doctor and two nurses used lethal injections ill four critically ill patients in a flooded New Orleans hospital after Hurricane Katrina.

In interviews, several experts said that although they did not know the details of the case, they suspected that it had to be more complicated than the “plain and simple homicide” asserted by the attorney general, Charles C. Foti.

One possibility is that the patients were suffering and the only way to keep them comfortable was with high drug doses that may, incidentally, have hastened their deaths. It is not known, though, how much the patients were suffering.

Charo, a professor of law and bioethics at the University of Wisconsin, said: “The real dilemma here is in getting at the very precise facts of the case. I can say that, as a general matter, if you have a patient who is in distress and who needs pain relief and if the only level of painkillers that will relieve the pain also poses a high risk of death then it is permissible to give the pain relievers, provided the patient has consented to the risk of death.”

Even if the patient can no longer give consent, Professor Charo said, it is still ethical for doctors to treat the pain if they believe it is what the patient would want.

“If that was the case, then this is not simple homicide, and I can only hope the investigators were attentive to this,” she said.

Never Eat Anything Bigger Than Your Head and other guidelines to ethical eating

I love what Art Caplan has to say about shopping in the supermarket in this Washington Post article entitled, "Is there anything left to eat?": Caplan believes there's no need to have "a moral aneurysm" every time we go to the supermarket. Every person, he says, needs to establish a scale of ethical priorities. Is taste most important to you? Cost? The environment? Your health? Animal suffering? Pick one thing that matters most and let that drive your decisions.

For Caplan, No. 1 on his list is whether suffering was involved. "So I want happy chickens, no veal, no foie gras. After that comes environmental impact, and then labor. I have an ethical guide in my head that helps me through the store."

He also points out that, in a way, we should be grateful we are even considering all these ethical questions. "These are the dilemmas of abundance," he says. "If we were living in Darfur, the only answer to 'what to eat?' would be 'anything I can find.' "

Brainy Bots

At Stanford University computer scientists are developing a robot that can use a hammer and a screwdriver to assemble an Ikea bookcase (a project beyond the reach of many humans) as well as tidy up after a party, load a dishwasher or take out the trash.

Researchers at the École Polytechnique Fédérale de Lausanne in Lausanne, Switzerland, are building large-scale computer models to study how the brain works; they have used an I.B.M. parallel supercomputer to create the most detailed three-dimensional model to date of a column of 10,000 neurons in the neocortex -- it is known as the "Blue Brain" Project. (Anybody ever read The Footprints of God?)

Blue Brain researchers say they believe the simulation will provide fundamental insights that can be applied by scientists who are trying to simulate brain functions. Researcher Robert Hecht-Nielsen is seeking to build an electronic butler called Chancellor that would be able to listen, speak and provide in-home concierge services. He contends that with adequate resources, he could create such a machine within five years. (ooh, wouldn't you like one of those?)

Bush exercises his first veto on stem cell bill

The "veto bubble" has finally burst. Five-and-a-half years into his presidency, George W. Bush has ended his record stretch of bill-signings as he rejected legislation Wednesday that would expand federal funding of human embryonic stem-cell research.

Attempts in Congress to override the veto, which would require a two-thirds vote, were expected to fail.

According to the Christian Science Monitor, analysts agree that President Bush's veto was risky but unavoidable. Since the issue of stem-cell research arose early in his presidency, when Mr. Bush approved federal funding of preexisting stem-cell lines, he has remained adamant that no federal monies be used on newer cell colonies. The president believes the killing of human embryos, from which stem cells are harvested, is murder, says press secretary Tony Snow.

But an editorial from the Washington Post this morning poses an interesting argument: "We understand that people can in good faith disagree on this question. But we don't understand the logic of Mr. Bush's position. If using discarded embryos to extract stem cells is murder, how can he permit it to proceed with private funding?" (or IVF research to continue for that matter?)

What’s wrong with being an old mother?

A 62 year old woman became Britain’s oldest mother, and one of the oldest in the world, on July 5 when she gave birth to a baby boy.Patti Farrant, a child psychiatrist, underwent fertility treatment abroad in order to fulfill her 60 year old husband’s dreams of becoming a father.Farrant used invitro fertilization techniques and a donated egg to get pregnant.The baby weighed 6 pounds and 10 and a half ounces.Doctor Severino Antinori was the doctor who supervised the procedures.In the early 1990’s doctor Antinori helped a 62 year old Italian women give birth using fertility treatments and a donated egg.Since then Italy has created Europe’s strictest laws about invitro fertilization techniques and other assisted reproduction procedures, and Farrant’s case was carried out in a former Soviet republic.Fertility clinics in Britain will not use assisted reproduction techniques for women past the normal child birthing years. Liz Buttle was Britain’s oldest mother until now.In 1997 she gave birth at the age of 60. The world’s oldest mother is Adriana Iliescu, a Romanian woman, who became a mother at the age of 66.
Read more:

Veto pending...

From R. Alta Charo just off the presses:

Rumor has it that the president's veto of the stem cell bill will take
place around 2 pm today.

To express either support or opposition to this action, you may call the
white house at comment line at 202-456-1111.  other white house numbers are:


202-456-1414

202.395.3000

Living Large in Chicago ...

Catfish beignets, curly fries smothered in cheese, pierogies with sour cream, beer-battered artichoke hearts, and fried dough buried in berry sauce and whipped cream -- all part of the traditional Taste of Chicago and all contributing to Chicago's reputation for being one of the 'fattest' cities in the US. And if Edward M. Burke, Chicago City Councilman since 1969, has his way it will be illegal for restaurants to use oils that contain trans fats, which have been tied to a string of health problems, including clogged arteries and heart attacks.

But even Mayor Richard M. Daley, who often promotes bicycle riding and who not long ago appointed a city health commissioner who announced he was creating health “report cards” for the mayor and the aldermen, has balked at a trans-fat prohibition as one rule too many.

What do you think? I love Chicago, it's my favorite city, and I'll like to see it be more healthy -- but does this go overboard? Or is it in the same category as banning smoking in public places? It brings up a host of legal and ethical questions, what role does government play in regulating lifestyle? And if I consciously choose to smoke or eat trans fats, can I really expect society to pay for my care? I'd love to hear your thoughts on this matter...

Adult Stem Cell Bill Defeated

Another update via R. Alta Charo:

By KIMBERLY HEFLING, Associated Press Writer

WASHINGTON (AP) -- Sen. Rick Santorum, a conservative struggling to win reelection, suffered a political setback late Tuesday when the House rejected his bill to encourage adult stem cell research. The 273-154 vote fell 12 votes short of the two-thirds majority required under the rules. Opponents, mostly Democrats, said the bill would have given the Republican Santorum and other anti-abortion lawmakers political cover for opposing a related bill that instead would fund embryonic stem cell research. The bill had passed the Senate unanimously earlier in the day. Santorum likens embryonic stem cell research to abortion because a days-old embryo is destroyed in the process of extracting stem cells.

A spokesman for Santorum did not respond to requests for comment.

Stem Cell Research Act - Roll Call!

Thanks to R. Alta Charo for this link which colorfully depicts how the Senate voted on the Stem Cell Research Enhancement Act (HR 810.) You can click on your state to get details on how your Senator voted. To the 63 Senators who voted "yes" - thanks for putting partisan politics aside and doing the right thing.

Immoral Not to Support HR 810

At the Bioethics and Politics Conference in Albany, one of the neo-conservative speakers quipped in a Q/A session, “I wish liberals cared as much about the unborn as they do about the uninsured.” I was struck by the immense lack of compassion for those who are unable to receive the medical care they and their families so desperately need today. So I was delighted, in light of the political frenzy going on in Washington DC right now on the various stem cell bills, to find this statement from June Walker, National President of Hadassah:

In a statement today, June Walker, National President of Hadassah, appealed directly to Senator Bill Frist, Senate Majority Leader, who visited Hadassah Medical Center in May 2005, to do all he can to ensure Senate passage (of HR 810). “By passing this legislation, the Senate will definitively demonstrate that stem cell research is not an issue that divides Americans by political party or faith. This bill would affirm the sanctity of both human life and the spirit of free inquiry-two tenets of America’s spiritual and political life behind which the vast majority of Americans proudly stand. It is immoral for our families, neighbors and friends to suffer while Washington politics hold hostage treatments within our scientific grasp. A presidential veto would not reflect the American people’s political will.”

Now that's what I call being "pro-life". You can read the full statement at: Hadassah News.

Bioethics: Struggle for the control of life (and death)

I just returned home from the Bioethics and Politics Conference in Albany. I say “just” because a flight delay in Albany caused me to miss my connection home to Seattle, forcing me to spend Friday night at the airport in Chicago. United finally got me back to Seattle (via a DC connection!) late Saturday night. The travel glitch made me miss an important personal event in Seattle and had my friends asking me once again, why are you so committed to these seemingly obscure “bioethical issues?”

I don’t usually share my personal woes on the WBP blog. But I’m doing so because it gives me the opportunity to point out that the most important achievement of Glenn McGee’s historic conference is that it clearly demonstrated that bioethics is neither a collection of sideshow issues (Schiavo, Baby Doe, or media issue du jour) nor merely a sub-specialty of philosophy.

As many of the speakers (Charo, Zoloth, Cohen, Moreno, Smith, Doerflinger, Cameron, Wolpe – wow, what a line-up) powerfully indicated, at the core of this politicized bioethics, is the ultimate power struggle for the control of life (and death) and our sense of ourselves as human beings. And this, my friends, is worthy of devoting ones life too. Congratulations to Glenn and the other scholars who participated for an excellent conference.

PS. WBP board member Linda MacDonald Glenn spent much of the conference interviewing all sides of this debate and will be posting a series of fascinating podcasts. Thanks to Linda for her commitment to bring the conference to a broader audience.

More podcasts from the ASBH conference

As a Women's Bioethics Project scholar and newly appointed faculty member of the Alden March Bioethics Institute, I was able to interview a number of speakers from the ASBH Conference on the Future of Bioethics and Politics in Albany, NY, including Glenn McGee, Art Caplan, Eric Cohen, Nigel Cameron, Jonathan Moreno, and Jay Hughes and capture the interviews for podcast, available here.

I was also able to capture two of the lectures from the conferences, those of R. Alta Charo and Edmund Pellegrino, although the sound quality on those is not as good as those of the interviews, at least until I can figure out how to sound edit them.

Look for pictures from the conference to be posted shortly ~ In the meanwhile, happy listening!

Live from New York ! -- the ASBH Politics and Bioethics conference!

Listen to our podcasts (1 and 2) about the how the 'rumble' in Albany started off with a bang!

Fellow blogger Alison McCook had this to say about the conference:

Civility and civil disobedience

The Bioethics & Politics conference hosted by the Albany Medical College got off to a bang today, not a whimper. As participants trickled in, networking and finding old friends, another, uninvited group calmly filed in, parked in front of the room, and started shouting at the tops of their lungs.

The protesters, around 30 or so, were from Not Dead Yet, a disability rights group that is against legalized euthanasia and other forms of "medical killing," as they call it. The meeting hall became quickly filled with cries of "nothing about us without us." Members quickly distributed fliers to participants that explained they were upset that conference organizers had gathered people from both sides of the political spectrum, but failed to include advocates of the disabled.

Huh? I’m all about pluralism, but the conference is about politics, and with only a day and a half at our disposal, it makes sense to focus the discussion. However, the director of the AMC’s Alden March Bioethics Institute, Glenn McGee, to his credit, took the microphone and said the organizers had decided to give Not Dead Yet a chance to speak. (Glenn even managed to open with a joke: "As you can see, everything is going according to plan.") Representative Stephen Drake spoke for 10 minutes about how politics is not important to people at the front lines of hot button issues ("We live in a world where partisan lines aren’t that important"), and received as much applause as any pre-planned speaker did the rest of the day. After his speech, he and his colleagues left, and it was all very civil.

The experience clued me in to the fact that bioethicists are, by the nature of their purview, adept at handling heated debates and, hopefully, finding a compromise many people can live with. If only other discussions had such a happy ending as this one.

Diagnosing Medical Malpractice -- Curing the Ailment, not just treating the symptoms

Senate Majority leader Bill Frist's answer to runaway health-care spending is to cap jury awards in medical malpractice suits -- for the fifth time in four years, he tried and failed to cap awards at $250,000 during his self-proclaimed "Health Care Week" in May.

But how's this for a novel approach?: Sens. Hillary Clinton and Barack Obama also want to save on health care, but rather than capping jury awards, they hope to cut the number of medical malpractice cases by reducing medical errors, as they explain in the New England Journal of Medicine.

Supporting this approach is a recent study out of the Harvard School of Public Health that showed that the legal system does a good job of weeding out claims without merit.

World's First 'test-tube' baby set to give birth; baby conceived the 'old-fashioned' way

On July 25, 1978, Louise Joy Brown, the world's first successful "test-tube" baby was born in Great Britain. Now the world's first test-tube baby is expecting a baby of her own. Brown, 27, is due to give birth in January. She has been married for two years to a security officer, Wesley Mullinder, and their baby was conceived the old-fashioned way."This is a dream come true for both of us," Brown told Britain's The Daily Mail newspaper. The couple live outside of Bristol where Brown is an administrative assistant for a shipping firm. They made headlines in 2004 when they married. The pregnancy is yet another in a long list of headlines surrounding Brown's life that began in such an unusual way.

Access to Abortion as a Human Rights Issue

Women's E-news reports that a Polish woman, Alicja Tysiac, applied for an abortion a few years ago, but her medical grounds were refused. She wound up carrying the pregnancy to term and losing her sight. Now her case awaits judgment by the European Court of Human Rights.

Rudeness ok for docs, says court

At first glance, you might think this was a story from the National Enquirer, but you'd be wrong. Apparently a New Hampshire physician told an obese patient that she was so fat "only black men would want her." The patient sued.

The judge agreed that the remark was uncalled for, but said that the physician had a right to speak bluntly, writing, "It is nonetheless important ... to ensure that physicians and patients are free to discuss matters relating to health without fear of government reprisal, even if such discussions may sometimes be harsh, rude or offensive to the listener."

Sure, sure--docs have free speech rights the same as the rest of us. But it seems neither professional nor kind. . . . which I think are characteristics we'd like to see in our physicians, no? One hopes that some professional organization will have something more to say to the doc in question.

Johann Hari: Why I support liberal eugenics

Johann Hari of the Independent claims this has nothing to do with the evils of Nazi eugenics; it is entered into by parents and it is motivated by love.

Can anyone say "genetic idolatry"? Aren't we more than the sum of our genes? Or are we mere 'meatbots'?

Shades of "The Dead Zone" -- the rewired brain

Anyone who has watched the USA network's series The Dead Zone will be surprised (or maybe not) to hear that doctors contend that man's brain rewired itself after being in a minimally conscious state for 19 years. According to the Boston Globe, Terry Wallis awoke from a coma-like state 19 years after tumbling over a guardrail in a pickup truck and falling 25 feet into a dry riverbed. Now doctors armed with some of the latest brain-imaging technology think they may know part of the reason why.

Wallis showed few outward signs of consciousness, but his brain was methodically rebuilding the white-matter infrastructure necessary for him to interact with the outside world, researchers reported yesterday in the Journal of Clinical Investigation.

``I believe it's a very, very slow self-healing process of the brain," said Henning Voss, lead author of the study and a physicist at Weill Cornell Medical College's Citigroup Biomedical Imaging Center.

Wallis emerged from a minimally conscious state in 2003 at the age of 39 and uttered his first word since Ronald W. Reagan was in the White House: ``Mom." Since then, the onetime mechanic from Big Flat, Ark., has regained the ability to form sentences and recovered some use of his limbs, though he still can't walk or feed himself.

Using both PETscans (Positron Emission Tomography scans) and an advanced imaging technique called diffusion tensor imaging, the researchers examined Wallis's brain after he regained full consciousness, and found that cells in the relatively undamaged areas had formed new axons, the long nerve fibers that transmit messages between neurons.

``In essence, Terry's brain may have been seeking out new pathways to reestablish functional connections to areas involved in speech and motor control -- to compensate for those lost due to damage," said the study's senior author, Dr. Nicholas Schiff, a neurologist at the Weill Cornell Medical College in New York.

Bioethics Rumble? Let's Roll!

A recent AJOB blog cites the building anticipation for a potential “bioethics rumble” at the ASBH Summer Conference: Bioethics and Politics: The Future of Bioethics in a Divided Democracy,” to be held July 13-14, 2006 at the Crowne Plaza in Albany, NY. Linda MacDonald Glenn and I will be blogging live from the conference and will report any bloodshed.

We were delighted that WBP’s soon to be published whitepaper was selected to be presented at the conference. Below is the abstract:

Bioethics and Public Policy:A Competitive Analysis of Americans United for Life

How does an established, pro-life advocacy group reshape itself into a self-proclaimed “non-profit, public interest bioethics law firm” using bioethics to drive its political agenda? Bioethics and Public Policy: A Competitive Analysis of Americans United for Life examines the strategies and tactics of one of the most prolific and active conservative organizations that is working to shape bioethics public policy through legislation, pro bono legal counsel, and public opinion. Analysis of Americans United for Life’s programs—such as model state legislation on bioethical issues, whereby they provide everything a state legislator would need to draft, defend, publicize and push through legislation—illustrates how an organization’s ability to focus at a state level to promote a conservative bioethics agenda fits in to the bigger picture of conservative politics. Americans United for Life also has important connections to influential D.C. based conservative think tanks and bioethics centers. It’s a fascinating look at how political influence directly shapes bioethics in the world today.

For more information on the conference: http://politics.bioethics.net/

Diagnosing The Right Depression

Seeking help for depression is the first step. But there are different types of depression, which need their own specific treatments. Learn the differences and what you can do to get better.

Such Obscenity!

From guest blogger, Peter J. Cohen, MD, JD, Adjunct Professor of Law, Georgetown University Law Center and Chair, Physician Health Committee, Medical Society of the District of Columbia:

I breathed a profound sigh of relief when I learned that the Congress had passed legislation increasing penalties for broadcast indecency as I am now assured that my eyes will no longer be assailed by “wardrobe malfunctions.” However, I wonder when our lawmakers will see fit to deal with the far more significant indecencies—nay obscenities—which we observe in our daily newspapers and TV news broadcasts every day. Just a few examples come to mind:

• Deplorable infant mortality, a disgrace to our nation
• Our impoverished people who suffer and die every day for lack of even basic health care
• Our society—far more concerned with the “legality” of immigrants than with their humanity
• A volunteer army that allows the overwhelming majority of our population to remain completely unaffected by our wars
• A system of lobbying, campaign financing, and influence peddling that make a mockery out of the democratic process

That is enough—Time and respect for the rain forests that produce our newsprint do not permit a complete listing.

Women's Bioethics Blog

Routine HIV testing in the District of Columbia

I have often wondered if blood samples taken for laboratory tests or during hospitalization are screened for human immunodeficiency virus (HIV). One could argue that routine screening of blood samples would be a good laboratory safety precaution; or that it could help catch infections in unsuspecting individuals, allowing early treatment and slowing the spread of the disease overall. A battery of questions flows: Could it also be argued that routine lab and hospital screening is too costly to be practical? Are there a set of guidelines for when HIV screening is performed? Are HIV screenings only performed when they must be ruled out as part of an explanation for a set of symptoms? Was my blood screened for HIV when I was hospitalized? Would I have been told only if my test was positive? Would routine hospital screening for HIV be considered a violation of privacy or other rights without patient consent?

Now the city of Washington, DC, which is believed to have the highest rate of HIV infection in the country (179.2/100,000 people), is urging mandatory HIV testing as part of routine health screening for all patients between the ages of 14 and 84. The Centers for Disease Control (CDC) has been pushing for physicians to routinely screen patients, but this is the first local effort of its kind. Starting tomorrow, the city will distribute 80,000 tests to community groups, doctors' offices, emergency rooms, and STD clinics. These are oral swab tests that produce results in twenty minutes, as opposed to blood tests that can take two weeks to process. According to Jason DeParle of the New York Times, this is "significant because many people who underwent the earlier tests never returned to learn the results, meaning those with the virus remained unaware of the risk they posed to others." I would take a guess that any test that can be processed in twenty minutes is also much less costly than one that gets sent to the lab for two weeks.

While the practicality of an oral test and the idea of routine testing potentially dissolve a few barriers toward HIV detection, there are still many questions to be addressed. Firstly, in a city of more than 550,000, how far will 80,000 tests go, and what happens when they run out? Susan Levine of the Washington Post reported on Saturday that the aim is to use up that supply by the end of the year, "which would mean reaching a fifth of their key population in the next six months." Both Patricia Nalls of the Women's Collective in Northwest Washington and Walter Smith of the DC Appleseed Center for Law and Justice expressed concerns about not having heard any detail about planning for necessary counseling and follow-up care for a newly diagnosed HIV-positive population.

It is also unclear as to whether routine screening does present a privacy issue. Alan Cross reported that the "recommendation met with some resistance from privacy advocates who felt that such a testing might end up stripping HIV-positive people of their privacy and a breach of confidentiality would make it difficult for them to lead normal lives."

Sources and further reading:

Deparle, Jason, "District of Columbia Urges Routine HIV Testing." New York Times, 25 June 2006, http://www.nytimes.com/2006/06/25/us/25hiv.html.

Levine, Susan, "DC Wants HIV Testing for All Residents 14 to 84." Washington Post, 24 June 2006, A01, http://www.washingtonpost.com/wp-dyn/content/article/2006/06/23/AR2006062301685.html.

Cross, Alan, "DE's new campaign to test 14 to 84 year-olds for HIV." Earthtimes.org, 25 June 2006, http://www.earthtimes.org/articles/show/7331.html.

Drug Maker Calls for Limiting Risk Information in Drug Ads

At a time when many are calling for more risk information in direct-to-consumer pharmaceutical ads, a new study from AstraZeneca puts a cap on the number of risks mentioned in TV spots before the consumer is overloaded.

Three is optimal. Four is good. Five is OK. Anything more than that, said the drug maker, and you start wandering into too-much-information territory.

But this runs contrary to counter to what the rest of the industry has discussed. The Food and Drug Administration has repeatedly asked for more risk information, and in remarks earlier this year the director of its drug marketing, advertising and communications division, Thomas Abrams, noted that 82% of pharmaceutical company violations in the past year were related to inadequate presentation of risk information.

Test may help "which came first" question in Alzheimer's

A new test may help scientists answer a perplexing "which came first" question about the development of Alzheimer's disease, possibly pointing the way to earlier diagnosis or even treatment.

Brain deposits of a small protein known as amyloid beta long have been associated with Alzheimer's. But scientists have been unable to determine whether the body begins producing too much of the protein or loses the ability to clear it away.

Now, a research team led by Dr. Randall J. Bateman at Washington University in St. Louis is poised to find that answer with a test that for the first time can monitor the protein.

An initial test of the new technique on six healthy volunteers determined that the protein is quickly produced and quickly cleared, keeping it in balance in the central nervous system, the researchers report in Monday's online issue of the journal Nature Medicine.

Does Anyone Remember what happened to the goose who laid the golden eggs?

In the Boston Globe:

Drowning in credit-card debt and student loans, young women are selling their eggs for big payoffs. But can they really make the right medical and moral decisions when they're tempted with $15,000?

Womb transplants may be possible in 5 years

My question is, how will this affect the moral and legal status of embryos and fetuses?

St Kitt's or the Island of Dr. Moreau?

On the sun-splashed Caribbean island of St. Kitts, Yale University researchers are injecting millions of human brain cells into the heads of monkeys afflicted with Parkinson's disease.
In China, there are 29 goats running around on a farm with human cells coursing through their organs, a result of scientists dropping human blood cells into goat embryos.
The mixing of human and animal cells in the name of medicine has been going on for decades. People are walking around with pig valves in their hearts and scientists have routinely injected human cells into lab mice to mimic diseases.
But the research is becoming increasingly exotic as scientists work with the brains of mice, monkeys and other mammals and begin fiddling with the hot-button issue of cloning. Harvard University researchers are attempting to clone human embryonic cells in rabbit eggs.
Such work has triggered protests from social conservatives and others who fear the blurring of species lines, invoking the image of the chimera of Greek mythology, a monstrous mix of lion, goat and serpent.
During his State of the Union speech in January, President Bush called for a ban on "human cloning in all its forms" and "human-animal hybrids," labeling it one of the "most egregious abuses of medical research."
He didn't elaborate, but scientists working in the field believe that by "hybrids," the president meant creating living animals with human traits - something they say they aren't doing.
Other critics are calling for stricter regulations on the research.

Man's (and Woman's) Best Friend Saves Life

From the Washington Post: A Bite and Bark That Saved a Life -- Cellphone Chomp Called 911 for Beagle's Owner:

Belle Weaver is flying into the nation's capital today to receive an award for saving a family member's life. Before she leaves town, she'll meet with her congressman, accept a certificate autographed by a football great and bow her head to receive a medal. Stories such as hers, of heroism and quick thinking, are always inspiring. But this one has a twist, and not just because Belle is 3 years old -- she's a beagle. And she used her owner's cellphone to call 911. Her owner, Kevin Weaver, 34, was in the throes of a diabetic seizure, lying unconscious on his kitchen floor in Ocoee, Fla., when Belle located his phone and chomped down on the keypad, triggering a call.

The only thing emergency dispatchers heard was barking, but it was enough cause to send help, they reasoned. Weaver, a former flight attendant, woke up hours later in the hospital, weak and disoriented. Belle was there by his side, having finagled a ride in the ambulance.

Are we unable to let go of our fears?

Blood shortages have been a problem in this country for some time now. There are always blood drives that try to entice and encourage people to donate blood for a good cause. From my point of view, I always found these blood drives to be a success, however the drives are not enough to lift the blood shortage to a sufficient status. According to an article written by Arthur Caplan, there seems to be an increasing shortage in blood supply owing to the fact that men who engage in same sex relationships are not permitted by law to donate blood. Apparently, since the AIDS epidemic became a threat in the mid 1980s, gay men have since not been allowed to even give their blood owing to their vulnerability to the disease. The government placed this law in effect when the epidemic was new and treatment was not available. Caplan feels that the shortage is owed to the fact that our government is still holding on to old fears by not allowing gay men to donate blood. With the advancement of medicine allowing for people to live longer and to combat the disease more efficiently, Caplan maintains that it is time for all people to give their blood by choice, and not be denied to do so just because of their sexual orientation. With the ever changing advancement of technology, AIDS and HIV can be detected earlier according to Caplan...so what should we be worried about? The government should realize that things are progressing at a positive rate in the medicine field. If we want these blood shortages to stop, the government should make some changes.Read more: http://www.msnbc.msn.com/id/13106365/

Combatting Obesity

Obesity has been on the rise since the late 1980’s. Today, approximately 65% of Americans are overweight, and over 30% of Americans are obese. The number of overweight children has also doubled. “According to some estimates, obesity results in thousands of deaths a year and accounts for $117 billion in U.S. health care expenses annually.”1
In an effort to combat the growing rate of obesity in the U.S., the FDA recently released the Keystone Report. In a world in which all of our portions are “super-sized,” the Keystone Report offers some solutions for controlling caloric intake, especially when eating outside the home. “Americans spend approximately 46 percent of their food budget on food prepared away from home and take in 32 percent of their calories from such foods.”1
The Keystone Report offers recommendations about how to change consumers eating behaviors. Specifically, the Report suggests increasing the marketing of lower calorie foods like fruits and vegetables and providing consumers with nutritional information. Although there has been an increase in the amount of nutritional information available to consumers, more improvements are possible. Most dining establishments still do not provide such nutritional information.
I agree that the FDA and other government agencies should continue to educate the public about health and dietary issues. However, because obesity rates are still on the rise, perhaps the government should also try to promote the benefits of eating more balanced meals at home. We will not see substantial improvements in the obesity rates until more education comes from within the home. Parents have to education themselves and their children about the benefits of eating healthy and exercising. Children sitting in front of the television hearing about exercising and eating more fruits and vegetables are not going to make any changes on their own. Unless parents talk to their children and lead by example, government initiatives will not make the improvements that they could.
Sources:
1http://www.fda.gov/bbs/topics/NEWS/2006/NEW01379.html
http://www.cnn.com/2006/HEALTH/diet.fitness/06/02/restaurants.obesity.ap/index.html

FDA Approves Thalidomide

The ratio of benefits vs. risks of a potential new drug is a main factor in deciding to approve a new drug. However, the acceptable ratio depends on the targeted condition or disease. For instance, numerous adverse effects are often associated with cancer treating medications. Due to the high mortality associated with cancer, these side effects are deemed acceptable compared to the death rates and other serious complications of cancer.
I read an article on CNN.com entitled “Thalidomide Approved for Cancer Treatment.” On May 25, 2006, the FDA approved the use of thalidomide in treating patients recently diagnosed with multiple myeloma. Thalidomide, in combination with dexamethasone, is to be used in treating multiple myeloma.
In the early sixties when thalidomide was used by pregnant women, it was discovered that thalidomide caused numerous birth defects. Specifically, it stunted the growth of fetal arms and legs and caused eye, ear, heart, and kidney defects. As a result, the use of thalidomide was banned worldwide in 1962.
Even today, with its FDA approval, thalidomide is being marketed under a “restricted distribution program.” Thalidomide labels display multiple warnings about the risk of birth defects. There is also a warning for male patients stating that it is unknown if thalidomide is present in semen. Due to the severe risks associated with thalidomide even the FDA provides information on its website about thalidomide and warns about the drug’s effects: “Do not take this drug if there is any possibility that you are, or may become, pregnant. Just one dose can cause severe birth defects.”
In addition to myeloma, thalidomide is also being examined in clinical trials as a treatment for a variety of solid tumors and blood cancers.
I found it interesting, and concerning, that a drug with such serious side effects will be used in hopes of prolonging the life of multiple myeloma patients. My concern is based on the CNN article’s suggestion that the success of the clinical trials is somewhat questionable and unknown. For the sake of those multiple myeloma patients that will take this medication in hopes of treating their condition, I hope that the efficacy of the drug outweighs the side effects.
Sources:
http://www.cnn.com/2006/HEALTH/conditions/05/25/thalidomide.cancer.ap/index.html
http://www.fda.gov/cder/news/thalidomide.htm
http://www.multiplemyeloma.org/treatments/3.04.html

Too Much Information -- DNA Home Kits

Imagine being able to order a genetic test over the Internet -- to see if you have inherited a predisposition to cancer or whether there might be a genetic component to your infertility -- without having to get approval from your doctor, consult a genetic counselor or risk the fallout that might result from filing an insurance claim.

Now imagine sitting alone at your home computer and receiving devastating news: test results that will forever change your life -- and your family's -- in ways you never anticipated.
Those are the promises and perils of the nascent, growing and largely unregulated phenomenon of direct-to-consumer (DTC) genetic tests. For the price of a mail order test kit containing swabs to scrape cells inside the cheek, nearly a dozen companies now offer curious consumers the chance, without ever seeing a doctor, to learn whether they carry genes for cancer, blood disorders or other diseases. Some companies are marketing personalized diet or skin care recommendations based on DNA analysis using tests that are not widely accepted in the scientific community.

For more, read on...

Hawking Says We Must Sail Beyond the Sunset To Survive

In a manner reminiscent of "To Sail Beyond the Sunset" (both the poem of Ulysses by Alfred Tennyson and the book by science fiction author Robert Heinlein), world reknowned astrophysicist Stephen Hawking has said that the survival of the human race depends on its ability to find new homes elsewhere in the universe because there's an increasing risk that a disaster will destroy the Earth.

Humans could have a permanent base on the moon in 20 years and a colony on Mars in the next 40 years, the British scientist told a news conference. "We won't find anywhere as nice as Earth unless we go to another star system," added Hawking, who arrived in Hong Kong to a rock star's welcome Monday. Tickets for his lecture planned for Wednesday were sold out.

He added that if humans can avoid killing themselves in the next 100 years, they should have space settlements that can continue without support from Earth.

"It is important for the human race to spread out into space for the survival of the species," Hawking said. "Life on Earth is at the ever-increasing risk of being wiped out by a disaster, such as sudden global warming, nuclear war, a genetically engineered virus or other dangers we have not yet thought of."

UN hears about HPV Vaccine

I am pleased to have been invited to speak at the UN Department of Economic and Social Affairs, Division for the Advancement of Women on June 6, 2006. The meeting was chaired by Ms. Rachel Mayanja, UN Assistant Secretary General and Special Advisor to UN Secretary General Kofi Annan on Gender Issues and Women's Advancement (OSAGI). Over 20 high-ranking UN officials attended the meeting. Novel developments of particular concern to women include human egg and other tissue markets, as well as the recently announced vaccine for cervical cancer, a disease which kills approximately 300,000 women each year--mostly in the developing world. I argued that it is vital for women, who have a special stake in bioethical issues, to come together to promote a thoughtful application of biotechnology to improve the status of women's lives, to safeguard women's bodies from harm, and to ensure that social policies regarding women are appropriately recognized and incorporated into public policy.
Read more about:www.iheu.org/bioethics

The Capitalization of Medical Services?

One morning last week I was rudely awakened by the blaring news report coming from my radio alarm about a private medical practice offering, for an extra charge, preferential patient treatment that would include services such as next-day appointments, three-minute return phone calls, and real-time access to a doctor by cell phone or email. I was horrified. If some patients pay extra fees for priority service, isn't response time and level of service for patients who can not pay extra fees necessarily de-prioritized and slowed? My jaw dropped a little further when I heard the doctor speaking for the practice rationalize the idea by explaining that without the extra revenue derived from premium services, his practice would be out-of-business within the next year or two.

I was immediately reminded of an issue I worked on when I was an advocate for artists and cultural organizations. In 2001, the United States Immigration and Naturalization Service (now the U.S. Citizenship and Immigration Services) implemented a $1000 premium processing fee for non-immigrant visa applications. This service worked in favor of businesses who could pay the fee to have the applications of new foreign employees processed in 15 days, but it significantly lengthened the time it took to process non-premium application (to as much as 120 days). As a result, the visa applications of international artists who could not pay the fee were delayed enough that some missed their own performances in the U.S. and many cultural institutions experienced booking difficulties.

I was a little groggy when I heard this news and I had missed the first half of the story, so I later Googled around for a matching news article with the information I missed. I didn't find an exact match, but I did find a number of other articles about the phenomenon—that is, concierge medicine or “pay-for-care” services. Concierge-style medical practices charge an annual fee of anywhere from $700 to $6000 for the patient conveniences mentioned above, and additional per-visit fees of $50 to $200 depending on the service provided. Many patients who utilize concierge medical services claim that these fee-based conveniences save them aggravation in obtaining care, provide them with better quality health care, and save them money and time in the long-run. Many of these patients also keep their regular health insurance to cover major and emergency medical needs.

I couldn't help but wonder, if I as a patient could pay the extra fees, why should I, on principle, have to pay anything on top of what I'm already shelling out for health insurance and copays, just to get decent service? Furthermore, would it not be selfish of me to opt for premium service knowing that medical care resources are limited and I would in effect be taking away a level of service from patients who can not afford extra costs?

Should a line be drawn between different kinds of services, those for which premium service is stratified by cost and those for which levels of service must be prioritized by something else? I thought to myself, it's one thing to charge extra fees for a service that does not directly infringe on the rights of an individual. I don't have a problem with the idea of stratefying cost according to speed of package delivery, as it is unlikely to affect any critical aspect of my life (like my health), and the use of premium services do not strain the resources of the delivery company. Health care services are sometimes prioritized by urgency of medical need, for example, in the emergency room, or when my physician will give me a same-day appointment because I have been running a high fever for several days. But once someone else can out-prioritize me by paying more, medical urgency goes out the window.

It then occurred to me that it may be more ethical to run a purely pay-for-service practice, as opposed to a practice that offered fee-based services for those who could afford them but still accepted patients who could not. (I'm not sure exactly how the practice on the news operated.) Some doctors who run concierge-style medical practices in fact claim that they are better able to care for their patients because they see fewer patients without sacrificing revenue and save time by not having to submit health insurance claims for patients. Declining rates of insurance reimbursements for providers was also cited as incentive to run concierge practices.

Still, the existence of a few concierge-style medical practices creates the potential for skew in who gets the better medical care and an environment of “you get what you pay for.” I can imagine that as things currently stand only a very small percentage of the population could or would be willing to pay several thousand more dollars a year for medical care. I am reminded of a conversation I had with a Philadelphia-based psychotherapist about the administrative and cost issues of insurance supplementation for mental health services: she told me that many of her colleagues had chosen to move their practices to Main Line areas, where patients would be likely pay for services not covered by insurance. This was not to suggest that those therapists were not aware that they were potentially contributing to an overall situation of better care for the “haves,” but that they had perhaps had made a very difficult personal choice, an ethical leap, that the benefits to perhaps themselves or their families or the future of their practices outweighed the issues (and their abilities to operate within them) presented in today's landscape of psychological and medical care in the United States. Though I certainly do not believe that the idea of concierge medical practices or psychological services available only in economically advantaged areas is a viable solution to the critical issues of a medical care coverage system that is groaning under its own weight, I do believe that it is worthwhile considering the idea that concierge medical practices are a valid development, or an ethical/pragmatic response to the current landscape of medical care coverage. This also forces consideration of the fact that, as things now stand, U.S. citizens are hardly on a level playing field in terms of medical coverage and quality of care, and I can't help but wonder that if pay-for-care medical service was the norm, things might not be that much different than they are now.

Some interesting news stories about concierge medicine:
http://www.bradenton.com/mld/bradenton/news/nation/14477842.htm
http://cbs2chicago.com/health/local_story_125141203.html
http://www.msnbc.msn.com/id/6885323/site/newsweek/

and from the Miami Herald.

The DaVinci Code and Women's Bioethics

Maybe it's a little bit of stretch, but what does the book and the movie The DaVinci Code have to do with Women's Bioethics? How about this for arguments: "...the latest challenge to women's lowly status in religion. The female place in sacred history, according to a group of researchers, goes beyond wife, mother and follower." The pro-life movement sees it this way: 'The Da Vinci Code is a piece of propaganda which follows the same pattern as the revolution that gave us abortion and the rest of our promiscuous culture. The fallout of that revolution ... could lead to the spiritual deaths of millions more."


What are your thoughts? Does anybody else see more connections? Or is this too much of stretch?

Human Papillomavirus (HPV) Recombinant Vaccine Approved by FDA

U.S. Food and Drug Administration (FDA) today approved a Quadrivalent Human Papillomavirus Recombinant Vaccine. It is the first and only vaccine to prevent cervical cancer and vulvar and vaginal pre-cancers caused by HPV types 16 and 18 and to prevent low-grade and pre-cancerous lesions and genital warts caused by HPV types 6, 11, 16 and 18 and is developed by Merck and will be marketed under trade name Gardasil.

Arthur Allen does a nice job of discussing some things we should be thinking about in his Slate article: And Now, the HPV Vaccine: Warts and all (http://www.slate.com/id/2143304/) :

"...how to get the vaccine to the women and girls who need it most—poor, uneducated women and those in the developing world. "None of us are going to be happy if the only women who get the vaccine are the same women who are already getting regular screens for cervical cancer," John Schiller, one of the vaccine's inventors, told me at his National Institutes of Health laboratory. The Vaccines for Children program, a Clinton-era entitlement, will probably make the vaccine available for free to poor children in the United States. But social conservatives like Focus on the Family leader James Dobson have opposed making vaccination mandatory, believing vaccination might lower barriers to teen sex.In a roundabout way, this prudery may keep the vaccine out of reach of poor girls. Research and experience have shown that only mandatory-vaccination laws—which typically increase vaccination rates by 10 to 15 percent—get even cheap vaccines to the poor. Given the politics, state legislatures and public health boards may shy from requiring HPV vaccine for middle-school entry."

And Justice Healthcare for All....

This falls under the category of 'no big surprise' : The federal government should guarantee that all Americans have basic health insurance coverage, says a committee set up by Congress to find out what people want when it comes to health care.

"Assuring health care is a shared social responsibility," says the interim report of the Citizens' Health Care Working Group, a 14-member committee that went to 50 communities and heard from 23,000 people.

The committee describes its recommendations as a framework. The recommendations don't say who would pay for universal health coverage or how much it would cost. The concept of government-guaranteed coverage runs counter to the Bush administration's position that consumers should bear more responsibility for their initial medical expenses.

Shades of X-Men and other augmentations

When Camille Walters plays soccer, her normally brown eyes have a spooky red tint – that’s because of the contact lens designed to give this athlete an edge.
That's because the 15-year-old wears tinted contact lenses that block certain wavelengths of light and help athletes see better. Oh, and they look cool, too.

But does these lenses give some athletes an unfair advantage? The associations that govern high school and college sports don't think so, but they're keeping an eye on the lenses.

Jerry Diehl, assistant director of the National Federation of State High School Associations in Indianapolis, Indiana, said his group doesn't believe the lenses provide the competitive advantage that Nike claims.

The federation allows the lenses and puts them in the same category as sunglasses or corrective lenses. The NCAA also allows the sports lenses because it considers them similar to sunglasses.

But Diehl said he's worried about the perception of an unfair advantage.

"If one affluent team can get this, it forces everybody else to go out and do that," Diehl said. "Is it really something that makes a difference? In this instance, at this juncture anyway, it doesn't seem to be any better or any worse than allowing what is already under the rule."

Dr. William Jones of Nashville said price will keep some athletes from buying the lenses, but he expects them to be popular on high school athletics teams in wealthier school districts.

Hands Off My _________ (Fill in the blank) !!!!

Between a post in the Sunday Times a few days ago about IVF clinics shutting down because sperm donors are not willing to donate unless they can maintain their anonymity and an article today in the Boston Globe about the ethical considerations of egg donations (Women who donate eggs have to take drugs that hyperstimulate the ovaries and undergo minor surgery; this puts them at risk for side effects, yet there is no immediate benefit to them or anyone else -- an uneasy and probably unprecedented combination), it's interesting that donors of both sexes are protesting. This poses an interesting dilemma and suggests that we perhaps need to seek stem cells from other places.

Progressive Bioethics?

A recent posting invited progressive bioethics scholars to participate in a private briefing at the upcoming ASBH summer conference in Albany. But it begs the question of “what do you mean by progressive?” The Center for American Progressive has done an inspired job of defining what they call “timeless progressive principles: human dignity, critical optimism, equity and social justice.” The board of WBP would add explicit support for women’s reproductive freedom (our mission states we are pro-choice and pro-science.) How this all translates into public policy is our challenge. We hope you’ll join us.

-- Kathryn Hinsch

Calling All Progressive Bioethics Scholars

Do you consider yourself a progressive bioethics scholar? Are you interested in getting more politically involved? Will you be attending the ASBH Summer conference in Albany, NY entitled “Bioethics & Politics - The Future of Bioethics in a Divided Democracy”? If so, you should email info@womensbioethics.org to get an invitation to a pre-conference (July 13^th 11-1pm – lunch included) private, invitation only briefing and round table discussion hosted by Jonathan Moreno, Center for American Progress and Kathryn Hinsch, Women's Bioethics Project. The briefing is not open to the press.

Created in God’s genetically modified image?

From Science and Theology magazine:

A priest, a rabbi, and an Islamic scholar walk into a room full of scientists …

Sound like a modern twist to a politically incorrect joke? Actually it happened in 1999 in Rockville, Md., and serves as an ideal metaphor for the growing cooperation between science and religion. The three religious leaders were among 11 experts called by the National Bioethics Advisory Commission to give religious perspectives on human stem cell research.

The witnesses agreed on little. But it was evident that a fundamental question had gone unchanged, at least since Nathaniel Hawthorne’s cautionary short story “The Birthmark” was published 163 years ago. Should scientists do something simply because they can? As biotechnology enables us to do more and more, that question becomes ever more finely parsed. From 1866 to this day, no one has looked askance at Gregor Mendel’s cross-pollination of pea pods. Yet in the spring of 1994, biotechnology firm Calgene’s genetically modified Flavr Savr tomato drew salvos from activists who charged that the company was producing “Frankenfood” that could harm human health and disrupt the food chain.

Human Enhancement Technologies and Human Rights (HETHR) Conference reports

Although I was unable to attend the Human Enhancement Technologies and Human Rights (HETHR) conference over Memorial Day at Stanford , it sounded like a fascinating discussion -- and I've been reading the reviews, including William Saletan's critique on Slate, but the article that caught my attention was Dale Carrico's response to William Saletan, entitled, "Thanks for the Back-Handed Compliments". There is one quote that stands out in mind: "...the real policy difficulties are matters of ensuring that everybody has access to good consensus scientific information about emerging medicine, and that the risks, costs, and benefits of these developments are all fairly shared among all the stakeholders to that development. Thrusting aside all the sometimes silly neologisms, the futurisms, posthumanisms, and technophiliasms, there is something deeply and intimately human about the traffic between biology and cultural/technological practice that produce the fragile and lovely personages that house our hopes and fears and memories."

Pharmacist's Suit Dismissed in Federal Court

Wal-Mart Stores Inc. acted appropriately by firing a Catholic pharmacist who refused to interact with patients seeking birth control prescriptions, a federal judge ruled Thursday.

Shabaz said Wal-Mart and Medical Staffing Network accommodated Noesen's religious opposition to contraception by having other pharmacists fill prescriptions. But he said Noesen went too far by putting customers who called about birth control on hold indefinitely and refusing to get service for those who showed up in person without notifying other pharmacists.

Medical Privacy Laws -- All Bark, No Bite....

Rob Stein of the Washington Post writes: Critics say lax enforcement may limit compliance. In the three years since Americans gained federal protection for their private medical information, the Bush administration has received thousands of complaints alleging violations but has not imposed a single civil fine and has prosecuted just two criminal cases.

We Are All Hybrids....

[Thanks for R. Alta Charo for the title]

By Rick Weiss of the Washington Post:

So you think you are the self-reliant type.

A rugged individualist.

Well, give it up. You'd be nothing without the trillions of microbial minions toiling in your large intestine, performing crucial physiological functions that your highfalutin human cells wouldn't have a clue how to do.

X-Men: The Last Stand

The Women's Bioethics Project will be conducting a series of online focus groups examining the bio-ethical implications of the recently released “X-Men: The Last Stand.” Plot outline: A “cure” for mutancy threatens to alter the course of history. For the first time, mutants have a choice to retain their uniqueness, though it isolates and alienates them or give up their powers and become human. Directed by Brett Ratner.

If you would like to participate, please email bookclub@womensbioethics.org with your name, age, gender, and geographical location. We need your demographic information to be sure we have a representative sample but all responses will be compiled without attribution. The groups will be held mid-July and the results presented to the WBP advisory committees and state legislators bioethics working group. Please consider participating in this important project. Incentive: WBP coffee mug to all participants.

[Submitted by Kathryn Hinsch]

Quote of the day....

"All the marvels and wonders of technology can amount to nothing unless it elevates humans to their highest potential" --

Today's quote is by Jacque Fresco, an inventor who I had the pleasure of meeting at a conference a few years ago. He describles himself most often as a multi-disciplinarian or “generalist” -- a student of many inter-related fields. He is a prolific inventor, having spent his entire life (he is now 89 years old) conceiving of and devising inventions on various scales which entail the use of innovative technology.

The quote comes from the film Future by Design, a documentary film by Academy Award® nominated Hollywood filmmaker William Gazecki --the film is a visually and intellectually engaging exploration of one man’s vision of a future where war is outdated, there is no shortage of any necessary resource, and our focus as a species is sustainability. But far from presenting a vision of Utopia, this documentary demonstrates a “possible future” -- with real and viable alternatives to our current paradigm of militarism and commercialism.

In the Future by Design, all systems work together. The personal, social, economic, industrial and governance arenas are all interconnected and balanced into one functional system. The Future by Design is a true participatory democracy, where each member of the society has the opportunity to input their needs, opinions and preferences into the central computer, which then assesses and analyzes all information to determine the use of resources in manufacturing distribution of goods and services. For an inspiring look at humanity's potential, check it out at futurebydesign.org.

[Models & Photos by Jacque Fresco & Roxanne Meadows]

I wonder if they'd refuse to sell Viagra, too?

Washington State Regulators endorse "refuse and refer" for morning-after pill. Druggists who personally oppose morning-after birth-control pills could refuse to sell them under a rule endorsed today by state pharmacy regulators.

The Board of Pharmacy's move mirrored the preference of the state pharmacy association but angered abortion- and women's-rights groups, and defied the wishes of Gov. Christine Gregoire.

Lisa Stone JD, Board member of the WBP and Executive Director of the Northwestern Women's Law Center had this to say about the rule: “If a pharmacist refuses to fill a prescription for emergency contraception, that's illegal sex discrimination. And it's wrong. But that's not all -- the Pharmacy Board's own records show that patients have been denied antibiotics and anti-depressants, among other drugs. I respect and admire pharmacists, and appreciate the skill and training they bring to the profession. But they have no place deciding what medications any patient may or may not take because they object to the medication, to the prescriber or to the patient standing before them. Under this proposed rule, a pharmacist could refuse to fill prescriptions based on ethnicity, national origin, sexual orientation, disability -- you name it, the choice of whether a patient received lawfully prescribed medicine would be in the hands of the pharmacist, not the doctor, and definitely not the patient.”

Look, up in the sky! It's a bird! It's a plane! No, it's...

[Hat tip to R. Alta Charo for the great header] Under the category of "this would change everything": As bizarre as it may seem, the sample jars brimming with cloudy, reddish rainwater in Godfrey Louis's laboratory in southern India may hold, well, aliens. In April, Louis, a solid-state physicist at Mahatma Gandhi University, published a paper in the prestigious peer-reviewed journal Astrophysics and Space Science in which he hypothesizes that the samples -- water taken from the mysterious blood-colored showers that fell sporadically across Louis's home state of Kerala in the summer of 2001 -- contain microbes from outer space.

Of Mice and Men and those in between...

Interesting article in Slate yesterday about the problem(s) with animal testing and how animal rights activists are questioning whether or not animal testing is necessary anymore and that evidence points to a need for new designs in pharmaceutical testing.

In a similar vein, Francoise Baylis gave an awesome telelecture today at the University of Vermont on "Ethical Issues in Chimera Research and Stem cell therapies for Human Neurodegenerative Disorders", an area which has been of great interest to me ever since I started researching the issue for my thesis at McGill (published here). Some articles that both she and I have written at actionbioscience.com outline the issues that scientists and researchers will be facing.

HPV debate: Virginity or Death?

Merck and GlaxoSmithKline have the answer to the threat of human papilloma virus in women; that is new vaccines that can help prevent it before it infects a system. HPV is an STD that can often lead to cancer in women and has diagnosed 10,000 American women a year. This new vaccine that can be administered to preteens before they become active is the cause of great controversy for Christian groups. They assume that this type of vaccine will allow children to engage in sexual activity before marriage. The article is in opposition of such a notion. The author argues that the real issue for Christian Conservatives is this debate is women’s virginity, just as it was in the original debate over abortion. HPV can be used as a great scare tactic for Christian conservatives because is it not prevented through the use of condoms. However, opponents of this vaccine are essentially holding that having sex before marriage is worse than having cancer later. The conservatives use the example of a 13 year old pregnant girl in Florida who had a child when she was a child herself. The article explains that she was too young to be having sex or an abortion, but it fails to explain why wasn’t too young to be forced to go through childbirth. Right- wing Christians consider that women should abstain from sexual activity. They try to achieve this through the use of fear. This is why people who are pro-life will not join with pro-choicers to lessen numbers of abortions by making birth control available. This has little to do with protecting human life and it is more focused on making sure women are tied to marriage. Read more here.

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Posted by Ana Lita to Women's Bioethics Blog at 6/02/2006 12:52:00 PM

And it might kill you, too.

This news report in today's NYT highlights the harrowing fact that female genital cutting, sometimes referred to as female circumcision, increases by 50% the likelihood that the woman or her baby will die during childbirth.

Those of us who are concerned with women's health and welfare would do well to consider this issue. Thinking about the amount of ink and anguish we spill in the US about the "mommy wars"--when this kind of thing is going on in the world--makes me crazy.