blog.bioethics.net

Happy New Year

The blog-dot will resume posting in 2008. Thanks to everyone who took the time to read or post a comment this year. We appreciate it.

photo: a plate from "Studies among the Snow Crystals ... " by Wilson Bentley, from the NOAA Photo Library

Following up: snapping pics of patients, the health care gift card

Here are a few updates and extensions to earlier posts on blog.bioethics.net:

Surgery is not photojournalism
The story of the Mayo Clinic resident who snapped a cellphone picture of a patient's penis tattoo has ended just about the way you would expect: strangely. Mayo announced late last week that the doctor is no longer practicing at the Phoenix hospital, though it won't say whether he was fired or he resigned. Apparently the search is now on to find out who leaked the details of the story -- including the patient's name -- to the Arizona Republic. The investigation has led to calls that the hospital has committed its own ethical violations while hunting for the leaker, though the nature of those violations are unclear.

Giving the gift of health care
It seems the "Health Care Visa Gift Card" is not just a speck of dystopian fiction made real, it's also part of a trend. Marketplace reports that gift cards for food and other everyday needs are becoming more popular as people lean toward giving more practical gifts.

-Greg Dahlmann

Is your professor juicing?

Tales of students popping adderall or some other stimulant to study longer or harder are, well, pretty much old news at this point. But what about professors propped up on Provigil (the stay awake drug modafinil)? A recent commentary by Barbara Sahakian and Sharon Morein-Zamir in Nature looks at some of the questions prompted by the rise of cognitive enhancement drugs. Most of the questions they pose won't be new if you've been following this topic, but there was one bit that jumped out at us:

In academia, we know that a number of our scientific colleagues in the United States and the United Kingdom already use modafinil to counteract the effects of jetlag, to enhance productivity or mental energy, or to deal with demanding and important intellectual challenges. Modafinil and other drugs are available online, but their non-prescription and long-term use has not been monitored in healthy individuals.

For many, it seems that the immediate and tangible benefits of taking these drugs are more persuasive than concerns about legal status and adverse effects. There are clear trends suggesting that the use of stimulants such as methylphenidate on college campuses is on the rise, and is becoming more commonplace in ever younger students. Universities may have to decide whether to ban drug use altogether, or to tolerate it in some situations (whether to enable all-night study sessions or to boost alertness during lectures).

Apparently these Provigil popping colleagues don't mind sharing. From a recent LA Times article about cognitive enhancement:

Sharon Morein-Zamir, a psychologist at Cambridge University who writes about the ethics of brain enhancement, said her interest in the medications was largely academic. But when someone she knew who had been taking Provigil for a neurological condition offered her some pills, Morein-Zamir's curiosity was piqued.

"I knew the literature and wondered what it felt like," she said.

The drug helped her focus as she worked at her computer for hours straight. But she wondered if it was a placebo effect.

"Maybe I would have gotten it done anyway," said Morein-Zamir, who launched an Internet poll Wednesday to ask scientists about their use of brain-enhancing drugs.

In that Nature piece, Sahakian and Morein-Zamir conclude that society may decide to regulate the use of cognitive enhancers in "competitive situations," much the same way we currently do for sporting events.

OK, so what's a competitive situation that might fall in to this category. Hmm... how about academic publishing? Just think of the potential conversations around the department coffee maker:

Did you hear about Bob? He just got another paper accepted.

There's no way he could have published that many times this year if he wasn't on the juice!

-Greg Dahlmann

figure from the Nature article by Sahakian and Morein-Zamir

Earlier on blog.bioethics.net:
+ Barry Bonds and enhancement's strike zone

Science's Breakthrough of 2007

And the winner is... human genetic variation. From the journal's article explaining its choice:

The unveiling of the human genome almost 7 years ago cast the first faint light on our complete genetic makeup. Since then, each new genome sequenced and each new individual studied has illuminated our genomic landscape in ever more detail. In 2007, researchers came to appreciate the extent to which our genomes differ from person to person and the implications of this variation for deciphering the genetics of complex diseases and personal traits.

Less than a year ago, the big news was triangulating variation between us and our primate cousins to get a better handle on genetic changes along the evolutionary tree that led to humans. Now, we have moved from asking what in our DNA makes us human to striving to know what in my DNA makes me me.

Techniques that scan for hundreds of thousands of genetic differences at once are linking particular variations to particular traits and diseases in ways not possible before. Efforts to catalog and assess the effects of insertions and deletions in our DNA are showing that these changes are more common than expected and play important roles in how our genomes work--or don't work. By looking at variations in genes for hair and skin color and in the "speech" gene, we have also gained a better sense of how we are similar to and different from Neandertals.

Already, the genomes of several individuals have been sequenced, and rapid improvements in sequencing technologies are making the sequencing of "me" a real possibility. The potential to discover what contributes to red hair, freckles, pudginess, or a love of chocolate--let alone quantifying one's genetic risk for cancer, asthma, or diabetes--is both exhilarating and terrifying. It comes not only with great promise for improving health through personalized medicine and understanding our individuality but also with risks for discrimination and loss of privacy.

And what about cell reprogramming? If you had money on it to show, you win. It was #2 on the Science list. Donald Kennedy, the journal's editor-in-chief, addresses that development in an accompanying commentary:

A strong Breakthrough runner-up arrived at this year's finish line just in time. Two new studies, one published in Science, showed how adult human epithelial cells could be reprogrammed, through the virally mediated introduction of just four genes, to behave like pluripotent cells; that is, able to act as embryonic stem cells do, to produce every descendent cell type. This breakthrough has produced some relief, but it also comes with some reservations. James Thompson of the University of Wisconsin, who did the first research with embryonic stem cells, has now taken a major step toward ending the "ethical" controversy over their use. But hold on: That controversy was generated by specific objections from one religion, not some universal ethic. There is every reason to continue research along the old path, with embryo-derived cells: The new methods may carry unknown liabilities, so making the case for changing Bush's 2001 presidential order should continue.

The whole list is posted at Science's site.

-Greg Dahlmann

Surgery is not photojournalism

To go in for surgery is to become vulnerable. We're put under anesthesia and, in some cases, literally opened up for others to see. But we trust that the professionals involved have our best interests at heart and whatever might be revealed about us will be kept confidential.

Alas, sometimes it's not.

The Arizona Republic reported this week that a surgeon at the Mayo Clinic in Phoenix couldn't resist the urge to share what he found during a recent gall bladder operation. It seems that when Adam Hansen, the chief resident of general surgery at the hospital, was attaching a catheter to the patient, he noticed that the patient had the phrase "Hot Rod" tattooed on his penis. So he snapped a picture with his cellphone and showed his colleagues. And then one of those colleagues called the Arizona Republic.

The Republic interviewed the patient, who said that Hansen called him to apologize and "He told me he didn't want me to read about it in the newspaper first." Nice. The patient also said Hansen told him he had erased the picture almost immediately (you know, after showing everyone in the office).

Said the patient to the Republic: "[The Mayo Clinic was] supposedly the best of the best. I have no complaints about the medical care I was given. But now I feel violated, betrayed and disgusted. I've never been in a hospital and (my) first experience is the worst thing ever." (He also added that "It was the most horrible thing I ever went though in my life," though it's unclear from the story whether he's talking about the picture or the experience of getting the tattoo.)

The Republic reports that Mayo has been investigating after one of the surgical support staff reported the incident to the administration and the punishment for Hansen could range from probation to termination.

It's notable that one of Hansen's colleagues dropped the dime on him. A study published earlier this month in the Annals of Internal Medicine reported that doctors were very resistant to reporting colleagues who had screwed up. That said, there were probably better ways of pointing out this mistake in judgment than calling a newspaper -- which itself might have been some kind of privacy violation.

And, of course, stories like this are almost certainly the exception to the rule. For something probably a lot more common, check out Freakonomics' Stephen Dubner's recent account of how strictly his doctor guards his privacy.

-Greg Dahlmann

Giving the gift of health care

There are moments when our modern age confronts us with a development to which we just don't know how to respond. Laughter? Tears? A groggy sidewards listing of the head in befuddlement? Maybe a combination of all three?

The new "Healthcare Visa Gift Card" is just such a development.

A healthcare visa what? you might ask. Well, the answer is pretty simple: it's a gift card for medical expenses -- you know, prescription drugs, visits to the doctor, and "indulging in healthy activities." Let's let the copywriters take it from here:

Most gifts promote happiness, but the new Healthcare Gift Card also promotes health! From college students and elderly parents to expectant mothers, the Healthcare Gift Card is a unique way to let loved ones know just how much you care.

Merry Christmas, Grandma! Go buy yourself some statins! No, really. From a WCBS-TV segment about the these cards:

When it comes to Christmas presents, Stacey Smith was stumped over what to give to her husband's grandmother.

"Especially an older person … they really have everything they need," Smith said.

But now she's found something that fits perfectly -- the "gift of health" through a medical gift card.

"She can use it towards her prescriptions and her medical bills or anything like that," Smith said.

As a blogger in Missouri pointed out, this was all very funny... when it was a scene in the film Brazil:

MOTHER: By the way, I saw a wonderful idea for Christmas presents at the chemists. Gift tokens. Medical gift tokens.

MRS TERRAIN: Oh, that sounds marvelous.

MOTHER: Yes, they're good at any doctor's and at many of the major hospitals -- and they're accepted for gynecological complications including Caesarean section.

So here we are, life imitating our dystopian art. You better spend that Healthcare Gift Card on antidepressants soon, though. After nine months, Visa starts charging you $1.50 for every month you hold a balance on the card.

Whatever. There are always free health insurance samples.

-Greg Dahlmann

(via MetaFilter and many of the comments there)

a pint a day keeps the doctor away?

From Wil Wheaton's blog (yes, that Wil Wheaton) comes the fabulous news that Guinness? Is good for you!

According to a new study out of the University of Wisconsin, drinking a pint of Guinness a day gives the same healthy-heart benefits as an aspirin a day (keeps the heart attack away). Apparently something in Guinness - but no lagers - reduces the clotting activity... at least, in the dogs that were in the study. Something tells me recruiting human research subjects won't be difficult!

No one is really sure what in the Guinness causes this anti-clotting activity; maybe it's added anti-oxidants, maybe it's just the effect of alcohol (leading speculation as to why the lager wasn't as beneficial). I do know that many asthmatics are recommended they drink a glass of wine or pint of beer a day, to alleviate inflammation and constriction, and there are of course numerous studies on the benefits of red wine. So, this would not be the first time alcohol has shown to have potential medicinal benefits.

I don't know about the rest of you, but I think this deserves a drink.
-Kelly Hills

[cross-posted to the Women's Bioethics Blog]

Portable Dialysis Passes First Trial

A portable dialysis machine has somewhat successfully completed its first clinical trial, raising hopes for many that one day, dialysis will not be a three day a week intensive at a clinic, but instead, a continual process occurring 24 hours a day.

In other words, a small and portable external kidney.

As anyone who is familiar with dialysis - personal use, friend, family member, working in a unit - knows, being attached to not only the machine but its location is a limiting lifestyle. No spontaneous road trips, impulse trips anywhere - even into the City to catch a show - have to be weighed against risk of missing a dialysis appointment.

Weighing in at approximately 11 pounds, a weight the California inventors hope to drop down to around 4 pounds, the portable dialysis machine looks something like a toolbelt wrapped around someone's waist. Using miniaturized components, it contains a bevy of devices to test and monitor blood, as well as thin and filter it.

Eight patients were part of this first trial, and they were encouraged to eat, drink, sleep, and generally live life as normal while they had it on. Those who tried sleeping found that they could, raising hopes that this could become a nightly home ritual rather than outpatient procedure. Maybe of more interest is the fact that of those eight patients, three were women - still something of a novelty in research studies not geared specifically at women.

Of course, being the first clinical trial on patients with end-stage renal disease, it didn't go without error - three of the eight patients had severe reactions. Two of those were because the heparin dose was off, creating blood thickness/filtering problems, and one was due to a temporary disconnection because of a dislodged fistula needle. Even then, though, all of the patients enthusiastically recommended the device.

And why wouldn't they? Slower rates of dialysis cause less pain for the patient and is easier to tolerate by the body, and perhaps more importantly, the device gives back a sense of freedom to those formerly weighed down with the giant anchor of immobile dialysis.
-Kelly Hills

Foreign Policy's 10 "missed" stories of 2007

Sure, the magazine's list includes items about topics such as borders, juntas and terrorism. But it also touches on transgenics, disease and robots:

(descriptions from FP's site)

#6 The American Heartland Grows Crops -- with Human Proteins

Farmers have long experimented with crops bred to produce better yields, with few ill effects. But with little public debate, something entirely new—rice engineered to produce human proteins—is coming to a grocery store near you. In May, the U.S. Department of Agriculture (USDA) authorized Ventria Bioscience to grow as many as 3,200 acres of special rice that produces proteins normally found in breast milk.

#8 Dengue Fever Runs High

Trends in Latin America and Southeast Asia have epidemiologists especially worried. The number of dengue cases in Latin America exploded to an estimated 1 million in 2007, twice the amount in 2006. Paraguay declared a state of emergency in March, and even Puerto Rico was logging 500 cases a week at the height of its outbreak. By October, 183 people had died in the region. Southeast Asia was also hit hard. Indonesia clocked 123,500 cases by October, with more than 1,250 people dead. Significant outbreaks have flared up in Cambodia, Malaysia, Thailand, and Vietnam. Although there is no vaccine, it doesn't have to be this way. Singapore got its dengue problem largely under control by running the world's toughest war on mosquitoes. Others should follow its lead.

#10 Armed Robots Take the Field in Iraq

However, the military isn't quite ready to shelve their human counterparts just yet. The SWORDS robots now seeing action in Iraq are manned by soldiers who remotely control their every move. But this new development does raise serious ethical and technological issues about the future of intelligent machines in war. As Peter W. Singer, director of the 21st Century Defense Initiative at the Brookings Institution, says, "If something goes wrong--and it always will--who is responsible? It's a classic question from science fiction, and yet our laws are so far silent on it."

And we should also mention FP's Passport, a great blog written by the magazine's editors.

-Greg Dahlmann

5 Books

Over at the Women's Bioethics Blog, I've posted a list of top five fictional books related to bioethics that I would recommend this giving season. I'll give you the list here, but due to length, suggest you click through to read what the books are about and the reasons I recommended them.

The List

1. I Am Legend by Richard Matheson


2. The White Plague by Frank Herbert


3. The Footprints of God by Greg Iles


4. Next by Michael Crichton


5. Darkness Falls by Kyle Mills

Look for in depth reviews of this books in the upcoming months!
-Kelly Hills

Craig Venter on the "DNA-driven world"

The would-be creator of synthetic life recently delivered this this year's Dimbley Lecture for the BBC (Edge has the transcript) and used the occasion to call on the public to get a better grip on science:

... as science has advanced, it has gone far beyond the immediately sensed world. It is now a world filled with dark matter in space, x-rays, gamma-rays, ultra violet light, DNA, genes, chromosomes, and bacteria that live in and around us in staggering numbers. We can't detect these directly, yet we feel the consequences of all of them. We are also now bombarded by information on wars, acts of terror, climate change and global warming, devastating storms, fuel shortages, emerging infections, flu pandemics, HIV, stem cells, animal cloning, genetically modified plants, and now the possibility of synthetic life forms, all while trying to cope with complexities of our daily lives. It is no great surprise then that there is a global resurgence of fundamentalism, a desire to get back to what appeared to be a simpler time, and a time when our primary senses and simple rules appeared to determine our life outcomes.

But I believe such a view is both simplistic and dangerous because it avoids the issues we need to face.

Our planet is in crisis, and we need to mobilize all of our intellectual forces to save it. One solution could lie in building a scientifically literate society in order to survive.

And, of course, we can't talk about Craig Venter without talking about his genome:

I chose to decode my DNA because in the complex debate concerning deterministic views of genetic outcomes and the fears that many have voiced about revealing all their genetic secrets. I as a leader in this field, wanted to show that we don't have to fear our genetic information. Our genetic code is not deterministic and will provide us very few yes-no answers. It will, however, provide probabilities concerning outcomes that we will eventually be able to influence. It seemed far better to me to use my own genome, rather than trying to convince anyone else that it was ok for them.

He added that he believes laws against genetic discrimination are necessary as we enter the age of widespread genome sequencing.

Venter also addressed the ethics of creating synthetic life... sort of:

One of the most significant and unique features of our research in synthetic genomics that often gets overlooked by the news media, is the long history, starting from the beginning of this work in 1995 and continuing today, of ethical review. As with the past 30 years of molecular biology, the organisms being designed cannot survive outside of the laboratory and are subject to strict containment. While we don't want students doing this work in their basements, this new field is stimulating an exciting new interest in biological studies.

A few other bits from Venter's lecture:

+ He says too many people "turn their brains off" when it comes to science and he argues that science education needs to be more focused on problem solving and less on memorization.

+ Venter predicts that we are at the beginning of a pattern of exponential growth in genomic technology, similar to what we've seen in electronics and telecommunications.

+ From that growth will flow advances in synthetic biology, which he believes will hold answers for addressing global warming and energy production.

+ And we also find out that he's a rapid metabolizer of caffeine, so it looks like his multi-cup a day coffee habit probably won't do him in.

While we're on the topic of Venter, make sure to check out Rick Weiss's piece in the Washington Post this week about synthetic biology. As you would expect, Venter gets quite a share of the attention, but the article focuses on a other efforts, too. And it includes this kind of quirky fact: the CEO of DuPont wears a pin-striped suit made from a chemical known as PDO, which was produced by partially synthetic bacteria.

-Greg Dahlmann

Earlier on blog.bioethics.net:
+ Craig Venter on Stephen Colbert
+ Craig Venter on the ethics of creating synthetic organisms
+ What is Craig Venter up to now?

Weekend reading: organ donation, designer babies

NYT Mag: Desperately Seeking a Kidney
Sally Satel recounts her story of looking for a kidney donor:

Maimonides, the 12th-century Jewish physician and philosopher, believed that anonymous giving was nobler than charity performed face to face because it protected the beneficiary from shame or a sense of indebtedness. He was onto something. I ruminated constantly about what it would mean to be related to someone “by organ.” Would my future donor assume a proprietary interest in how I lived my life, since she had made it possible? Would she make sure I was taking proper care of “our” kidney or lord her sacrifice over me? Or would I hold it over my own head, constantly questioning whether I might have said or done anything that could offend or disappoint my donor, anything that might be taken as ingratitude? How could a relationship breathe under such stifling conditions? It was exhausting to think about; I wanted no part of a debtor-creditor relationship. I didn’t want a gift, I wanted a kidney.

Satel does finally get a new kidney and the act of altruism prompts her to call for some kind of compensation for donors. Not money, she says, but something.

WSJ: For Religious Group, True Charity Begins on Operating Table
Laura Meckler reports on the Jesus Christians, a group which has embraced kidney donation as a religious calling:

More than 460 people have given kidneys anonymously in the U.S. over the past decade, and many others have donated to strangers they met online, amid a huge shortage of available kidneys. Nearly 75,000 people in the U.S. are waiting for kidney transplants.

Many hospitals aren't interested in donors who don't have an established, personal relationship with the recipient. That is partly because of fears that such donors may be secretly -- and illegally -- paid. Other concerns: Stranger donors may be psychologically disturbed, unrealistically hopeful that donating a kidney will improve their own lives, or likely to back out.

The University of Minnesota has handled 42 transplants involving anonymous donors, including two Jesus Christians. Catherine Garvey, a transplant coordinator there, says neither case caused concerns. "There's definitely a religious reasoning to it," she says, "but people often quote a spiritual or religious reason."

The article includes the story a young Australian man who had tried to donate a kidney to a Canadian woman. The hospital in Canada canceled the transplant after the man's mother wrote a letter calling his ability to make independent choices into question. Meckler reports that the potential donor and hopeful recipient are now looking for an American hospital to do the transplant.

Philly Inquirer: Two polar, persuasive stands on reproductive genetics
Carlin Romano reviews Ronald Green's "Babies By Design" and Michael Sandel's "The Case Against Perfection":

We have, Green concludes, always tried to make ourselves healthier, better and better looking (largely succeeding over the centuries), and nothing's going to stop us from doing so in the imminent age of the "$1,000 genome." When genetic profiles come down far enough in price, everyone and his or her doctor will have to confront these choices. "The time to start talking about this challenge," Green warns, "is now."

By contrast, in The Case Against Perfection, Sandel argues against Western science's bent since Francis Bacon to control nature whenever it can. Choosing our children's qualities, he contends, may not only impair their autonomy and skew our desired egalitarian social landscape, but will - this is Sandel's most distinctive point - deny us our sense of life as a "gift," an "endowment" that should exceed our control.

-Greg Dahlmann

looking for cats that glow in the dark

A video followup to the posts about glowing cats:

-Kelly Hills
[cross-posted to the Women's Bioethics Blog]

Speed reading the December 13 Democratic debate

The Democrats running for the presidential nomination got together in Iowa Thursday for their last debate before the caucuses. We've pulled highlights from the transcript that might be of interest here at our little intersection of the web. Topics included health care spending, biomedical research and torture. The breakdown is after the jump.

(read the rest)

Speed reading the December 12 Republican debate

The Republicans running for the presidential nomination got together in Iowa Wednesday for another debate. We've pulled highlights from the transcript that might be of interest here at our little intersection of the web. The breakdown is after the jump.

(read the rest)

Art Caplan at MSNBC: Does this man look black to you?

Art writes that James Watson's own genes raise questions about the meaning of race:

One of the greatest scientific achievements of the 20th century should now be attributed to a black man, or so it seems.

James Watson, the man who worked with Francis Crick to identify the double-helical structure of DNA, who upon casual inspection might well qualify for the title of "most blatantly Caucasian male" among a raft of serious contenders that includes Mitt Romney, Tucker Carlson, Harry Reid and Peyton Manning, is actually black!

An Iceland-based genomics company, deCODE genetics, conducted an analysis of Watson's DNA, which Watson had allowed to be placed on the Internet, and found that 16 percent of his genes are likely to have come from a black ancestor.

The flamboyant head of deCODE, Kari Stefansson, himself a strong contender for the most obviously Caucasian male award, whose company carried out the analysis, said in a classic bit of white male understatement, “It was very surprising to get this result for Jim.”

Indeed, the racial outing of Watson was quite a surprise — most likely to the 79-year-old Nobel-prize winner. This past October he was forced to cancel a tour promoting his new book in England after opining in a British newspaper that he felt “inherently gloomy about the prospects for Africa” because “all our social policies are based on the fact that their intelligence is the same as ours — whereas all the testing says not really.” Jim’s fretting left him without a job at home — he retired from his job as chancellor at the Cold Spring Harbor Laboratory in New York — and no longer especially welcome on the speaking circuit anywhere serious. Finding out one has black genes seems especially inconvenient for somebody proclaiming blacks to be genetically inferior.

Watson’s critics are piling on with glee to such delicious irony. But while it is more than tempting to use this incident to bury the influential source of some very irresponsible racial speculation (yeah, OK, I have been indulging myself in the temptation) a number of other more important lessons need to be drawn from the news of Watson’s reclassification in the family of man.

(read the rest)

Bush vetoes SCHIP reauthorization and expansion, again

On a recent quiz I gave my students, one of the questions was: Which of the following groups are not "entitled" to healthcare: the elderly, children, prisoners, or veterans?

Some low-income, uninsured kids get access to health care through Medicaid, but there are income and age eligibility requirements that vary by state. The State Children's Health Insurance (SCHIP) Program is a federally financed program designed to help states expand health care coverage to uninsured kids either through Medicaid or other programs.

For the second time in three months, President Bush just vetoed bipartisan legislation that would have expanded the State Children's Health Insurance (SCHIP) program.

The Center for American Progress writes:

After Bush vetoed the SCHIP legislation in early October, he argued, "When it comes to SCHIP, we should be guided by a clear principle: Put poor children first." By all accounts, SCHIP has been successful in accomplishing this mission. Since 2000, while 6.8 million people lost health coverage, "SCHIP and Medicaid ensured that the proportion of low-income children without health insurance actually declined during this period, from 20 percent in 2000 to 14 percent in 2005." The second version of SCHIP that Congress passed sought to address Bush's major concern about the bill "by capping eligibility at 300 percent of the federal poverty line -- slightly more than $60,000 for a family of four." Yet Bush trotted out the same excuse yesterday for vetoing the popular and successful health insurance program. "This bill does not put poor children first," he said, "and it moves our country's health care system in the wrong direction." The administration apparently views the confrontation over SCHIP as "making for good politics." The New York Times reported, "The White House, convinced that Republicans lost Congressional seats last year because the public was fed up with government spending, calculates that Mr. Bush will please fiscal conservatives by drawing the line against a big expansion of the program."

WHAT'S NEXT: Authorization for SCHIP expired on Sept. 30 and has twice been extended by continuing resolutions passed by Congress to keep the federal government operating. "But the second extension is due to expire on Dec. 14, and no one is sure what will happen next." The fate of this critical program "remains undecided," as lawmakers negotiate a new five-year funding package that can win Bush's approval or draw a veto-proof majority in the House and Senate. If Congress cannot win over Bush's support, leaders from both parties are expected to "pass a one-year extension of the program" with the aim of including "enough money in the measure to maintain current levels of enrollment, estimated at 6.6 million children." While campaigning in 2004, Bush pledged, "In a new term, we will lead an aggressive effort to enroll millions of poor children who are eligible but not signed up for the government's health insurance programs." Now, Bush has become the one man standing between 10 million low-income children and their health insurance.

My kids keep asking how many days until Christmas? I'm counting the days until the next inauguration.

-Andrea Kalfoglou

About those glow in the dark cats

As Kelly posted earlier, the South Koreans have cloned cats with RFP genes. A side-effect is that the cats glow under ultraviolet light. Sure, there's probably a legitimate scientific reason for these experiments (it proves that the manipulated gene was passed on to the clone), but the cynic in me wonders if there isn't another motive. Perhaps the researchers' retirement accounts will now be funded by revenue generated by consumers who just have to have a glowing cat as a pet. What could be more hip? Skeptical? Did you know you can buy genetically altered zebra fish that glow in lots of different florescent colors from your local PetCo? The one exception is California where those left coasters seem to think that using the awesome powers of genetics ought to be used for less frivolous purposes. Hm.

-Andrea Kalfoglou

photo: GloFish.com

Earlier on blog.bioethics.net:
+ Transgenic fish bust in New Zealand

The "gold standard" for sex education in schools

By Andrea Kalfoglou

My local county school board has been struggling for the past few years to come up with a new sex education curriculum that satisfies everyone -- or that can at least get past the lawsuits and delays. About 15 miles away, a DC school is using a program that, as Washington Post columnist Courtland Milloy writes, "might well be the gold standard," for sex education programs.

The Carrera Adolescent Pregnancy Prevention Program, developed in 1984 by Michael Carrera of the Children's Aid Society, is a "far cry from the traditional approach" to sex education in public schools. Instead of providing students with "the old health class with a gym teacher's lecture on safe sex or abstinence," the Carrera program offers a "holistic approach" that teaches students "basic skills" along with "heavy doses of self-respect, integrity, discipline, responsibility and teamwork," according to Milloy. Students take classes in "family life" and sex education that are "age appropriate and involve parents who also take classes on how to talk to their children about sensitive issues," Milloy writes.

Carrera programs, implemented at schools across the U.S., have reduced teen pregnancy by 50% and increased high school graduation rates, according to the Children's Aid Society. None of the 5,000 teens enrolled in the program through 2003 has reported testing HIV-positive. According to Milloy, some people have said the program's cost of about $8,000 per student annually is too expensive.

My public health students were shocked to learn that we spend less than 1 out of every $100 of our health care dollars in the U.S. on prevention. Do we really need a cost effectiveness study to demonstrate that a program that reduces teen pregnancy, sexually transmitted infections, and school drop out rates is worth the investment?

Andrea Kalfoglou is an Assistant Professor at the University of Maryland, Baltimore County

South Koreans Clone Cats That Glow in the Dark

In the news today is the announcement that South Koreans have cloned cats with altered fluorescence proteins (RFP). The idea is to be able to eventually develop treatments for human genetic diseases. Researchers are also suggesting that other uses for this technology will include rescuing species from near-extinction.

And, as an added side bonus, the cats glow when exposed to when exposed to ultraviolet beams. They certainly look kind of cool.

Of course, I suspect South Korea and the scientists themselves are on edge, given the Hwang Woo-Suk scandals - but all things considered, that whole thing probably makes this particular achievement all the more likely to be true.

-Kelly Hills

Separated at birth... for research

The story of Paula Bernstein and Elyse Schein sounds like something from a movie. The identical twins were separated at birth, adopted by different families. In their early 30s Schein started looking into information about their birth mother and in the process found out that she had a twin. The women were re-united, happily, via an adoption agency in 2004.

Those details alone make for an interesting story, but it becomes even more amazing when you add in the fact that the twins were separated as a part of a psychological study. The research was conducted by Peter Neubauer and Viola Bernard, who wrote at the time that the study "provides a natural laboratory situation for studying certain questions with respect to the nature-nurture issue and of family dynamic interactions in relation to personality development." The adoptive families were never told their children were separated twins, only that they were involved in some kind of developmental study. Bernard has passed away, but Bernstein and Schein were able to track down Neubauer. They say he would reveal nothing about the study's findings to them -- and the results are sealed until 2066. Bernstein said on CNN that Neubauer expressed no remorse for his role in the study. "We felt that our lives had been orchestrated by these puppet masters, who put their research needs before the needs of us and the other twins and triplets," Schein said in that same CNN interview. (Lawrence Wright, the author of a book about twin studies, said to NPR's All Things Considered of the study, "From a scientific point of view, it's beautiful. It's practically the perfect study. But this study would never happen today.")

The highly questionable ethics of their separation acknowledged, the experience of Bernstein and Schein does shed some interesting light on genetics -- and maybe even cloning. The sisters were amazed to find out that even though they had been separated from birth, they shared a number of similar mannerisms, career choices and interests (even the same favorite movie, "Wings of Desire" by Wim Wenders). But their lives had still taken somewhat different paths. On NPR's Talk of the Nation, the two women talked of an apprehension about "who had done a better job with their DNA." Schein says she initially felt that Bernstein looked down upon her and the choices she had made, which led to some difficult conversations. They say they've now worked through those feelings.

-Greg Dahlmann

photo of Bernstein and Schein: Elena Seibert/Random House

Comment highlights: moral objections, stem cell follow-up, personhood for embryos, and hugging

+ The issue of medical professionals refusing to provide services because of moral objections continues to be a hot topic. Our most recent post on this issue -- about doctors -- prompted a string of passionate comments. SabrinaW really focused the issue in her comment when she pointed out, "... a large amount of the conflict stems from differing expectations of what a person who is certified by the medical community as a physician (or as a pharmacist) can be reasonably expected to do."

+ Insoo Hyun was nice enough to stop by and post a link to a paper he wrote with Shinya Yamanaka, Rudy Jaenisch and Konrad Hoechedlinger about iPS cells and embryonic stem cell research. We really appreciate it when researchers and authors take the time to contribute to the discussion.

+ After a post about the personhood for embryos movement, Mr. Gunn observed, "My theory about these ballot amendment things are that they know there's no chance of them passing, but the whole point is just to motivate people to come to the polls who'd likely vote for their candidate. It's a great strategy, one which the Democrats fail to use as effectively." The post also featured interesting, skeptical follow-up by Beverly Knuckols and Laura(southernxyl) about some of the comments from the quoted article.

+ And in response to a post about physicians hugging their patients, Emily wrote, "If my doctor tried to hug me I would be seriously freaked out. No thank you."

Thank you to everyone who's been taking the time to contribute comments. We really appreciate people getting involved with the discussion here at blog.bioethics.net.

-Greg Dahlmann

Time's top 10 scientific discoveries of 2007

We're not so sure about the criteria used to make the selections (see #10: real-life kryptonite), but the list includes three topics that come up here all the time:

#1 - Stem cell breakthroughs

#2 - The publishing of Venter's entire genome

#5 - Heart valve tissue grown from stem cells

By the way, if you're a fan of the end-of-year list, be sure to check out Rex Sorgatz's impressive compilation of them.

-Greg Dahlmann

Thinking about stem cell research and intent

The New York Times profiles Shinya Yamanaka today and the piece includes a number of interesting details about his research. But the anecdote that stands out most is the one about what prompted him to pursue the creation of induced pluripotent stem cells.

Shinya Yamanaka

Inspiration can appear in unexpected places. Dr. Shinya Yamanaka found it while looking through a microscope at a friend’s fertility clinic.

Dr. Yamanaka was an assistant professor of pharmacology doing research involving embryonic stem cells when he made the social call to the clinic about eight years ago. At the friend’s invitation, he looked down the microscope at one of the human embryos stored at the clinic. The glimpse changed his scientific career.

“When I saw the embryo, I suddenly realized there was such a small difference between it and my daughters,” said Dr. Yamanaka, 45, a father of two and now a professor at the Institute for Integrated Cell-Material Sciences at Kyoto University. “I thought, we can’t keep destroying embryos for our research. There must be another way.”

Later in the article it's mentioned that Yamanaka's San Francisco lab does use embryos for research -- he says it's currently unavoidable, but adds that his goal is to stop.

James Thomson

Much has been made recently about the degree to which moral concerns did or didn't push the research in this direction. But in the end does it matter? If Yamanaka -- or Thomson -- alone had created iPS cells, would that (should that) have changed the way we look at the development? Does it make a difference if two researchers are propelled by two different motivations to arrive at the same endpoint?

-Greg Dahlmann

photo of Yamanaka: Kyoto University
photo of Thomson: Jeff Miller/University of Wisconsin-Madison

Sifting through the NYT Mag's "Year in Ideas"

For the last seven years the New York Times Magazine has been publishing a list of the notable "ideas" at the end of each year. This year's list includes 70 of them, but who has the time to read through all of them? (You know, aside from us). So here are the ideas that might be of most interest here at the blog-dot:

Alzheimer's Telephone Screening
A 50 question phone survey that would measure "cognitive vital signs" to help identify Alzheimer's patients before the typical symptoms present themselves.

The God Effect
University of British Columbia psychologist Ara Norenzayan has found that priming people with thoughts of God or civic duty can induce them to act more altruistically.

Neurorealism
Eric Racine's word to describe the credulousness induced by showing people images of brain scans along with explanations for some kind of behavior or outcome. (Check out the 2005 paper "fMRI in the public eye" Racine authored with Judy Illes and Ofek Bar-Ilan for Nature Reviews Neuroscience.)

The Right to Medical Self-Defense
Eugene Volokh's argument that a terminally ill patient should have the right to buy any treatment that has passed Phase 1 FDA testing. Volokh's position grew out of the Abigail Alliance case.

Zygotic Social Networking
Two companies have started social networking sites based on genetic testing. Users can find distant relatives, upload baby pictures and compare family trees.

Community Urinalysis
Oregon State environmental chemist Jennifer Field has been testing sewage water for traces of drugs. "It’s the closest to the urinal you can get without violating privacy," she said.

You might be a bioethicist if...

Over at the Women's Bioethics Blog, Linda has reprinted Chicago bioethicist Timothy Murphy's spoof on the Jeff Foxworthy "you know you might be a redneck if..." joke. Some of them hit scarily close to home.

My personal favourite? You know you might be a bioethicist if "a reporter calls to ask you about a breaking case you know nothing about, but you nevertheless express an opinion."

Definitely worth a read-thru!
-Kelly Hills

A cheek swab! Oh, you shouldn't have!

We were so relieved to find out there's still time to order a "DNA Portrait" holiday gift kit. For $390 (and up) a company called DNA11 will turn a DNA sample taken from a cheek swab into art (example above). The Information Aesthetics blog runs through the gift considerations:

because: as looking at your own phenotype in the mirror bores you, the genotype might be more intriguing.
however: one first might need to look up the definition of narcissism.

Hmm. It's like you, too, can be Craig Venter. At any rate, Al Roker is a fan, so they must be cool.

-Greg Dahlmann

Take that, armchair!

Intrigued by Kwame Anthony Appiah's reference to a YouTube video of the "The Experimental Philosophy Anthem," we went ahead and tracked it down. It's, um, interesting:

Perhaps not surprisingly, the short string of comments on the YouTube page for the video is uncharacteristically high-minded for the site. It may very well be the first time someone has name checked set theory in a YouTube comment.

-GD

Weekend reading: experimental philosophy, ordinary deaths, and The Ethical Imagination

NYT Mag: The New New Philosophy
Kwame Anthony Appiah focuses attention on the "experimental philosophy" movement, which involves -- brace for it -- data collection:

Not only are philosophers unaccustomed to gathering data; many have also come to define themselves by their disinclination to do so. The professional bailiwick we’ve staked out is the empyrean of pure thought. Colleagues in biology have P.C.R. machines to run and microscope slides to dye; political scientists have demographic trends to crunch; psychologists have their rats and mazes. We philosophers wave them on with kindly looks. We know the experimental sciences are terribly important, but the role we prefer is that of the Catholic priest presiding at a wedding, confident that his support for the practice carries all the more weight for being entirely theoretical. Philosophers don’t observe; we don’t experiment; we don’t measure; and we don’t count. We reflect. We love nothing more than our “thought experiments,” but the key word there is thought. As the president of one of philosophy’s more illustrious professional associations, the Aristotelian Society, said a few years ago, “If anything can be pursued in an armchair, philosophy can.”

But now a restive contingent of our tribe is convinced that it can shed light on traditional philosophical problems by going out and gathering information about what people actually think and say about our thought experiments.

Appiah also declares "neuro" the new "nano" and asks "Is the Knobe effect a bug or a feature?" If Appiah's take on "x-phi" gets you thinking about what methods should be applied to philosophy, maybe you should take the time to drop a few of those thoughts in a essay for The Method in Bioethics competition.

The Smart Set: What's Your Doomsday?
Jennifer Fisher Wilson has some good (or maybe bad) news for us -- we probably won't die of some cataclysmic:

So why don’t we stop worrying about death by disaster or high drama and take some control of our fate by living more healthfully? Perhaps because this would require prioritizing our future self over who we are today. It is one thing to know what is good for us, and it is quite another to live preventively every day, abstaining from many of life’s pleasures along the way. Furthermore, living healthfully is no guarantee of freedom from disease.

Or perhaps it is because we don’t actually believe in the inevitability of our own death. Just as the first few gray hairs or wrinkles are a surprise — even though we knew they would come eventually — the arrival of death, be it fast or slow, will likely surprise us, too. Both Freud and Schopenhauer noted that on a deep, personal level, people do not really believe in their own death, and Heidegger noted that the concept that all men are mortal usually involves a tacit reservation “but not I.”

Hmm. Sounds like it might be a case for an experimental philosopher.

MercatorNet: The Ethical Imagination
Michael Cook warmly review's Margaret Somerville's "The Ethical Imagination" -- and takes a few shots at a whole bunch of other people:

Unhappily, too few people acknowledge the deep moral seriousness of bioethical debates. Compared to global warming, the obesity epidemic, and Hollywood strikes, embryos and euthanasia are also-rans. Consequently, most of us go with the flow and end up supporting the whacky views of the professionals. But Somerville somehow manages to rouse people from their bioethical slumber and stirs their consciences. So her book deserves the close attention of anyone who treasures human dignity.

By the way, if you're not familiar with MercatorNet, it describes itself as a "dignitarian" publication.

-Greg Dahlmann

Enhancement today: ear lobes

This holiday season what do you get the cosmetic surgery enthusiast who has everything? How about an ear lobe job? From the New York Observer:

When Mrs. L., an Upper East Side woman in her 60’s who asked that her real name not be used, was receiving Restylane in her face from Dr. Geronemus about six months ago, the doctor told her that there was some filler left and that maybe she should consider plumping her thinning earlobes. “I thought that was kind of funny, but after the injections my ears looked great!” she said.

And at just $750 per vial of Restylane, it's practically a steal.

(via)

-Greg Dahlmann

iPS cell therapy coverage roundup

As we reported yesterday, a team from Rudy Jaenisch's lab at the Whitehead Institute, along with a group led by Tim Townes at UAB, announced in Science that it has used induced pluripotent stem cells to treat sickle cell anemia in mice.

+ Jaenisch tells the Washington Post's Rick Weiss that the problem of how to reprogram the skin cells without using viruses is "the big issue." (The retroviruses used can introduce errors into the cells' DNA). Jaenisch also reiterates his support of work on embryonic stem cells. "All the progress in this field was only possible because we had embryonic stem cells to work with first. We need to make more ES cells and really define which are going to be the best ones for different applications," Jaenisch tells Weiss.

+ The Whithead team tried to get around part of the cancer problem by deleting one of the genes used to induce pluripotency. (The gene seems to play a role in tumor formation.) But Jacob Hanna, the lead author of the paper in Science, tells Reuters' Julie Steenhuysen that removal of that gene "is far from solving the problem." Hanna also tells Reuters that embryonic stem cells are "the gold standard."

+ ACT's Robert Lanza tells New Scientist's Andy Coghlan, "This study shows how incredibly valuable this technology could be for human therapy, and in particular for repairing human genetic defects." But Lanza cautions this approach could be much more difficult if treatment required replacing most or all of a patient's cells with altered versions.

+ Townes tells the AP's Lauren Neergaard that he will next be testing to see if human cells from sickle cell patients can similarly be reprogrammed. (Actually using them for treatment is still a ways off because of the virus issue.)

+ The University of Cambridge's Azim Surani strikes a note of caution in a BBC report: "But in addition to the safety concerns, we have to be cautious about extrapolating from mouse studies to humans. The mouse IPS cells are not identical to human IPS cells. We need more research. There are still significant hurdles to overcome."

+ Of using this approach in humans, Jaenisch tells Bloomberg's Rob Waters: "If I were to select a disease that would most likely succeed first, it would be some blood disease. I would not make a prediction when, but I think it will be sooner than we think."

+ Small discrepancy in quotes from Jaenisch about the effectiveness of the therapy in mice. New Scientist quotes him saying of the mice "All improved to almost normal. These mice are basically cured." The Washington Post quotes him saying, "All the parameters we can measure are now normal. The mice are cured."

+ There's a somewhat odd absence of this story in the New York Times. As of 10 am today the only mention of this story on the NYT site is an AP article toward the bottom of its science page.

Induced pluriptoent stem cells used for therapy

A team from Rudy Jaenisch's lab at the Whitehead Institute reports this week in Science that it has used induced pluripotent stem cells to treat sickle cell anemia in mice. The researchers are touting the results as "proof of principle" that iPS cells can used for therapies, though they caution there's a lot of work to be done before iPS cells should be used in humans.

Here's what the Jaenisch team did:

+ Using mice that had been created with the human gene that causes sickle cell anemia, skin cells from the tail were reprogrammed to become pluripotent.

+ The now pluripotent cells were prompted to differentiate into cells that would become hemopoeitic (bone marrow) stem cells.

+ The researchers then took those cells and swapped out the gene for sickle cell anemia with the version of the gene that doesn't cause disease.

+ The bone marrow in the donor mice was killed off and the corrected hemopoetic cells were transplanted into the mice.

+ Tests of the mice indicated that the transplants were successful and the mice didn't exhibit signs of sickle cell anemia.

There are still a number of obstacles to using this approach in humans. The process used to create the iPS cells is known to increase the likelihood of the cells turning cancerous. Part of the problem is that one of the four genes used to induce pluripotency seems to play a role in cancer formation. The Jaenisch team tried to get around this issue by deleting that gene after they had reprogrammed the cells. But there's still the issue of how the four pluripotency-inducing genes are inserted in the first place. The current method uses retroviruses, which can introduce random errors into the DNA of the reprogrammed cell. The search is on to find ways around these problems. (Back in November Jaenisch told the Washington Post he didn't think the retrovirus issue was a big hurdle)

So where does this most recent iPS cell advance leave embryonic stem cell research? According to Jaenisch, ES cell research is still important. "We wouldn’t have known anything about IPS cells if we hadn’t worked with embryonic stem cells. For the foreseeable future, there will remain a continued need for embryonic stem cells as the crucial assessment tool for measuring the therapeutic potential of IPS cells," Jaenisch said in a Whitehead press release.

-Greg Dahlmann

Issue to watch: personhood for embryos

The Chicago Tribune reports that anti-abortion activists in six states are pushing for ballot referendums that would grant "personhood" and constitutional rights to embryos. The head of Georgia Right to Life tells the Tribune the goal is to introduce such initiatives in as many as 30 states during the next few years.

A companion piece to the article includes a number of questions from bioethicists, including AMBI's Linda MacDonald Glenn (who's been following this issue on the Women's Bioethics Blog.) From that piece:

"You could have people policing women's behavior during pregnancy to be sure they don't smoke or drink or do anything that could possibly harm the fetus," says Lori Andrews, director of the Institute for Science, Law and Technology at Chicago-Kent College of Law.

Doctors might hesitate to treat pregnant women for conditions such as diabetes or depression because the treatments could "impact embryos in an unknown way and expose [physicians] to potential liability," Andrews suggests.

"What about an ectopic pregnancy" where the embryo is implanted in a woman's fallopian tube, Glenn asks. "Do you have an obligation to try and save the embryo -- because it's a person -- even though such pregnancies aren't viable?"

And what about embryos frozen in fertility clinics around the country? Could they claim a right to gestation in a woman's body because that's what they need to grow and develop, asks Dr. John Lantos, a pediatrics professor at the University of Chicago and John B. Francis bioethics chair at the Center for Practical Bioethics in Kansas City.

-Greg Dahlmann

(thanks to Jim Fossett for the article pointer)

Earlier on blog.bioethics.net:
+ Frozen embryos get some colorful representation in court

Everyone, Do the Protein Synthesis Dance!

Laurie passed this gem of a 1970s science explanation video on to me, and really, the only thing I can say in response is, "and people wonder why my generation is so strange - look who was raising us!"

-Kelly Hills
[cross-posted to the Women's Bioethics Blog]

Bush and iPS cells: another "Mission Accomplished"?

By James Fossett

The White House, Charles Krauthammer, Wesley J. Smith and other Bush Administration apologists have been working hard the last few days to spin the announcement of the development of induced pluripotent stem cells (iPSC’s) as a scientific silver bullet that wouldn’t have happened without the Bush Administration’s principled opposition to human embryonic stem cell (hESC) research that induced scientists to find a “moral” means of producing stem cells.

All politicians spin, but this one’s a doozy, on a par with Iraq’s weapons of mass destruction and "I did not have sex with that woman."

(read the rest)

Glenn McGee in The Scientist: My Eye's On You

In his December column Glenn is thinking about how we'll look at visual enhancements:

Picture-perfect vision, with lovely dark pupils and irises of any color you want. Who wouldn't want that? Every person who wears glasses or contact lenses, or who just has that classic wish of the pilot or bird watcher - to see just a little bit better, farther, or more clearly at night - or who, vanity of vanities, wants slightly brighter green eyes, would be delighted to hear that stem cell research is moving us closer to the day when eyes might be created in the lab and implantable.

Looming is the prospect of creating human eyes (or at the very least, central components of the eye) for the purposes of replacing, repairing, or regenerating unhealthy or damaged tissue. Scientists are finding pieces of the puzzle, those factors that control the generation of eyes (Nature, 449:1058-62, 2007). As eye researcher Nicholas Dale of the University of Warwick told LiveScience, "If you knew all the genes, and how to turn them on, that you needed to make an eye, you could start with very early embryonic cells and turn on all the right genes and grow an eye in a dish."

If you think growing an organ in a dish sounds like science fiction, think again.

(read the rest)

Speed reading the December 4 Democratic debate

The Democrats running for the presidential nomination got together in Iowa Tuesday for another debate (this time it was on the radio). We've pulled highlights from the transcript that might be of interest here at our little intersection of the web. Our usual list of topics didn't get much attention this time around (Iran and immigration took most of the focus), but the candidates did touch on a few things that are tangentially related: regulation of toxics in consumer products, science education and global warming. The breakdown is after the jump.

(read the rest)

To hug, or not to hug

When -- if ever -- should a doctor hug her patients? Michael Wilkes, who's an M.D., takes up the topic in a recent column for the Sacramento Bee:

When we teach students about antibiotics or surgical procedures, our first step is to look at the indications – when is it useful? A fever or cough may suggest an infection requiring medication; serious stomach pain and vomiting may suggest an intestinal obstruction requiring surgery. A person who is distraught, devastated or otherwise needs some emotional support may indicate the need for a hug. The dose required is difficult to determine, but it ranges from a quick little embrace with a pat on the back to a sustained, comforting squeeze.

The outcome we hope to achieve when utilizing the hug is not a cure of any condition but rather a connection that conveys that another person cares and is trying to understand. As with other medical interventions, the hug has potential adverse effects. We risk offending the huggie, or having him or her misinterpret our hug as having romantic overtures.

Despite the risks, Wilkes seems to be pretty strongly in favor of doctor-patient hugging -- and not just because of the effect on the patient. He mentions that sometimes he needs the emotional connection.

-Greg Dahlmann

Speed reading the coverage of "Love and Sex With Robots"

The reviews of David Levy's book predicting human-robot marriage (and, um, other activities) are in and they're... skeptical:

+ In the New York Times, Robin Marantz Henig writes that her experiences in reporting a previous story about robots had "primed" her for Levy's thesis. That doesn't mean she's totally buying in to his approach, though:

But despite my own brief robot crush, I would have appreciated a little ironic distance. Levy simply embraces the sexy robots in our future, whether they are a sensitive cybermale or an adoring female robot that is like “a Stepford wife, but without her level of built-in subservience.” But it isn’t the subservience that makes the uniform, unthinking, unblinking Stepford wives so unnerving; it’s the fact that they are — hello! — robots.

Marantz Henig ultimately wishes that Levy would have devoted more of the book to not whether people will develop intimate relationships with robots, but whether or not that's actually a good thing.

+Salon's Farhad Manjoo criticizes Levy's book for being "maddeningly dense and in stretches unpardonably dull," but he praises Levy for taking up a fascinating topic: "Fascinating because the prospect of human-robot love is, though self-evidently insane, also undeniably attractive, and certainly not implausible."

+In the LA Times, Seth Lloyd writes that Levy makes "serious arguments" and "His chapter on blow-up rubber sex dolls and the like will surely rank as the definitive study of such phenomena for years to come." But, citing the great difficulty researchers have encountered in developing artificial intelligence, Lloyd has serious doubts that the technology necessary for Levy's robot-human marriage prediction will be available by 2050.

(read the rest)

Is that your right or my right?

From a Boston Globe piece about "body language analyst" Tonya Reiman:

"If you are going for a job in accounting, law, medicine, or another field bound by a strict code of ethics, tilt your head to the right," she said. "Trying to become America's Next Top Model? Tilt to the left."

Noted.

-Greg Dahlmann

Thomson takes on the conversation surrounding induced pluripotent stem cells

James Thomson and AAAS head Alan Leshner have a very direct op-ed in the Washington Post today about all the discussion surrounding induced pluripotent stem cells. It seems they're not too happy with what they've been hearing. Here's a clip:

A new way to trick skin cells into acting like embryos changes both everything and nothing at all. Being able to reprogram skin cells into multipurpose stem cells without harming embryos launches an exciting new line of research. It's important to remember, though, that we're at square one, uncertain at this early stage whether souped-up skin cells hold the same promise as their embryonic cousins do.

Far from vindicating the current U.S. policy of withholding federal funds from many of those working to develop potentially lifesaving embryonic stem cells, recent papers in the journals Science and Cell described a breakthrough achieved despite political restrictions. In fact, work by both the U.S. and Japanese teams that reprogrammed skin cells depended entirely on previous embryonic stem cell research.

Thomson and Leshner go on to dispute the "President Bush's moral guidance helped bring about this discovery" storyline, they call out Charles Krauthammer for being inaccurate, and they try up to stir things up on the issue of all the embryos stored in fertility clinic freezers.

-Greg Dahlmann

(via James Fossett)

Earlier coverage of induced pluripotent stem cells on blog.bioethics.net

Weekend reading: physician-assisted suicide, organ donation, paleovirology

NYT Mag: Death in the Family
Daniel Bergner writes about the effort of former Washington governor Booth Gardner, who has Parkinson's, to get a physician-assisted suicide referendum passed there in 2008:

“Why do this?” he asked, turning from the other tables toward me. “I want to be involved in public life. I was looking for an issue, and this one fell in my lap. One advantage I have in this thing is that people like me. The other” — his leprechaun eyes lost their glint; his fleshy cheeks seemed to harden, his lips to thin, his face to reshape itself almost into a square — “is that my logic is impeccable. My life, my death, my control.”

A good portion of the piece focus on objections to physician-assisted suicide, including thoughts from Susan Wolf about the role of gender and Patricia King about ethnic disparities.

Boston Globe: Match for Life
Michele Morgan Bolton profiles MatchingDonors.com, the non-profit online service that aims to connect people who need organs with donors:

The practice of living donors making arrangements directly with patients via the Internet has drawn critics.

Douglas Hanto, chief of transplantation at Beth Israel Deaconess Medical Center and professor of surgery at Harvard Medical School, wrote in March in the New England Journal of Medicine that soliciting organs the way MatchingDonors.com does threatens the fairness of how organs are allocated. He said he would like to see available donations directed to the top of existing United Network waiting lists, after the donor's family, friends, and preexisting relationships.

But over time, Dooley and Lowney said, more professionals are backing them.

"We have great ethicists on our side who say we bring people into the pool who aren't currently in the pool," Dooley said. The American Society of Transplant Surgeons, which initially opposed the public solicitation that MatchingDonors.com espouses, recently declared that it may make more organs available.

Interesting item from the article: MatchingDonor's co-founder Jeremiah Lowney says he doesn't think he'd ever be able to donate one of his organs to a stranger.

The New Yorker: Darwin's Surprise
Michael Specter looks at the efforts of "paleovirologists" to resurrect extinct retroviruses stored in our DNA:

Then, last year, Thierry Heidmann brought one back to life. Combining the tools of genomics, virology, and evolutionary biology, he and his colleagues took a virus that had been extinct for hundreds of thousands of years, figured out how the broken parts were originally aligned, and then pieced them together. After resurrecting the virus, the team placed it in human cells and found that their creation did indeed insert itself into the DNA of those cells. They also mixed the virus with cells taken from hamsters and cats. It quickly infected them all, offering the first evidence that the broken parts could once again be made infectious. The experiment could provide vital clues about how viruses like H.I.V. work. Inevitably, though, it also conjures images of Frankenstein’s monster and Jurassic Park.