blog.bioethics.net

Euthanasia in France and Netherlands

AP reports on the incredible announcement from Amsterdam that Groningen Academic Hospital has created an independent board to review cases for euthanasia of terminally ill persons with "no free will," which includes "children, the severely mentally retarded and people left in an irreversible coma after an accident." The Health Ministry is preparing an answer to the regulations.

Three years ago, the Dutch parliament made it legal for doctors to inject a sedative and a lethal dose of muscle relaxant at the request of adult patients suffering great pain with no hope of relief.

The Groningen Protocol, as the hospital's guidelines have come to be known, would create a legal framework for permitting doctors to actively end the life of newborns deemed to be in similar pain from incurable disease or extreme deformities.

Labels: active euthanasia, disability rights, euthanasia, France, life?, Netherlands, passive euthanasia, who decides death

EPA Criteria for Pesticide Dangers are Unethical and Flawed

found the studies flawed by conflict of interest, failure to meet ethical standards established by the Declaration of Helsinki, unacceptable informed consent procedures, inadequate statistical power and inappropriate test methods and end points.

Labels: animal studies, Conflict of Interest, EPA, flawed studies, health risks, Helsinki Declaration, industry-sponsored research, internal oversight failures, scathing critique, what were they thinking?

What is a Blog?

Labels: blogging, definitions

An AIDS Vaccine that Works??

Labels: AIDS research, clinical trials, France, HIV, keeping perspective, Nature, politics, science and policy wars, small sample size, UN

Happy Birthday to Us

Labels: ASBH, awards, happy birthday blog, novel funding methods

Interesting New Data on Ethical Safeguards in Psychiatric Research

Labels: confidentiality, Dominic Sisti, human subjects, IRB, issues around informed consent, research ethics

Keine Cloning

Labels: cloning prohibitions, Germany, human cloning

Arf Arf Arf

Is it necessarily the right choice to apply advanced medical technology to animals? Is it really the best option for the animal involved? And is it always the right choice for the pet owner, who might in some cases accrue staggering veterinary bills?

Labels: Art Caplan, chemo for your pet?, quality of life, staggering medical bills, treating animals, when to treat

Preparing to Use Medical Marijuana?

If the ruling works out, it's on sale at Target. Only 4-8 weeks to get it when you order now. Or click "add to my wish list," dude.

Labels: blogged to death, Christian Science Monitor, death by a thousand links, IOM, medicinal marijuana, New York Times, Supreme Court

More Debate on Memory Erasing Drugs

Labels: eliminating trauma, luddites, memory management, neocon bioethics, President's Council on Bioethics, Propranolol, Washington Post, we're not omniscient-and?

Swiss Voters Support Embryonic Stem Cell Research

Labels: Catholicism, embryonic stem cell research, Green Party, historic votes, Switzerland

Korean Stem Cell Claims

This story in the Korean times makes the claim that Korean researchers have demonstrated the ability of this patient to walk as a result of umbilical cord blood derived stem cells. The story is being trumpeted everywhere as the 'research Reeve was pushing for, if only society would have allowed it to go forward', but in fact the most likely spin of this report - if it even turns out to be real and replicable - will be that the embryo-derived stem cells Reeve lobbied for aren't what he needed. Which may or may not be true, but either way it is annoying because the power of adult cells to heal cannot be fully explored without continuing research on embryos at least for a few more years.

Labels: Korea, stem cell therapy, umbilical stem cells

Pro-Life? Show it with Child Health Policy

And today? Though there is little federal information about abortion's prevalence during the first W. Bush administration, Christian ethicist Glen Stassen discusses the data that suggests that abortions have dramatically increased since President Bush took office. Perhaps the fear that women quite obviously (and rightly) have about the lack of sufficient child care might play more than a minor causal role in this pretty interesting correlation. (thanks to metafilter.

Labels: abortion, Christian ethicist, coherance, consistency of thought, healthcare costs, logical conundrum, pro-life, pro-life? prove it, reducing the amount of suffering, women's health

British Sperm Shortage

Labels: Britain, creating perfection, Cryos, Denmark, donor transparency regulations, sperm shortage

Little Updates from Thanksgiving Weekend

Tulane may not be setting up the Big Easy Bioethics Center just yet but it is at least setting up a pretty interesting speakers' series. Don't go drunk, except maybe to the enhancement lecture.

There aren't many people working on the bioethics of IT-driven genomics, although much is being written in the popular literature. Most recently the fields have begun to set up conferences at which a lexicon is developed as well as a kind of institutional history of the ways in which all of the relevant fields (and there are many) have begun to converge. Ok a little plug: one of us has written a book about computational genomics and ethics, but only four people in his immediate family read it.

A symbol was paraded of the UK's problem establishing any kind of marrow registry enrollment among those of minority ethnic background. Asian families in particular do not often donate bone marrow.

Speaking of children in the UK who require special assistance, this piece in the News Telegraph chronicles the NHS' controversial decision to fund preimplantation diagnosis (and IVF) for families who seek to have a child in part to secure a donation. Covering the same story of Zain Hashmi, the piece highlights the problem for those of minority ethnic background.

China has a mess on its hands with DNA identification:

A non-regular investigation conducted recently in Zhejiang Province indicated that the requests for DNA identification of ones own children are rapidly increasing at a rate of 40 - 50% every year.

So George Annas isn't the only bioethicist playwright (although he is damn good): Christmas Carol has been adapted by Santina Maiolatesi of Chesapeake Research Review (along with Doris Baizley). No word on who will play Mini Tim.

Swiss News agency The Local discusses the off-label prescription of medications in children in the EU, in particular in Sweden, at Karolinska Institutet and elsewhere, noting a new European Commission regulation that requires that medical companies "begin testing medicines intended for children on children."

An Orlando judge has upheld the living will of a 73-year-old Florida man, after it was argued that his wife's durable power of attorney (a general, not a healthcare document) might trump the living will. His wife argued vehemently that she could not agree to disconnect his life support systems. The effect of the news is hard to judge, but it appears that we are in for more confusion about what these documents mean and how they relate to the legal system and to other legal instruments. Helpfully, the Florida legislature has not offered any specific instructions on how to interpret the role of any other documents, so the judge gets to make up new policy de novo!

Another piece on how sperm donors from Denmark are so hip.

Drug Policy Alliance offers its interpretation of the Monday Supreme Court deliberations on medical marijuana, which are to involve questions both of states' rights and of the scope of drug and medical policy.

Kangla Online reports that Imphal, India based Regional Institute of Medical Sciences has been admitted to the UNESCO bioethics world network. Imphal is in the northeast of India, a nation that is becoming an international bioethics powerhouse, in part due to the incredible focus on sex selection in the nation but also due to pretty innovative approaches to law and philosophy of medicine there.

You think you could be an unethical sort? The kind of person who would put the ring of Gyges to its most obvious use? Would you torture prisoners? You are human, so the answer is probably yes, or so new research on cruelty suggests.

Labels: anti-Schiavo, bone marrow, Britain, George Annas, holidays, IVF, living wills, pgd, shameless self-promotion, Tulane

See The Wizard

John Kwon has been the often quiet voice behind the design of The American Journal of Bioethics' website for years

Labels: AJOB, biography, John Kwon, the wizard

Three Kills and You're Out

Labels: Florida, lawyers v doctors, malpractice, three strikes, unfriendly states

Living Wills Do Not Work

Living wills have become one of bioethics' most embarrassing failures - an imaginative idea that has the support of the majority of bioethicists despite a total lack of support for their efficacy. From the start it has been clear to at least some of us that these documents just make things more confusing and litigious. An incredibly imaginative experiment, it is time to call living wills just that - an experiment, based on little data and thrust out into the medical community at large on the strength of a few prominent persistent vegetative state cases. Given the coverage of this most recent missive in the debate about how to handle patient wishes at the end of life, it will be interesting to see if hospital ethics committees continue to assert that living wills are a smart thing for patients to have.

It is high time for some legislative retooling of the Patient Self-Determination Act and supporting state legislation. The experiment has failed. Time to pull the plug.

Labels: end of life, forced trust, Glenn McGee, Hastings Center, inaccurate assumptions, issues around informed consent, living wills, necessity of dialogue, paper shields, we're not psychic yet

Why No Bioethics on the California Proposition 71 Governing Council?

No matter what your position on stem cell research, there simply must be a dedicated stem cell ethics expert among the governors. If it weren't so serious a matter, one would have to laugh at the idea that these University and institute administrators are properly trained to think about how and whether to dispense the money and for which studies. It is a question several are beginning to ask anew, echoing concerns from those who opposed Prop 71 but themselves supported hES research. Bioethics in California has always been a developing phenomenon, although the Stanford center is arguably among the top programs in the nation. Hopefully at least some of the ballast for deliberations about which programs should be funded will be provided by people in stem cell bioethics in California. But that is a very, very short list of people.

Even more important, California should finally begin to build up some bioethics programs, particularly in the universities that plan to do significant new stem cell research. If the past is any predictor, that will not be easily accomplished in California, where bioethics has just never really taken a foothold in terms of university budgets and powerhouse faculties. There are plenty of good people in bioethics in California, but it is difficult to identify a group of major research centers in bioethics in the state, despite its preeminent place in biotechnology research. Proposition 71 should be the full employment act for California bioethics, to borrow Art Caplan's description of the role ethics money in the Human Genome Project had on bioethics in the 1990s. But if it is business as usual in the most populous state in the nation, bioethics may become an unfunded sport for university CEOs. That would not only hurt bioethics, it would hurt the people of California, who are clearly hoping for a careful, smart use of the $3 billion windfall for stem cells. For them, ethics has to stay in the mix in a serious way.

Labels: California, employing bioethicists by the buckets, hESC, Proposition 71, Stanford, state stem cell politics, stem cell research, what were they thinking?, where's the bioethicist?

California DNA Law Worrisome Threat to Privacy

Labels: ACLU, California, civil liberties, DNA collection, felonies, genetic databanks, laws, ownership of body, Proposition 69, unreasonable search/seizure

Bioethics Abandons the Creationism Debate

Labels: Art Caplan, creationism, education, ethical challenges, evolution, religion, silence is not always golden, textbook disclaimers

Living Wills Have "Failed"

-Dominic Sisti

Labels: Dominic Sisti, Hastings Center, living wills, surrogate, terminal illness

Depo-Provera Safety

Labels: birth control, black box warning, Depo-Provera, health risks, Majikthise, Pfizer

Moving Toward Bioethics in Secondary School

Labels: Dominic Sisti, education, highschoolbioethics.org, Penn, smart and novel

Compassion in Hemlock

Labels: assisted suicide, Compassion and Choices, Hemlock Society, Oregon, right to die

Privacy, but Not So Much

One of my favorite passages in The Republic involves Socrates' discussion of a ring that allows the wearer to become invisible and undetectable. The discussion that ensues is about what sort of thing those with whom Socrates is in dialog would do with that kind of power. Eventually they are honest and admit that with that power they would be unable to resist using the power to get away with all sorts of evils. Socrates makes the interesting point that one can only be trustworthy when there is the temptation to violate the trust of someone, that is, there's no point in discussing whether or not you are a good person until you have the opportunity to be bad without anyone's knowing it. This is the essence of clinical trust. If you are going to violate patients unless there is a camera in the room, you really shouldn't be a physician. But that is no argument for cameras to root out dangerous docs.

Cameras cannot protect a patient from a physician, and there is simply no way to justify the additional invasion of privacy - from a camera designed only to protect physicians from charges of sexual abuse. Think about it - the physician has you naked. They do exams that are intimate. If they are drawing enjoyment from that, beyond what is appropriate for a clinician, how in the world are you going to prevent that by exposing the patient to a further violation of privacy? The risk is also pretty obvious that the tapes will be stolen: keep in mind that the cameras are supposed to be super-discrete (says the Economist), so how long do you think it will be before those videos are traded among residents, or even uploaded or sold as porn tapes? This is a really stupid idea, and the Economist appears to have thought about it for all of fifteen minutes.

Labels: abuse of power, Britain, confused journalists, Economist, half-baked ideas, sexual assault, stupid ideas, trust violation, trusthworthiness

Reports of Bioethics' Demise Seem a Bit Premature

“Hardly wet behind the ears, bioethics seems destined for a short lifespan. Conspiring against it is exposure of the funding of some if its US centres by pharmaceutical companies; exclusion of alternative perspectives from the social sciences, retention of narrow analytical notions of ethics in the face of popular expression and academic respect for the place of emotions; divisions within the discipline (including one over its origins and meaning); and collusion with, and appropriation by, clinical medicine. To many its embrace of everything bearing on human life renders it, paradoxically, bankrupt."

I could go on (and he does a bit more) but you get the point. We are all familiar with the sad state of British University life as cut after cut decimates the ranks of the professoriate there but have things really degenerated to the point where a hack is offering this sort of loony assessment as serious analysis (and getting it published to boot)?

Every so often British physicians and university purists and their publications try to pronounce bioethics dead. This latest declaration seems to have been penned by someone who cannot, however, diagnose the difference between a field (not a discipline!) entering into middle age with all its attendant crises of self assessment and self-doubt and a field that has never been more firmly entrenched within colleges, medical schools and other institutions not only in North America but, if the numbers showing up for the International Association of Bioethics meeting in Australia are any indication, worldwide.

Just to put things right in case Professor Cooter is having a hard time seeing what is going on in the field by what must be a very dim light underwritten by the laundered drug money funding that provides his full career support;

there are no academic bioethics centers in the United States funded by pharmaceutical companies, the only centers/programs/persons funded by private sources involve right to life or political orientations inclining to the right;

it is fairly easy to find out which centers/programs, persons have accepted grants or contracts or gifts by asking them (no EXPOSURE –insert Cooter’s heavy breathing here—required),

no academic bioethics center or medical ethics program has received more than a tiny percentage of funding from drug companies (some think they ought to be providing more funding in the way of general, unrestricted gifts),

the social sciences are not excluded from bioethics and, in fact, there is some danger that empirical bioethics may come to dominate all other modes of inquiry although quantitative social science may lie outside Cooter’s ken,

there is no intolerance of the emotions on the part of bioethicists—there is however an intolerance of using emotional responses as a form of argument (what I many years ago dubbed the Yuk factor) as well there should be,

there are divisions within the field (again not discipline) as again well there should be—it is a sign of intellectual vitality perhaps not recognized among the few remaining British historians of medicine,nor is there collusion with academic medicine unless talking to one’s colleagues if one works in a medical school happens to constitute cooptation or collusion.

Cooter’s worry about bioethics' “embrace of everything bearing on human life” I leave to more level-headed students of the sexuality of intellectual life than myself.

Cooter’s bizarre screed follows hard on the heels of Carl Elliot’s discovery of a new form of argument in a just out piece in the Hastings Center Report—arguendo ad Pfizer. By intoning Pfizer repeatedly Professor Elliot seems to think he can confirm Professor Cooter’s contention that bioethics has sold itself out to Big Pharma.

Cooter, Elliot and others seem so irritated by bioethics or some bioethicists that they either have to pronounce the field finished or irrevocably tainted. My hunch is that this sort of nonsense is a sign that whatever else it is doing, bioethics is being appropriately irritating to pedants everywhere. - Art Caplan

Labels: academia, big pharma, crazy scientists, denial is a river, the death of bioethics, The Lancet, this is serious research?, Wellcome Trust Centre

"Motorcyle Diaries" a Medical Ethics Flick

Labels: Dominic Sisti, medical ethics, movies, uninsured

Last Minute Abortion Language in the Budget

Labels: 11th hour provisions, abortion, conscience protection, Dominic Sisti, right to refuse

Asian Stem Cell Labs Dwarf Ours

Labels: Asia, brain drain, stem cell research

Ads to Get a Liver Condemned by UNOS

Todd Krampitz garnered national attention last summer when he advertised for a new liver on two Houston billboards and a Web site. Doctors had diagnosed the 32-year-old Houston man's severe liver cancer in May, and he was deemed too sick to be placed on donor lists.

A week after going public, Krampitz received an organ from an out-of-state family who had heard of his plight. The operation was performed at The Methodist Hospital.

Sherril Lanthier, director of the Multiorgan Transplant Center at The Methodist Hospital, said the hospital will review the new recommendation announced late Friday.

"We look at everything that comes from UNOS and we follow their guidelines," Lanthier said. "We will look at it ourselves and make a policy within the hospital."

But she added: "We can't control what our patients do. We certainly don't advocate it."

After Krampitz's surgery, he and his wife, Julie, put up another billboard saying "Thank You," and encouraged more people to consider organ donation. After their successful appeal, others in need of organs used similar campaigns.

The nearly unanimous vote Thursday by UNOS officially condemned soliciting organ donations through advertising.

Labels: advertising for organs, organ donation, organ transplants, solicitation, UNOS

Move Over, ISI Citation Index

Labels: ahead of the curve, blogging, Google, ISI indices, technology, tenure

UN deadlock defeats cloning ban

Labels: Bush, cloning prohibitions, international bans, research bans, stem cell research, United Nations

A More Dramatic Case Than Schiavo - Major Story

HOSPITAL, WIFE BATTLE OVER PATIENT'S LIFE A HEARING IN ORANGE WILL CONSIDER THE FATE OF A CLERMONT MAN WHO HAS A LIVING WILL.

BY ANTHONY COLAROSSI | SENTINEL STAFF WRITER
POSTED NOVEMBER 18, 2004

Hanford Pinette made his wishes clear in a living will: He never wanted to be kept alive by a machine.

Today Pinette, 73, lies in an Orlando hospital, where machines run his lungs and kidneys. Doctors see an unresponsive patient with no hope of recovery. Alice Pinette sees her husband of 53 years clinging to life.

Now the Clermont man's fate will be fought out in a courtroom in an unusual battle waged by Orlando Regional Healthcare System officials, who want to let him die, against Alice Pinette, who wants to keep him alive.

"They're just trying to pull the plugs," Alice Pinette, 73, said Wednesday, standing in the doorway of her home. "He still communicates with me, and I won't let them do it."

A hearing in the case is scheduled for Tuesday before Orange Circuit Court Judge Lawrence Kirkwood. The outcome could have broad implications on the enforcement of living wills, which are supposed to remove uncertainty about a patient's wishes in the event of a terminal illness and incapacity.

Paul Malley, president of the Tallahassee-based Aging With Dignity, a national organization that advises people about the benefits of living wills, said he could not recall a Florida hospital going to court to enforce a written living will over the wishes of a patient's family.

"It's definitely highly unusual for a hospital to bring up a case like this," Malley said. "Where this case is, is a real challenge. There may not be an easy answer here."

The argument doesn't center on Pinette's wishes, but whether he's sick enough to carry them out.

"He's all right," Alice Pinette said. "He's getting better, a little each day."

David L. Evans, Orlando Regional Healthcare's lawyer, said the hospital maintains Pinette will not get better and is trying to abide by the patient's wishes.

"All we can do is come in and describe his medical condition and his competency," Evans said last week. "We're just doing what we feel we're legally obligated to do."

The Pinette matter is almost a reversal of the Terri Schiavo case.

Schiavo collapsed 14 years ago and is now in a Clearwater nursing home in what doctors call a progressive vegetative state. She is kept alive by a feeding tube and left no written directive of her wishes.

Schiavo's husband, Michael, contends his wife told him she would not want to be kept alive. Her parents, Bob and Mary Schindler, have battled Schiavo in court, arguing their daughter is aware of her surroundings.

The case sparked a national controversy when Gov. Jeb Bush and the Florida Legislature intervened to block a court order removing Terri Schiavo's feeding tube. The courts ruled in Michael Schiavo's favor and the case remains on appeal in Florida's courts.

The case has been cited as an example of why people need to write living wills.

Pinette, a Korean War veteran and government engineer who moved to Clermont in 1994 from Maryland to retire, wrote a living will in 1998 and assigned his wife to carry out his wishes, designating her as his "surrogate."

In the event of a terminal condition with no probability of recovery, Pinette stated: "I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong the process of dying."

Pinette stated in the will that he wanted "to die naturally" and receive medication only to "alleviate pain."

But Alice Pinette produced a durable power of attorney signed by her husband on the same date in 1998.

The power of attorney states her husband assigned her "to decide for me [Hanford Pinette] any matters regarding my health care, including, but not limited to, consenting to withhold or withdraw life-prolonging procedures."

Earlier this year, Pinette suffered congestive heart failure, his wife said. He has been hospitalized since February, according to the petition filed by Orlando Regional Healthcare, and is currently at Lucerne Hospital.

Despite Alice Pinette's assertions that her husband is not terminally ill, the hospital argues in court documents that Pinette's "renal system, respiratory system and cardiovascular system are all being supported by artificial means alone."

The petition also says Pinette is not competent to make his own decisions and is not likely to recover his mental capacity. The hospital's bioethics committee which reviews cases such as this also agreed to withdraw life support.

And two doctors -- Sanjay Muttreja and Juan Herran -- submitted affidavits that Pinette is terminally ill and has no "medical probability" of recovering.

"It is my opinion as Mr. Pinette's treating physician that Mr. Pinette meets the requirements of his living will," Muttreja said in his affidavit.

But Alice Pinette, who goes to the hospital daily, said her husband "still communicates with me."

She said Pinette squeezes her hand, shakes his head and has indicated that "he wants to go home."

That is proof enough to her that he's not terminally ill.

"There's a lot of people they say that about, and it's not true," she said. "They've been after me since July to put him down."

Robert Wilkins, a Maitland attorney whose practice includes living wills, said Alice Pinette is fighting an uphill battle.

"You should be able to control your own destiny and a surrogate shouldn't be able to override that," Wilkins said. "It really isn't her prerogative, it seems to me, to disregard that."

Wilkins said Alice Pinette's best hope is if her attorney can successfully argue that the living will is invalid.

Alice Pinette's attorney, William E. Ruffier, could not be reached for comment Wednesday.

Malley, the Aging With Dignity president, said the case may help others avoid this situation by talking about living wills and the responsibilities of the surrogate before it's too late.

The best person to be someone's surrogate, for instance, might not be his or her spouse, Malley said.

"It's a difficult situation," Malley said. "But it can be avoided with other families."

Labels: Art Caplan, DNR, do not treat, Florida, legal hearing, life support, living wills, not-Schiavo, pain management, palliative care, quality of life, terminal illness

The FDA's Darkest Days Are Here

In the past four years, the Food and Drug Administration has taken a noticeably less aggressive approach toward policing drugs that cause harmful side effects, records show, leading some lawmakers, academics and consumer advocates to complain that the agency is focusing more on bolstering the pharmaceutical industry than protecting public health.

:Federal drug regulators are "virtually incapable of protecting America" from unsafe drugs, a federal drug safety reviewer told a Congressional panel on Thursday, and he named five drugs now on the market whose safety needs "to be seriously looked at."

In testimony before the Senate Finance Committee, Dr. David
Graham, the reviewer in the Food and Drug Administration's
office of safety research, used fiery language to denounce
his agency as feckless and far too likely to surrender to
demands of drug makers.

Labels: deals with the devil, FDA, is incompetent too strong a word?, New York Times, pharmaceutical industry, public health, risk to public health

Illinois' Stem Cell Aspirations Take a Dive

The defeat of the amended version of HB 3859, which opponents argued would allow "laboratory cloning" as part of stem cell research, depended upon the votes of Downstate Democrats.

Republican senators Kirk Dillard, Christine Radogno and Adeleine Geo-Karis broke ranks with the Republican caucus and voted to support the measure.

Labels: Illinois, state stem cell politics, stem cell research, Wesley Smith

Cockroach Ethics

Garnet Hertz will be showing his most recent prototype: a cockroach-controlled mobile robot system. The system uses a living Madagascan hissing cockroach atop a modified trackball to control a three-wheeled robot. Infrared sensors also provide navigation feedback to create a semi-intelligent system, with the cockroach as the CPU. This work will be framed within the contexts of intelligence, embodiment, artificial life, the history robotics, and Michael Jackson.

Labels: bio-art, cockroaches, embodiment, happy web elf, machineproject.com, mobile robot system, post-modern surrealism

RU-486 Suspension

Labels: abortion, drug bans, FDA, MetaFilter, RU-486, rules violations, Washington Post

Where I Want to Be Ill

Labels: ahead of the curve, rapid adopters, technology, wifi

Guest Blogger Dominic Sisti

Here's a biosketch: Dominic A. Sisti is a researcher at the University of Pennsylvania Center for Bioethics, an ethicist at Holy Redeemer Health System in Philadelphia, and an adjunct instructor at Villanova University. Dominic received his master's degree from the University of Pennsylvania (Bioethics, 2000) and his Bachelor of Science degree from Villanova University (Biology, 1996). He serves on several ethics committees and is currently working to develop the Center's High School Bioethics Project (PI- Prof. McGee) (see highschoolbioethics.org). Dominic is a co-editor of Health, Disease, and Illness: Concepts in Medicine (with Profs. Caplan & McCartney, Georgetown University Press, June 2004).

Labels: bioethics programs, bioethics scholars, Center for Bioethics, Dominic Sisti, highschoolbioethics.org, Penn

Surprise: Consumers are Scared of Medical Errors & Increasingly Dissatisfied with U.S. Healthcare

Despite enormous frustration, few people indicated a desire to use the courts as recourse, calling into question policymakers' renewed interest in malpractice legislation, said Harvard pollster Robert Blendon.

"They do not view the malpractice system as the way to resolve these problems," Blendon said. "They would like the medical errors reported by a public agency, have the agency release it and then have it printed in some kind of Consumer Reports, and then they can go somewhere else" for care, he said.

About one-third of those surveyed said either they or a family member had experienced a medical error, but only 11 percent of them said they had sued for malpractice. By much larger margins, respondents favored remedies such as suspending the license of a doctor or nurse who makes medical errors.

Belmont Report Now Officially Too Old to Live With Mom

Labels: basic ethical principles, Belmont Report, HHS, research ethics

Medicinal Marijuana in Tennessee

Labels: medicinal marijuana, regulations, smart and novel, Tennessee, Vanderbilt

Sue Me? You'll Die Before You Win

Here’s a letter (CLICK FOR PDF)I got sent by a Kentucky reporter today. Outrageous.

The underlying suit alleges failure to read radiological and other images, or failure to read them properly, with resultant undetected illnesses, cancers, etc. The affected folks apparently live in rural areas and will have to do some serious driving to find alternative medical services.

One thing that strikes me is this: It’s one thing for a physician to say, “I really can’t treat you while you’re suing me.” It’s quite another for an entire health system to say, “None of our physicians can treat you while you’re suing any of us.”

Labels: Kentucky, lawsuits, malpractice, physician oaths

Dying to Live

Labels: Art Caplan, clinical decision making, defining death, dying to live, organ donation, organ transplants, scarcity

Illinois is Coming for the Stem Cell Pot, Too

Labels: Art Caplan, Bush, Illinois, research bans, state stem cell politics

Democrats Grow Spine From Stem Cell

Labels: Democrats, finding spines, missing links

Australia Protects Patient Privacy

Labels: Australia, patient privacy

Next: The Philip Morris Center for Neuroethics

Labels: anti-depressants, clinical research, neuroethics, nicotine

Shell Shock

Euthanasia = Kevorkian?

Labels: crazy scientists, death on demand, euthanasia, good death, ownership of body, peaceful pill, right to die, Wesley Smith

What's Up Roundup

More about how the world will end, or at least it will feel like that in Wisconsin, if the state doesn't kick up its stem cell spending.

Wisconsin should be more worried about New Jersey, whose new acting governor is going to be asking voters to approve borrowing "hundreds of millions of dollars" to fund embryonic stem cell research.New Jersey's last governor, in early retirement, is being eulogized all over the place for his role in advancing stem cell research there.

A new novel from Jodi Picoult examines purposeful birth for organ donation and Courtney Devores likes it. AJOB will have a review; anybody want to do it?

Seattle PI discusses moral surprise in the election.

Go figure that fewer people want hormone replacement therapy after a study showed that they might harm women. Who would have guessed?

I love this piece in OregonLive about the Seventh-day Adventists' role in Operation Whitecoat, the long-running biologic research program between 1954 and 1973. The courage of these who were exposed to all sorts of horrific germs is interesting. Moreno is quoted.

I love university fluff about professorial accomplishments, because it means that the university recognizes that it actually has a faculty. Here's a nice piece about Bob Levine's appointment to the CDC vaccine task force.

Speaking of university press, this short one by a Princeton undergrad looks at Peter Singers' class' visit to a NICU. Singer visits a NICU. What does he say in his ethics consults??

Leave it to an evangelical to coin a new bioethics term: the bioethics porkfest.

Labels: brain drain, hodge-podge, New Jersey, NICU, organ donation, purposeful birth, Singer, stem cell research, university fluff, Wisconsin

Canadian Research Ethics ...

Labels: internal oversight failures, research ethics, The Scientist, U British Columbia, what Canadian research ethics?

Female Foeticide: An Indian Response to the Sex Selection Debate

Labels: foeticide, IAB, misuse of technology, selective abortion, sex ratio, sex selection, universal norms of bioethics, World Congress of Bioethics

Papal Statement on Euthanasia

Euthanasia is among the dramas of an ethic that presumes to establish who can live and who must die

Labels: Catholicism, distortion of ethics, euthanasia, religion, the Pope

What Happens When Your State Allocates $3 Billion for Stem Cell Research

Labels: adult stem cell research, California, everyone wants to come to the party, Proposition 71

Austalian Cloning Restrictions

Labels: Australia, cloning prohibitions

The Coldest War

Labels: human guinea pigs, Jonathan Moreno, military, vulnerable subject populations

The New Moral Majority (UPDATED)

Labels: agendas, ethics of politics, evangelists, fundamentalism, new moral majority, religion

Merck and Ethics

He said that although some Merck insiders urged him to inform the FDA of the findings and keep Vioxx on the market, he acted decisively, withdrawing the drug within a week.

After taking the reins in 1994, Gilmartin said within a year he had established the company’s first ethics office. He said Merck had established numerous ethics systems during his tenure — including a confidential phone number employees can call for advice concerning their ethical dilemmas.

Merck’s commitment to ethical behavior goes beyond complying with U.S. and international laws, he said. “As Plato put it, good people do not need laws to tell them how to behave responsibly; bad people always find a way around the laws.”

Gilmartin said Merck’s code of ethics is displayed in 25 different languages at company headquarters in Trenton, New Jersey. “Over time, ethical behavior turns into a competitive advantage,” he said.

Labels: behaving ethically, big pharma, FDA, Merck, pharmaceutical industry, Vioxx

Pigs Need Never Die Again

Labels: cardiology, Johns Hopkins, pigs, stem cell therapy

Would You Like a Camcorder with that Pesticide, Son?

In exchange for participating for two years in the Children's Environmental Exposure Research Study, which involves infants and children up to age 3, the EPA will give each family using pesticides in their home $970, some children's clothing and a camcorder that parents can keep.

Labels: common sense, EPA, human guinea pigs, inappropriate payments, vulnerable subject populations, what were they thinking?

Now Come the Days of the Evil Clones of Death (UPDATED)

Labels: Catholicism, evil clones of death, human cloning, Ratzinger, the Pope

Bioethics in Philadelphia? Let's Cover Australia Instead!

But the media is in Australia. There, at the World Congress of Bioethics, even single papers like this one on face transplantation, and this one on deafness genetic testing are getting major coverage. The EU draft consensus document on stem cell research finalized by John Harris received coverage around the world. Yes these are important documents and it is good that the world is covering these meetings, sponsored by the International Association of Bioethics. Where were the media a couple of weeks ago? Sydney beats the heck out of Philadelphia, granted, but somebody at ASBH must be scratching his head ... or perhaps the winds have begun to fade IAB as the primary public bioethics group?

Labels: ASBH, Australia, CDC, conferences, IAB, Philadelphia, World Congress of Bioethics

Choice? What Choice?

I led the fight to confirm Justice Thomas and I almost lost my seat as a result of it in the United States Senate. And every one of President Bush's nominees I have supported in the committee and on the floor.

Labels: abortion, embryonic stem cell research, politics, pro-choice, Roe v Wade

Is TennCare a Dragon that Eats Everything?

Labels: hungry dragons, Medicaid, New York Times, Tennessee

The Next Pointless Reproductive Scandal...

Labels: ART, IVF, unconventional families

Alternative Medicine: What are the Ethics of Research?

Labels: alternative medicine, JAMA, research ethics

Ivy League Eggs Wanted

Labels: advertising, creating perfection, egg donation, IVF, Ivy League, mistaking science fiction for science fact, reproduction

The Shame of Preimplantation Genetic Diagnosis in Japan

Labels: ASRM, Japan, pgd, reproduction, shame

Four Parents, Sort of

Labels: IVF, multiple parents, Pennsylvania, responsibility, surrogate

UPDATED: Bush Administration Appeals Decision on Oregon Assisted Suicide Law

Labels: Ashcroft, assisted suicide, BBC, good riddance, lifenews.com, Oregon, US Circuit Court of Appeals

How Dr. Koop Faces (His Own) Death

Labels: C. Everett Koop, death, near-death experience

Medical Errors Revisited

Labels: IOM, learning from mistakes, medical errors

Wired News: Clone Ban Unlikely to Pass Senate

Labels: adult stem cell research, banning technology, cloning prohibitions, Proposition 71, stem cell therapy, Wired

Calling All Device Manufacturers: Come to Sunny South Africa!

Harvard Bioethics

Labels: bioethics programs, Ezekiel Emanuel, Harvard, medical ethics, NIH, Norman Daniels

Facial Transplant Face Off

Labels: Cleveland Clinic, face transplants, IRB, Rick Weiss

China to Ban Brain Surgery for Drug Addiction

Labels: brain surgery, China, drug addiction, side effects suck

Votes & Values (Multiple Sources)

Labels: big pharma, blogging, Daily Kos, deals with the devil, election, healthcare costs, hodge-podge

Jobs Jobs Jobs

Labels: bioethics, did medicine save philosophy, jobs, napkin math

Bush Science Advisor & the Second Term Critics

Labels: Bush, policy, politics, science advisor

Canadian Perks

Labels: Canada, drug reform, physician contracts

William F. May on George W. Bush

Labels: Bush, politics, stem cell research, UVA

A First Federal Step into Evidence Based Medicine

At issue are questions that will determine the future and price of health care: Do new cancer drugs costing $10,000 to $20,000 a dose help in many situations where they are now being prescribed? What are the long-term effects of weight-loss surgery, costing $30,000 to $40,000 per operation even when there are no complications? How well do implantable defibrillators for heart patients, each costing $35,000, work? Will PET scans to look for early Alzheimer's disease, costing $1,670 per scan, make any difference?

Labels: evidence-based medicine, Medicare, New York Times

IVF Risks and Benefits

Labels: educating the masses, IVF, New England Journal of Medicine, teaching

Britain? Stem Cell Leaders? Meet California.

Labels: brain drain, Britain, California, stem cell research

Sex Selection Mass-Produced

Labels: sex selection

w-2: Searching for Good News in a Bush Victory

Kiss pharmaceutical reform goodbye. There is no way George Bush will do any less for pharmaceutical companies than he has done for oil companies. In fact, if anything, the election will draw a more direct analogy between oil and drugs: Bush now has no reason to fear reprisals from those who oppose the drug industry's extraordinary pricing structure in the United States. Bush's cronies may not yet directly profit from the drug industry in the way that they do from Haliburton, but you can bet plenty of Bush appointees are thinking seriously about their future in biomedical lobbying. Pharma will need the President as its collusion with FDA officians and others comes to the fore. Pharma knew what it was buying with Bush, "make no mistake." Any reform effort that included drugs from Canada, including the one Bush said he was "looking at," and any effort to seriously curtail the price of drugs for seniors, will fall prey to the three million vote margin of victory. Drugs will cost more and fewer people will be able to afford them.

International efforts to, well, do anything that Bush opposes are in real trouble. Unfettered international drug research is part of the bargain. Advocates for research subjects have lobbied the WHO and the UN - and those organizations have lobbied the US - to stop the most lopsided and colonialist drug industry research efforts in developing nations. How many research programs in Africa have really rewarded research subjects with any kind of improvement in healthcare quality, even for the disease being researched? Not many.

Healthcare access and insurance reform? Look, no one wants to be pessimistic. Health insurance reform is long-overdue and we in the U.S. have to find a way to provide affordable healthcare to tens of millions of U.S. uninsured. Here's a great Bush solution that lots of Americans seem to support: tort reform! All we have to do is stop those big lawsuits against physicians, and we can save a whole lot of ... wait ... what? Only 3% of the cost of healthcare is in any way related to lawsuits? Ok, wait, so maybe stopping patients from recovering the damages juries want to award them in cases of malpractice won't have much financial effect ... except on physician and lawyer salaries. But Republican voters aren't weeping about that. What they will cry about is the bills that they, and all of us, will have to pay as we watch emergency rooms continue to be the provider of healthcare for the poor, the sick and the legions of uninsured - hundreds of millions of dollars in unnecessary treatment. Those costs have to come out of somewhere. Just watch your premiums skyrocket, guys. Red states will also bleed red ... ink. Maybe there will be a direct correlation between insurance increases and prices at the gas pump! Who knew anything but college tuition could go up so fast?<[>

Enough has been written about Bush's war on science to establish beyond question in the mind of anyone in a blue state that Bush, as a final-term president with uniform control of the U.S. government, will be able to quietly support all sorts of insidious efforts around the nation. Just as gay marriage is quietly being outlawed around the nation, look for Bush to lend support of several kinds to state efforts to roll back protection of women's reproductive healthcare. Bush could care less about evolution, but the "intelligent design" movement can rest easy that Oklahoma's new senator and many other new elected officials around the nation are supporters of creationism in the classroom.

There is still one winable battle, although I fear it is not in Ohio or Iowa. The battle is to reform or reject the President's Council on Bioethics. Leon Kass is no doubt gearing up to lead all the President's ethicists for another term of 'moral seriousness'. He must be put on notice that bioethics cannot afford four more years of feckless, xenophobic neocon posturing, even if it is delivered with austerity. Kass should have apologized to the nation for selling the proceedings of his Council through a for-profit, conservative commercial press. He should not have abused the reputation of one of the world's most prestigious biomedical scientists, Elizabeth Blackburn, named by Bush to the PCB and then shown the door under the pretense that she did not attend enough meetings. Blackburn was by all accounts one of the most active participants in the dialog about stem cell research, emailing Kass and others constantly. Kass could not find another way to defend the PCB against the charge that it sat idly by while the Bush administration (or he) fired one of two moderate scholars, and "retired" the other one, replacing both with ultraconservatives. So Kass resorted to distortion and blame in broad public view. To this day he has neither apologized nor attempted any kind of rapprochement with Blackburn or for that matter with anyone more moderate than William Kristol.

The new generation of conservative bioethicists seems dedicated to the proposition that debate is the enemy, or more accurately that opponents are best left ignored. The PCB virtually ignores the bioethics literature in its writing and anthologies. There are passing references to those who agree with them on matters at hand, most noticeably Carl Elliott, but it has become a hallmark of Bush Bioethics that no position is argued by the PCB while there are people 'in the room' with whom one must argue, unless absolutely necessary. This Council must go, or at least be made to play a peripheral role in the bioethics scene, unless it is radically remade with voices from both sides of the aisle. Supposedly even Wesley Smith agrees that there should be such voices. Now it is time for the American Enterprise Institute's Hertog Fellow Leon Kass to act with courage so that we really can have a "richer" bioethics.

It is a pretty terrible day for those of us in bioethics who supported the right to choose, hES research, and dozens of other areas I have not taken the space to discuss. But the real tragedy would be if bioethics did not take from this mess the lesson that not all battles must be fought nationally. State-by-state we will see the new changes made in bioethics-relevant law. California's Proposition 71 is just the beginning of some very important new shifts that deserve some real pragmatic consideration. Bioethics may not be as prestigious when it is fought out in the states, but that is where the battles now lie, at least for four more years. - Glenn McGee (UPDATED 11/3;11/20 )

Labels: big pharma, Bush, Canada, election, FDA, Haliburton, Leon Kass, neocon bioethics, politics, President's Council on Bioethics, stem cell research, universal health care, war on science

Nature: Embryonic Stem Cell Research 'Lite'

Researchers might also use the new method to grow stem cells from morula-stage embryos that have stalled in their development and are incapable of growing into babies, suggests stem-cell researcher Jose Cibelli of Michigan State University in East Lansing. "You could remove a big obstacle from the ethical standpoint," he says.

Labels: embryonic sanctity, hESC, human nature, stem cell research

SF Chronicle: Proposition 71 Passes

Labels: California, hESC, Mel Gibson, Proposition 71

Military Medical Ethics

Labels: JAMA, medical ethics, military

Headless Clones Rear Their Ugly ... Shoulders?

Labels: cloning, hype, media spin, mistaking science fiction for science fact, organ farms

Picking Wolpe's Brain

Labels: brain imaging, brain-activated computer, fMRI, neuroethics, neuroscience, Paul Root Wolpe, psychopharmaceuticals

Kinder, Gentler Germ Warfare

Labels: germ warfare, germs, unique therapy

Gene Doping

Labels: gene doping, Penn, ScienceNews

The Wild West of Stem Cell Reports

Labels: Russia, stem cell research

The Kindness Deficit

Labels: Art Caplan, big medicine, cynicism, health insurance coverage, kindness deficit, uninsured

Bioethics in New Zealand

Labels: fellowships, New Zealand, policy

Mini Medical School

Labels: community outreach, medical education

Embryonic Stem Cell Research Legal Now in Spain

Labels: Art Caplan, embryonic stem cell research, hESC, President's Council on Bioethics, Spain

The Pandemic Will (Not) Be Immunized?

Labels: avian flu, H5N1, pharmaceutical industry, potential pandemics, WHO

The Black Drug?

Labels: BiDil, heart failure, NitroMed, targetting drugs

Mercury in 2004 Flu Shots: Pediatricians Urge Infant Vaccination Either Way

Labels: autism, influenza, thimerosal, vaccination

Whose Fault is SARS?

Labels: Hong Kong, responsibility, SARS

Wisconsin is Petrified of Stem Cell Migration UPDATED

Labels: brain drain, California, intellectual property, Proposition 71, stem cell research, Wisconsin

The Ever-Increasing Misuse of Science UPDATED

Labels: Art Caplan, bad science, Bush, Leon Kass, neocon bioethics, psuedoscience, Union of Concerned Scientists