The Pistorius Effect

[Cross-posted from my Care to Elaborate blog]

A lot of discussion has been going around regarding Pistorius. Should he or shouldn't he be allowed to compete for a spot in the Beijing Olympics? If he makes it, should he or shouldn't he be allowed to compete. There’s concern over what this will do to sports in general; what kind of message is it sending out to others; and how it could throw off future comparisons within the sport, making some sports records incomparable.

In Art Caplan’s Opinion piece, he discusses Tiger Woods' laser eye surgery and how he now has better than 20/20 vision. This surgery allows him to continue to compete with vision, not just without glasses or contacts, as with the first surgery, but better than that. Caplan says, "That's why it cannot just be "advantage" that determines whether someone can use technology to compete. The deciding factor is whether something confers a significant, not a slight advantage."

But what about the other sports, like Major League Baseball? What about those players who have gotten the Tommy John surgery? Have these individuals been enhanced, do they have an unfair advantage to those that have not have the surgery? Or what about those players who like Tiger Woods have gotten the laser eye surgery, and are able to tell the difference between a curve ball and a fast ball better than others.

Caplan goes on

"We don’t expect to compare the performances of today to those of the ancient Greeks, but we do expect some ability to compare what happened today to be compared with what happened yesterday, a year ago, a decade ago or even 50 years ago.

It may be fascinating to see who can go the fastest on rocket-powered legs or throw a heavy weight the farthest using performance-enhancing drugs, or genetically engineered muscles. But what you have then is an exhibition or a show, not a sport. In some ways, this is what the professional wrestling and no-rules body building already are.

To be a sport you need something approximating a fair playing field, some boundaries on the attributes of those who compete so they are comparable to one another and some ability to compare today’s performance with those in the not-so-distant past.

That is why I am not sure Oscar Pistorius should compete.

He may not have a marked advantage, but his artificial limbs make him too different from those he competes against, and too unlike those who have raced before. It's not about giving him an opportunity. The issue is that Pistorius risks destroying exactly what he wants to do — compete in a sport."

The previously mentioned surgeries also offer advantages over both today and yesterday’s competitors. Situations arise where an athlete seriously injures himself and, with modern technology, instead of having to retire they are put back together. By putting them back together, and in some cases, back on the playing field as they were before or even better, technology is playing a part in the sports world. A search for 'surgery' on CBSsports.com produced 47,500 results, I acknowledge that not all of these individuals were undergoing corrective or elective surgery to return to the game, but it is still quite a lot.

There is discussion because he has an unfair significant advantage. He’s disabled and he can keep up, maybe not yet qualify, but he can keep up, regardless of his disability. The concern mimics the perspective I had of the American Gladiator. An average guy breaks the boundaries and competes, but hope is that the next competitor will be above average with potential to blow everyone else out of the water. Then, there is the potential for an unfair competition with not everyone being able to get or, rather, need the legs. It’s better to keep the competitors separate, the Paralympians and the Olympians, so they are on a level playing field.

The significant advantage everyone’s examining is still there for those willing to play regardless of the competition in the Olympics. Pistorius and others like him can still compete in the Paralympics with their “advantage”. Will the athletes of the Paralympics also be comparable within the past 50 years? Can the artificial limbs of 50 years ago be comparable to those of today in competition? Is the Paralympic committee ok with all of this lack of comparison or are their records already taking into account the differences in technology?

I have two scenarios; granted there could be more, please share them.

Scenario 1:

Pistorius competes in the Beijing Olympics, he places whatever. Others like him are inspired and also try out. Not guaranteed a position based on sympathy, but on capability, like everyone else. Those who can meet the competition minimums will compete, those who can’t won’t.

Scenario 2:

Pistorius competes in the Beijing Paralympics, he places whatever. Others like him are inspired by his attempt to participate in the Olympics as a result try out for the Paralympics. Not guaranteed a position based on sympathy, but on capability, like everyone else. Those who can meet the competition minimums will compete, those who can’t won’t.

Technological advances are driven by demand. Those who are already amputees are going to want better ones. Those who compete are going to want faster ones. Where will these individuals be competing? I go back to

“It may be fascinating to see who can go the fastest on rocket-powered legs or throw a heavy weight the farthest using performance-enhancing drugs, or genetically engineered muscles. But what you have then is an exhibition or a show, not a sport. In some ways, this is what the professional wrestling and no-rules body building already are.” (Emphasis added)

The Paralympics is an arena to compete in sports, even though they allow Cheetah Flex Foot for competition. Maybe they have an interesting show in their future.

“To be a sport you need something approximating a fair playing field, some boundaries on the attributes of those who compete so they are comparable to one another and some ability to compare today’s performance with those in the not-so-distant past”

The Paralympics offer a fair playing field for those with artificial limbs like Cheetah Flex Foot; where the Olympics offer a fair playing field for those with limbs (oh, and the special external technological advances they have, i.e. special swimsuits, clothing, shoes, and equipment. Which with the demand to be better will also advance)? Knowing that we aren’t going to get rid of artificial limbs like Cheetah Flex Foot, and knowing they are going to make an impact somewhere, which competitive arena will they be allowed to affect and advance?

This Sh** is Bananas

Over at the Daily Galaxy a very disturbing post about the likely fate of the fruit that changed the world, unless advancements in biotech can find an answer:

"It’s less sensational news than skyrocketing food and oil prices, but the beloved yellow banana may soon disappear forever. Bananas are even more heavily consumed in many parts of the world than rice or potatoes, but now a fungus called Panama Disease is turning them brick-red and inedible. Here’s the worst part: There is no cure for Panama Disease and it is spreading very quickly. Experts surmise that within the next three decades, the sweet and creamy food staple will be nonexistent."

You can access the full post here.

It's hard to imagine a world without bananas...
[Apologies to all those who now have Gwen Stefani's Hollaback Girl stuck in the heads.]

Medical Breakthrough or Monstrosity?

“Scientists have begun blurring the line between human and animal by producing chimeras—a hybrid creature that's part human, part animal.”
Mary Ann Mott, National Geographic News


According to Reuters UK ( “Factbox: Human Fertilisation and Embryology Bill” ), controversial medical research innovations are being debated in Parliament’s House of Commons this week. The Human Fertilisation and Embryology Bill raises several interesting bioethical issues, one of which would allow the creation of human-animal hybrid embryos to be used for medical research.

Interspecies embryos would be created by taking a cell from a patient and inserting it into an enucleated animal ovum. An electric shock would fuse the two cells together allowing the formation of an embryo. Because the genetic material from the animal has been removed, the resulting embryo would be 99.9% human and an excellent model for medical research. The proposed legislation mandates that these embryos must be destroyed before 15 days, and they must not be implanted into the uterus of a woman or another animal.

The advantage of creating mixed-species embryos is that they can be a powerful research tool for developing stem cell models without the use of human eggs. Embryonic stem cells would be taken from the new hybrid embryo and injected into specialized human tissues, giving researchers insight on understanding the progression and possible treatment of medical conditions such as Alzheimer's disease, cystic fibrosis, Parkinson’s disease, diabetes, and other inheritable diseases. Stem cells could also be used to repair human tissue by allowing new tissue that is genetically matched to the individual to be cultivated for damaged body parts without the risk of rejection.

Scientists and researchers are excited about the medical possibilities that may unfold, and supporters of this bill are convinced that these techniques are “an inherently moral endeavor” that could eventually save millions of lives. There is, however, a great deal of public anxiety about the ethics of experimenting across species boundaries. Many critics find it unnatural and morally wrong to combine human and animal genetics. They also question the benefits of hybridization, claiming that there is no evidence that this will help cure diseases and that other research methods are more effective. They find it both misleading to the public and an abomination to nature. “There are other ways to advance medicine besides going into the strange, brave new world of chimeric animals.”

Even scientists are divided on this issue. Although there may seem to be medical advances to be gained from human-animal hybridization, we really need to make sure that these benefits outweigh the possible risks. In the words of William Cheshire, associate professor of neurology at the Mayo Clinic’s Jacksonville, Florida branch,


“We must be cautious not to violate the integrity of humanity or of animal life over which we have a stewardship responsibility. Research projects that create human-animal chimeras risk disturbing fragile ecosystems, endanger health, and affront species integrity.”



[Photo courtesy of goatboyfilms.com/.]

First Female DNA Decoded

[Cross-posted from the Blazing Indiscretions blog, hat tip to blogger Jay Vos]

The first decoding of DNA in a female was done in The Netherlands, reports DutchNews.nl. A red-haired, 34-year-old Dutch woman has become the first woman in the world to have her compete DNA unraveled, genetic scientists at Leiden University Medical Centre announced on Monday.
---
[T]he sequencing data of a female provides more insight into the X chromosome. 'Because the X chromosome has to do all the work in one half of the population - the males - selection has been tougher during human evolution,' according to Van Ommen. 'This means the X chromosome is less variable.'

Male sequencing data has already been unraveled from Jim Watson, co-discoverer of the double helix structure of DNA, from researcher Craig Venter and from two Yoruba Africans. 'It was time to balance the genders a bit,' news agency AP reported Van Ommen as saying.

Decoding the DNA took six months, but the scientists point out they could only use the sequencing equipment when it was not being used for other projects.

Six 'uniquely' human traits now found in animals

To accompany the article So you think humans are unique? New Scientist magazine has selected six articles from its archive that challenge notions that the following characteristics are uniquely human (subscription required):

1. Culture - Read the original article: Culture shock (24 March 2001)

2. Mind Reading - Liar! Liar! (14 February 1998)

3. Tool Use - Look, no hands (17 August 2002)

4. Morality - Virtuous nature (13 July 2002)

5. Emotions - Do animals have emotions? (23 May 2007)

6. Personality - Critters with attitude (3 June 2001)

Do you think humans are unique? Take our poll!

Quote of the Day

From Julian Baggini in his New Statesman article: "The justifiable desire to keep religious dogma out of public life has led to an unjustifiable tendency to treat religious views as a whole as separable from civic life. It is in the interests of everyone, believer or not, to end this artificial divide and start a real intellectual tussle in which secular and sacred views battle it out, rationally and in the open."
Full article accessible here.

'Rapid Organ Recovery' ambulance proposed in NY

In the NY Times, a number of bioethicists comment on a plan to deploy a special ambulance to collect the bodies of people who have died suddenly from traumas or heart attacks and try to preserve their organs: "The organ team would wait five minutes after EMTs give up on resuscitation, to create a clear demarcation between efforts to save lives and those to preserve organs. 'The process of resuscitation would be very distinct from the process of organ recovery so that we would be sure that, ethically, there's no potential for an overlap or misconstruing of what's going on,' said Bradley Kaufman, a top medical director for the New York City Fire Department, which operates ambulances."

However, a number of bioethicists, such as Michael A. Grodin, Robert Truog, Art Caplan, Leslie Whetstine, and Nancy Dubler, who is helping vet the plan, have expressed concerns that the plan may undermine public trust in emergency medical care and the organ donor system and aggravate fears of disadvantaged groups that already harbor deep distrust of the medical system.

Access to the full article here.

Senator Boxer calls for FDA Accountabilty For Medical Devices

Some of you maybe remember the great post on the Beauty and the Breast blog Supreme Court Rules You Can’t Sue Medical Device Makers Because the FDA Does Such a Great Job Assessing Safety?

In response to the ruling, Senator Barbara Boxer (D-CA) introduced a bill last week that would bring greater accountability and transparency to the Food and Drug Administration’s (FDA) regulation of all medical devices. Millions of Americans are implanted with devices ranging from pacemakers to breast implants, yet don’t realize that medical devices are not rigorously approved like pharmaceuticals. The bill (S.3020), the Food and Drug Administration Accountability and Transparency Act, will provide the FDA with several tools to help ensure the safety of these devices.

Because of less stringent safety approval mechanisms, the FDA allows manufacturers to conduct post-approval studies. But in many cases these studies are altered or not completed and consumers are left in the dark about safety problems.

“The FDA has been charged with a central role in safeguarding the health of our nation. Since the creation of this agency more than 100 years ago, the role of the FDA has expanded to ensuring the safety of foods, drugs, medical devices, and even cosmetics. Too often, however, the FDA lacks the authority or the resources to safeguard the health of our nation….[this act] would give the FDA several tools to ensure the safety of medical devices, including larger fines to hold these companies accountable,” Senator Boxer said.

Medical device manufacturing is a $75 billion industry, with considerable lobbying power, which enables them to secretly waive or alter post-approval agreements with the FDA, without informing consumers. This bill would end this practice by requiring such changes to be placed in the Federal Register.

Senator Boxer also stated: “If the Secretary of Health and Human Services determines that a manufacturer’s failure to conduct post-market surveillance is a risk to public health, this legislation give the Secretary the authority to notify health professionals that have been using these devices about any safety concerns.”

Sybil Niden-Goldrich, a long-time advocate of the breast-implant issue, applauded Senator Boxer: “More than 360,000 women received breast implants last year—a 40% increase over the last five years. Yet none of these women knew silicone implants were approved on the basis of post-approval studies that subsequently were watered down by FDA and aren’t being conducted. Senator Boxer’s bill would correct these grave injustices.”

Some bioethics stories of note this past week....

For you trekkies, could this be Data version 1.3? -
Selmer Bringsjord, director of the Rensselaer Artificial Intelligence and Reasoning Laboratory at Rensselaer Polytechnic Institute, spends a lot of time in Second Life, but not for recreation or entertainment -- he and his team at RPI (RPI) are the creators of synthetic agent Edd Hifeng, who they have endowed with a limited ability to converse and reason.

See the rest of the article here.

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Do difficult times call for deep brain stimulation?

Brain-stimulation devices for treating depression have faced unexpected setbacks. To serve the 40 million or so sufferers who fail to respond to antidepressant drugs, a few companies have tried to treat the disorder with electronic implants and electromagnets. These therapies, however, have stumbled en route to the doctor's office.

To take a crack at those intractable cases, experiments exploring five device therapies will start this year. In total, nine different technologies are now under investigation in at least 27 human trials.

Full story here.

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A Superhighway to Bliss

JILL BOLTE TAYLOR was a neuroscientist working at Harvard’s brain research center when she experienced nirvana.

But she did it by having a stroke.

On Dec. 10, 1996, Dr. Taylor, then 37, woke up in her apartment near Boston with a piercing pain behind her eye. A blood vessel in her brain had popped. Within minutes, her left lobe — the source of ego, analysis, judgment and context — began to fail her. Oddly, it felt great.

Access the rest of the story here.

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Concerns about carbon nanotubes as carcinogenic

Nanotechnology experts are calling for prompt government action to ensure that carbon nanotubes are properly regulated, after researchers discovered that some carbon nanotubes can cause precancerous growths in the same way that asbestos does.

Researchers led by Ken Donaldson of the University of Edinburgh’s Centre for Inflammation Research, UK, found that in mice, long, straight, multi-walled carbon nanotubes can cause the same kind of damage as that inflicted by asbestos fibres when they are injected into
the lung's outer lining, called the mesothelium.

Full article accessible here.

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How Our Brains are Wired for Belief

From the Pew Forum on Religion and Public Life, transcripts from a discussion about how recent advances in neuroscience and brain-imaging technology have offered researchers a look into the physiology of religious experiences. The whole article and transcripts accessible here.

Art Caplan on 'Blade-Runner' ruling

[Cross posted from blog.bioethics.net]:

Over at MSNBC, Art writes that he's not so sure that Pistorious should be allowed to compete in the Olympics:

Should anyone who must run on prosthetic legs be allowed to compete in the Olympics or other sporting events?

Oscar Pistorius, a college student from South Africa, has been told he can compete in the Beijing games this August, in either the 400-meter or the 1600-meter relay race as a member of the South African team, if he can reach a qualifying time.

The decision has been greeted around the world with approval. Some see it as a triumph for the disabled. It is easy to see why. Pistorius, known as the Blade Runner, is a very appealing, articulate young man who trains hard and sincerely wants a chance to compete. But I am not sure letting him run is the right decision.

Pistorius was born with major bones missing in both his lower legs. His legs were amputated at the knees when he was a child. He runs using artificial limbs made of carbon fiber, known as Cheetah blades. The controversy over whether Pistorius should be allowed to compete has focused exclusively on whether his Cheetah blades give him an unfair advantage.

Last January the International Association of Athletics Federations (IAAF) said, based on a report from a German scientist, that mechanical legs give anyone using them an advantage in a race. They are more energy efficient than human legs, ultra-light, springier and do not fatigue. The IAAF said since the Cheetahs helped athletes perform better, it would ban their use. That decision meant no Olympics for Pistorius.

Pistorius appealed the ban to the Court of Arbitration for Sport (CAS) in Lausanne, Switzerland. Scientists at six universities in three nations took a look at Pistorius’ artificial legs. They concluded that the available evidence about the advantages of the Cheetah blades was insufficient. Last week the court said that, until more evidence was produced, Pistorius was eligible. The IAAF backed down and Pistorius can now compete.

What if further study does show that Pistorius can run faster because his artificial Cheetah blades work better than legs? Should he or others be kept out of competitions involving able-bodied persons?

(read the rest)

Bad Council

Conservative bioethics takes “dignity” for a spin in a disquieting new report.

Scientific advances that alter minds and bodies in novel ways can make people uneasy. The President's Council on Bioethics has become a forum for the airing of this disquiet, and the concept of "dignity" a code word for addressing it. This body recently released a 555-page report, and what it reveals should alarm anyone concerned with American biomedicine and its promise to improve human welfare. The May 2008 issue of The New Republic spells it out: this brand of government-sponsored bioethics does not want medical practice to maximize health and flourishing; it considers that quest to be a bad thing, not a good thing.

Although the Dignity report purports to be based on universal moral concerns, it springs from a movement to impose a radical political agenda, fed by fervent religious impulses, onto American biomedicine. How did the United States, the world's scientific powerhouse, reach a point at which it grapples with the ethical challenges of twenty-first-century biomedicine using Bible stories, Catholic doctrine, and woolly rabbinical allegory? Read the article, note the credentials (better, the incredentials) of the report’s contributors, and laugh…or weep.

Harmon wins Pulitzer for DNA Age series

New York Times reporter Amy Harmon has received a Pulitzer Prize for explanatory reporting, awarded for “her striking examination of the dilemmas and ethical issues that accompany DNA testing, using human stories to sharpen her reports.” Ms. Harmon’s on-going series “The DNA Age” explores the impact of genetic technology in every day life. In 2007, she authored ten articles in this series, several of which focus on genetically-related disabilities.

Among the articles is “Facing Life with a Lethal Gene” detailing the experience of Katharine Moser, an occupational therapist who has tested positive for the Huntington Disease gene and who has yet to develop symptoms. Another article, “Cancer Free at 33, but Weighing a Mastectomy” follows the struggle of Deborah Lindner, a woman who has tested positive for the gene which leaves her at high risk for BRCA-related breast and ovarian cancer. Ms. Lindner decides to have a double mastectomy to avoid breast cancer.

Two related articles in the series, “Prenatal Test Puts Down Syndrome in Hard Focus” and its follow-up, “Genetic Testing + Abortion = ???” brought national attention to the complex subjects of prenatal testing, abortion, Down syndrome, parental advocacy, and the ethical dilemma of many liberals who are both pro-choice and pro-disability rights.

For a full description of this Pulitzer Prize category, Ms. Harmon’s autobiography, and all of the prize-winning articles, see the Pulitzer website. All of Ms. Harmon’s DNA Age articles can be viewed here.

Congratulations Amy! Posting thanks to blog reader Nancy Iannone.

Summer Blockbuster: BiggerStrongerFaster

It seems athletes are the theme of week -- Starting May 30, a movie about the chronic use of steroids in the United States, asks this question, among others: "If you had to take a drug with side effects like anabolic steroids to keep your job and support your family, would you?"





For more info, check out the website BiggerStrongerFastermovie.com,

Amen to that...

If you're a baby boomer, you gotta love this story in the NY Times :

Older Brain Really May Be a Wiser Brain

When older people can no longer remember names at a cocktail party, they tend to think that their brainpower is declining. But a growing number of studies suggest that this assumption is often wrong.

Instead, the research finds, the aging brain is simply taking in more data and trying to sift through a clutter of information, often to its long-term benefit.

The studies are analyzed in a new edition of a neurology book, “Progress in Brain Research.”

The rest of the article can be accessed here.

The 'Blade-Runner' to compete in Olympics

In a follow-up to our previous blog entry about bionic athletes, Olympian hopeful Oscar Pistorius, won his appeal in front of the Swiss-based Court of Arbitration for Sport. The court ruled that his carbon-fiber prosthetic limbs do not give him an advantage over other runners.

Blogger and disability rights activists Greg Wolbring has some interesting stuff to say about the ruling in his blog:

1) The ruling I assume will be interpreted to be a ruling against the scientific data claiming that the cheetah legs lead to an unfair advantage. The ruling leaves the door open that one could exclude a runner with prosthetics from competing in a ‘natural leg’ running event if it can be proven that the ‘artificial’ legs lead to an unfair advantage. This makes sense. So far the process of investigating theses new ‘artificial’ legs is not developed enough to be called a golden standard so its open for interpretations. Once tests are developed that are accepted as the golden standard and they show an unfair advantage one can see that that runner won’t be allowed to run against the ‘biological leg’ runners.

2) However the ruling seems to give the answer to another question. Are the Olympics about athletes who have a body adhering to the norm of the homo sapient species? In other words is the Olympics about athletes with a ‘normal biological body’? The ruling cements the view that the Olympics are not about biological bodies per se. So one can compete in the Olympics independent of whether certain biological parts are replaced by artificial parts.
If the replacement does not lead to a competitive advantage athletes with artificial body parts can compete against athletes where the body part in question is biological and not artificial.
If the replacement does leads to a competitive advantage one could see the ruling opening the door for the scenario where the athletes with artificial body parts compete against each others in the Olympics whereby the artificial body parts are treated like a pole used in pole vaulting…

Greg's blog can be found here.

GINA is now the law of the land

Finally! The Genetic Information Nondiscrimination Act has been signed into law. More info here, there, and everywhere. Oh, and here too.

Recent reproductive rights rulings ...

A quick recap of two recent rulings that may be of interest:

Yesterday, a federal appeals court overturned Virginia's ban on late-term abortion, passed in 2003 as the "Partial Birth Infanticide Act". Although the US Supreme Court upheld a federal ban on late-term abortion in 2007 (Gonzales v. Carhart), the Richmond-based US Court of Appeals for the 4th Circuit concluded that the Virginia ban was overly restrictive in comparison. In particular, unlike the federal ban, the Virginia law provided no legal protection for physicians who "accidentally" perform an intact dilation and extraction while performing a second-trimester abortion.

Across the pond, the British Parliament voted to keep an upper limit of 24 weeks for elective abortion, rebuffing critics who sought to lower the limit to 12 weeks. A very small number of infants born after only 24 weeks of gestation survive, but a majority of British MPs felt that the small chance of survival did not justify further restrictions on a woman's right to choose.

Some bioethics stories of note...

[Courtesy of Rick Moody]

-- DIGNITY AND AGING

In the most recent issue of THE NEW REPUBLIC, Steven Pinker has an article on "The Stupidity of Dignity," in which he attacks the uses of the idea of dignity by Leon Kass and other members of the President's Council on Bioethics. Kass is the author of LIFE, LIBERTY AND THE DEFENSE OF DIGNITY: The Challenge for Bioethics. Pinker, it seems, has little respect for the concept of dignity in bioethics. On the contrary, he sides with Ruth Macklin, author of a
2003 article titled "Dignity Is a Useless Concept." Pinker, like Macklin, believes that "dignity" is a squishy, subjective notion. Above all, Pinker sees dignity as an insidious application of what he terms "theocon bioethics," associated with Kass and his allies.

This is a debate in which I am interested party, since I am co-editor of the book DIGNITY AND OLD AGE, which contains two chapters where I question the hegemony of the ideal of autonomy, so prominent in bioethics today. I do argue that dignity can and should play a critical role in thinking about ethics and the lived experience of old age, precisely because it captures elements of the world not captured by the ideal of self-determination. Pinker, by contrast argues that dignity is relative, fungible, and sometimes harmful, saying that "dignity is a trivial value, well worth trading off for life, health, and safety." Yet even Pinker is compelled to admit that "people generally want to be seen as dignified. Dignity is thus one of the interests of a person, alongside bodily integrity and personal property, that other people are obligated to respect."

Is it really true that dignity "is just another application of the principle of autonomy?" I think not, but the argument is too long for the space of this newsletter. Still, as Kant well understood, there are certain ideas that are impossible to escape. Suffice it to say that, like "freedom" and "happiness," the idea of "dignity" will not soon go away. It is an intrinsically contested concept and one that deserves our attention in all of the stages of life.

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-- JUSTICE AND DEMENTIA

The Report "Achieving Care and Social Justice For People With Dementia" explores the issue of caring for people with dementia. It not only defines what "care" is but goes on to explain what "good care" should be. They authors examine the theory and practice of good care, using the moral categories of: Attentiveness, Responsibility, Competence, Responsiveness and Trust. The key point is that good care requires a continual negotiation between those providing and those receiving care. If caregivers adopt an ethic of care, patients will be assured of fundamental human rights.

For a related upcoming event, note the conference on "Creativity, Communication and Dementia" scheduled for May 30 - 31, 2008 in Vancouver, British Columbia. This event
is sponsored by the Society for the Arts in Dementia Care and the Canadian Institute of Health Research. For details contact: Dr. Dalia Gottlieb-Tanaka at (604) 986-6408 or email at: info@cecd-society.org.

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-- IS PNEUMONIA THE OLD MAN’S FRIEND?

Physician William Osler once described pneumonia as “the old man’s friend:” that is, a relatively convenient way of dying. But what if we deliberately withhold cheap and effective treatment-- say, antibiotics-from older people with dementia? Dr. Gregory Rutecki has pushed this question: "Do [the elderly] die from complications contingent on the antibiotics themselves-- violating primum non nocere? Induction of bacterial resistance as well as
the impact thereof on society is not of primary concern. If the question of resistance is not being asked in other often younger cohorts, it cannot be asked solely with respect to the physically-marginal, demented elderly. They cannot be punished for their so-called biological tenacity."

From "Revisiting an Ethical Conundrum: An Older Person’s Friend
or a Renewed Assault on the Biologically Tenacious?" by Gregory W. Rutecki, MD.

-- H.R. Moody

A disturbing prediction on cervical cancer deaths ...

Today's New York Times has an article summarizing the disturbing results of a new study looking at trends in cervical cancer morbidity and mortality in Latin America.

In an era in which most cases of cervical cancer can be prevented or detected early and treated, the study – sponsored by the Sabin Vaccine Institute, the Pan American Health Organization, and the US CDC, among others – concluded that cervical cancer-related deaths are likely to double in Latin America in the next 20 years. Fewer than five per cent of women in Africa, Asia and Latin America are screened for cervical cancer, as compared to 70% of women in North America and Europe. Most of these women also lack access to newly-approved HPV vaccines.

Does this truly have to be the case? Must we continue to needlessly condemn 250,000 poor women to death every year? Even if we accept the argument that current screening and treatment technologies – Pap smears and the HPV vaccine – are too costly to be used widely in resource-poor countries like Haiti and Nicaragua, what about lower cost screening technologies like VIA (visual inspection of the cervix using acetic acid)?

For almost a decade, it has been known that clinicians, usually nurse-midwives, can detect more than three-fourths of pre-cancerous and cancerous cervical lesions simply by wiping a patient's cervix with acetic acid (white vinegar) and examining it visually. That this method is not more widely used, particularly in light of a recent Lancet study showing that VIA is as effective as traditional screening methods in India, is shameful.

It's time to wake up and smell the vinegar ...

Hear WBP founder Kathryn Hinsch in person

If you live in or near Maricopa County, Arizona, don't miss this chance to hear WBP founding director and board president Kathryn Hinsch speak on women and bioethics at the YWCA's Empowering Women Lecture on Tuesday, September 16, at the Orpheum Theatre. More on the YWCA and its goals from the Arizona Republic here.

Happy 3rd Birthday to our blog!

Please join me in wishing the Women's Bioethics Blog a very happy Birthday -- it's been three years this month since we started this endeavor and we're still going (and growing) strong...Thank you to all of our wonderful bloggers and loyal readers!

Bionic Athletes stepping out of the debate and in to action

I've been fascinated with the growth in public awareness recently regarding bionic athletes. It's very interesting to watch something go from fringe and then mainstream. Almost a year ago, an article by Jamais Casico made me take a real look at what it is to be bionic when he talked about getting hearing aids in The Accidental Cyborg. Since then, I've had a heightened awareness and intrigue for the topic. Last month my husband's ESPN came in, I am admittedly not a reader of this particular magazine, but the cover was beautiful. It had bionic Little Leaguer Anthony Burruto on the cover preparing for the pitch and the debate: Bionic Athletes Is Baseball Ready for This Guy? Are You? I had to read it immediately and highlight profusely the interesting comments, while my husband watched and let it slide that I had both read and defamed his magazine before he had even cracked the issue.

The comments inside were intriguing: "...he [Hugh Herr] doesn't want his human legs back because soon they'll be archaic", "Technology...is quickly outpacing evolution, and few know how to respond", "Others will fret that some athletes might cut off a limb to gain a prosthetic advantage." This last quote has been a debate between a close friend and I for months now. I think this is a probability in the future, people are very competitive and those who were not born to compete may pay to be able to do so at any cost. She, only the other hand, is appalled at the idea, she is very open-minded about things, but this one crosses her line of what people would subject themselves to. The difference in opinions is understandable, we come from different experience and backgrounds, she had a mother who had to have her legs amputated for medical reasons and saw firsthand what life is like without limbs. Me I only know from what I read and imagine. We therefore amicably agree to disagree.

My other favorite quote however, and the one I saw on American Gladiators this week, was, "Shed a tear for the 'disabled' today. Tomorrow they might pity you." I wish I would've written this. I thought of it Monday evening when I was watching American Gladiators. This is a requirement in my home, my son is enamored with the Gladiators as any almost 9 year old should be. They showed the next competitors and who did they have...a leg amputee...a bionic athlete, John Siciliano.

My first thoughts were good for him, and my second was good for NBC or whoever in the company selected him to compete. The show, with it's overly muscular Gladitors, typically has competitors that are also overly muscular and look as if they're training for, well, to take on a Gladiator. This guy, however, was different. He wasn't overly muscular, he was a Para-Olympian Gold Medalist, he had endurance and a great determination took to take them all on. I watched and rooted for him. He didn't win, but it wasn't without a fight. The last challenge was tough and I must be honest, it was a bit sad and disheartening. No matter what his determination was, his leg was not outfitted for the Eliminator. The water challenge made the leg wet, the leg was the J-shaped Flex Foot version not good for ropes, tight-rope walking or going down the pipe, also not good with the wet leg. When it came to the end, he fought hard while the crowd cheered, he finished with pride.

Honesty again, this made me tear up, seeing him and knowing that he won't be the first, hoping others out there built like a Gladiator will want to compete also, as an equal to the Gladiators and to show up the first bionic competitor. Except the next time, they will be outfitted with prosthetics to take on the ropes, water, and the evil travelator. Bionic athletes are not going away any time soon,and as was mentioned in ESPN magazine, "Thousands of vets will return to the U.S. without limbs, and they will want the best replacements...and those vets will take their prosthetics to the blacktop and the field. Disabled athletes will get only more competitive."

So I say, good luck to the next competitor and welcome to the mainstream. We're going to be seeing a lot more of you in the future and I hope that we will all benefit from your determination and continual drive for best technologies.

Smart advice re genetic testing

Today's Newsday includes this fantastic op-ed by Wylie Burke, an ethicist and medical geneticist at the University of Washington, and H. Gilbert Welch, a primary care doc and researcher at Dartmouth. (Full disclosure: I work with Wylie and think the world of her. Read the editorial, and you'll have an inkling of why that is.)

Dr. Welch is also the author of a wonderful book, Should I Be Tested for Cancer? Maybe Not and Here's Why that provides lots more information about the ways in which "predictive" testing and population-level screening can create problems for patients.

Is Life A Gift?

[Cross posted with permission from the IEET site]

By Michael LaTorra

Harvard's Michael Sandel argues in his book The Case Against Perfection: Ethics in the Age of Genetic Engineering that life is a gift and that we should accept the unbidden nature of this gift, working toward acceptance and solidarity with others rather than seeking unbridled mastery over human biology.

But is life properly viewed as a gift?

The claim that life is a gift automatically entails a responsibility on the part of the recipient of that gift to respond with gratitude and without taking issue with the precise attributes and characteristics of what has been given and received. One is supposed to live by the aphorism "Don't look a gift horse in the mouth" (or you might see a lot of rotten teeth). So to accept Sandel's premise that life is a gift is also to accept that one is obliged to respond in a certain way and without closely scrutinizing the actual conditions of what has been received.

But is life a gift at all? The alleged giftedness of life is not inherent in life itself. Something can be given and received without that something being a gift. Communicable diseases are given and received, yet we do not usually consider diseases to be gifts. In some cases, some individuals will say that they learned valuable lessons from their struggle with a disease. In that sense, perhaps we could deem a disease to be a gift. A better term for such an event, however, would be a test.

A test is given and received, just like a gift. However, a test may properly be viewed as fair or unfair, depending on whether the test is appropriate to the skill and knowledge level of the person being tested, and whether the test is free from trickery or deception. We are not expected to have any sense of social obligation to be grateful for being tested. We are not expected to overlook unfairness, bias or deception in the test itself. Indeed, we have a duty to evaluate the fairness of the test so that neither we nor other test-takers should be badly affected by an unfair, biased, deceptive or inappropriate testing instrument.

Life as we currently live it has many undesirable features, such as sickness, old age, too-short duration, painful death, and other limitations. To represent life as a gift without recognizing these negative attributes is to bias the discussion of how life might be improved. If life were merely a gift, one would have to wonder about the motives or competence of whomever chose to give such a gift. If you were shopping for the perfect gift to give someone you loved, would you give them spinal bifida and Huntington's disease?

Life is not always or only a gift. Life is also a test. A crucial element of this test is how life itself might be improved so as to lessen suffering, improve capacity, enhance abilities, and extend the duration of every desirable aspect of life itself. This is the lesson of life. This is how the test is well-met. The true gift of life is to make it better than it was when first received.

Worth the read today...

From Wired's Science Blog: "The First Genetically Modified Human Embryo: Advance or Abomination?

Scientists have created the first genetically modified human embryo.

What does this mean to you?

Led by Nikica Zaninovic, researchers at Cornell University added a green fluorescent protein to an embryo left over from assisted reproduction. They destroyed the embryo five days later. It is believed to be the first documented genetic modification of a human embryo." Rest of the article can be accessed here.

Image: Five-day-old (unmodified) human embryo, courtesy of the Wellcome Trust. They provide information about the UK's proposed Human Fertilisation and Embryology Bill here.

What do you see in this picture?

I'm fascinated by how pop culture shapes, and is shaped by, our society's view of bioethical issues. Here's the Mother's Day cover of the New Yorker.

It shows a woman peering gooily into a shop window, mooning over a warm and wriggling litter of--wait for it--not puppies, but diapered babies. Meanwhile, her male companion tries to drag her away from the window, eyes rolled heavenward in the universal male posture of "Not this again!"

There's a lot to unpack here, beginning with the idea that women view motherhood the same way they view a new pair of shoes; that men view women's desires to become mothers with the same exasperation as they view the shoe-buying habits some of us have; that babies are like puppies (warm, fuzzy, commodities)....

You can play too! What other assumptions and analogies are implied here?

Happy Mother's Day from the WBP

You don't have to have a child to feel like a mother, or be motherly, or motherlike or maternal. We can be mothers to our ideas, our passions, to our pets, to our extended families -- being a mom can also be about being a nurturing caregiver, a protector of life and liberty, a guardian of the weak and the fragile, and a steward of the earth and all of its living creatures.


So, from all of us at the Women's Bioethics Project, we wish you a Happy and Joyful Mother's Day!

Dude, Where's my artificial womb?

A couple of our bloggers (Terry Tomsick and Jennifer Bard) have written articles on ectogenesis (aka the artificial womb or the uterine replicator), which is a fascinating area, considering all the ethical, legal, and social implications. And just in time for Mother's Day bioGeek and blogger Terry Johnson also speaks to this issue at the IO9 website:

"Whether you'd prefer a new and improved reproductive system installed as a replacement for your own or external to yourself (say, next to the washing machine), there are a few recent advancements bringing it a step closer to reality. An emulsified liquid blood substitute called perflubron has had some success used as a replacement for amniotic fluid for premature babies in respiratory distress. It's not a complete replacement for the complex stew of hormones, lipids, and proteins normally present in the amniotic fluid, it is at least a promising way to get oxygen into developing lungs."

He concludes, "we're still many decades away from a safe, human uterine replicator that can bring an embryo from conception to zeroeth birthday party. Even once we've sorted out the technical aspects of the womb itself, we'll have to deal with what the rest of the mother's body contributes to development. Hormones have already been mentioned, but baby also borrows mommy's disease-fighting machinery. Our replicator will require nearly complete endocrine and immune systems, too.

All in all, I'd take a serious look at adoption."

Full article accessible here.

Conference May 23rd in NYC: New Dilemmas in Medicine

Conference: New Dilemmas in Medicine, co-hosted by the IHEU-Appignani Bioethics Center & Bioethics International

Where: 777 United Nations Plaza, 2nd Fl., New York, NY

When: May 23, 2008 9. 30 am-7. 00 pm

To Have the Best Child Possible: The Coming Age of “Procreative Beneficence?”

Genetic science has the potential to provide prospective parents with unprecedented control over their unborn child’s characteristics and attributes. In vitro fertilization and pre-implantation genetic diagnosis allow couples to sort out “good” from “bad” embryos prior to the start of pregnancy. Although these technologies are almost exclusively employed to detect genetic and/or chromosomal abnormalities among embryos, their use for selection of other medical and non-medical traits is conceivable. Tomorrow’s couples may have the opportunity to select embryos that will not only be the least susceptible to disease but which also have particular hair colors, skin tones, temperaments, or other personal attributes. Advocates of these eugenic initiatives have argued that future couples will have a moral obligation to pursue these technologies whenever possible to achieve the greatest benefit for their children, a principle known as “procreative beneficence.” Still, secular and non-secular critics alike argue that use of such technologies is immoral and may be potentially devastating to children and the structure of society.

. Arthur Cooper, M.D., Director of Trauma & Pediatric Surgical Services, Columbia University- Harlem Hospital Center

· Jennifer Kimball, Executive Director Culture of Life Foundation

· Eva Kittay, Ph.D. SUNY Stony Brook

· Barbara Katz Rothman, Ph.D. CUNY Baruch College

· Udo Schuklenk, Ph.D. Queen's University, Canada

· Panel Moderator: TBD

Ethics and Pharmaceutical R&D: Who Should Be Responsible for Tomorrow’s Drugs?

The vast majority of prescription medications are developed and sold by private pharmaceutical companies. Under the current market-based system, however, some critics argue that pharmaceutical companies have financial incentives to support R&D that will yield the biggest return but which may not be in the best interests of improving the health of patients worldwide. They claim, for example, that pharmaceutical companies are far more interested in producing Viagra than vaccines, and call for change in paradigm of drug design and provision. Others point to the high costs of R&D and the critical importance of blockbuster drugs to the future development of less profitable vaccines and antibiotics; without the former, they argue, there could be no breakthroughs.

· Angela Ballantyne, Ph.D.,Yale University Interdisciplinary Center for Bioethics, Visiting Scholar

· Chalmers C. Clark, Ph.D., Associate Professor, Department of Philosophy, Union College

· Paul Howard, Ph.D., Director of the Manhattan Institute's Center for Medical Progress

· Wilmot James, Ph.D., Executive Director of the Africa Genome Education Institute

· Jason L. Schwartz, Ph.D., Researcher, University of Pennsylvania Center for Bioethics

· Panel Moderator: Jason Lott, M.D., University of Pennsylvania School of Medicine

Saying “No” to Patients: Medical Professionals as Conscientious Objectors

Central to the professional and ethical mandate of physicians, pharmacists, and other healthcare personnel is the provision of medical care consistent with the best interests of their patients. However, news of healthcare professionals refusing to provide certain types of care to their patients under the auspices of “conscientious objection” have raised questions about the role of professionals’ personal beliefs in fulfillment of their purported obligations and duties. Examples include doctors refusing to terminate pregnancies, pharmacists refusing to dispense emergency contraception, certain Catholic hospitals receiving public funds refusing to issue morning-after birth control to rape victims, and others.

• Robert Baker, Ph.D. Director & Professor of Bioethics, The Union Graduate College-Mount Sinai School of Medicine
• Thomas Berg, L.C., Ph.D., Executive Director, Westchester Institute for Ethics & the Human Person
• Laura Katzive, Deputy Director, International Legal Program, Center for Reproductive Rights
• Mark Mercurio, M.D., M.A., Yale University School of Medicine, Director of the Yale Pediatric Ethics Program, and Co-Chair of the Hospital Ethics Committee
• Rosamond Rhodes, Ph.D., Professor & Director Medical Education, Bioethics Education, Mount Sinai School of Medicine
• Girija Nandan Singh , Ph.D., University Professor & Head of Geography at R. D. & D. J. College Munger, Bihar, India
• Panel Moderator: Austin Dacey, Ph.D., Center for Inquiry, NYC

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

Following the conference there will be a cocktail reception featuring an Argentinean Tango performance by Laura Real.  This will be from 7:00 PM to 9:30 PM at the Consulate General of Romania, located nearby at 200 East 38th Street @ Third Ave

Registration Fees (includes cocktail reception):
General Public - $65
Students - $30

One can attend the cocktail reception only for $30.

Pay at the door, or send your check to:
IHEU-Appignani Center for Bioethics
P.O. Box 4104
Grand Central Station
New York, NY 10162

Contact person: Ana Lita: (212) 687-3324 AnaLita@iheu.org

Girls & sports & character

Not a bioethics story, but I can't resist sharing this one.

Albany Medical Center Prize Awarded to Two Female Biomedical Researchers

For the first time since its inception, the Albany Medical Center Prize, (the largest prize for medicine in the United States, and second world-wide only to the Nobel), was awarded to two women.

Dr. Joan Steitz of Yale University does research that has improved the lives of people suffering from a variety of auto-immune diseases, while Dr. Elizabeth Blackburn of UCSF discovered the enzyme telomerase, which repair telomeres on chromosomes (and many believe may be linked to aging).

The women will share the $500,000 prize.

Wanted: Women to Eat Chocolate

What woman wouldn't want to sign up for this clinical trial? From across the pond:

"Researchers in Norwich have set themselves an easy challenge: finding 150 women prepared to eat a bar of chocolate a day.

The chocolate is free, and made specially for the trial by a Belgian chocolatier. The intention is to see whether it improves the women’s health." To see the rest of the article, click here.

Iron Man: Not So Far From Reality

Iron Man, the upcoming summer blockbuster, has captured the attention of kids and comic book aficionados everywhere -- Isn't this every kid's dream? To be super strong, and a superhero? Well, it's not as far out in the future as you may think -- Although I've written about the ELSI (Ethical, Legal, and Social Implications) of future Augmented Cognition (sorry about the shameless plug), the first step, the Augmented Human Robotics System is already here. Too cool for words, this system not only has military applications, but promises to replace wheelchairs and crutches for those patients suffering with mobility disorders. Check out a prototype here:




Ooooh, I want one of these...(oh, for my nephews and nieces, of course).

More on Malaria -- It really is a preventable disease.

One of the places I teach is at the University of Sciences in Philadelphia, in the Department of Biomedical Writing. The Chair of Biomedical Writing is Susanna Dodgson and she is an amazing woman -- you can see her talking about her program at Pharmed Out, an independent, publicly funded project that empowers physicians to identify and counter inappropriate pharmaceutical promotion practices, and who we just added to our blogroll.

In addition to teaching and being the department chair, she is the Editor-in-Chief of the Medical Journal of Therapeutics Africa, and she has recently taken on the cause of eradicating malaria. She went on location in Lagos, Nigeria and produced, with the help of faculty and students of the Biomedical Writing program, this great video why malaria should be and continue to be a major world health concern and just how malaria can be prevented:



We had posted earlier about World Malaria Day and Blackout for Malaria on Facebook, but Susanna's video is a reminder that one day isn't enough. Go, Susanna!

The “third tier” in US health care?

It’s a sickening situation. Physicians’ incomes are under attack: think lower reimbursements, higher costs for malpractice premiums and the like, greater business costs, claims processing hassles, and deadbeats.

What’s a poor doctor to do? One possible cure is the concept of Concierge Care.

Concierge Care (or Boutique Medicine, or Platinum Practices, one name hasn’t stuck) could offer a patient such privileges as 24-hour phone or pager access to the doctor, house calls, and guarantee of an appointment with your chosen doctor the same day you call.

The cost: a fixed annual fee that could range beyond $20,000 a year, depending on the services provided, and the patient’s age and health.

I’m not quite old enough to remember the days when doctors offered all the above and a lot more to everyone, for a lot less.

So there it is: to the other tiered services available in the US (UPS for the rich, the post office for everyone else; private schools for the rich, public schools for everyone else) we can now add a three-tiered “health” care system: no coverage at all for 45 million people, inadequate medical services for most of the rest of us, and Concierge Care for the lucky, wealthy few.

The God Squad Redux?

There has been a simple problem with organ transplants, for as long as it has been technologically possible to do so: there are never, ever enough organs. And that leads to the simple, painful, difficult question of how you decide who receives a organ, and who is consigned to death that could have been prevented. And perhaps most importantly, how do you make that decision ethically?

For better or worse, much of the debate on who gets to play god has centered in and around the medical facilities in Seattle. Almost everyone knows the history of Dr. Belding Scriber and the hemodialysis God Squad, with the now-infamous headline “They Decide Who Shall Live and Who Shall Die.” And their criteria for choosing who did receive dialysis is almost painful to consider these days: a married Christian white man with children? Worthy member of society, should be saved! Single convict? Let 'im die.

It's a well-known history, in bioethics and Seattle proper. So it was with some surprise that I read, in the morning's news cycle, that the University of Washington was back in the news with accusations that their transplant committee was playing god. Only this time, they're second-guessing other medical professionals in the process.

The situation itself is simple: a man in need of a liver transplant was prescribed medical marijuana use by his physician to control pain, alleviate nausea, and stimulate his appetite.

The marijuana use, according to a doctor at Harborview Medical Center, would prohibit his paperwork for transplanting being processed. He would have to abstain for six months - a ruling eventually dropped in favour of an offer to reconsider after completion of a 60 day substance abuse program. Sixty days that the patient didn't have. On appeal, the University of Washington Medical Center agreed to consider the case again, and a week ago rejected the man from transplant consideration for a second time.

Medical use of marijuana was approved by Washington voters back in 1998, yet use of illicit substances is often grounds for rejecting someone's place on the transplant list. UNOS leaves the specific criteria to each individual hospital, and the information coming out of Seattle seems to suggest that UW's policy is not automatic rejection, but instructions to abstain for six months to then be reconsidered. (And of course, the medical center itself is not commenting on this case, save to say a range of factors play into every decision made regarding transplant cases).

The problem with this is hopefully simple: if a patient is using marijuana under medical supervision, why should it be considered problematic? Or any more problematic than the use of any other addictive substance (such as most pain medications).

The other problem is less simple. Physicians trying to do right by their patients, trying to alleviate pain and suffering (something that is often difficult to even motivate physicians to do, as continued coverage of the dearth of chronic pain management indicates), are inadvertently creating a situation where their patients are actually being denied further medical treatment based on their current treatment.

Peggy Stewart, a clinical social worker in the UCLA liver transplant center, has a simple solution: create a national eligibility criteria, so that everyone is on the same page, and aware of what will and will not increase their chances at actually being placed on the list.

Or, if I may be so bold as to point out the obvious, don't penalize a patient for following the medical advice of a fully licensed physician.
-Kelly Hills

Random Acts of Mindfulness

Grrl Scientist posts about a Lakewood, WA police officer who stopped traffic so a duck and her family could finish crossing a highway. (silent video included in post)

While superficially this is an act of kindness by someone in a position of authority or simply a removal of a potential traffic hazard, on a higher level, this story demonstrates a mindfulness about the parts of Nature that we cannot control, the aspects that will keep living and doing regardless of our own engagements. And we all have a choice to ignore those aspects, or we can spare a bit of the immense power we have to embrace something as fundamental as helping a family in the course of its life.

As May dawns and brings with it the rigorous flush of new life, I urge everyone to consider a random act of mindfulness that appreciates the living world around us.

Kudos go out to Officer Carrell and to the drivers for taking a moment to appreciate life.

(This story was so heartwarming I just had to share it)

Cochlear Implant Manufacturer Facing Multi-Million Dollar Fine

As a quick search on this blog for the word deaf shows, I am a pretty vocal advocate of Deaf rights, and quite anti-cochlear implant for d/Deaf children. Because of the nature of the procedure, and its permanence, I do believe it's a choice that an autonomous agent should consent to rather than have pushed onto them. And this article from the LA Times just adds to that belief: the FDA wants to fine cochlear implant manufacturer Advanced Bionics $2.2 million for apparent manufacturing violations that actually put patients at risk for additional hearing loss, electrical shocks, and other issues. (Frankly, those two are enough, as far as I'm concerned.)

As for my other objections, they are relatively simple from a technological standpoint. Unless technology has rapidly changed in the last few years, one of the major drawbacks of cochlear implants is that they do destroy any residual hearing. This is why many doctors suggest only implanting one ear, in case a better technological or biological solution comes along later down the line. So you are wedded to the device implants, and that technological level, for the remainder of your life.

Stop and think about this for a minute. Go dig around in your junk drawer and take a look at your cell phone from three or four years ago. Or better yet, go find a computer from the 1980s.

How would you like to have that technology (in all it's now unsupported glory) embedded as a part of you that you are reliant upon for the remainder of your life, regardless of whether or not people continue to support that level of technology?

From a purely technological, I spent too long in the software industry, standpoint (and leaving out all notions of Deaf culture), it's simply a bad idea.

This Advanced Bionics lawsuit is just another in a long list of reasons cochlear implantation is a decision that should be made only by competent adult agents.
-Kelly Hills