All Sorts of NY Times Stuff: Autism, Clinical Trials, Tsunami

The NY Times reported this week that many with autism have essentially adopted the argument of those with Downs who make the claim that theirs is a different form of human life and experience, rather than a disability, syndrome or disease. Now they cover the absence of real evidence on what cures autism, if anything, and the meaning of that absence for patients and the health professions. Getting treatment for autism is increasingly difficult, because insurers do not want to pay, and the burden on siblings is more profound that has been realized. Each of these articles will be helpful for anyone dealing either with autism or with the more general issues in the ethics of just distribution of health care.

One piece on the Celebrex, Vioxx, Aleve problems and their implications for public perception of the FDA.

Are physicians boring? Like this needed an article.

NY Times covers medical relief efforts in the aftermath of the incredible tsunami devastation. This piece itemizes the hurdles that physicians and other health relief forces will face. Among the most significant distribution issues is one that involves the general inability of international and national groups in healthcare to work together or to do their own logistics:

The aim is to avoid much of the competition and lack of coordination that have hampered the response of governments and private organizations to earlier catastrophes, Robert Holden, a member of the command center team, said in a telephone interview. In responding to the tsunami in South and Southeast Asia, he said: "The biggest problem is ensuring that those who survived continue to survive and provide the materials they need. We must avoid creating a secondary disaster because we can't get the necessary materials through."

Denise Grady writes about the lives of five people enrolled in different clinical trials. This piece should be used by anyone teaching research ethics to clinicians.

Organ Transplants - a 50 Year Look Back

From the New York Times.

Bioethics and the New York Mets

Dan Brock of Harvard is in the New York Times discussing the NY Mets. Seriously.

Preparing to Use Medical Marijuana?

NY Times' coverage of the Supreme Court deliberations and the context of the case, which we have already blogged to death, is pretty good, but the constitutional subtlety is mind numbing, as seen in this Christian Science Monitor piece. Hey, cut to the chase: here's the Marijuana Policy Project briefing, this is a link to the IOM report, and this is what the Court said on this matter the last time the Bush administration came knocking.

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.

The FDA's Darkest Days Are Here

FDA Is Flexing Less Muscle, write Marc Kaufman and Brooke Masters in this major page one story on the FDA. The gist:

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.

Today the New York Times joins in the page one coverage

: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.

Is TennCare a Dragon that Eats Everything?

Medpundit reviews the evidence that Tennessee's bold medicaid experiment has failed. But either way, the New York Times says it is probably dead.

A First Federal Step into Evidence Based Medicine

New York Times' Gina Kolata argues that Medicare's new policy of requiring evidence of efficacy for any new or expensive care for recipients amounts to a huge step into evidence based medicine. While she does not put the move into international context, it will be interesting to see scholars do so. Kolata's take is that this is a big move overall:

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?

Retail Giant Wal-Mart's Health Insurance Scrutinized

The New York Times reports that they are under fire for leaving too many employees without benefits-based health insurance coverage. The impact on state budgets is discussed as is the Wal-Mart response.

A Permanent Ethics Panel on Vaccines at CDC

This is huge news for bioethics. If you've been wondering whether there will ever be a federal-level bioethics group with real teeth, many will tell you that this will be the one: The New York Times is reporting today that CDC has taken its most significant step ever into bioethics, creating a permanent panel on ethical issues in vaccine distribution. Senior scholars abound, including longtime CDC bioethics consultant and Yale fixture Robert Levine, John Arras, Tom Beauchamp, and Emory's Kathy Kinlaw. Great comments here from Arras.

Caplan & NYT on Flu Shot "Public Health Disaster"

From the MSNBC column. Chris Mooney posts the New York Times review of the facts about the whole flu vaccine problem, which is also must-reading.

From MCW - Drafting Docs

Will President Bush begin drafting physicians and under what circumstances? James Hughes posted this NYT piece at MCW-B/E.

Better Performances Through Chemistry

The New York Times reports in its Sunday "Arts and Leisure" Section about classical musicians using drugs to calm fears before performances. It has been an open secret for some time that doctors prescribe beta-blockers, as well as other drugs, to quell performance anxiety. This article reports that, in the classical music world at least, its use is ubiquitous. Some doctors have prescribed one-time use for nervous grooms or people scared to fly; but should they be routinely used by performers who find their calming effect improves their performance?

Implantable Chip to Store Health Records

The New York Times announced a new implantable 'Identity Badge' chip for health care that goes under the skin. It is about the size of a grain of rice and can hold your health care records. Interestingly, it is not only the usual objections of surveillance and privacy that the paper writes about, but also the fundamentalist Christian worry that it could be the "mark fo the beast" warned about in the Book of Revelation.

Face Transplantation

The New York Times has devoted an essay in its health section today to The American Journal of Bioethics Target Article on Face Transplantation. The story has, Taylor & Francis tells us, been front page news in - get this - more than 800 newspapers worldwide. The Times piece, though, is the first significant mass media editorial on face transplantation and it puts a bioethics journal squarely into the mix. We're pretty happy about that. It is all the more rewarding that the exchange comes from our friends at Hastings Center!

Derrida Dead

The "father of deconstructionism" has died of cancer at age 74, and an obituary in The New York Times filed today is just the beginning of what will likely become a more mainstream appraisal of the significance of his work.

Times Follows End of Life Cases

What keeps thisNew York Times piece on clinical and moral interventions at the end of life from degenerating into an "also-Schiavo" piece is that it really reads like a set of cases where bioethics conversations are both necessary and effective. Jessica Berg of Case (and our new Book Review editor along with Mark Aulision) comments.

UPDATE: NYT on Cloning and First Amendment

Brian Alexander, one of the best of the "bioethics essayists" to emerge in the past five years, helps the Times' Magazine make a first foray by a newspaper into one of the more interesting questions concerning current and pending laws governing both cloning and embryo research: could they survive an appellate court review? Is it unconstitutional (or wrong) to restrict scientific experimentation on the grounds that such a restriction violates freedom of expression? Brian quotes Robertson, Kass and Sunstein on the analogy between experimentation and reporting. Brian tells us the Times' editors cut his interview with Lori Andrews on her great work on the specific issue of the constitutionality of cloning per se. I wondered about why the piece didn't mention the important FDA policy prohibiting cloning that aims at gestation; Brian says the editors cut that too.