The doctors in the Winnipeg Samuel Golubchuk case are intent on showing his family and society who is boss. Two more have resigned rather than provide care. From the story:

CBC News has learned that two other doctors–Bojan Paunovic and David Easton–have also said they will no longer care for Golubchuk.

“What I can tell you is that there are three critical care doctors who have recently resigned from the [intensive care unit] shift schedule at the Grace Hospital,” said Heidi Graham, spokeswoman for the Winnipeg Regional Health Authority. The WRHA is working with other physicians to ensure the hospital can continue to provide critical care despite the loss of the three doctors, Graham said.

A few thoughts: First, this seems a power play to me–even though I have no doubt that the physicians sincerely believe that maintaining Mr. Golubchuk is the wrong way to go. Second, in their determination, they are, in effect, abandoning other patients in their care. Third, the court is precisely where this case belongs. If wanted life-sustaining treatment is really so egregious that it is torture–rather than merely a matter of a profound disagreement over values–doctors and hospital bioethics committees should have to prove it in an open court with full rights of due process and appeal for the patient/family. Moreover, I think the hospital should pay the legal expenses of the patient/family otherwise it becomes David versus Goliath.

And now, let’s ponder this paradox. The Bioethics and Medical Establishments generally insist on the right to withhold wanted life sustaining treatment based on their views about the quality of the patient’s life and/or the proper use of the resources involved. In contrast, they also insist that doctors and other medical professionals appalled by birth control, Plan B, RU 486, abortion, or (eventually) assisted suicide should not be able to opt out based on their moral principles because patients have a right to these services. Yet, the futile care cases involve life and death while the others usually are elective in the sense that there are not lethal consequences for the denial of services.

In reality, it isn’t a paradox because the medical issues are actually the fronts for the real contest, which is about determining the first principle moral values that will govern general society–as, when I think about it, are many if not most of the issues that we discuss here at SHS.

Using a gene from a magnetically sensitive bacterium, scientists have genetically engineered mammalian cells to produce magnetic nanoparticles. The finding, by a team of Emory University researchers, could give medical researchers a new way to more precisely track cells in the body. (Technology Review)

Is reading someone’s genetic code the same thing as practicing medicine? That issue has always loomed over the nascent direct-to-consumer genetic-testing industry, which includes such well-known names as 23andme, Navigenics, and DeCodeMe. (Wired)

Should doctors be paid extra for doing the right thing? The Hippocratic Oath aside, money goes a long way in coaxing doctors to provide better care — and health insurers are increasingly providing financial incentives that do just that. But while insurers forecast that cash bonuses will improve quality of care and lead to future cost savings, some experts question whether patients will win out in the end. (TIME)

It’s a perfect storm of ethical anxieties: good organs going to bad people; medical professionals (perhaps) on the take; and, not least, a shudder of xenophobia. (Slate)

The new AMA principles call for all medical care outside of the U.S. to be voluntary. They address financial incentives, insurance coverage for care abroad and care coordination. The principles also call for patients to be made aware of their legal rights prior to travel and to have access to physician licensing and facility accreditation information prior to travel. (Earthtimes)

Clinical trials hoping to identify a vaginal microbicide that is both safe and effective against HIV have all but skirted questions befitting the evaluation of an approach intended primarily for sexually active women of childbearing age: What if a woman becomes pregnant while using a product? Can exposure to a product, especially early in pregnancy, pose a risk to the developing fetus? Does pregnancy affect how a particular microbicide is supposed to work? (ScienceDaily)

In a collision of science and demographics, Massachusetts has emerged as the nation’s most prolific producer of twins, triplets, and other multiple births. (The Boston Globe)

The collection of essays, The Ethics of Bioethics, brings together a number of thinkers, including ethicists, legal scholars, and medical practitioners that offer perspectives on the subject of bioethics that are primarily professional, in contrast to the strictly theoretical or what could be loosely categorized as academic perspectives on the subject that tend to dominate the classroom. (Metapsychology)

Bone marrow stem cells are known to possess numerous regenerative properties in humans (clinical trials), including healing of heart attack damaged myocardium, reversing liver failure, and stimulating new blood vessel production in patients with ischemic limbs. Bone marrow stem cells may be mobilized using conventional agents such as G-CSF, or other newer agents such as parathyroid hormone, or some even have reported seaweed extracts. (StemCellPatents)