February 2010
Glenn McGee and American Catholics in Assisted Reproduction Barfight
First published in the St. Louis Post-Dispatch and then the Washington Post, Glenn McGee makes the provocative claim that American Catholics aren't any more likely to follow the most recent edict from the Vatican that Catholics should not use IVF for reproduction than they are heeding admonitions against using birth control.
The statistics say that only 4% of married Catholic couples use natural family planning--so what do you think the rest of them are using? So to extrapolate, what do you think that Catholic couples having trouble with fertility are going to do? Listen to Rome and not have a child or go see a fertility specialist and use reproductive technologies? What do you think?
I think McGee has it right. The teachings of the Church are out of sync with that American Catholics are likely to do--but hey, it's not the first time.
Summer Johnson
The blog.bioethics.net Archive Rises Like a ...
At last we've found a few minutes to assemble the archive of The American Journal of Bioethics Editors' blog through 2007 and publish them in an accessible venue. If you get nostalgic for the days when we translated documents about the Korean stem cell scandal, or those glorious years of the neocon bioethics movement, drop by and shuffle through thousands of posts on every topic in bioethics. Especially the "this didn't really happen, did it?" chapter in the history of bioethics: who can forget, for example, that sunny morning when the President's Commission on Bioethics' chairman lobbied in the Senate Chambers bearing a paper copy of "the Bush 2nd term agenda for bioethics?"
Back then, everyone else had to identify that they weren't an editor, except, um, the editor. The blog posts that are not signed in the archive were authored by yours truly as Editor-in-Chief.
Glenn McGee PhD
Whistleblowers Everywhere Breathe A Sigh of Relief
Texas nurse Anne Mitchell has won a victory for whistleblowers everywhere after being sued under Texas law for reporting the physician she worked for as being malpracticable using confidential information.
He said that she had ruined his reputation, that she was malicious and had inappropriately used records to which she had access. I mean, how dare she? She's a nurse! What is she doing looking through those medical records?
Apparently this doctor wouldn't know a lot about medical ethics and records. He had previously been dinged by the Texas Medical Board in 2007 for $1,000 and "continuing medical education in the area of ethics, medical records and the treatment of obesity."
Mitchell in her letter had claimed a set of 6 additional, more recent violations. She reported his performing a skin graft, other minor surgical procedures and prescribing herbal medications that the doctor sold on the side.
To boot, he has searched her computer to find her anonymous letter and he fired her after her found it.
Ultimately, if you are a physician working at a weight-loss clinic, do you really need to be performing skin grafts? But more than that, if you have already been fined by the Texas Medical Board and have been told you are not qualified to oversee a physician assistants or nurse practitioners and to get ethics training, you'd better be on your best behavior.
Whether this nurse was an "upstart" isn't the point. Neither is whether nurses generally are saints. This case should never have become the referendum on nurses and whistleblowers it was.
This doctor just seemed to be, and has been for sometime, a not very good one--and the fact that someone had the guts to point it out should be applauded. Thank goodness the Texas courts had the good sense to protect this woman regardless of whether she was a nurse or a good person or anything else. Her right, and everyone else's, to protect patients from quackery has prevailed.
Summer Johnson, PhD
Jacob Appel Takes on the Pope
What do you do when you are a Catholic hospital in value conflict? Ignore the Pope or ignore the indigent, the needs of American Catholics for birth control and abortions, and healthcare generally in conflict with the edicts of Rome?
It's a tough call, but according to Jacob Appel today on the Huffington Post the saving grace is that doctors in these hospitals are still bound by the same ethical guidelines regardless of the kind of hospital they are working in, Catholic or not.
And thank goodness, I would really hate to have the Pope governing my healthcare decisions. So if you have to go to a Catholic healthcare institution, be glad that there are medical ethics guidelines for your healthcare professionals.
Summer Johnson, PhD
Do You Know Why Glenn McGee Wants to Live Forever?
Well, your first answer chould be, "Doesn't everyone?"
But if the actual answer is, "I haven't a clue", then click on this link.
McGee, the John B. Francis Chair in Bioethics at the Center for Practical Bioethics, will discuss how science is giving us an opportunity, if not to actually live forever, to live an additional 25, 50, or 100 years in his inaugural lecture on February 24th at 6 PM.
But before you grab for that stem cell smoothie, McGee will ask his audience to grapple with many of the questions, not only of can we but of ought we extend our lives. Questions both for individuals but also for communities that were addressed in the December 2009 issue of AJOB.
To learn more about the lecture or to register to attend, contact the Center for Practical Bioethics.
Summer Johnson, PhD
Caplan: Zealot's Bad Study Leads Autism Community Astray for A Decade
As Arthur Caplan tells us in this week's MSNBC column, one bad study and a zealot's pursuit of a theory can lead an entire movement and entire generation of parents astray. This is, in effect, what Andrew Wakefield did with his now thoroughly debunked theory about the link between MMR vaccines and autism.
To read the column on the web, click here or read it in its entirety below.
Summer Johnson, PhD
How a zealot's word led us astray on autism
A dozen years ago, a British physician named Dr. Andrew Wakefield published a paper in the prestigious medical journal The Lancet that did immeasurable harm to children.
Wakefield, who back in 1998 was working at London's Royal Free Hospital, claimed in the article that the vaccination of 12 children with measles/mumps/rubella (MMR) vaccine had caused a reaction in their bowels that caused autism.
At a press conference shortly after the paper came out, Wakefield urged parents not to give their children the combination vaccine.
The British press went crazy over the report. The word and the fear quickly spread around the world.
Since the controversial paper was published, British parents abandoned the vaccine in droves, leading to a resurgence of measles. Vaccination rates for measles have never recovered, and there are outbreaks of the disease in the U.K. every year.
And across the globe, millions of parents who choose to follow their own doctors' advice and vaccinate their children have had to face the anxiety of an alleged link to a dread disease.
All this despite the fact that no scientists were ever able to replicate Wakefield's findings.
Yesterday, The Lancet, after years of investigations, lawsuits, press complaints and accusations, took the unprecedented step of withdrawing this 12-year-old article as misleading and false.
Why did The Lancet finally act? Because the British board that licenses doctors recently concluded that Wakefield had "shown callous disregard" for the children in his study and had "abused his position of trust" in doing his research. In language I have almost never seen from a disciplinary body, the General Medical Council added that Wakefield acted "dishonestly," was "misleading" and "irresponsible" in the way he described the findings of his tiny study about the danger of MMR vaccine in The Lancet.
As it turns out, for the study Wakefield took blood samples from children at his son's birthday party, paying them 5 pounds each.
The language was probably not strong enough. The Wakefield paper killed children and left others deaf and disabled from preventable diseases as their parents, in an effort to avoid autism, left them unvaccinated.
Vaccination has always had its critics. Using needles to put things into children's bodies has always left some parents uneasy. And the epidemic of autism has left other parents searching for some cause, some agent, some substance that might be to blame.
Vaccination became a prime suspect because it occurs so close to the time at which autism used to be first diagnosed. And Wakefield's paper was all the ammunition anti-vaccinators needed.
Wakefield's study was both tiny and flawed. Nearly all of his 13 other co-authors eventually bailed out on the article. Still, the press could not resist from spreading the scary news over and over again, even though no one could get the same findings as Wakefield did. And Wakefield himself, supported by a fanatical anti-vaccine lobby that to this day cannot let go of the vaccine-autism connection, continued to spread fear of vaccines right up to the time of his disciplinary hearing.
Some will try to portray Wakefield as a martyr, sacrificed for the profits pharmaceutical companies make from vaccines. But the profit from childhood vaccination has always been a very small part of Big Pharma's big profits. The companies still in the childhood vaccine business generally stay there from a sense of duty to the public health not greed.
Wakefield is no martyr. He is a scientist who would not give up on his theory no matter how much evidence accumulated that vaccines are not linked to autism. And that makes him guilty of letting his zealotry blind him to the harm avoiding effective vaccines did to many vulnerable children.
The bitter lessons of the decision to expunge the Wakefield paper from medical history are clear. No single, small study should ever be taken as the basis for a massive change in anyone's behavior when it comes to your health and that of your family. And the desire to find some reason, any reason, for the plague of autism should not blind us to the fact that the evidence clearly shows that vaccination is not the culprit.
