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April 18, 2014

Cost of Treating Patients May Influence Doctors

(New York Times) – Saying they can no longer ignore the rising prices of health care, some of the most influential medical groups in the nation are recommending that doctors weigh the costs, not just the effectiveness of treatments, as they make decisions about patient care. The shift, little noticed outside the medical establishment but already controversial inside it, suggests that doctors are starting to redefine their roles, from being concerned exclusively about individual patients to exerting influence on how health care dollars are spent.

Preterm Births, Multiples, and Fertility Treatment

(Science Codex) – While it is well known that fertility treatments are the leading cause of increases in multiple gestations and that multiples are at elevated risk of premature birth, these results are not inevitable, concludes an article in Fertility and Sterility. The article identifies six changes in policy and practice that can reduce the odds of multiple births and prematurity, including expanding insurance coverage for in vitro fertilization (IVF) and improving doctor-patient communications about the risks associated with twins.

Research Brings Significant Improvement in Genetic Analysis of Tumors

(Medical Xpress) – Every tumour is unique and requires specific treatment. A thorough and complete analysis of the genetic activity in the tumour cells is necessary to determine the appropriate treatment. Researchers at TU Delft, in collaboration with researchers from Columbia University and the Antoni van Leeuwenhoek Hospital have achieved significant improvements in this type of analysis. The results were published on 4 and 10 April in the scientific journals PNAS and PLOS Genetics.

April 17, 2014

A Fine Balance: Disability, Discrimination, and Public Safety

(The Conversation) – A recent discrimination case has highlighted the difficulty of balancing the rights of disabled medical students with the rights of the community to safe medical and health care. In the BKY v The University of Newcastle, a New South Wales tribunal found the university had discriminated against a medical student by refusing her an extension to complete the five-year medical course beyond the usual maximum of eight years.

Should Drug Firms Make Payments to Doctors?

(BBC) – Gifts and payments to US doctors from drug firms are seen by some as encouraging unnecessary prescriptions. Do such transfers make any difference and will President Obama’s healthcare reform help, by forcing companies to disclose them? Prescribe enough drugs and – as detailed in 1974 Senate hearings – a doctor could accumulate points to exchange for a wide range of consumer desirables – colour TVs, watches, microwave ovens, lawnmowers, golf clubs.

For Diabetics, Health Risks Fall Sharply

(New York Times) – Federal researchers on Wednesday reported the first broad national picture of progress against some of the most devastating complications of diabetes, which affects millions of Americans, finding that rates of heart attacks, strokes, kidney failure and amputations fell sharply over the past two decades. The biggest declines were in the rates of heart attacks and deaths from high blood sugar, which dropped by more than 60 percent from 1990 to 2010, the period studied.

Former Hospital Technician Behind Bogus Mammogram Results Gets Jail Time

(CNN) – A former Georgia hospital technician was sentenced to up to six months in prison after pleading guilty to manipulating the mammogram records of 1,289 patients. Ten of those women were given false negatives, and two of them are now dead, a prosecutor says. Rachael Rapraeger told the patients at Perry Hospital that their mammograms yielded negative results when a doctor had never reviewed them, according to court documents.

Stem-Cell Treatment for Blindness Moving through Patient Testing

(MIT Technology Review) – A new treatment for macular degeneration is close to the next stage of human testing—a noteworthy event not just for the millions of patients it could help, but for its potential to become the first therapy based on embryonic stem cells. This year, the Boston-area company Advanced Cell Technology plans to move its stem-cell treatment for two forms of vision loss into advanced human trials. The company has already reported that the treatment is, although a full report of the results from the early, safety-focused testing has yet to be published. The planned trials will test whether it is effective.

April 16, 2014

UK ‘Has Fewer Hospital Beds Per Person Than Most European Countries’

(The Guardian) – There are fewer hospital beds per person in Britain than most other European countries, with less than half the number of many, a report has found. According to the Organisation for Economic Co-operation and Development (OECD), the UK had three hospital beds per 1,000 people in 2011, with Ireland having the same number. This was far behind the majority of other countries on the continent, with Germany having 8.3 per 1,000 people, Austria 7.7, Hungary 7.2, Czech Republic 6.8 and Poland 6.6.

PET Scans Offer Clues on Vegetative States

(New York Times) – A new study has found that PET scans may help answer these wrenching questions. It found that a significant number of people labeled vegetative had received an incorrect diagnosis and actually had some degree of consciousness and the potential to improve. Previous studies using electroencephalogram machines and M.R.I. scanners have also found signs of consciousness in supposedly vegetative patients.

Scientists Embark on Unprecedented Effort to Connect Millions of Patient Medical Records

(Washington Post) – Inside an otherwise ordinary office building in lower Manhattan, government-funded scientists have begun collecting and connecting together terabytes of patient medical records in what may be one of the most radical projects in health care ever attempted. The data — from every patient treated at one of New York’s major hospital centers over the past few years — include some of the most intimate details of a life. Vital signs. Diagnoses and conditions. Results of blood tests, X-rays, MRI scans. Surgeries. Insurance claims. And in some cases, links to genetic samples.

Popping a Polypill Makes Treating Heart Disease Easier

(New Scientist) – Taking all your heart drugs in one combined pill appears to work as well as taking them individually. This is the upshot of the largest systematic review so far of “polypills” designed to treat cardiovascular disease. Polypills can combine up to five different medications – including statins, aspirin and drugs that lower blood pressure – in a single tablet. Proponents of the combined pill hope it will reduce the number of deaths from cardiac problems by tackling multiple disease components at once and reducing the number of pills that people have to take.

The Changing Legal Climate for Physician Aid in Dying

(JAMA) – While once widely rejected as a health care option, physician aid in dying is receiving increased recognition as a response to the suffering of patients at the end of life. With aid in dying, a physician writes a prescription for life-ending medication for an eligible patient. Following the recommendation of the American Public Health Association, the term aid in dying rather than “assisted suicide” is used to describe the practice. In this Viewpoint, we describe the changing legal climate for physician aid in dying occurring in several states.

New Video Highlights the Need for a Plan When It Comes to Incidental Findings

(Bioethics.gov) – The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has posted its latest video, in which Commission Members discuss their report Anticipate and Communicate: Ethical Management of Incidental and Secondary Findings in the Clinical, Research, and Direct-to-Consumer Contexts. In the three minute piece, Members highlight the essential message of the report on the ethical management of incidental findings across contexts: the importance of practitioners—including clinicians, researchers, and direct-to-consumer (DTC) companies—having a plan to anticipate and manage incidental findings.

Event: Summer Seminar in Health Care Ethics

The Department of Bioethics & Humanities at Washington School of Medicine
27th Annual Summer Seminar in Health Care Ethics
Seattle, Washington
August 4 – 8, 2014

See here for more information.

April 15, 2014

3-D printing is revolutionizing surgery

(Crain’s) Reaching into a beat-up, red-and-white cooler lined with a white terry-cloth towel, Dr. Matthew Bramlet pulls out a replica of an infant’s heart. The size of a small pear and chalky to the touch, the model was made in a 3-D printer. Last spring, Dr. Bramlet, 38, a pediatric cardiologist at Children’s Hospital of Illinois in Peoria, commissioned it from the hospital’s new innovation lab while planning surgery for a girl with a congenital heart defect.

GlaxoSmithKline Faces Bribery Allegations in Poland

(The Guardian) – GlaxoSmithKline has been accused of bribing doctors to prescribe its medicines in Europe. The UK-based drug company, which has faced claims of corruption in China and Iraq, has been accused over its alleged behaviour in Poland. A former sales representative for the company told the BBC’s Panorama programme, which airs on Monday night, that reps paid doctors to boost prescriptions there.

Blood Type Influences Prostate Cancer Relapse, Study Shows

(The Telegraph) – A man’s blood group has been shown to significantly influence the chance that prostate cancer will return after successful surgery. Men with group O blood are far less likely to suffer a recurrence of the disease following surgical intervention. By contrast, men with blood group A were shown by new research to be 35% more likely to fall victim to the disease again, even after surgery.

I’d Seen Dementia’s Toll on My Patients. Now I Was Watching the Disease Unravel My Family.

(Washington Post) – As a geriatric psychiatrist, I understood the devastating toll dementia could take on an entire family. I had urged my mother-in-law to seek care early, which she had done, so she knew her options included activities to stay socially engaged, medication to slow the illness and possibly experimental treatment. But on a personal level, I was worried about my father-in-law, my wife, her siblings and myself. We would be my mother-in-law’s caregivers for the rest of her life. She was 76; my father-in-law was 79.

How Flesh-Eating Strep Bacteria Evolved into an Epidemic

(Wired) – Bacteria aren’t kind enough to leave behind a fossil record (save for cyanobacteria), but they’re evolving fast. Really fast. Their short life cycles mean that generations come rapid-fire, adapting through natural selection into the monster pathogens that are currently shrugging off our finest antibiotics. It’s all the more troubling when we’re dealing with the flesh-eating variety. A new study, published today in the Proceedings of the National Academy of Sciences, details the evolution of one such bacteria, group A Streptococcus. By charting its evolution, scientists hope to gain invaluable insights into tackling subsequent generations of these menaces, and to begin to better understand the very nature of epidemics.

April 14, 2014

Phase 1 Trial for ALS Results of Novel Stem-Cell Therapy Presented by Neuralstem Representative

(Bio News Texas) – Neuralstem, a company that specializes in producing commercial quantities of neural stem cells of the brain and spinal cord, publicly presented the findings of their Phase 1 clinical trial involving amyotrophic lateral sclerosis (ALS) at the Keystone Symposia “Engineering Cell Fate and Function,” occurring April 6-11 in Olympic Valley, California. Results were published in Annals of Neurology in mid-March, but principal investigator Eva Feldman, PhD, MD, discussed the results of Neuralstem’s NSI-566 stem cell trial in ALS during a workshop on “Clinical Progress for Stem Cell Therapies” at the symposia.

 

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