"Don't Ask, Don't Smell"

by Emily Stephens

Love Potion 69? Weapon of Ass Destruction? Have you heard of the “gay bomb”? It’s a weapon—or rather the theory of a potential nonlethal weapon—that has gay activist groups and anyone with half a brain up in arms. News of an United States Air Force “Gay Bomb” began circulating way back in 1994, when the Sunshine Project (a now-disbanded Berkeley watchdog group who tracked government spending) obtained a 3-page proposal written by the Air Force Wright Laboratory in Ohio for future non-lethal chemical weapons.

According to the proposal, “One distasteful but completely non-lethal example would be strong aphrodisiacs, especially if the chemical also caused homosexual behavior.” Wright Laboratory asked for $7.5 million to fund research and development of the project. It also proposed other non-lethal weapon ideas such as a sweating bomb, a flatulence bomb, and spraying the enemy with bee pheromones and releasing beehives into the combat area. The gay bomb certainly takes the cake, however. “The notion was that...by virtue of either breathing or having their skin exposed to this chemical...soldiers would become gay,” explained Edward Hammond of the Sunshine Project.

The Department of Defense claims to have dismissed the idea at a very early stage, but Hammond doesn't believe them. “The truth of the matter is, it would have never come to my attention if it was dismissed at the time it was proposed. In fact, the Pentagon has used it repeatedly and subsequently in an effort to promote non-lethal weapons, and they submitted it to the highest scientific review body in the country for them to consider.” Nonetheless, government officials insisted again in June 2007 that no funding was awarded to the project.

It’s hard not to be fascinated by non-lethal weapons. Imagine fighting a war where nobody dies. But a gay bomb? Really? There are so many inherent problems and assumptions within this formula, it is actually terrifying to think something like this might be possible. After all, it would mean human beings, like mindless drones, are incapable of controlling their actions. And, personal agency, or free will, is totally out the window. It also assumes that gays make ineffective soldiers at best. “Throughout history we have had so many brave men and women who are gay and lesbian serving the military with distinction,” said Geoff Kors of Equality California. “So, it’s just offensive that they think by turning people gay that the other military would be incapable of doing their job.”

Is there any medical truth behind the “gay bomb”?

Two compounds long suspected of being pheramones were tested: a testosterone derivative produced in men's sweat and an estrogen-like compound in women's urine. The estrogen-like compound activated smell-related regions in women and the hypothalamus in men. Basically, the hypothalamus governs sexual behavior and the pituitary gland’s release of hormones. Conversely, the male sweat compound activated the hypothalamus in women and the smell-related regions in men. However, when the study was repeated with homosexual men, it was discovered that gay men responded the same way as women—as if the hypothalamus’s response was determined by sexual orientation. A similar study was performed with lesbian women where they partly shared activation of the anterior hypothalamus with heterosexual men.

Scent can influence how our brain fires, but can it control how we act? Perfumes and body spray advertisers would like us to think so. Many aphrodisiac substances contain human sexual pheromones in order to stimulate the opposite sex. “Copulins” were patented in the 1970s as
products that release human pheromones following questionable research on rhesus monkeys. However, no data has ever supported that pheromones cause “rapid behavioral changes, such as attraction and/or copulation.” [1,2]

How Wright Laboratory planned on overcoming the small hurdle of forcing a rapid behavioral change is unclear. Their efforts were not ignored, however. The lab won the 2007 Ig Nobel Peace Prize for the “gay bomb.” Ig Nobel Prizes, a parody of the Nobel Prizes, are given away at Harvard University around the time the recipients of the genuine Nobel Prizes are announced. Ten achievements are awarded each year that "first make people laugh, and then make them think." Needless to say, the gay bomb made for a perfect nominee. By the way, no one from the DoD bothered to attend the ceremony or accept the Ig Nobel prize.

What's this mean for our military's future? I guess I should start working on my proposal for pillow fights, whoopie cushions, and water balloon grenades: Operation You Gotta Be Kidding. Do you think the DoD will give me $7.5 million?

1. Wyatt, Tristram D. (2003). Pheromones and Animal Behaviour: Communication by Smell and Taste. Cambridge: Cambridge University Press. p. 298 Quoting Preti & Weski (1999) "No peer reviewed data supporting the presences of...human...pheromones that cause rapid behavioral changes, such as attraction and/or copulation have been documented."

2. Bear, Mark F.; Barry W. Connors, Michael A. Paradiso (2006). Neuroscience: Exploring the Brain. p. 264 ...there has not yet been any hard evidence for human pheromones that might [change] sexual attraction (for members of either sex) [naturally].

Pro-Life Drugstores: A Trend for the Future?

By Randy Hendrickson

According to the Washington Post ( “Pro-Life Drugstores Market Beliefs” June 16, 2008), no methods of birth control will be sold in DMC Pharmacy, based in Chantilly, Virginia. This faith-based pharmacy will open in August, however, no birth control pills, morning after pills, condoms, or any other forms of contraception will be available, even with a prescription. This may be the beginning of a new trend in pharmacies that are refusing to sell products that the health care providers (pharmacists in this case) find morally objectionable. “[S]uch methods can cause what amounts to an abortion, and contraceptives promote promiscuity, divorce, the spread of sexually transmitted diseases and other societal woes…. This allows a pharmacist who does not wish to be involved in stopping a human life in any way to practice in a way that feels comfortable.” Some pro-life pharmacies do not sell contraception products only, whereas others also refuse to sell tobacco, pornography, rolling papers, or other commodities that are deemed morally questionable. The patient has the option of going elsewhere to another pharmacy if she does not share this philosophy.

In traditional pharmacy practice, the legal and moral obligations have always involved ensuring that the proper medication ordered by the prescriber is properly delivered to the patient. Physicians, not pharmacists, hold the ultimate responsibility in making sure that the final treatment outcome is achieved. However, according to the American Association of Colleges of Pharmacy’s Commission to Implement Change in Pharmaceutical Care, the definition of ‘pharmaceutical care’ now focuses on “the pharmacists’ attitudes, behaviors, commitments, concerns, ethics, functions, knowledge, responsibilities, and skills on the provision of drug therapy with the goal of achieving definite outcomes towards the improvement of the quality of life for the patient.” How does provision of contraceptive products fit into this view of pharmaceutical care?

Bioethicists have mixed feelings about this issue. Some hold that the needs of the patients should come before the beliefs of the health care professional.

Nancy Berlinger of the Hastings Center for Bioethics Research, claims that “if you are a health care professional, you are bound by professional obligations,” and you can’t refuse to do what is required by the profession.
R. Alto Charo, a University of Wisconsin bioethicist, also fears that pro-life pharmacies may proliferate in the future, especially in rural areas, “creating a separate universe of pharmacies that puts women at a disadvantage.”

Others have differing views:

Loren E. Lomasky, a bioethicist at University of Virginia, states that finding a niche market based on ethical beliefs and “product differentiation expressive of differing values is a very good thing for a free, pluralistic society."
Similarly, Pharmacists for Life International, which is dedicated to the pro-life philosophy, supports the pharmacist’s right to refuse to fill prescriptions for birth control products.

Several other issues are also at stake. Many pro-life pharmacies do not have signs indicating that they will not dispense contraceptives. As a result, women who need the morning after pill may be wasting valuable time finding a pharmacy that will fill her prescription. This would also be a major concern for rape victims. There have also been reports of pharmacists who not only refuse to fill the prescription, but also refuse to return the prescription to the patient so that she could have it filled at another pharmacy. This, however, is extreme, but it has been reported.

A few states, including New Jersey, California, Illinois, and Washington, have laws that require pharmacies to fill all prescriptions for contraception products OR help women find other means to fill their prescriptions, such as recommending other available pharmacies. The state of Virginia, however, has no such restrictions and no intentions to adopt any such prohibitions.

Because of the societal issues that are constantly evolving, the ethics of pharmacy (and medicine in general) has changed tremendously over the past few years, and these changes make the need for an ethical framework more vital today than it has been in the past. Health care providers need to be cognizant of both the expanding ethical responsibilities as practitioners, but also the traditional moral obligations to patients. Hopefully a balance can be achieved that will benefit all involved.

"These Are Early Days"

Stem cells, bioethics, and…vacations to Thailand?

Those were some of the hot topics last week at the Pennsylvania Convention Center, where the International Society for Stem Cell Research held its sixth annual meeting. The ISSCR kicked off the week with a public workshop and symposium highlighted by some of the world’s leading stem cell experts.

The workshop provided an overview of stem cell biology, which was particularly useful to me because I don’t have a background in science (there were many moments, however, when the discussion passed over my head at a much higher altitude).

Dr. Jonathan Epstein, co-director of the Institute for Regenerative Medicine at the University of Pennsylvania, provided a fascinating look at the potential of stem cells to help regenerate heart tissue. Our bodies can regenerate some organs, such as the liver—so why not hearts? Epstein presented a video showing functional heart tissue generated with stem cell technology. The new cells could be seen beating under the microscope, then continuing to beat in unison as they developed into a larger piece of tissue.

Below is a clip showing beating heart cells derived from human embryonic stem cells similar to the one Epstein presented:



For me, Epstein’s presentation magnified the potential of stem cell research. It was only one example of the latest research happening in the labs of researchers around the world. As Epstein was quick to point out, “these are early days.”

Some researchers can’t wait to tap into the potential. As a result, stem cell tourism has popped up in Thailand, China, India, and elsewhere around the globe. The ISSCR unveiled a set of guidelines to halt what its president, Dr. George Daley, calls “the snake oil we’ve seen in medical fraud for centuries.”

But what lies ahead? Dr. Jonathan Moreno, medical ethicist at the University of Pennsylvania, discussed the ethical issues surrounding stem cell research. The moral and metaphysical debate about the status of the human embryo has permeated the political arena over the last decade, and it is likely to continue with the election of a new American president in November. Moreno noted that both Barack Obama and John McCain support stem cell research but have yet to articulate the details and conditions of their policies.

Having made 140 trips to Capitol Hill to educate elected officials about stem cell research, Dr. John Gearhart often finds himself in the center of the political storm. Gearhart remembers his first trip to Congress vividly: “the first person I met asked what it felt like to kill the smallest Americans.” Amy Comstock Rick, president of the Coalition for the Advancement of Medical Research, is also no stranger to members of Congress. CAMR wants to reverse President Bush’s policy on stem cell research, and “will not stop until we get new legislation,” according to Rick.

Whether new legislation is imminent or not, the stem cell debate will no doubt remain heated at the nexus of politics and science.

Consumer Protection as a Check on the Genetic Era

We have most definitely entered the "gene age."  With the unraveling of the human genome, it became clear that it only would be a matter of time until each of our individual genomes became both knowable and available.  That time is virtually upon us with the recent surge in direct-to-consumer genetic-testing startups.

However, with the genetic epoch, we also have been ushered into -- perhaps unwittingly for many -- an era of extremely heightened caveat emptor, given the serious potential for misinterpreting, misunderstanding, misusing, and abusing such complex, sensitive, personal information.  Fortunately, it appears that the time of consumerism has not passed us by.  In fact, consumerism is alive and well, as evidenced by the consumer-motivated response by government officials in New York and California to these novel service providers.  To learn more, check out:  "Genetic-testing Start-ups Asked to Stop Selling in Calif." by Stefanie Olsen, available at http://news.cnet.com/8301-10784_3-9971383-7.html (June 17, 2008).

Messing with our Minds? - Smart drugs and the ethics of neuro-enhancement

The ABC (Australian Broadcasting Company) interviewed neuroethicists Walter Glannon and Barbara Sahakian about the the ethical concerns of neuroenhancements – are we just ‘messing with our minds’, challenging our authentic selves?

And what about long term risks, particularly for children, when brain chemistry is still in formation? Is brain-doping cheating? One of the interesting ethical and societal questions about neuroenhancement is whether or not we, as a society, will use them ‘smart drugs’ to our benefit, to create a healthier balance in our lives – e.g., finish our work early so we can go home and spend time with our families and loved ones or just have a more balanced life in general -- or will we use them to become manic, nonstop, super-productive working machines?

Listen to the podcast here and let us know what you think.

We may be more than stardust --

In a quick drive-by post, scientists are saying that genetic material from outer space found in a meteorite in Australia may well have played a key role in the origin of life on Earth. Turns out, we may all be space aliens. Check out the link here.

BIRTH

By Emily Stephens

"In the eyes of the speechless animal, there is wisdom that only the truly wise can understand." – from a Native American legend

Meet Natividad (that’s Spanish for “birth”). He used to be one of the countless mange-covered, sickly, emaciated street dogs in Nicaragua rummaging through human waste in order to stay alive. Last October, Natividad was found by Costa Rican “artist” Guillermo Vargas Habacuc in an alleyway of Managua, and then displayed in Vargas’ "Exposición N° 1" in the Códice Gallery. Natividad was not given food or water during the duration of the show. Behind him, the Spanish words 'Eres Lo Que Lees' or ‘you are what you read’ was written on the wall in dog biscuits. The Sandinista anthem played backwards, and 175 pieces of cocaine burned in a massive incense burner nearby. Most disturbing are the pictures of the patrons who visited the show—uncaringly looking away from heart-wreching Natividad and consumed by other artwork. No one knows who took the photographs, nor the photographer’s intentions.

The director of the Códice Gallery insists the dog was fed regularly and only tied up for three hours on one day before it escaped. Hmmm. Vargas wouldn’t say whether the dog survived the ordeal, but he pointed out no one tried to free the dog, give it food, or call the police. The “artist” hoped to cast light on people's hypocrisy because “no one cares about a dog that starves to death in the street.” Vargas was inspired by the death of Natividad Canda, a Nicaraguan addict killed by two Rottweilers in Cartago Province, Costa Rica, while being filmed by the news media in the presence of police, firefighters, and security guards. After Vargas was recognized for his work and asked to participate in the 2008 Bienal Centroamericana in Honduras, an online petition started, which currently boasts over 2.5 million signatures from around the globe.

Here’s where the facts get hazy. Internet postings claim Natividad was tied up in the gallery until he died a few days later. Vargas plans on murdering another street dog in the 2008 Bienal Centroamericana art festival. Vargas has signed the petition to ban him from the Honduras festival in mockery of it. Oh, and the people heading the Bienal Centroamericana are ignoring the worldwide petition and fully supporting Vargas’s art choices. Are these things true? I was able to track down a letter from the World Society for the Protection of Animals (WSPA) to Snopes (who was trying to debunk the whirlwind of speculation surrounding this story.)

WSPA is aware of the situation and also that misconstrued allegations appear in many articles. “It involved one dog, and this dog was not replaced by another after it had died.” A story about a dying street dog didn’t exactly spur on the local press, so very little coverage is available. “It was never made clear whether the dog actually died, how long it was there, and why nobody did anything if it was suffering.”

Unfortunately, there are no animal cruelty laws in Nicaragua, so Vargas’s mistreatment of Natividad was not breaking the law. “As far as we are aware, he is not planning on doing this exact same thing again, but the controversy now lies in the fact that he has been chosen to represent Costa Rica at the Central American Biennial, set to take place in Honduras this year, with an exhibit apparently not involving a dog this time. The WSPA Costa Rica office…contacted the Ministry of Art and Culture, to urge them to consider disallowing Vargas from representing Costa Rica at the Central American Biennial. The response was that since Vargas was participating at the Biennial with a different exhibit, they could not ban him from attending. We will, however, continue to monitor the situation in case further action can be taken at any time.”

My opinion?

Art is to create, not to destroy.

Natividad is a statement. A grotesque, violent statement to the world about so many things. The desperate condition of dogs in third world countries. The hypocrisy of our outrage when we don’t even take care of our own homeless domesticated animals. The irony of valuing the life of a dog over the poverty of a people. I do not support this “art” in any way, shape, or form, but like the rest of the world, it has me thinking. We are an interconnected society for better and for worse. How does the way I live my life, the values I uphold, and the hypocrisies I hide, impact the rest of this world? Yes, researching this story made me cry. Sure, I could sit back, shake my head at society, be outwardly and inwardly appalled—or I can do something. I can make a difference.

To be honest, I am overwhelmed by the good causes out there, but that doesn’t mean I shouldn’t participate. Dying willow trees need money, featherless parrots need charity, overly large grasshoppers require aid--give to this, give to that. My head starts to spin and I develop a form of learned powerlessness where I don’t do anything but promise that when the right thing comes along I will act.

I have lived too many years inactively. I can and will help now, no matter how small. I can’t save everybody, but I can make a difference. I can feel better about this world. Here’s one suggestion how:

1. Begin with your signature. Awaken parts of the world that have no animal cruelty rights :
http://www.petitiononline.com/mod_perl/signed.cgi?13031953&94501

2. Check out Casa Lupita, a grass roots non-profit group recognized for their efforts in saving and improving the lives of Nicaraguan street dogs like Natividad: http://www.buildingnewhope.org/casa-lupita.html

3. This video was made by “Frenchie,” a teenager who volunteered at Casa Lupita: http://vids.myspace.com/index.cfm?fuseaction=vids.Channel&ChannelID=26945826

4. To help animals worldwide consider:
http://www.wspa-usa.org/pages/56_urgent_action_needed.cfm

5. Finally, go hug a dog…or cat…or chinchilla. I know I will.

P.S. It’s interesting to note that this type of “art” has spread into the human world. Gregor Schneider, a German artist, is planning to display a person dying as part of an exhibition.

Thanks for your sacrifice ...

Following up on the thread started by Jenny below comes a piece on the Associated Press newswire about health care for female veterans.

Women make up a significant and increasing percentage of soldiers - about 200,000 women currently serve, representing nearly 15% of the military personnel. Yet the Veteran's Administration is still behind the curve on recognizing that these fighting women have different medical needs and expectations than their male counterparts.

As the AP article notes, not only is there a dearth of physicians specializing in women's health but many VA facilities even lack the basic equipment and infrastructure to meet the needs of female soliders. For example, the report mentions a lack of female bathrooms or female-only changing facilities, leading me to suspect that most VA hospitals are actually converted athletic stadiums.

Don't even ask about women-only group counseling options, even for those who are suffering post-traumatic stress as a result of sexual abuse (a military tradition). Of course, the Bush Administration has been arguing that our veterans are not necessarily entitled to mental health care, so this may be one of the few examples of gender equality in the VA medical system.

“America’s Medicated Army:” The Future of our Soldiers and How they Cope with War?

By: Jenny Walters

In recent months, reports about rising suicide rates for our soldiers in Iraq and Afghanistan have been on the rise.

An article entitled, America’s Medicated Army, by Mark Thompson, focused on medicating our soldiers with antidepressants “to calm nerves strained by repeated and lengthy tours in Iraq and Afghanistan.”[1] According to the Army’s fifth Mental Health Advisory Team report, an anonymous survey of U.S. troops in fall 2007 revealed about 12% of combat troops in Iraq and 17% of those in Afghanistan are taking prescription antidepressants or sleeping pills to help cope with the stress of war. Unfortunately, due to the stigma surrounding antidepressant use and the need for mental help among soldiers, the above numbers are more than likely a vast underestimate of the actual number of medicated soldiers.1

The increase in the use of antidepressants and sleeping pills reflects the “heavy mental and psychological price being paid by soldiers fighting in Iraq and Afghanistan.”1 A recent Pentagon surveys suggests 70% of soldiers deployed to war zones manage to “bounce back to normalcy;” while 20% will suffer from “temporary stress injuries” and the remaining 10% are affected by “stress illnesses.” According to the Pentagon, stress injuries or illnesses begin with mild anxiety, irritability, difficulty sleeping, and growing feelings of apathy and pessimism. As the symptoms progress, they worsen to include panic, rage, uncontrolled shaking, and temporary paralysis. When the soldier returns home, escalating symptoms can further lead to broken marriages, suicides, and psychiatric breakdowns.1

In 2008, mental trauma has become so prevalent among soldiers in Afghanistan and Iraq, the Pentagon is now considering expanding the list of “qualifying wounds for a Purple Heart…to include posttraumatic stress disorders (PTSD).”1

The use of medications to cope with wartime stress has been debated for years among insiders in the service. According to a book entitle Combat Stress Injury: “No magic pill can erase the image of a best friend’s shattered body or assuage the guilt from having traded duty with him that day. Medication can, however, alleviate some debilitating and nearly intolerable symptoms of combat and operational stress injuries and help restore personnel to full functioning capacity.”1 Ultimately, medications keep the soldiers fighting and deployed, and save the Army money on training and deploying replacements.1

One military doctor remarked: “Boy it’s nice to have these drugs…so we can keep people deployed.” Whereas, professionals such as Dr. Frank Ochberg, a veteran psychiatrist and founding board member of the International Society for Traumatic Stress studies, doubts the use of medications stating: “Are we trying to bandage up what is essentially an insufficient fighting force?”1

As side effects of antidepressants become more prevalent, the Food and Drug Association (FDA) pushed for a “black box” warning stating “the drugs may increase the risk of suicide in children, adolescents…and went on to include young adults ages 18 to 24,” the average age of the military force fighting the war in Afghanistan and Iraq.1

As of May 29, 2007, 115 soldiers killed themselves last year, including 36 in Iraq and Afghanistan.1 This was the highest military suicide rate since 1980. According to Thompson: “Nearly 40% of Army suicide victims in 2006 and 2007 took psychotropic drugs-overwhelmingly, selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft.” The army reported the primary reason for the above suicides to be due to “failed relationships.” However many civilian experts “sense a link between suicides and prescription drug use.”1

As medicating U.S soldiers becomes more and more prevalent; it is important to understand some of the facts about what the soldiers are faced with on a day to day basis. According to a recent mental-health survey conducted by the U.S. Army: “while nearly two-thirds of the soldiers surveyed in Iraq in 2006 knew someone who had been killed or wounded, fewer than 15% knew for certain that they had actually killed a member of the enemy in return.” This “imbalance” leads soldiers to experience “a haunting mismatch in combat life….and contributes to feelings of intense fear, helplessness, or horror.”1

According to military psychiatrist, because our soldiers are faced with horrors we could not imagine, thousands are being driven to take antidepressants just to cope with day to day life of wartime in Iraq and Afghanistan.1

Thompson stated: “If troops do not get sufficient time away from combat…antidepressants and sleeping aids will be used to stretch an already taut force even tighter. Lawrence Korb, Pentagon personnel chief during the Reagan Administration went on to state: “This is what happens when you try to fight a long war with an army that wasn’t designed for a long war.”1

Marc Thompson’s article on the medicating of today’s Army was compelling, riveting, and disturbing. Ultimately, the U.S. Army appears to be medicating our young soldiers just to keep them sane enough so they can fight another day in Iraq and Afghanistan. What I don’t understand is: why aren’t we hearing more about this; how dose the Army justify this; and what will become of our young troops?

As stated above, the average age of our troops is 18 to 24. To many of us, the soldiers are just children. Many of these soldiers are coming home with immense amounts psychological trauma. However, instead of receiving combined therapy with counseling and, if required, medication; they are administered their monthly prescriptions for some “happy pills,” in hopes the medication will cover up and/or help to ease their pain.

Ethically, the Army’s concept of medicating our troops to keep them deployed and fighting longer does not work. What is happening in Iraq and Afghanistan is alarming. As we approach a new presidential term, I can only hope for a better future, and maybe, just maybe someone will step in and put an end to this travesty and bring our troops home.

[1] Thompson M. America’s Medicated Army. Time. June 2008. Available at: http://www.time.com/time/nation/article/0,8599,1811858,00.html. Accessed on Jun 08, 2008.

Motherhood, the Elephant in the Laboratory: Women Scientists Speak Out

Motherhood, the Elephant in the Laboratory: Women Scientists Speak Out
Edited by Emily Monosson & published by Cornell University Press
978-0-8014-4664-1
232 pages

I recently contributed to this wonderful book that includes 34 stories from women who have juggled both their careers in science with the 24/7 demands of raising children. These are challenges many of us have to face regardless of whether we are seeking tenure in a philosophy department, working in a lab, or teaching part-time. There is strength in numbers, and strength in letting our voices be heard. We don't whine, but we do discuss some of the personal and institutional barriers that need to come down in order for women to feel supported in their careers and in raising the next generation. Another goal of the book was to encourage more women to join the discussion and advocate for meaningful change. You can contribute by adding your two cents to the book's blog.

Amazon is selling it at a great discount. The editor and authors would welcome reviews of the book for blogs, journals, etc. If you are a book reviews editor and want a review copy, please contact: Jennifer A Longley jal225@cornell.edu at Cornell University Press.


Contributors:
A. Pia Abola, biochemist, writer, and editor
Caroline (Cal) Baier-Anderson, University of Maryland, Baltimore; Environmental Defense
Joan S. Baizer, University at Buffalo
Stefi Baum, Rochester Institute of Technology
Aviva Brecher, U.S. Department of Transportation, Volpe Center, Cambridge, Massachusetts
Teresa Capone Cook, American Heritage Academy
Carol B. de Wet, Franklin & Marshall College
Kimberly D'Anna, University of Wisconsin-Madison
Anne Douglass, NASA Goddard Space Flight Center
Elizabeth Douglass, Scripps Institute of Oceanography
Katherine Douglass, George Washington University
Deborah Duffy, University of Pennsylvania
Rebecca A. Efroymson, U.S. government research laboratory
Suzanne Epstein, Food and Drug Administration
Kim M. Fowler, Pacific Northwest National Laboratory
Debra Hanneman, Whitehall Geogroup, Inc. and Earthmaps.com
Deborah Harris, Fermi National Accelerator Laboratory
Andrea L. Kalfoglou, University of Maryland, Baltimore County
Marla S. McIntosh, University of Maryland
Marilyn Wilkey Merritt, George Washington University
Emily Monosson, toxicologist and writer
Heidi Newberg, Rensselaer Polytechnic Institute
Rachel Obbard, British Antarctic Survey, Cambridge, England
Catherine O'Riordan, Consortium for Ocean Leadership
Nanette J. Pazdernik, independent author and molecular biologist
Devin Reese, National Science Resources Center
Marie Remiker (pseudonym)
Deborah Ross, Indiana University-Purdue University Fort Wayne
Christine Seroogy, University of Wisconsin-Madison
Marguerite Toscano, independent geoscientist, writer, and editor
Gina D. Wesley-Hunt, Montgomery College
Theresa M. Wizemann, Merck & Co., Inc.
Sofia Refetoff Zahed, University of Wisconsin-Madison
Gayle Barbin Zydlewski, Cove Brook Watershed Council, Maine; University of Maine

Guest Authoring and Ghost Writing

In their April 16, 2008 issue, the Journal of the American Medical Association (JAMA) published an article titled Guest Authorship and Ghostwriting in Publications Related to Rofecoxib: A Case Study of Industry Documents from Rofecoxib Litigation based on documents discovered during lawsuits against Merck related to their brand-name drug Vioxx (rofecoxib).

Two of the major issues raised in this article are guest authoring and ghostwriting. These issues often go hand in hand.

Guest authoring occurs when an individual who does not meet authorship criteria is listed as a named author for an article. Many journals, including JAMA, follow the guidelines for authorship identified by the International Council of Medical Journal Editors (ICMJE). These authorship guidelines require that a named author be involved in the design of the study, conduct of the study or analysis of the data, and writing or substantively reviewing/revising the manuscript. Only those individuals meeting all three criteria should be listed as authors; anyone else who contributed to the manuscript should be listed appropriately in the acknowledgments section.

Ghostwriting occurs when an unacknowledged individual writes most or all of a manuscript, which is then submitted with other individuals as the named authors. The American Medical Writers Association (AMWA) has published a Position Statement on the Contribution of Medical Writers to Scientific Publications that recommends including a statement in the acknowledgments section to indicate when a medical writer or medical editor has provided assistance in writing or preparing a manuscript for submission to a journal as well as acknowledging the source of funding for these services. By including this information in the acknowledgments section, transparency is maintained. When this information is not included, then in effect the medical writer is acting as an unnamed ghostwriter for the named authors on behalf of the pharmaceutical company.

The recent JAMA article indicates that some of the rofecoxib manuscripts submitted for publication were written by Merck staff or by medical publishing companies on behalf of Merck. After the manuscript were drafted and a target journal chosen, then selected academic researchers or key opinion leaders were contacted about being named authors on these articles; this constitutes guest authoring. The recent JAMA also indicated that some manuscripts were written by staff at an external communications company at the request of the pharmaceutical company using paid medical writers; this constitutes ghostwriting.

From an ethical standpoint, it is more beneficial to the reader to know who was involved in designing and conducting a clinical study as well as who paid for it. When it comes to publishing the results, it is also important for the reader to know who analyzed the results and wrote the manuscript that result in the published article that they are reading. If a well-respected leader in a therapeutic area conducted an independent study, analyzed the results, and presented his conclusions in an article that was published in a scientific journal then readers would have a great deal of confidence in the information presented. On the other hand, if a pharmaceutical company designed and conducted a clinical study assessing the efficacy of one of their own products, had their staff statisticians analyze the data, and their internal medical writers or an external communications company write a manuscript, then readers might have less confidence in the presented material.

It is possible, however, that neither scenario is ideal. The thought leader could be so convinced that his hypothesis is true that he analyzes the data in such a way that skews the results. Or the staff at the pharmaceutical company could be striving to be as transparent, conscientious, and protective of patient health and well-being as is possible, rather than focusing only on their profits. The reality is likely somewhere in between. Transparency in terms of who did the work, who paid for it, and who is telling the scientific community about the results makes it more likely for individuals to have some trust in the presented data.

Named authors should have participated in the designing or conducting the study, analyzing the results, and writing or substantially revising the manuscript. Medical writers involved in preparing manuscripts should be acknowledged in the published article. Statisticians who analyzed the study data should also be acknowledged. The source of funding for the author, investigators, medical writers, and statisticians should also be included in the acknowledgments section.

The Mexico Option

“If you drink this, you will die.”

Those were among the last words Shirley Justins says she spoke to her long-term partner, Graeme Wylie, in March 2006. Moments later, according to Justins, Wylie poured a lethal dose of Nembutal into a glass and drank it. The Australian died a short time later.

Justins told her story during a controversial trial before the Supreme Court in New South Wales in which she is accused of murdering the 71-year old Wylie, a former Qantas pilot. During testimony last week, Justins admitted to assisting Wylie commit suicide but denied being part of a murder plot. Caren Jenning, a friend of Justins who purchased the Nembutal in Mexico, is charged with being an accessory to murder.

The case is controversial for several reasons. Wylie suffered from Alzheimer’s disease, which led to the denial of his application for legal euthanasia in Switzerland. He also changed his will a week before his death, leaving nearly all of his $2.4 million estate to Justins, who rejected that she had a conflict of interest. In addition, Jenning admitted lying to police to avoid investigation into Wylie’s death.

The trial has also featured testimony from Australia’s top euthanasia advocate, Philip Nitschke. The founder of Exit International advised Wylie, Justins, and Jenning on possible methods of suicide in 2005. Nitschke taught them about euthanasia tourism, a thriving industry in Mexico that provides an opportunity to purchase Nembutal in pet shops under lax regulations. Some advocates call it “the Mexico option.”

Nembutal is popular among euthanasia campaigners because it causes painless death in humans in less than an hour. Veterinarians around the world use it to anesthetize and euthanize animals, but the drug is not readily available to the general public—except in Mexico.

Do humans have the right to a peaceful death? Nitschke and Jack Kevorkian think so. As the Australian courts determine the fates Justins and Jennings, advocates for euthanasia will continue to fight for the right to die on their own terms.

And they’ll go to pet shops in Tijuana to do it.

Resetting the odometer?

In the health section of today's New York Times is a disturbing article on the increasing number of hymenoplasties - the surgical version of "reclaiming one's virginity" - being performed in Europe and elsewhere. It seems that some young Muslim women are driven to undergo this medical procedure to conform with what many might consider outdated cultural expectations of purity.

Of course, it doesn't help that these expectations are reinforced by misguided court decisions like the one reported in the Times piece. It seems that a divorce court in Lille annulled the 2006 marriage of two French Muslims because of "breach of contract." Apparently, on their wedding night, the groom found his bride was not the virgin she had claimed to be.

Cultural implications and arguments aside, I find it disturbing that the simple lack of blood on the nuptial sheets was sufficient proof for the groom to announce to the entire wedding party of his bride's fallen status. Sounds like someone needs an anatomy lesson.

Rapture of the Geeks: Don't Get Left Behind

Hoping for immortality? More specifically, the arrival of the singularity—that crucial moment when machines attain superhuman intelligence and we will be able to upload our brains to achieve indefinite life spans (although it may not be life as we currently know it)? In a riff on the best-selling "Left Behind" series, IEEE has issued a special edition exploring the likelihood of the Singularity occurring within our lifetimes -- with tantalizing titles such as The Consciousness Conundrum, Rupturing the Nanotech Rapture, and The Singularity: Neither Heaven nor Hell.

Whether or not you are a “believer”, it is definitely worth the read.

[Illustration: Bryan Christie Design]

Dangerous to Your Health? Media Coverage of Health Issues

By Randy Hendrickson

The Public Library of Science (PLoS) recently reported a study of the quality of media coverage of health issues, including treatments, tests, products, and procedures, in the United States. The study (“How Do U.S. Journalists Cover Treatments, Tests, Products, and Procedures: An Evaluation of 500 Stories” by Gary Schwitzer at the University of Minnesota School of Journalism) evaluated how U. S. journalists are reporting health issues. Over a two-year period, the study rated the accuracy, balance, and completeness of news stories from a variety of media. A rating instrument that included 10 criteria was used to evaluate each of the 500 news stories. These criteria look at how well each story:

1. Adequately discusses costs
2. Quantifies benefits
3. Adequately explains and quantifies potential harms
4. Compares the new idea with existing alternatives
5. Seeks out independent sources and discloses potential conflicts of interest
6. Avoids disease mongering
7. Reviews the study methodology or quality of evidence
8. Establishes the true novelty of the idea
9. Establishes the availability of the product or procedure
10. Appears not to rely solely on a news release

This study showed that “….journalists usually fail to discuss costs, the quality of evidence, the existence of alternative options, and the absolute magnitude of potential benefits and harms.” This raises the issue of the quality of the information that reaches consumers. Because this information can have a dramatic, and possibly harmful, effect on consumers, Schwitzer and colleagues are working with news organizations and editorial executives to make them aware of these problems and to correct the imbalanced view that is often portrayed. The results of each evaluation were emailed to the journalist who wrote the article or news segment. The shortcomings of the news stories were mainly attributed to a lack of time and space. Those journalists who had more time to research and write the articles and more space in which to publish them or airtime tended to produce more balanced and complete stories. “We hope that our evaluation of health news will lead news organizations—and all who engage in the dissemination of health news and information—to reevaluate their practices to better serve a more informed health consumer population.”

Vain Cain Wasn't Abel

By Emily Stephens

Let me introduce you, before the story starts--
A Gigi is a girly-girl, the kind that never farts.
They love clothes, malls, and a muscley stud,
And squeal when confronted with boogers and mud.
High heels, short skirts, and lotsa thrills--
The kind that gives the good boys chills.
She’ll steal away the boy of your dreams,
With flirtation bursting from her seams.
No brains, all laughs, pouty lips, tight butt.
The kind our grandmums called a slut.
Buried ‘neath mascara, lipstick, powder, polish–
And a waistline rather smallish,
Past the fake-n-bake orange and yellow skin,
You’ll find a girl who’ll always win.
Plain, smart girls simply can’t compare,
To the Gigi’s looks, the Gigi’s hair.

At the age of twenty, I’d still never been kissed,
See a Gigi stole his heart away; he never knew what he had missed.
She bounced in with her boobies, her makeup all aglow,
She shook her head and giggled like there was nothing she did know.
Her lips were rouged with redness.
Her talent? She could flirt.
Man, next to her, I know it’s true; I looked no more than dirt.
And so that’s when I started to hatch a plan so cruel.
I’d sneak into the Gigi lair, and attack right after school.
Underneath the cover of stormy summer nights,
I’d overcome the Gigi Queen and proclaim Normal Girl rights!
If I could find her weakness, I’d get her where it hurt…
A Gigi hates mud, slime, and yes, they really do hate dirt.
Perhaps a chemical reaction could destroy her makeup glow?
I know, yes, of course! I’d attack with H-2-O!

I ran quickly to my closet, and pulled from the depths therein
A water gun from Target, neon orange with hot-blue trim.
I filled it up with water, nice and cold at first,
Then realized red food coloring might end my vengeful thirst.
Gun ready, I looked into the mirror and gasped in the light,
I’m too obvious, too Caucasian, too gosh darn freakin’ white!
Black shoe polish was all I owned, therefore it had to do.
I covered my arms, my legs, my face, my neck was dark black, too.
Grabbing my gun, I ran into the night,
Yelling and howling and filled with delight.
Revenge would be mine, and the Gigi would wish
She’d skipped over my village, stayed away from my dish.
Chadwick Schmet was his name and gone was his heart,
But that Gigi would pay, that Gigi would smart!

High-pitched giggles echoed through the air,
And I knew I’d arrived at the Great Gigi’s lair.
Quickly, I hid in a green prickly bush,
While watching for Gigi, I pulled thorns from my tush.
At the smell of perfume, I gasped in delight.
The Queen Gigi was there, and still giggling--how trite.
Chadwick was nearby, consumed by her chest,
A massive upheaval of what boys like best.
Her body looked twisted, bent out in contortion--
It’s not normal to grow boobs in such a proportion!
Poised and ready I sat, growing more and more mad,
Then I burst from the bushes screaming, “EEE-GAD!”
The Gigi spun round, terrified by my cry,
As my gun exploded water right into her eye.
I barked like Xena, did a She-Woman dance,
Then squirted some more so it looked like peed-pants.
Swooping away as quickly as in,
I left her in tears and knew I did win!
She strutted around with what beauty was left,
The boys laughed as she cried, her ego bereft.
Yes, Queen Gigi did most certainly regret,
Entering my village to steal Chadwick Schmet.

Thunder cracked above as I fled from the scene–
“Oh my gaa!’ was her wail, “Am I, like, totally bleeding?”
I laughed to myself as I escaped into night,
My clever plan had filled the Gigi with fright.
Storm clouds above gave way to rain,
And I danced in the droplets like a girl gone insane.
Looking down at my arms, I ended my scoff,
Rain dropped on my skin, beaded up, then ran off.
Tiny streams made their way from my foot to my head,
I only meant to camouflage, but was water-proofed instead.
Shoe polish clogged my pores, covering skin with its grit.
Heavens to Betsy, I was such an idiot!
I ran home rather quickly—to the bath, jumped right in.
Scratching and scraping black from my skin.
I tore at my stained flesh all through the night
And when the sun rose, I looked down in fright.
Despite all the paint that I left in the tub,
My skin stayed black through the scratch, scritch, and scrub.
It took weeks--the natural sluffing of skin cell--
To remove the horrid curse. Goodness gracious, it was hell.

Believe it or not, this is a true story. Overlooking all my dramatic license, the psychology and neurology of revenge is a fascinating topic. In fact, according to Dr. Michael McCullough, a psychologist at the University of Miami, ''The best way to understand revenge is not as some disease or moral failing or crime, but as a deeply human and sometimes very functional behavior. Revenge can be a very good deterrent to bad behavior, and bring feelings of completeness and fulfillment. Think of the urge as kind of hunger, a lust, a deficit the brain is seeking to fill, and you can see why revenge fantasies can be so delicious.''

Dr. Eddit Harmon-Jones, a neuroscientist from the University of Wisconsin used brain-wave technology to monitor where anger and vengeance originates within the brain. Quite surprisingly, insulted people showed bursts of activity in the left prefrontal cortex—the same location where hunger and cravings are processed. According to Dr. Harmon-Jones, “[This brain activity] seems to reflect not the sensation of being angry so much as the preparation to express it, the readiness to hit back.”

We walk a fine line (consciously and subconsciously) to control our impulses after being wronged. Research shows vengeance is most often sought in a covert manner. Several forgiveness studies found that when men were asked to recall offenses committed against them they were less vengeful toward the offenders. Women, on the other hand, began at a lower baseline for vengeance, were equally unforgiving as men, but magnified the offenses they received. Apparently, “hell [really] hath no fury like a woman scorned.”

Spreading rumors, stealing boyfriends, dagger-like stares—it’s all very familiar, admit it. However, few of us want to appear malicious. The ideal is to ruin our enemy without repercussions, without anyone able to link us to the crime. Interestingly, men gain more satisfaction when witnessing retribution than women. The University College London monitored the brain activity of both sexes as they watched people they liked and disliked suffering pain. Women tended to empathize even with those they hated, while men enjoyed the suffering of foes.

Many anthropologists believe retaliation keeps individuals in line where formal laws or rules do not exist. Retaliation can be a sort of cultural mediator that keeps us from breaking tacit taboos. Whether or not vengeance is acceptable, there are ways to assuage intense feelings of retaliation. For example, protesting injustice can be an empowering process. Dr. Harmon-Jones studied brain-wave patterns in students who were told tuition had increased dramatically. “They all got angry,” he said, “but signing a petition to block the increases seemed to give many some satisfaction.”

So, next time…

I learned from this lesson, though it took many months
For the polish and shame to leave the skin of this dunce,
Tho’ a little bit’o’water might cause a Gigi dismay,
Sweet revenge ain’t so sweet when karma gets in the way.
Perhaps retaliation isn’t what it’s cracked up to be;
Next time I’ll consider some old-fashioned charity.

Or maybe I’ll start a petition…

Mothers' Little Helpers?

By Randy Hendrickson

A New York Times article ( “Experts Question Placebo Pill for Children” --May 27, 2008) raises the question of whether giving children placebo pills for minor childhood illnesses is an ethical practice. Based on the premise that pharmacologically inert compounds can actually produce improvements in some medical conditions, Jennifer Buettner, a mother of 3 small children, developed a cherry-flavored chewable dextrose tablet, the first branded, pharmaceutical grade placebo. The therapeutic effect is based on the power of suggestion. If parents use the placebo to “trick” their children into thinking that they are taking real medicine, the children will consequently feel better. The placebo, called Obecalp™ (placebo spelled backwards), goes on the market on June 1 and will be available in retail stores and on Efficacy Brands website. It is being advertised as being “invented by a Mommy.”

Several bioethicists speak out about the use of placebos in children:

• Howard Brody, MD, PhD, a medical ethicist at the University of Texas Medical Branch at Galveston, claims that there is no way to predict the response of placebos, especially in children. There may be a dramatic response in some children, whereas others may have no response at all. “The idea that we can use a placebo as a general treatment method strikes me as inappropriate.”

• Franklin G. Miller, PhD, a bioethicist for the National Institutes of Health, agrees. “As a parent of three now grown children, I can’t think of a single instance where I’d want to give a placebo.”

There is also the question of deception:

• Steven Joffe, MD, MPH, a pediatrician and bioethicist at Dana-Farber Cancer Institute, does not condone parents purposefully lying to their children. “It makes me squeamish.”

In addition, other physicians have expressed concern that giving children a pill for every minor ache or pain will lead children to believe that you can only get better by taking pills or medicine. They will not come to realize that most ailments will eventually resolve on their own. In most cases, what children really need is a little comforting, nurturing, and attention, rather than fake pills.

The Ethics Behind Drug Ads

By: Jenny Walters

Everyday, as we watch television, whether it is the home and garden or sports channel, we cannot help but be confronted with an infinite number of drug ads. In a recent article published in Time magazine entitled “Do Consumers Understand Drug Ads,” the author, Kate Pickert, discussed how the consumer perceives drug ads.

According to Pickert, drug makers spend nearly $5 billion a year on drugs ads; with every $1000 spent resulting in 24 new prescriptions.[1] From the Nasonex bee to the Lunesta butterfly, you cannot turn on the television without viewing a drug ad. However, this May 2008, during a House Commerce Committee meeting, lawmakers focused on “deceptive” drug ads produced by pharmaceutical companies such as Pfizer and Merck, and argued the need for tougher regulations.1 In addition, the U.S. Food and Drug Administration (FDA), which mandates and monitors the content of drug ads, met earlier last week to discuss the topic of the content of drug ads in detail.1

Pickert stated the aim of many drug ads is to: “leave you confused about the information.” According to the FDA, drug ads must present a “fair balance” of the benefits and risks of a drug. However, this “fair balance” is rarely seen; as pharmaceutical companies create drug ads to sell a product, not warn consumers of the risks of a product. Therefore, the risks and side effects portion of a drug ad is usually fast, complicated, and masked by visuals effects that distract the consumer from what is being said.1 In fact, many consumers find the risks and side effects portion of drug ads comical at times. A recent Saturday Night Live episode even poked fun at the drug ads style of the presenting risks and side effects in their skit about Annuale, a made up birth control pill.1

As public scrutiny grows, pharmaceutical companies continue with their marketing ventures and are now turning to medical device ads.1 In Nov 2007, Johnson & Johnson launched a new television ad for Cypher, “a drug-coated coronary stent, designed to prop open narrowed arteries.”1 Ads, such as the Cypher ad, target millions of consumers who lack the medical knowledge to make a decision on whether they require such a device.1 According to Pickert, the Cypher ad creates questions regarding the “social benefits of medical advertising.”

From my perspective, a nurse, a mother, a pharmaceutical employee, and a consumer, I can see all sides of the drug ad dispute. Drug ads can be helpful to consumers, as they do provide them with information they may have otherwise not been aware of. However, the confusion created and the blatant disguising of side effects of a drug, is of great concern for me. Although at times the drug ads may be comical, ultimately they show the need for pharmaceutical companies to promote their products, make money, and put the patient safety last. As stated above, the pharmaceutical companies are trying to sell products, not warn of the risks and side effects of the products.

[1] Pickert K. Do consumers understand drug ads? Time [serial online]. May 2008. Available at: http://www.time.com/time/printout/0,8816,1806946,00.html. Accessed on May 18, 2008.

Patients in search of VIP treatment

By: Jenny Walters

Most people have experienced “assembly line patient care.” The kind of patient care where you wait in an overcrowded office with 20-30 other patients; where you are seen an hour or later after your scheduled appointment by, a physician, but usually a physician assistant for all of a 5 minute visit; where you are lucky if the physician takes a minute, of that 5 minute appointment, to look up from his/her notes to make eye contact with you. If you haven’t experienced this type of patient care, consider yourself lucky….very lucky.

In an age of insurance company driven patient care, patients finds themselves in the “assembly line” situation more often than not. In fact, at times it may feel almost impossible to find a physician’s office that does not function on these premises. A recent article in Time magazine, written by Jeninne Lee-St. John, entitled Giving Patient the VIP Treatment, focused on the new emergence of VIP treatment physician practices.[1] According to Lee-St.John, many patients are choosing to pay immense out-of-pocket premiums to obtain more personalized attention.

In the more than 1,000 “concierge, or boutique, practices” that are open today, physicians are limiting the number of patients they see so they can devote more time to each or them.1 Concierge practices accept insurance for routine tests and treatment, but charge patients additional fees for extras like: no waiting, longer office visits, and round-the-clock availability via e-mail or cell phone.1

Many concierge practices are primary care offices. However, OB/GYN physicians are now beginning to enter the new area of concierge practices. Elite Obstetrics and Gynecology, in Ft. Lauderdale is one such practice. Elite charges patients an additional $15,000 on top of insurance, “for VIP prenatal care that includes add-ons like a fetal ultrasound photo at every visit, private birthing classes, one massage per trimester, optional home doctor visits, physicians home and cell numbers, e-mail addresses, and the guarantee that your physician will be at the hospital for your full active labor and delivery.”1 Elite is able to make the guarantee that each physician will be available for each of their patients birth by accepting obstetric patients by due date, and accepting no more than four woman due per month.

Critics argue concierge practices are for the wealthy; and high quality healthcare should be available to all patients, not just those who can afford it. However, many of the concierge physicians report: “Most of our patients are normal people who just care a lot about their health.”1 Dr. Lanalee Araba Sam, a physician from Elite OB/GYN stated: “Women seem to spend more time picking a hairdresser than picking who’s going to take care of them for nine months and be responsible for the baby.” For woman who are deeply interested in their health, but who cannot afford Elite’s fees, Dr. Sam will sometimes offer her services at a discounted rate or for free.1

As we draw closer upon the next presidential election, we are overwhelmed with claims and promises of better health care and health care or all. It is impossible to say what changes we will really see with our new president. However, one thing is clear, the current health care system must change in order to better accommodate patients. Patients shouldn’t be forced to pay immense out-of-pocket fees to obtain high quality patient care; and patients shouldn’t feel like a number in assembly line. Instead, high quality patient care should be available to all. The question is ….How are we going to make that happen?

[1] Lee-St. John L. Giving patients the VIP treatment. Time. May 2008. Available at: http://www.time.com/time/health/article/0,8599,1779338,00.html. Accessed on June 1, 2008.

Cervical Cancer Vaccine: Do we need it?

By: Jenny Walters

As you watch television, you cannot go a day or even a couple hours without seeing the commercial for Gardasil, “the first ever cervical cancer vaccine.” Gardasil claims to stop cervical cancer before is starts. The Gardasil vaccine is recommended for girls ages 11 to 12, but can be used in girls as young as 9. According to an article from the Mayo Clinic, written by Bobby Gostout, MD, and entitled Cervical cancer vaccine: Who needs is, how it works, Gardasil is the newest addition to the official childhood immunization schedule.[1]

Cervical cancer affects 10,000 women a year and leads to 4,000 deaths.1 In 2005, according to the World Health Organization, there were an estimated 500,000 new cases of cervical cancer. Cervical cancer is the leading cause of death in women, even with treatment.

Various strains of the human papillomavirus (HPV), are responsible for most cases of cervical cancer.1 HPV spreads through sexual contact. Gardasil specifically blocks two cancer-causing types of HPV: types 16 and 18. Gardasil also blocks types 6 and 11, which are associated with genital warts and mild Pap test abnormalities.

The Gardasil vaccine allows young girls immune system to become “activated before their likely to encounter HPV.” Vaccinating young girls also allows for higher antibody levels, which results in greater protection against cervical cancer.1

To see earlier positive effects of the Gardasil vaccine, the Center for Disease Control (CDC) recommends a “catch-up immunization for girls and women ages 13 to 26” be administered.1 Currently, the vaccine is not required for school enrollment, but may be in the future.1 Gardasil has been proven to be “remarkably safe.”1

Common side effects include: soreness at the injection site, low-grade fever or flu-like symptoms. There were no reports of clinical trial discontinuation due to serious side effects. So what does this all mean?

As a mother and wife, HPV is not a threat I worry about now. However, during nursing school, I had a class of about 18 girls. Of those 18 girls, almost every one of them had the HPV infection. It seemed as though each week I would hear of another student having an abnormal Pap test due to HPV. HPV is non-discriminating, it can affect anyone. If the Gardasil vaccine can help block HPV infection, than maybe one day cervical cancer will no longer be the number one killer of women.

[1] Gostout B, MD. Cervical cancer vaccine: who needs it, how it works. Sep 2007. Available at: http://www.mayoclinic.com/health/cervical-cancer-vaccine/WO00120. Accessed on Jun 02, 2008.

Is One-A-Day One Too Many?

By Leane Scoz

"Train, say your prayers, and eat your vitamins."--Hulk Hogan

If vitamins are good enough for the Hulkster, they should be good enough for all of us. And, most Americans agree. Vitamin supplements are a multi-billion industry. With over a third of American adults consuming them on a regular basis, the risks and benefits should be well known.

However, recent reports reveal insufficient evidence to support the beneficial effects of multivitamins. In fact, an NIH panel review and Mayo Clinic article both report beta-carotene supplements actually increase the risk of lung cancer in smokers. Also, a Harvard Men's Health Watch suggests that high doses of multivitamins may raise prostate cancer risk. The study had limitations since it was not originally designed to support this assessment, however, it does raise the question on whether or not our daily "helpers" are really doing their jobs or causing us more harm than good.

The NIH and the Mayo Clinic articles suggest another negative aspect for multivitamins is that the products are not strictly regulated, which implies that the labels may not exactly include everything contained in the bottles. However, both agree that studies do exist to support the use of folic acid supplements for pregnant women to prevent neural tube birth defects, calcium and vitamin D supplements to protect the bones of postmenopausal women, and antioxidants and zinc supplements to slow the worsening of age-related macular degeneration.

Most Americans assume multivitamins are safe and effective since they are readily available on store shelves and marketed heavily in the media. And why shouldn't we feel this way? Vitamins are found in nature in the foods we eat everyday. Vitamin supplements make us feel healthier and believe we will prevent chronic diseases, colds, and flu. We are taught that vitamin deficiencies can be extremely dangerous and hazardous to our health. We do not think that too much of certain nutrients can be harmful.

As always, people need to make an educated decision when it comes to multivitamin use. They need to carefully assess their health, consult their physician, and weigh out the possible benefits and risks before determining if a multivitamin is right for them. Maybe, Hulk needs to amend his slogan to say, "...consider eating your vitamins."

Saving Your Self: Backing Up Your Mind Files

As many of you know, the idea behind the Singularity is that someday we will be able upload our consciousness to machines; although we are at least a couple of decades away from that, Lifenaut.com is a project that starts the process -- a place to back up your mind files -- a digital self storage place, if you will.

Check out the cool video:




And look for our podcast soon interviewing Bruce Duncan about what they hope to achieve.

Old-Fashioned Science or Necessary Evil?

The international debate over animal testing got a shot in the arm last week when renowned primatologist Jane Goodall urged the European Union to find alternatives to experimentation on animals. Armed with 150,000 signatures and a lifetime of heralded research, Goodall called for the introduction of a Nobel Prize to reward research that avoids testing on live, sentient beings.

Goodall delivered her message as the EU prepares to update its 22-year old directive on animal testing. Scientists and animal rights campaigners also descended on Brussels to join the debate over how to proceed on the controversial issue.

Campaigning for animal rights is nothing new for Goodall (pictured), who founded the Jane Goodall Institute in 1977 to “advance the power of individuals to take informed and compassionate action to improve the environment for all living things.” Goodall also heads up Advocates for Animals, an animal rights organization in Edinburgh, Scotland.

It didn’t take long following Goodall’s call to action in Brussels for supporters of animal research to chime in. Colin Blakemore, professor of neuroscience at Oxford, argues that while strict controls should be required, animal experimentation is a necessary evil in the world of scientific research. Blakemore is no stranger to controversy; according to a 2003 article, he endured over a decade of attacks and abuse by animal rights campaigners for engaging in experiments that led to the deaths of newborn kittens.

The animal testing debate clearly raises important ethical questions (not to mention the blood pressure of its participants). Which procedures should be considered acceptable, and at what expense to the animals? How can we determine when animal suffering is “minimized?” Should animals be considered part of the polity?

Perhaps the most important question relates to the human mind. Goodall mentions that the “amazing human brain” should work to find new ways of testing that don’t involve animals. The brain’s capacity to reason gives humans an incredible gift—one filled with responsibility. As new methods of conducting scientific research evolve, the debate over that responsibility will define the future of animal experimentation.

Darwin v. God

"We now have it within our power to eradicate from the face of the earth that age-old scourge of mankind: malaria." The year was 1958. President Eisenhower announced his war on the devastating disease in his State of the Union speech. Malaria was a hot topic. Two-fifths of the world's population were at risk of contracting malaria, 200 million suffered malarial infections, and 2,000,000 to 2,500,000 died from infection each year. Ten years earlier, in 1948, chemist Paul Hermann Müller was given the Nobel Prize for his intensive research of a chemical called dichloro-diphenyl-trichloroethane, or DDT. The chemical provided Eisenhower with a toxic contact poison capable of killing the female Anopheles mosquito—the sole transporter of malaria. The World Health Organization plus sixty other governments joined President Eisenhower’s insecticide blitz campaign to obliterate the very existance of malaria by 1968.

How is it possible, then, that 50 years later, over one million African children die from malaria every year?

"As a result of the Campaign, malaria was eradicated by 1967 from all developed countries where the disease was endemic and large areas of tropical Asia and Latin America were freed from the risk of infection. The Malaria Eradication Campaign was only launched in three countries of tropical Africa since it was not considered feasible in the others. Despite these achievements, improvements in the malaria situation could not be maintained indefinitely by time-limited, highly prescriptive and centralized programmes." [1]

In 1972 ,William Ruckelshaus (administrator of the U.S. Environmental Protection Agency [EPA]) banned the use of DDT. However, only two years earlier he made the following statement to the U.S. Court of Appeals, "DDT has an amazing an exemplary record of safe use, does not cause a toxic response in man or other animals, and is not harmful. Carcinogenic claims regarding DDT are unproven speculation." [2] Furthermore, during the DDT hearings, the EPA hearing examiner, Judge Edmund Sweeney stated that "DDT is not a carcinogenic hazard to man... DDT is not a mutagenic or teratogenic hazard to man... The use of DDT under the regulations involved here do not have a deleterious effect on freshwater fish, estuarine organisms, wild birds or other wildlife." [3]

What is the truth about DDT? Is it as bad as they say? Does DDT truly cause cancer, mental retardation, birth defects? Does it threaten the environment, the bald eagle, thin the egg shells of wild birds, and indiscriminately kill helpful insects? Does DDT breed super mosquitos and super parasites impervious to our most powerful insecticides? And, ultimately, do these negative consequences outweigh saving the lives of over one million African infants and children?

Entire websites are dedicated to the pros and cons of DDT. Both sides are very convincing. They back up arguments with substantial and impressive studies. Unfortunately, hours of research has led me to no definite conclusion. If we eradicated malaria from most of the developed world, why can’t we rid Africa of the epidemic? I can’t point my finger at any one cause: the decision to ban DDT, the greed of pharmaceutical companies, the corruption of African governments, the misappropriation of donated monies, the lack of ability to successfully distribute mosquito nets and anti-malarials, or an unspoken and perhaps unrealized general opinion that Africa really doesn’t matter—or worse, that natural selection should take their lives.

Perhaps the greatest irony of this tragedy is that we have the cure. The deadliest strain of parasite, P. falciparum, is spread person-to-person by infected female Anopheles mosquitos. This insect was virtually erradicated in the United States by DDT and anti-malarials during the late 1950s and 1960s. Although DDT is the most affordable solution (which is especially appealing to poorer nations like Africa), strict environmental regulations and questionable longterm effects makes what was once a “quick-fix” for the U.S. in the late 1960s, a next-to-impossible scenario for the 350–500 million cases of malaria that occur worldwide.

In September 2006, The Washington Post published an article announcing WHO’s reversal of the 30-year-old policy to ban DDT in malaria-ravaged countries. According to Arata Kochi, the director of WHO’s malaria department, "WHO will use every possible and safe method to control malaria." Therefore, the organization plans to spray pesticide once- to twice-a-year on the inside walls of mud and thatched huts. Each application’s estimated cost is $5. Kochi continued, “I am here today to ask you, please help save African babies as you are helping to save the environment. African babies do not have a powerful movement . . . to champion their well-being.” WHO hopes DDTs impact will repeat the success of a 2000 study in Zambia where incidences of malaria lowered 35% in sprayed neighborhoods. Their decision that the benefits of the carcinogenic DDT outweigh the physical and environmental risks is a controversial one.

When discussing the epidemic with an average, Caucasian-American, God-fearing co-worker, I was surprised to hear her wonder aloud if these children should die. Believe it or not, there is strong argument for population control. In the 1960s, WHO even discussed malaria as important to the overpopulation problem. According to www.junkscience.com, a site dedicated to debunking false scientific allegations:

Population control advocates blamed DDT for increasing third world population. In the 1960s, World Health Organization authorities believed there was no alternative to the overpopulation problem but to assure than up to 40 percent of the children in poor nations would die of malaria. As an official of the Agency for International Development stated, "Rather dead than alive and riotously reproducing." [4]

My conversation with my co-worker branched into the Malthusian catastrophe, who to let live and who to let die, and finally, “what’s the point of saving African children if they will most likely later die of AIDS?” Whether or not you believe in population control, how is it ethical for us to save ourselves and not the people of Africa? Malaria was a deadly reality of our past. Did we second guess our decision to save ourselves? Why do we deserve to outwit “natural selection” and not do the same for those in Africa? How is it ethical to save our own children at the expense of the environment and then allow “natural selection” and “population control” to destroy the lives of over a million African children?

I have struggled with this blog because I couldn’t find any answers. My limited human brain is incapable of solving this huge, overwhelming problem. I have arrived at one decision, though. I believe it is a sacred human right to survive. God help us if we decide the earth is too populated and which of our populations deserve to die.

1. Bull World Health Organ,1998;76(1):11-6.
2. Barrons, 10 November 1975.
3. Sweeney, EM. 1972. EPA Hearing Examiner's recommendations and findings concerning DDT hearings, April 25, 1972 (40 CFR 164.32, 113 pages). Summarized in Barrons (May 1, 1972) and Oregonian (April 26, 1972).
4. Desowitz, RS. 1992. Malaria Capers, W.W. Norton & Company.