June 2010
AJOB Primary Research Launches with TWO Issues At Once!
The American Journal of Bioethics is proud to announce the "birth" of its second spin-off journal, AJOB Primary Research.
This newest AJOB journal has launched with two issues arriving online at once! Volume 1, Issue 1 contains 6 original empirical research articles from researchers around the globe as well as an editorial by Dr. Alexander Kon and a blog review by Dr. Summer Johnson.
Volume 1, Issue 2 begins with an editorial by Paul S. Appelbaum entitled "Understanding Understanding" and is followed by 5 original research articles on topics ranging from pharmacist conscientious objection, religion and genetics and genomics, understanding informed consent, and the impact of written policies on euthanasia in the Netherlands.
Congratulations to the entire AJOB team on this outstanding accomplishment and these fantastic two new issues.
Summer Johnson, PhD
July Arrives Early for AJOB!
The July issue of The American Journal of Bioethics arrives early with three fascinating articles--two about sex (one the biological kind, the other the active kind) and the other about transhumanism.
First, in an editorial by yours truly, Disaster in the Gulf: Public Health and Public Responsibility, I ask about the public and moral responsibility for the protection of public health in the Gulf. While this may seem like an obvious moral issue now, when this article was penned more than a month ago and the magnitude of this oil spill was not nearly so great, the responsibility for and implications of this disaster were much less clear. Now, sadly, they are obvious, but no less relevant.
The first Target Article by Robert Sparrow asks the provocative question whether the human species would be enhanced if all of its members were biologically female, or put another way, whether we gain anything via sexual reproduction and leaving our XX or XY's to chance.
The second article by Timothy Murphy explores new ethical territory in research ethics asking us to question the morality of researchers having sexual relationships with research subjects.
In the final article of the set, the moral status of transhumanists is questioned and in particular whether the traditional concept of human dignity applies.
Take a look at these articles on bioethics.net. It is a stellar issue, if I say so myself!
Summer Johnson, PhD
New Website is Match.com for Your Genes
Before I even describe the services purportedly offered by BeautifulPeople.com, let me quote Art Caplan who has summed it up better (characteristically so) than anyone else could: "It's pure, utter nonsensical baloney, at best." Oh, and he also said it's bad for society and is clearly a form of eugenics.
That said, it's also hilarious and fascinating hucksterism at its finest. Despite their URL, BeautifulPeople.com will match those less attractive specimens of the human species as well with single women and those offering fertility services to couples and singles who are looking for ways to reproduce.
Apparently this site isn't new, however. Over the last 8 years, BeautifulPeople.com has accumulated 600,000 members from 190 countries. But it is the forum section of its website that is perhaps its most controversial for its ability to "hook up" service providers, gamete donors, surrogates and others without any oversight (of course, just like the rest of the assisted reproduction world) at all.
But what is most disturbing about this website is their purported philosophy about both the beautiful and non-beautiful alike: "Initially, we hesitated to widen the offering to non-beautiful people....But everyone -- including ugly people -- would like to bring good-looking children into the world, and we can't be selfish with our attractive gene pool." How charitable. At least no one can accuse them of being beautiful gene hoarders.
But one can accuse them of being discriminatory. Apparently, in an effort to keep their genetic gene pool as full of beautiful people as possible, the site recently culled 5,000 members who gained weight, says AOL. I mean, come on, what if obesity is more genetic than we currently know? BeautifulPeople.com would not want to be responsible for cute, but chubby offspring, now would it?
Of course, the entire notion that the genetic material of beautiful people could somehow be responsible for the production of more beautiful people is about as scientifically reliable as getting genetic material from Nobel Prize winning sperm or Ivy League egg donors. (It's not.)
This website feeds on our society's desperate need to be (or at least feel) beautiful and the (false) belief that the right genetic combination will guarantee that for one's children.
As Caplan so aptly put it, this website "builds the myth that beauty is gene deep." Moreover, the belief that beauty is determined by genetics doesn't hold up, says Caplan. "A lot of attractiveness is determined by the cosmetics industry, surgery, the fashion industry and money. Genes are pretty far down on the list."
So what is a prospective parent to do if they want a beautiful child? Get a grip. Realize that becoming a parent is not about your own selfish desires and instead is about creating a family and loving that child regardless of how high their cheekbones are or their weight or their hair color. (And as their parent, you will have the rest of their life to impose your own screwed up notions of beauty and body image upon them, so why not just leave their genetics alone?)
Summer Johnson, PhD
NY State to Presume Consent For Organs?
NY State will presume consent for organ donation, that is, if Assemblyman Richard Brodsky gets his way. Acknowledging that the demand for transplantable organs vastly outstrips supply and the fact that presumed consent works in other European nations, Brodsky has proposed that the default would be that all New Yorkers would donate their organs upon their death unless they were to check a box "opting out" on their driver's license registration form.
This, in combination with legislation promoting better education about organ donation, is hoped to increase the number of donors in a state where just 13% of residents agree to donate.
While many oppose presumed consent, I would argue that in lieu of a better alternative to increase the number of cadaveric organs available for donation limited implementation of such a policy (perhaps in just a few counties for a 2 year period) with significant amounts of public consultation would iron out any kinks in such a proposal and prevent any major problems that opponents of presumed consent note (namely that unaware or uninformed citizens would end up donating organs by default against their wishes).
Until we can make organs in a dish or our need for organs for transplant is reduced, some policy solution must exist. This one is a good one that we know works in other contexts--the key for New York will be its implementation, community consultation, and citizen buy-in, if the legislation is ever passed.
Summer Johnson, PhD
Consent for "Docu-Medical" Shows Doesn't Make It Okay
I will confess that the commercial for the new ABC medical documentary drama, "Boston Med", had me thinking, "Gosh, I kinda want to see that." Then I really hated myself, for about 30 seconds.
Then I moved on with the rest of my life. Until I read The Boston Globe article featuring the 8 part television event, I hadn't really considered it to be much more than another hyping of the medical profession, another example of American's obsession with good looking doctors and nurses in scrubs in the vein of Gray's Anatomy and the like.
But in fact, this show is likely to be different--not just because it films real patients at three Boston hospitals. But because it picks the most extreme cases and acts as though this is medicine. It will make Americans believe that House M.D. is in fact how every day medicine is practiced. Out of eight hours of TV drama America will see: a double-lung transplant, a face transplant (AJOB style), pediatric heart surgery.
What happened to primary care? Oh, I forgot--runny noses and flu shots don't make very good television.
But that is precisely the problem. By glamorizing the highest tech, highest cost, highest drama health care in this country, Americans think that this is the most important kind of health care, the care to which they are entitled, the care that we all would be lost without.
I am glad that George Annas and Art Caplan have alerted us to the ethical problems for the patients and physicians who actually participate in the shows themselves, but I am much less concerned with whether a patient actually gave their full and free informed consent to be on an hour of prime-time television than the message that this hour of prime-time television conveys to millions of Americans.
If just one PSA could run during each commercial break during "Boston Med" that told viewers the cost of a face transplant and how many primary care visits just one of those procedures could provide uninsured Americans or if information about healthcare reform could be put at the end of every single episode, perhaps some of the damage of this sensational show could be undone.
House M.D. has already given us a sense that every test and every procedure can and ought to be done in American hospitals and it is my fear that Boston Med will just be just another instrument playing in that same band.
Summer Johnson, PhD
Kagan on Bioethics
Hat tip to Business Week for shedding some light on U.S. Supreme Court nominee Elena Kegan's views on bioethics.
Here's the rundown:
She's pro-physician assisted suicide and opposed proposals to ban it in 1997 and has said the DEA lacks the power to penalize physicians who give life-ending drug to patients.
She's "skeptical" about the use of medical marijuana--but only because there isn't enough data to support it.
She opposed banning the creation of human embryos for research.
All things considered, Kagan is about as liberal as they come when it comes to bioethics. I wonder what she thinks about Craig Venter?
Summer Johnson, PhD
