The American Journal of Bioethics (Volume 8, Issue 3 2008) is now available by subscription only.

Articles include:

“Strangers at the Benchside: Research Ethics Consultation” by Mildred K. Cho;  Sara L. Tobin;  Henry T. Greely;  Jennifer McCormick;  Angie Boyce; David Magnus, 4-13

“Conflicts of Interest in Research Ethics Consultation: Where to Go From Here?” by Bethany Spielman, 17-18

“Even Stranger Still: Moral Experience as a Significant Focus for Research Ethics Consultation” by Stuart G. Finder, 22-23

“From Strangers to Partners: Emerging Forms of Research Ethics Consultation” by Michele A. Carter; Susan S. Night, 29-31

“Review of Regina Herzlinger. Who Killed Health Care? America’s $2 Trillion Medical Problem– and the Consumer-Driven Cure.” by Ross S. White, 67-68

Good news and bad news. An Australian jury has convicted two women who killed an Alzheimer’s patient. From the story:

The Sydney jury found Shirley Justins guilty of manslaughter and Caren Jenning guilty of being an accessory to manslaughter for the euthanasia drug death of former Qantas pilot Graeme Wylie…Justins pleaded guilty to aiding and abetting suicide early in the trial, and said Wylie was desperate to die before his dementia got worse. Jenning also told the jury she was motivated by mercy in travelling to Mexico to obtain the Nembutal for Wylie, who was one of her oldest friends.

Normally, such a defense melts hearts and juries–caught up in the “quality of life” ethos of our age–often will not convict. And that brings us to the bad news:

Apparently the women had a financial incentive for the deaths:One week before his overdose, Wylie drew up a new will leaving all but $200,000 of his $2.4 million estate to Justins.

The previous will had left 50 per cent to Justins and split the remaining half evenly between his two daughters, Tania Shakespeare and Nicola Dumbrell. Prosecutor Mark Tedeschi QC told the jury Justins was motivated by a desire to secure her financial future, and either deliberately killed Wylie or let him take the drug Nembutal and was indifferent to the fatal consequences.

Sadly, I believe that but for this proof, the case might never have been brought.

Predictably, the death on demand advocate Philip Nitschke was appoplectic:

Euthanasia campaigner Phillip Nitschke is advising Alzheimer’s sufferers against getting tested for the disease, after two women were convicted over the drug death of a dementia sufferer.

To Nitschke, nothing comes before the euthanasia agenda–not even obtaining proper medical care. Yet, he remains a hero of the international movement and a darling of the Australian media.

Little noted, but hopefully long remembered, the Congress passed and President Bush recently signed, the Genetic Information Non Discrimination Act of 2008. Given the ability now to quickly test the genetic makeup of each and every one of us–with or without permission–doing our best to make sure that the information thereby gained isn’t abused is a matter of some urgent concern.

Little has been reported about the contents of the bill. Now, a helpful article in the New England Journal of Medicine tells us what is included–and what isn’t. From the article:

What GINA does:

- Prohibits group and individual health insurers from using a person’s genetic information in determining eligibility or premiums
- Prohibits an insurer from requesting or requiring that a person undergo a genetic test
- Prohibits employers from using a person’s genetic information in making employment decisions such as hiring, firing, job assignments, or any other terms of employment
- Prohibits employers from requesting, requiring, or purchasing genetic information about persons or their family members…

What GINA does not do:

- Does not prevent health care providers from recommending genetic tests to their patients
- Does not mandate coverage for any particular test or treatment
- Does not prohibit medical underwriting based on current health status
- Does not cover life, disability, or long-term-care insurance
- Does not apply to members of the military

Yes, there will be litigation, which I abhor. (That might sound funny coming from a lawyer but there is a reason I don’t do that much anymore.) Alas, since we can’t count on the goodwill of men, the new law seems the best way to ensure that the intimate information that can now be obtained from–and thanks to the Internet made available to–all is not used as a weapon against those with some genetic propensity to an illness or disability. Since that undoubtedly includes every single one of us, this new law should help protect us all from being discriminated against because our genes are deemed not up to snuff.

Worry: The bill apparently says nothing about medical discrimination, i.e. imposing rationing or futile care treatment limitations based on likely medical outcomes as seen in the gene crystal ball.

The High Court in Cape Town has ruled that two doctors cannot continue to carry out unauthorised clinical trials of vitamins for HIV/AIDS in South Africa. (SciDev)

14 Member Organisations of the European Science Foundation have launched a key initiative to keep Europe at the forefront of regenerative medicine; broadly defined as the development of stem cell therapies to restore lost, damaged, or ageing cells and tissues in the human body. (PhysOrg)

New Zealand parents involved in IVF programs could soon be allowed to choose the sex of their child if the government follows the advice of its Bioethics Council. (The Age)

On the heels of its ruling on same-sex marriage, California’s highest court will decide another potentially landmark civil rights case: whether doctors can refuse to treat certain patients for religious reasons. (Washington Post)

A government-sponsored survey of the use of computerized patient records by doctors points to two seemingly contradictory conclusions, and a health care system at odds with itself. (New York Times)

Last Monday, the state’s laboratory field services group issued 13 cease-and-desist letters to genetic testing companies. Wired.com obtained a copy of the letters (pdf.) from two recipients. And the tough talk in a recent teleconference among regulatory officials confirms the seriousness of the department’s intent. (Wired)

Scientists claim they have cured advanced skin cancer for the first time using the patient’s own cells cloned outside the body. (BBC)

The U.S. has five-star rankings for restaurants and hotels. So why not five-star rankings for nursing homes? (AP)

Could pig-to-human transplants revolutionize medicine? a report on the promises, risks and controversy. (FRONTLINE)

Whether a Republican or Democrat moves into the White House in January, opponents of embryonic stem cell research will be out in the cold for the first time in nearly a decade.
(STLtoday)