Jiggle While You Wiggle!

In today's "odd medical news", Wired Magazine is running a story about a new diet pill gel method that involves something akin to, and that can in fact be used for, the expanding gel crystals used for long-term plant watering.

No, really.

Seems that Luigi Ambrosio, lead researcher on the project, which is currently undergoing clinical trials at Rome's Policlinico Gemelli hospital, and a colleague traveled to America, were horrified by the expanding waistlines as far as the eye could see, and decided that an absorbent material related to work they were doing for a Swedish paper product company had promise as an appetite suppressant and satiatant. Plus treating edemas and...watering plants. (No, I'm not going to let that one go.)

Basically, you pop this little cellulose pill and drink two eight ounce glasses of water. The water helps the pill expand into a tennis ball size/shape lump of gel, which sits in your tummy until being flushed through and out your GI tract. It's essentially gastric banding, but with a spacer instead of a clamp. (Many people commenting in other places say that drinking a glass or two of water alone is the same thing, but it's pretty clear - heh - that the benefit of this is that it can't quickly flush out of your stomach, and won't create the sloshy indigestion that is possible when food hits a stomach full of liquid.)

And on the one hand, this sounds interesting. Weight loss, proper diet, the whole nine yards, are undoubtedly a major issues in not just America, but much of the world. This seems like it could offer a method by which people who might otherwise be frustrated at the inability to feel full while eating calorically accurate amounts of food could learn what the right size meal is while not feeling hungry and any associated psychological twinges of failure that goes along with it.

On the other hand, though, what's the potential for abuse here? It sounds like the makers are hoping to release it as a supplement, which means no FDA or medical oversight. What would this do to someone who's already thin, but convinced they need to lose more weight? Would it enable anorexias to further depths of not eating? Is it possible to overdose, fill up with too much gel, rupture something? Is it a choking hazard? How hard would it be to clear from an airway, if the gel expanded in the throat and not the stomach? There are a lot of questions around implementation and safety that need to be addressed before it's released on the general market.

Still, using plant hydration gels is undoubtedly clever, and in a society that is battling the dual self-image issues of seeing virtuous beauty in thinness, and loathing in the expanding size many people have or are becoming, the jiggling, wiggling, belly-ful pill will undoubtedly find a home in many medicine cabinets.

A Question of Priorities... Issues in Stem Cell Research

Our friend and colleague, Art Caplan, does a keen job in his MSNBC column of dissecting the issues surrounding the latest breakthrough in stem cell research, which has been a leading news story everywhere, including the New York Times, Washington Post, and Nature. He advises that doctors and funders shouldn't put all their embryos in one basket, so to speak. He makes several good points, encouraging the Congress to pass the Stem Cell Research Enhancement Act of 2007. I think it is important to note that Congress and the Administration, if they are serious, should be pouring money into all aspects of stem cell research -- adult, umbilical, and embryonic. Each type of cell has its advantages and disadvantages, from what my research colleagues tell me -- adult stem cells, which are not as pluripotent, communicate well and integrate fairly well with surrounding cells. Embryonic stem cells, while very pluripotent, tend to act as 'wild cards', and we are still learning how keep them from growing out of control. And umbilical cord stem cells are somewhere in-between, but you don't hear much about them in the media, possibly because there doesn't seem to be funding or encouragement for research using umbilical cord stem cells. Could that be because the private biobanking business has cornered the market on these, encouraging parents to freeze and store their babies' cords for a mere $3000? (not to mention to yearly storage fee). While the Institute of Medicine recommended setting up public banking of cord blood last year, little has been done to implement that recommendation.

If this Administration sincerely wanted to help individuals with debilitating diseases, and further research in the interest of public health and welfare, and make significant progress, it would have sanctioned and funded public biobanking and research on umbilical cord stem cells a long time ago. But it is easier it seems, to deflect the issue, cloaking it in simplistic sound bites. Or to distract us to seemingly more pressing issues like the war on terror, although the debilitating chronic diseases we battle everyday as health care providers are a greater threat to our lives (and our quality of life) than terrorism. What really what it boils down to is a question of priorities.
[Image courtesy the ALS Association]

Addendum 06/08/2007: The House has voted to pass the Stem Cell Research Enhancement Act of 2007 with a vote of 247/176/10, not enough votes to override a presidential veto.

US Courts Grant Asylum Over Forced Abortion

The AP is reporting that the federal court have ruled women who've been forced to have abortions by their government, such as China, may be granted the protection of asylum. It's an interesting ruling predicated upon the allowance of victims of forced sterilization to seek asylum in the United States, and extends the grant to spouses as well as the victim of the forced procedure.

One of the questions at the heart of this case was what counts as forced - in the case, the woman did not try to flee before her forced abortion, so immigration lawyers argued that it was not an issue of force or unwanted pregnancy (ie she would have tried to hide/flee/get away). That strikes me as, bluntly, dumb. It's another variation of blaming the victim, a concept we at least try to discredit.

But on the other hand, the couple sought asylum in 2002, and the forced abortion reportedly happened in 1980. They never sought asylum prior to that, even though they had lived in Guam since 1991 - in fact, the asylum appeal only arose when the couple's work visa expired and they were being sent back to China.

Given that we routinely deny asylum appeals and return people to countries like Libya, where they will undoubtedly face religious or political persecution, jail, perhaps even death, one has to wonder at the justice in this ruling, for an incident that happened 27 years ago. On the one hand, you don't want to slip into a truly utilitarian measure of one person's plight over another, but on the other, at times, it becomes hard to not wonder at what appears to be blatant and legal injustice.

In the Category of "Note to Self at CDC: Use our planes"

The American Journal of Bioethics Editors' blog and other blogs have been filled this week with the story of Andrew Speaker, the lawyer from Georgia who took an international flight from Prague to Montreal after having learned from the Centers for Disease Control and Prevention that he is suffering from XDR-TB (the abbreviation for extensively drug-resistant tuberculosis). The questions about whether or not he has endangered others with his travels are flying thick and fast, and then it turns out, this whole mess could have been avoided had the CDC decided to send one of its three jets to pick him up.

Where Were the CDC Planes? [ABC News]

Rats! (well, Mice, really) and the future of personalized medicine

More from Wired's med-tech section:
A specially bred genetically diverse panel of mice (which roughly cover all the genetic variation in the human race), could finally deliver the long-unfulfilled promise of personalized medicine.

Full text here.

The Re-Wired Brain: Possible hope for children with Autism and sensory processing disorders

Mark Woodman had his kid's brain hacked; three months ago he took his 7-year-old son, Caleb, through a neurological treatment at the Sensory Learning Program in Boulder, Colorado, designed to recalibrate his brain. And he is happy to report in detail, in an article in Wired, that the hack has made a huge difference.

In Mark's blog diary, he also discusses a term that was unfamiliar to me: neurological diversity.
He was criticized for 're-wiring' his son's brain rather than accepting him as he is; that autism is just a different form of human thinking. It's hard for me to understand this criticism -- my first inclination, as a parent, is to do whatever necessary to prevent or alleviate suffering for my child -- and while I recognize that different forms of thinking or interpretation of sensory stimuli can lead to new ways of looking at the world, it's hard for me to imagine having to function with a brain that doesn't allow for the simple pleasures of childhood.

Thank you, Mark, for being brave enough to share the journey of you, Caleb, and the rest of your family with the rest of us!

Full text here.

Woman's (and Man's) Best Friend knows more than they're saying...

From the Washington Post this morning, another argument that personhood is not a clear cut line:
[A] provocative new experiment indicated that dogs can do something that previously only humans, including infants, have been shown capable of doing: decide how to imitate a behavior based on the specific circumstances in which the action takes place...

"Every day, we're discovering surprises about animals and finding out animals are far more intelligent and far more emotional than we previously thought," said Marc Bekoff, an animal behaviorist who recently retired from the University of Colorado. "We're really breaking down the lines between the species."

Kidney Transplant 'Reality" TV Show Is a Hoax

Apparently, the joke was on us -- from the Associated Press this morning:

"The television show in which a woman would donate a kidney to a contestants was revealed as a hoax Friday, with presenters saying they were trying to pressure the government into reforming organ donation laws.

Shortly before the controversial program was to air, Patrick Lodiers of the ``Big Donor Show'' said the woman was not actually dying of a brain tumor and the entire exercise was intended to put pressure on the government and raise awareness of the need for organs.

The three prospective recipients were real patients in need of transplants and had been in on the hoax, the show said.

The program concept had received widespread criticism for being tasteless and unethical." (including this blog)

The full article here.

A View to a Kill: Release of Microbe Study Spurs Bioterror Worries

The American humorist Will Rogers once quipped: "You can't say civilization isn't advancing. In every war they kill you in a new way.":

From Rick Weiss of the Washington Post, today:

"Researchers in Germany reported yesterday that they had altered the DNA of a disease-causing bacterium to enable it to infect a species it cannot normally sicken -- a double-edged advance that experts said could deepen scientists' understanding of human diseases but could also speed the development of novel bioterrorism agents.

The change in infectiousness -- the first of its kind ever engineered from scratch -- poses no direct threat to human health, scientists said, because the microbe already causes a human disease: the food-borne illness called listeriosis.

The change allows that microbe to sicken mice, a species it has no natural capacity to infect.

Still, the work has biosecurity implications because it could, in theory, be applied in reverse, endowing a bacterium that causes a serious animal disease with an unprecedented ability to sicken people."

Full text here.

Hit the Road, Jack! (and don't you come back)

I was debating with a legal colleague/friend of mine whether or not Dr. Jack Kevorkian was a hero, a villain, 0r neither. My friend, who has faced and coped with a life-threatening illness, felt that Kevorkian should applauded for bringing this important topic out into the open -- I felt that Kevorkian was a dangerous individual, who had taken advantage of the unfortunate situation of some vulnerable patients (the woman who suffered from Chronic Fatigue Syndrome, a non-terminal illness, comes to mind).

Now that Kevorkian has been released from prison, he wishes to re-activate the discussion. But I have to join with our friend and colleague, Art Caplan, in saying "Hit the road, Jack":

"Assisted suicide debate has passed Dr. Death by
Jack Kevorkian's back, but here's why we shouldn't listen to a word he says

The last time I saw Jack Kevorkian was April 23, 1994, in a courtroom in Pontiac, Mich.

Oakland County prosecutors had charged him in the death of 54-year-old Janet Adkins of Portland, Ore. The charges were assisting in a suicide, murder and delivering a controlled substance for administering drugs without a license. I was there to testify that what he had done to Adkins — providing her with his "suicide machine," which she used in the back of his 1968 VW van parked in a dark campsite to end her life — was both immoral and a gross violation of medical ethics.

Kevorkian, who became known in the press as "Dr. Death," was found not guilty. A few years later he was asked by Thomas Youk, a 52-year-old who had trouble breathing and swallowing due to advancing Lou Gehrig's disease, for help in dying. Kevorkian injected him with a lethal dose of potassium chloride while videotaping the ghastly proceedings. He sent the tape to "60 Minutes," which aired it. This gave prosecutors incontrovertible evidence that Jack had gone from assisting in suicides to personally killing people. He was sentenced to 10 to 25 years for murder. After serving just over eight years, Jack is back.

I believed Kevorkian was a very dangerous killer then, and I still believe it now. He helped dozens of depressed and disabled people die without trying very hard to convince them to live..."

The rest of the commentary can be found here.

Microsoft and the future of human computer interfaces: If we change the way we look at things, will the things we look at change?

One of the very interesting issues that we face in bioethics is the merger of human and machine -- the ethical, legal, and social implications -- (stayed tuned for upcoming article references, including references to Glenn McGee's code of robot ethics) and I think this recent innovation will bring another step closer to the integration of the human body and machine:

Microsoft unveils revolutionary device
New top-secret 'Surface' will change the way we look at computing

"At the touch of a hand, the hard, plastic tabletop suddenly dissolved into what looked like tiny ripples of water. The ‘water’ responded to each of his fingers and the ripples rushed quickly away in every direction....the radical new approach starts with the guts of the device itself. Under the impact-resistant plastic top skin on an otherwise nondescript table hide five infrared scanners, a projector and a wireless modem. The scanners recognize objects and shapes placed on the top and respond to them accordingly."

Full text here.

Next stop, the holographic interface, like in the movie Minority Report?

All creatures great and small...

From the NY Times this morning: Coca-Cola and PepsiCo Agree to Curb Animal Tests

"Coca-Cola and PepsiCo, have agreed to stop directly financing research that uses animals to test or develop their products, except where such testing is required by law."

The debate about whether animal models are testing are needed is discussed in the article, with quotes both from Dr. John A. DeSimone, a professor at Virginia Commonwealth University (citing the need for animal models) and Dr. Alan Goldberg, director of the Center for Alternatives to Animal Testing at Johns Hopkins University (citing that advances in alternatives to animal models, many of which are usually more scientifically precise, have already reduced the number of lab animals in use by 50 percent.)

"The two soft drink giants are the latest companies to respond to scrutiny by PETA, which has mounted a campaign to denounce animal testing practices in the beverage industry, an industry that, unlike cosmetics or pharmaceuticals, had largely been unpublicized in the animal testing arena."

For the full text, click here.

Shake It Up, Baby (Twist and Shout)

It really is true that what comes around, go around -- 50 years ago or belt vibrators in gyms and health spas were all the rage, and now it seems, a variation on the same theme is back:

In the Washington Post this morning, this article:
"What if you could burn fat while shaking a martini? Actually, it's your body that shakes like a martini on a new type of fitness machine that's generating lots of buzz and celebrity use. Even NASA has tested the concept.

These machines use vibrations to tone muscle and claim to do it faster. Aggressive promoters also say the equipment improves flexibility and strength, reduces pain and stress, builds muscle and reverses osteoporosis.

However, researchers warn of possible injuries ranging from back pain to cartilage damage. One even warns that the high-powered jiggling might harm the brain. They say the science is thin and too little is known about the long-term effects of such powerful vibrations.Still, NASA is studying vibration as a possible tool for reducing muscle atrophy and bone loss during astronauts' long, weightless trips in space."

Rest of the article here.

Happy Second Birthday to the WBP Blog!

I can't believe the Women's Bioethics Blog just turned two years old this month -- thanks to Kathryn Hinsch, the WBP Board, our wonderful volunteer bloggers, our fellow bloggers, and all those in the academic and health-related field for your invaluable support, emotional and otherwise. Look for changes in the next year, as we experience growth spurts, changes in format, and new additions to our team.

If you are interested in blogging for us, contact either Kathryn (khinsch[at]womensbioethics.org) or Linda (lindaglenn[at]biomedlaw.com).

Naturally, Scientific Support for feeling good...

Is the brain pre-wired to enjoy altruism? The Washington Post summarizes this article as such: “Altruism, the experiment suggested, was not a superior moral faculty that suppresses basic selfish urges but rather was basic to the brain, hard-wired and pleasurable.”

Full text of the article here.

Queen (strike that) -- Big (Kidney) Donor for a Day

For those of you not old enough to remember, Queen for a Day was television show in the 1950's and 60's, one of the original big prize giveaway shows and a forerunner to today's 'reality television." It was popular, in part, because it evoked sympathy with viewers who hoped to see those with hardest of luck catch a break once in a while, at the same time fantasizing that it might be one of us 'regular folk' -- but a Dutch TV executive has taken this concept to a new level (a new low, one might say):

A Dutch reality show that claims to be trying to draw attention to a shortage of organ donors said Tuesday it would go ahead with a program in which a terminally ill woman will choose a contestant to receive one of her kidneys. The program, "Big Donor Show," has been attacked as unethical and tasteless.
At least one member of the Dutch parliament plans to ask the government to block Friday's broadcast.

Does anyone seriously believe that a show like this would highlight the need for organ donation and the plight of those waiting in a useful manner? Or does it just appeal to the darker side of human nature?

The Onion: New Fetal Consent Bill

Major Hat tip to the Editors of the American Journal of Bioethics Blog who posted on this their website --


New Abortion Bill To Require Fetal Consent

Four More Breast Cancer Genes, and Nary a Genetic Counselor in Sight

In a season two episode designed to coincide with a pink ribbon, breast cancer awareness campaign, Grey's Anatomy depicted a woman seeking a prophylactic oopherectomy and double mastectomy in reaction to the news she tested positive for BRCA-1 mutation after her mother died from ovarian cancer. Of course, being Grey's Anatomy, the storyline was played for maximum drama - but that doesn't mean we should simply roll our eyes and assume it creative writing at its best. Women do pursue prophylactic double mastectomies after testing positive for BRCA mutations, even though science is still out on the potential medical benefits.

With the news that four more genetic mutations have been linked to breast cancer, we are going to have to seriously consider what it means to have a genetic mutation, to look beyond the lab at the actual impact the geneticization of medicine is having on how patients are both viewed and treated, and consider what appropriate treatment actually means.

"I'm not a real bioethicist, I just play one on TV!"

Earlier this year, we blogged about House, MD and Grey's Anatomy: Showing the world the need for clinical ethicists one episode at a time.
Reuters claims that health experts help TV docs get facts straight:
"That young mother with breast cancer on "Grey's Anatomy" may do more than just drive the storyline: She may also be teaching you something.
Recognizing the reach of popular television shows, real-life doctors and public health experts are at work behind the scenes to add a dose of education to entertainment."

Now if they could only get a bioethicist on House MD to stop his bad-boy behavior! (or in the case of Grey's Anatomy, bad-boy, bad-girl, just plain bad behavior).

Bring Out Your Dead (and other party strategies)

Respect of the dead is a value deeply ingrained in all cultures and religions; it was an issue as rescue workers retrieved bodies from New Orleans after Hurricane Katrina, and when funeral directors were found to be stealing body parts. And it has been as issue that has also been addressed by US courts as early as the 1870's (See Pierce v. Proprietors of Swan Point, 14 Am. Rep.667, 10 RI 227 (1872), where the Rhode Island Supreme Court held the body of deceased beloved was a sort of “quasi-property” ). So, it was rather surprising when I spotted in the NY Times today that cemeteries are seeking breathing clientèle holding daffodil brunchs and first class meals, complete with butler service, in cemetery chapels and mausoleums as a way to raise money for reconstruction and upkeep.

I'm not sure that this is respectful of the dead, in fact, part of me feels that it is downright morbid, even though cemeteries are often beautiful, peaceful places. On the other hand, El Dia De Los Muertos, the three-day Mexican holiday to honor and celebrate loved ones who have passed on, seems respectful enough.

What to do you think?