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February 28, 2006

One Step Forward, Two Steps Back?

One of the things that hinders progress in addressing the challenge of 45 million uninsured in our country is the possibility of making things worse rather than better. Currently, the charge is that the new Medicare prescription drug program has done just that. USA Today briefly reviews one doctor’s effort to continue his patient’s medication. And Reuters provides a brief overview of the ways various states stepped in to help citizens who experienced problems with the federal program. Doubtless, some of the 45 million uninsured have made a conscious decision to forego coverage, but for those who seek coverage, programs put in place to address current shortcomings must be carefully thought through. In short, we need more dialogue about how best to address questions of resource allocation and access to healthcare.

Cases

On Tuesdays, The New York Times runs the “Cases” column in which a physician shares a bit of their personal experience. The column is insightful for those of us who are not physicians but have a keen interest in doctor-patient relationship. This week’s edition chronicles one physician’s realization that “Even the Whiners Sometimes Get Sick.”

Bioethics in the News — February 28, 2006

  • Medicare Red Tape Snares Drugs (USA Today)
  • US States to Recoup Costs of Medicare Drug Glitches (Reuters)
  • Doctors Take Note: Even the Whiners Sometimes Get Sick (New York Times)
  • Confusing Studies Don’t Alter Health Advice
    (AP)
  • Stigma Still Shadows Psychiatric Care (HealthDay)
  • February 27, 2006

    Bioethics in the News — February 27, 2006

    California Stem Cell Institute Trial Starts Today (via Los Angeles Times)

    Three groups (People’s Advocate, National Tax Limitation Foundation, California Family Bioethics Council) filed two lawsuits, which have been combined into a single trial, asserting that the lack of direct state control over the Institute for Regenerative Science established by Proposition 71 is an unconstitutional use of public funds. The Attorney General and the Institute claim that Proposition 71 amended the state constitution to allow for this. The courts are going to attempt to sort it all out. Stay tuned.

    The expression of an unpleasant or embarrassing notion by a more inoffensive substitute (via Yahoo! News)

    John Leo writes an interesting opinion piece on the ways in which language is altered in order to mask what is really being said. He gives a variety of examples, some humorous, some confusing, some sad. Eventually, he zeros in on bioethics.

    The language game requires players to insert a strong negative word for what your opponent wants (e.g., the death tax) and eliminate similar hot-button words used on your side. Just as “abortion” has virtually disappeared from the names and language of abortion-rights groups, the word “embryo” is fading from the vocabulary of those who favor “embryonic stem-cell research.” Since polls show that the public reacts negatively to the news that minute human embryos are created and destroyed in the research, the media now speak of “early stem cells.” The troubling word “cloning” is fading too; “therapeutic cloning” is replaced by its technical term, “somatic cell nuclear transfer.”

    While the title of the column is “Evasive Language Results In Suboptimal Outcomes,” Leo does not give a clear explanation of how it is that euphemisms yield bad results. Perhaps he believes the relationship is obvious. We all want to understand and be understood, yet some are willing to sacrifice clear communication in the pursuit of unfettered science. Leo’s bioethics example is case in point.

    Fascinating Neuroethics Item (via BBC )

    Scientists at the University College London have discovered that brain activity prior to an event effects memories formed of the event. Researchers used EEG to monitor the brains of volunteers while somehow cueing them and then showing them items. Later the volunteers were tested on their memories of the items. The EEG revealed patterns to the activity in the brain just before items were shown and how well volunteers remembered the items. Research continues on the link between this pre-activity and long-term memory formation.

    Quick Links and Other News Items of Interest

    Stem-Cell Institute Trial to Begin Today (Los Angeles Times)
    Evasive Language Results In Suboptimal Outcomes (Yahoo! News)
    Scientists ‘Can Predict Memories’ (BBC)
    Healing in the Lap of Luxury (HealthDay)

    February 24, 2006

    Bioethics in the News – Friday, February 24, 2006

    FDA Balancing Act (via The Wall Street Journal)

    The FDA will soon debate the question “Should a promising drug that carries a known and deadly side effect still be allowed on the market?” The drug in question, Tysabri, a drug to treat MS, was taken off the market last year after three people contracted a brain infection (two of the patients died). The Wall Street Journal does a good job of teasing out the issues the FDA will consider as it tries to find a balance between benefits and risks.

    European Medicines Agency Balancing Act (via BBC)

    A U.S. company that developed a genetically modified goat that produces an anti-clotting protein in its milk has been denied an application for the medication. The drug, Atryn, would have been the first produced from a genetically modified animal, according to the BBC. In short, “The European Medicines Agency said the company applying for the licence had failed to demonstrate the benefits of the drug outweighed its risks.”

    World’s Largest Retailer to Improve Employee Health Benefits (via Los Angeles Times)

    H. Lee Scott Jr., CEO of Wal-Mart Stores, Inc., is set to give a speech to the National Governor’s Association Meeting in Washington, D.C., on Sunday in which he will outline plans to improve employee health benefits. Key changes include an expansion of the value plan health insurance option ($11-$20/mo), shortening the amount of time part-time employees will have to wait to buy into the insurance program (currently 2 years), allowing part-time employees to buy health insurance for their children, and opening clinics in stores. Wal-Mart has 1.4 million employees in the United States, and “this week reported annual profit of $11.2 billion on $312 billion in sales.” Wal-Mart already has a track record of moving employees off of Medicaid—according to a spokesperson: “Seven percent of associates join Wal-Mart already on Medicaid. Within two years, that number drops to 3%.” These new initiatives, surely, are another step in the right direction.

    Quick Links and Other News Items of Interest

    Tricky FDA Debate: Should a Risky Drug Be Approved Again? (Wall Street Journal)
    ‘Pharmed’ Goat Drug not Approved (BBC)
    Wal-Mart Says It Will Boost Health Benefits (Los Angeles Times)
    Kidney-Swap Couples Doing Well (Chicago Tribune)

    February 23, 2006

    Bioethics in the News – Thursday, February 23, 2006

    Fake Findings Used to Secure $16M Grant (via Pittsburg Tribune Review)

    University of Pittsburgh scientist Gerald Schatten received a $16.1 million, 5-year grant from the National Institutes of Health based largely on the now discredited South Korean cloning research. The grant is to fund cloning and embryonic stem cell experiments in monkeys and with existing federally approved stem cell lines. The work is to take place at the Magee-Womens Research Institute, which is currently under construction in Oakland, California. The future of the grant is uncertain given the recent developments in the world of cloning, but serious questions need to be examined before public monies are spent. The Pittsburg Tribune Review has done a public service by obtaining the grant application documents through a Freedom of Information Act request and bringing attention to the matter.

    Innovation in Healthcare Cost Evaluation (via New York Times)

    With much talk of health insurance moving toward Health Savings Accounts (HSAs) and other systems that would shift some if not most of the responsibility for evaluating the costs of healthcare to consumers, website WebMD is positioning itself to be a resource for those evaluations.

    WebMD says it has signed contracts with big health insurers and employers to operate private-access sites where employees can keep track of their medical records, look up information about diseases and compare costs and ratings for doctors and hospitals.

    In principle, the competition these kinds of entrepreneurial ideas bring can help the kind of transition that HSAs represent, but great care is necessary to ensure that present inequities are not perpetuated due to a lack of access to or familiarity with computers or the internet. Perhaps this is but one of many innovations that can bring good information to patients.

    Quick Links and Other News Items of Interest

    Fake Findings Used to Secure $16M Grant (via Pittsburg Tribune Review)
    WebMD Wants to Go Beyond Information (New York Times)
    ‘Pharmed’ goats seek drug licence (BBC)
    S.D. Abortion Bill Takes Aim at ‘Roe’ (Washington Post)
    Twins More Likely for Older Mums (BBC)
    Twins Nation (Chicago Tribune)

    February 22, 2006

    Bioethics in the News – Wednesday, February 22, 2006

    Transparency Vital in Clinical Trials (Wall Street Journal [subscription required])

    Pharmaceutical company Northfield Laboratories is currently running a clinical trial of a blood substitute called PlyHeme. The Wall Street Journal (subscription required) raises questions about the fact that an earlier trial was halted and the results were never published (81 people received the substitute, 10 had heart attacks, 2 of whom died). The search for a suitable blood substitute has been going on since at least the 1960s, according to the article, and such a product would bring a host of benefits. Due to the condition of patients who would be the best candidates for treatment (i.e., severe trauma), informed consent is difficult if not impossible to obtain. The FDA has therefore required Northfield to conduct community awareness campaigns about the trial in areas where it is being conducted. However, “Several hospitals have told community meetings that previous trials showed PolyHeme to be safe, failing to mention the 10 heart attacks in their printed materials.” Northfield believes that other factors are responsible for the adverse results. It is vital that clinical trials be as transparent as possible about their associated risks. A more transparent process would have been to disclose the previous adverse results and explain the reasoning behind why they may have occurred.

    Economic Misdiagnosis? (via New York Times)

    According to the New York Times, “doctors seriously misdiagnose fatal illnesses about 20 percent of the time,” and that “rate has not really changed since the 1930′s.” One reason for the lack of improvement, according to the same article, is a lack of economic incentive to do better. No doubt, economic incentives could play a role in improving the rate of misdiagnosis, but are there other ways move forward (e.g., an increased emphasis on Hippocratic values and covenantal relationships between doctor and patient)?

    Opinions worth Reading (via National Review and Christianity Today)

    Two members of the President’s Council on Bioethics, Gilbert Meilaender and Robert P. George, respond in National Review to fellow PCB member Michael Gazzaniga’s recent opinion piece on cloning and embryonic stem cell research in the New York Times. Meilaender and George take Gazzaniga to task both for his views on the status of the embryo and for the lack of “serious reflection” he demonstrated in expressing those views. Meilaender and George’s critique aptly demonstrates both the kind of serious reflection as well as the kind of civil interaction we need more of in bioethical debates.

    The “Life Matters” column written by Nigel Cameron for Christianity Today brings to our attention the growing “enhancement” movement in bioethics. In short, enhancement is the effort to use science and medicine to make us “better than human.” Among the items that fall into this category are genetic selection, cybernetics, brain-altering drugs, and the active pursuit of radical life extension. According to Dr. Cameron, “The real problem here is the passivity with which these possibilities are being accepted.”

    Quick Links and Other News Items of Interest

  • Amid Alarm Bells, A Blood Substitute Keeps Pumping (Wall Street Journal[subscription required])
  • Why Doctors So Often Get It Wrong (New York Times)
  • “That Thing in a Petri Dish” (National Review)
  • The Pursuit of Enhancement (Christianity Today)
  • Singapore: Stem Cell Insurance Now a Reality (TodayOnline)
  • Doctors Face Ethics Showdown in California (AP)
  • February 20, 2006

    Bioethics in the News – Monday, February 20, 2006

    Type 1 Diabetes Research (via BBC)

    A research team at the University of Minnesota has cured type I diabetes in monkeys by transplanting islet cells from pigs and combating rejection with a combination of drugs. The team is hoping to begin human trials in 2009. Teams in the UK are running a clinical trial transplanting islet cells from donated human pancreases, but a shortage of donated human organs lead the Minnesota team to explore the possibility of using pigs. Some who advocate on behalf of type 1 diabetes patients have prominently called for government funding of cloning and embryonic stem cell research in order to potentially develop treatments for the disease. Here, though, are two promising, life-affirming alternatives.

    Private Health Care in Canada? (via New York Times)

    The Canadian Supreme Court in June found that if the public health system was not meeting the needs of patients, private insurance and private clinics are legal alternatives. A number of Canadian politicians are calling for more discussion of various ideas that would move Canada toward more of a European a healthcare model. The New York Times article points out that this is quite a change in thinking: “Public health care insurance, where citizens go to their doctor or to the hospital for basic services paid for by taxpayers, has long been considered politically sacrosanct in Canada, and even central to the national identity.” Allocation of resources and access to healthcare are international issues and it will require hard work to ensure true justice.

    Quick Links for February 20

    Pig Cells May Reverse Diabetes (BBC)
    Ruling Has Canada Planting Seeds of Private Health Care (New York Times)

    Other News Items of Interest

    Body Parts Snatching Case Reverberates (AP)
    Getting ‘Physical’ Can Cost Men a Bad Habit or Two (USA Today)
    Free Clinics Pop Up to Deal With Uninsured (AP)
    Experts: Autism Surrounded by Misunderstanding (Reuters)

    February 17, 2006

    Bioethics in the News — Friday, February 17, 2006

    Stem Cell Showdown in the Show Me State

    Missouri is currently in the midst of a debate over whether the state government should fund cloning and embryonic stem cell research. Yesterday, at the Missouri Press Association Day at the state Capitol, two scientists debated the issue, zeroing in on the essential question: “It comes down to whether you view the cells created by the process [somatic cell nuclear transfer (SCNT)] to be a person.” One professor “believes that cells in a Petri dish are not persons.” This language of person is meant to indicate a category distinct from human being. In this way of thinking, not all human beings are persons—not all human beings deserve equal treatment, only persons. This is dangerous. Human beings and human persons are one in the same. For a discussion of why human beings and human persons are one in the same, see “What Does It Mean to Be Human?” by Teresa Iglesias.

    Eggs in Arizona

    The Arizona House Judiciary Committee voted 6-2 “to criminalize the practice of buying and selling human eggs.” The bill allows women to donate eggs, but forbids “money or other valuable consideration.” The egg issue has united people across the political spectrum because of its inherent danger, its commodification of human tissue, and its potential to exploit women. According to Capitol Media Services, advertisements indicate that “women can earn up to $24,000 for six separate egg donations.” The bill now moves to the full House for consideration.

    In Depth Back and Forth over Alternative Stem Cell Proposals

    Several proposals for obtaining stem cells with the same power as embryonic stem cells (i.e., pluripotent) but which do not require the destruction of human embryos have been floated in the past year or so (see “‘Ethical’ Embryonic Stem Cell Research?” for a brief overview). The magazine Communio: International Catholic Review has recently published an in-depth series of articles on two of the proposals, Altered Nuclear Transfer (ANT) and Oocyte Assisted Reprogramming (OAR). Serious reading on a serious topic.

    Quick Links for Friday, February 17, 2006

  • Professors tangle over stem cells (Kansas City Star)
  • What Does It Mean to Be Human? (CBHD)
  • Arizona: Sales ban on eggs of women advances (Capitol Media Services)
  • “Ethical” Embryonic Stem Cell Research? (CBHD)
  • Critiques of Altered Nuclear Transfer (ANT) And Oocyte Assisted Reprogramming (OAR) (Communio)
  • February 16, 2006

    Bioethics in the News — Thursday, February 16, 2006

    HSA

    A survey to be released today reveals that CEOs view increasing healthcare costs as an impediment to expanding their workforces. Many employers are asking employees to shoulder more of the cost, and a majority is experimenting with initiatives like healthcare spending accounts, or using discounts to reward a healthy lifestyle.”

    Meanwhile, President Bush yesterday delivered a speech reemphasizing his State of The Union call for an expansion of Health Savings Accounts (HSAs). The speech was delivered at the headquarters of Wendy’s, a company that offers HSAs to its employees.

    Finally, The Wall Street Journal has (on their free OpinoinJournal site) an op-ed commenting on Maine’s attempt to ensure that all its citizens are covered by health insurance The writers, who work in healthcare policy, point out the high cost of the program and suggest that “a better alternative for uninsured individuals in Maine is Health Savings Accounts.” Access to healthcare is a huge issue, and clearly, HSAs are picking up a lot of momentum.

    Cloning: Intuitions and Science

    Dartmouth Neuroscientist and President’s Council on Bioethics member Michael Gazzaniga has an op-ed in The New York Times arguing that “all clones are not the same.” Gazzaniga takes the distinction between reproductive cloning and biomedical cloning and appeals to intuitions about what constitutes a human person: “Look at your loved ones. Do you see a hunk of cells or do you see something else?”

    In making this appeal to intuition, this scientist ignores the information that science provides about the embryo. According to Human Embryology & Teratology (3rd edition), “it is now accepted that the word embryo, as currently used in human embryology, means ‘an unborn human in the first 8 weeks’ from fertilization.”

    In short, all clones are the same. Biomedical cloning and reproductive cloning both yield human embryos (unborn humans).

    Links for Thursday, February 16, 2006

    February 15, 2006

    Bioethics in the News — Wednesday, February 15, 2006

    Clinical Trials of Non-Embryonic Stem Cells (Washington Times)

    Johns Hopkins is currently running a trial to see if mesenchymal stem cells from bone marrow can regenerate a damaged heart.” While the results will not be known for several months, the story provides an interesting overview of the process of “making a new therapy available.” Hint: “a difficult and heavily regulated process.” This isn’t a necessarily criticism, rather, it is reflective of a high level of concern for patient safety. In addition, understanding the rigorousness of the process helps bolster arguments than any treatment from embryonic stem cell research and/or cloning is years if not decades away, and stands in sharp contrast to the kind of rhetoric heard from proponents of government funding for such research.

    Prescriptions, Promising but Pricey (New York Times)

    Genentech plans to charge $100,000 per year for its cancer drug Avastin.

    Until now, drug makers have typically defended high prices by noting the cost of developing new medicines. But executives at Genentech and its majority owner, Roche, are now using a separate argument — citing the inherent value of life-sustaining therapies. If society wants the benefits, they say, it must be ready to spend more for treatments like Avastin and another of the company’s cancer drugs, Herceptin, which sells for $40,000 a year.

    Certainly drug companies have to earn a profit in order to stay in business and contiue to deliver existing medications and develop new ones. The arguments presented in this article, though, smack of ruthless profiteering. Perhaps something has gotten lost in translation (Roche is a Swiss company). At any rate, don’t look for these kinds of economic issues to go away anytime soon.

    Wal-Mart Ordered to Carry Morning After Pill in Massachusetts (Reuters)

    A Massachusetts state regulatory board voted unanimously “to require Wal-Mart stores to stock morning-after contraceptives, two weeks after three women in the state sued Wal-Mart for refusing to fill orders for the pills.” Wal-Mart says that it does not stock the pill due to low demand. Illinois is the only other state that requires Wal-Mart to stock the morning after pill, and Illinois pharmacists have filed suit claiming a violation of their rights of conscience. Here the dispute arises out of the fact that one of the actions of the morning-after pill is to prevent a fertilized embryo from implanting in the uterus (an abortifacient action). Proponents of the morning-after pill argue that it is not an abortifacient by asserting that pregnancy does not begin until implantation. Again, these kinds of issues are not going away soon. For an overview of conscience issues, see “Protecting the Health Care Provider’s Right of Conscience” by law professor Teresa Stanton Collett.

    February 14, 2006

    Bioethics In The News — Tuesday, February 14, 2006

    Egg Donation for Cloning to Expand in Britain (BBC, The Times)

    Currently in the UK egg donation for research purposes is restricted to women who are already undergoing medical treatment. This is not providing enough eggs for the scientists who have been granted cloning licenses, so the Human Fertility and Embryology Authority is expected on Wednesday to approve egg donation from women who otherwise would not have any reason to undergo the ovulatory hyperstimulation and egg retrieval procedure.

    The key elements here are 1) the procedure puts women at some risk of fertility damage, kidney damage, and even death in rare cases; and 2) there is no benefit for the women donating. The Times captures it well:

    Josephine Quintavalle, of Comment on Reproductive Ethics, said: “The journal Nature last week described egg donation as an ‘unpleasant, invasive process’ which can cause ‘life-threatening side effects’. How extraordinary then to find the HFEA endorsing donation at a time when scientists are at last acknowledging the significant risks associated with the process.”

    Clinical Trials in China (Wall Street Journal)

    Western pharmaceutical companies are conducting clinical trials in China because it is less expensive than running them in the US or Europe, and because, in many cases, “Chinese authorities . . . want trials conducted in their own country before allowing the drugs to be sold” (subscription required). These authorities, on guard that Western companies not exploit Chinese patients or cut corners in the trials, have established a regulatory system to oversee clinical trials. The main downside the WSJ article identifies is that patients often cannot afford the drugs once they leave the trial.

    Company Tags Employees (Financial Times)

    A private video surveillance company has implanted electronic RFID (radio frequency identification) chips into the arms of two employees as a means of identifying them and controlling access to sensitive areas of their facilities. Some worry about privacy issues, but others assure that it is not a tracking device. Expect to hear a lot more about RFID in the future.

    Eavesdropping on the Hippocampus (Nature News)

    Scientists at MIT inserted wires directly into the region of the brain of rats involved in learning and memory, then let the rats run a course. When the rats paused, they replayed the course in their minds, probably helping to reinforce the memory. Neuroethics is one of the latest bioethics topics, and (shameless plug) the topic of CBHD’s 2006 summer conference. A PDF of the conference brochure is available here.

    February 13, 2006

    Bioethics In The News – February 13, 2006

    U.S. Senator Jim Talent (R-MO) has removed his name from a bipartisan bill (Brownback, R-KS and Landrieu, D-LA) to ban all forms of human cloning. Talent is emphasizing alternative techniques for obtaining stem cells (altered nuclear transfer or ANT), and feels the Brownback/Landrieu bill might forestall such research. Those leading the push for ANT disagree.

    A study that examined the incidence of Alzheimer’s in twins suggests that “Up to 80% of the risk of developing Alzheimer’s disease is genetic.” Important to note here is that the link between genetics and environment is unexplored. Key quote from the head of research at the UK Alzheimer Association:

    This study makes advances towards quantifying this relationship and will help scientists to understand more about the role of genetics in the development of the disease.

    However, we still don’t know enough.

    More research is needed into the role genes play in developing late onset Alzheimer’s.

    We also need to better pin down the environmental factors that may increase a person’s risk of developing the disease.”

    One vogue gift in China this Valentine’s season is “eyelid doubling,” a plastic surgery procedure “where an extra crease is added to the upper eyelid to make the eyes look larger.”

    You may recall the recent advertising campaign by Dove entitled “Campaign for Real Beauty.” One aspect that received considerable attention was the “Real Women Have Real Curves” series of ads. Interestingly, the centerpiece of the Campaign for Real Beauty in Singapore is an internet poll on the question, “When surgery adds an extra eyelid, does it remove your identity?” Twice as nice is currently leading 3,062 – 1,672.

    60 Minutes: A Surplus of Embryos

    60 Minutes last night aired a report on the surplus embryo situation in the United States. Currently, there are approximately 400,000 frozen embryos in fertility clinics around the country. As the report identified, the couples to whom these embryos belong have five options: 1) use the embryos to have another child; 2) destroy the embryos by thawing and discarding them; 3) donate the embryos to another couple for adoption; 4) donate the embryos for medical research (i.e., stem cell research), which will destroy the embryos; or 5) do nothing, allowing the embryos to remain frozen.

    More than anything, the report highlights the fact that the reproductive medical industry is under regulated. A review of the book Baby Business: Elite Eggs, Designer Genes, and the Thriving Commerce of Conception at Salon.com (subscription/registration required) makes much the same point.

    However, freeing up surplus embryos for research will not solve the embryonic stem cell debate. The same study (PDF) that revealed the fact that the number of frozen embryos had reached 400,000, also found that only 2.8% (about 11,000) of those embryos were available for research.

    In addition, the problem with arguing for more regulation is two-fold. First, as Dr. George identified in the 60 Minutes report, fertility regulation may be “the true third rail of American politics, maybe a more dangerous issue even than Social Security.” Second, and perhaps not unrelated, is the fact that regulation could lead to what many would consider worse outcomes. The United Kingdom, for example, closely regulates fertility medicine and mandates that frozen embryos be destroyed after a set period of time (5 or 10 years, there has been some dispute).

    Finally, to come back to the idea that surplus IVF embryos won’t solve the debate, take a look at a series of articles from July 2005 at Slate.com. Entitled “The Organ Factory,” the series points out the logical progression of the ethical arguments currently being advanced in favor of embryonic stem cell research.

    To borrow language from TV Guide, Cheers to CBS for a good report, but Jeers for missing the larger context.

    February 10, 2006

    Review and Comment on the News

    The National Institutes of Health and pharmaceutical companies Pfizer and Affymetrix are joining forces to form the Genetic Association Information Network. The goal is to identify key combinations of genetic variations that might indicate whether a person is at an increased risk of conditions such as heart disease, cancer, or Alzheimer’s. In addition, the Department of Health and Human Services is seeking funding from Congress for a project to study the interaction of genes and environment.

    “This is not just an academic exercise by a bunch of nerdy gene hunters,” says Francis Collins, head of the National Human Genome Research Institute. “This is an effort that will transform medicine.”

    As this kind of research moves forward, we as a society will need to address the concern that genetic information that identifies increased susceptibility to disease not be used in a discriminatory way (insurance, employment, etc.).

    The Mississippi House has passed legislation to ban embryonic stem cell research 108-4. The bill now moves to the Mississippi Senate. Interestingly, the AP story on the bill’s passage contains the following:

    Information distributed by the Juvenile Diabetes Research Foundation International says there is “widespread confusion” about somatic cell nuclear transfer, or SCNT, also called “therapeutic cloning.” The foundation says the procedure involves removing the nucleus of an unfertilized egg and replacing it with the nucleus of an adult cell.

    The foundation said the procedure is “a fundamentally different procedure from reproductive cloning, as was used by scientists in 1996 to create Dolly the sheep.”

    Well . . . yes and no. Yes, there is widespread confusion, but only because of statements such as this one. No, these are not fundamentally different procedures. They are not, in fact, different procedures at all. There is only one cloning procedure, somatic cell nuclear transfer (SCNT). The fundamental difference is what is done with the embryo that results from this procedure. It is either destroyed in an attempt to harvest stem cells (cloning for biomedical research) or it is transferred into a uterus for gestation (cloning for reproductive purposes).

    60 Minutes this Sunday will delve into the ethics of embryonic stem cell research with a report by Lesley Stahl. Robert George and Art Caplan will each have a say. Tune in or set your TiVo.

    Bioethics & Health News
    February 10

    Op-ed: The Losing Battle Against Doping

    The Olympics are back. Yes, that time is upon us when you try to figure whether those judging the skating performances are drunk, insane or both, how anyone can really take seriously as athletics any activity involving sweeping with a broom, and which professional hockey player not implicated in a burgeoning betting scandal will be the first to trash his hotel room or wind up taking literally the exhortation to be passionate, which is a part of the philosophical babble that the International Olympic Committee emits every two years.
    (MSNBC)

    Woman Who Weighs 37 Pounds Has Healthy Boy

    A woman who is 3 feet tall and weighed 37 pounds before she got pregnant has given birth to her first child — a healthy boy. Eloysa Vasquez, who uses a wheelchair and had two miscarriages, suffers from Type 3 osteogenesis imperfecta, a disorder that makes bones soft and brittle.
    (USA Today)

    Birth Defects Up in Polygamous Area

    A rare, severe birth defect is on the rise in an inbred polygamous community on the Utah-Arizona border, according to a doctor who has treated many of the children.
    (AP)

    Call to Let Doctors Have Work Nap

    Junior doctors should be able to nap on nightshifts to help them cope with the work, the Lancet journal says. The Lancet said naps were “back in fashion” and could help doctors stay alert.
    (BBC)

    Cocoa-Derived Medicines Still Years Away

    Medications derived from a component of cocoa are still several years away despite studies suggesting it could help prevent cancer and cardiovascular diseases in humans, food and industry experts said on Thursday.
    (Reuters)

    Girls Try Drugs, Alcohol at Higher Rates

    Even as teen drug use is declining overall, a new government analysis shows that teenage girls are trying marijuana, alcohol and cigarettes at higher rates than boys – a reversal of past trends that is causing alarm among experts.
    (AP)

    February 9, 2006

    Gene Doping at Torino?

    Surprising, but not shocking news from The Scientist:

    With the Torino Winter Olympics due to kick off on Friday (February 10), anti-doping authorities are still hoping that the spectre of gene doping — the misuse of gene therapy to boost athletic performance — will not cast its shadow over the competition. However, a recent court case in Germany appears to suggest otherwise.

    It seems that a running coach in Germany tried to obtain a drug called Repoxygen, which delivers a specific gene to muscle cells in order to alter the cells oxygen use. The drug is, according to the manufacturer, “in preclinical development” (i.e., untested in humans). It isn’t clear that any gene doping actually occurred, and this doesn’t relate directly to the Olympics. The main point is that this kind of thing is on the horizon, and may in fact be closer than we think.

    Some of the best work on the topic of biotech athletic performance enhancement comes from the President’s Council on Bioethics. Of particular interest is Chapter 3, “Superior Performance” from the report Beyond Therapy.

    Bioethics & Health News
    February 9

    Cancer Deaths Fall, Ending 70-Year Trend

    The war on cancer may have reached a dramatic turning point: For the first time in more than 70 years, annual cancer deaths in the United States have fallen.
    (AP)

    Global Warming a Major Health Risk: Scientists

    Global warming is already causing death and disease across the world through flooding, environmental destruction, heatwaves and other extreme weather events, scientists said on Thursday.
    (Reuters)

    NIH Seeking Private Funds for Genetics Research

    Government scientists are launching a major project to uncover elusive genetic variations that make people vulnerable to some of the most common diseases, and then determine what in the environment — pollution, behavior, diet — pushes those people into full-blown illness.
    (MSNBC)

    Brain Scans May Predict Alzheimer’s Risk

    Brain scans may one day help detect Alzheimer’s disease and other forms of cognitive impairment before symptoms appear. A new study has found a relationship between performance on certain cognitive and memory tests and certain differences in the brain.
    (HealthDay)

    Antidepressants May Harm Infants’ Lungs, Report Says

    Expectant mothers who took antidepressants like Prozac late in their pregnancy were significantly more likely to give birth to an infant with a rare but serious breathing problem, doctors are reporting today.
    (New York Times)

    Feds Consider Warnings on ADHD Drugs

    Federal health advisers considered on Thursday whether warning labels might be needed on drugs for attention deficit hyperactivity disorder following the deaths of 25 people taking the increasingly popular medicines.
    (AP)

    February 8, 2006

    Bioethics & Health News
    February 8

    Abortion Foes Gain on New Front

    A new front in the debate over abortion is emerging in legislatures across the nation. Abortion foes are gaining ground with proposals to require doctors to tell women seeking abortions that their fetuses might feel pain during the procedure.
    (USA Today)

    FDA Reports 51 Deaths of Attention Drug Patients

    Deaths of 51 U.S. patients who took widely prescribed drugs to treat attention deficit disorder prompted regulators to start watching for heart attacks, high blood pressure and other problems in 2004, a report released on Wednesday said.
    (Reuters)

    Many Preemies Do Well in Early Adulthood

    Many very premature infants appear to play catch-up by early adulthood, reaching levels of education and employment that are similar to those of normal-weight children, a study found.
    (AP)

    Killings Loom Over Debate on Treating Mentally Ill

    Against the vivid backdrop of recent killings by mentally ill people, both sides in the national debate over whether mentally ill people who have not committed a crime can be forced into treatment are preparing for a showdown in the Legislature here.
    (New York Times)

    US Launches Two Studies of Genes and Disease

    Why can one person smoke with no apparent ill-effects while another gets lung cancer? Why does one identical twin get Alzheimer’s when his brother does not?
    (Reuters)

    Feds Get Corporate Donations for Research

    Government scientists are launching a major project to uncover elusive genetic variations that make people vulnerable to some of the most common diseases, and then determine what in the environment – pollution, behavior, diet – pushes those people into full-blown illness.
    (AP)

    February 7, 2006

    Bioethics & Health News
    February 7

    Face Transplant Patient Displays Features

    The Frenchwoman who received the world’s first partial face transplant showed off her new features Monday, and her scar: a faint, circular line of buckled skin around her nose, lips and chin. But where she once had a gaping hole caused by a dog bite, she now has a face.
    (AP)

    When Death Is on the Docket, the Moral Compass Wavers

    Burl Cain is a religious man who believes it is only for God to say when a person’s number is up. But in his job as warden and chief executioner at the Louisiana State Penitentiary in Angola, Mr. Cain is the one who gives the order to start a lethal injection, and he has held condemned inmates’ hands as they died.
    (New York Times)

    Alzheimer’s disease may be mostly genetic

    The largest study to date of twins and Alzheimer’s disease indicates that inheritance may play a role in nearly 80 percent of cases, researchers said on Monday.
    (Reuters)

    Many Care Homes ‘Fail on Drugs’

    Nearly half of England’s nursing and care homes fail to meet minimum medication standards, inspectors say.
    (BBC)

    Mentally Ill Shaken by New Medicare Plan

    Even among the incident reports crossing Craig Knoll’s desk weekly now, this one stood out: A 43-year-old client of Knoll’s mental health agency, a man who suffers from bipolar disorder, had come from his pharmacy frustrated to the point of meltdown. There were snags in his new Medicare drug plan. Of his four medicines, it would fill only two.
    (Washington Post)

    Rare Chlamydia Strain Infecting Gay Men

    A particularly bad strain of chlamydia not usually seen in this country appears to be slowly spreading among gay and bisexual men, an infection that can increase their chances of getting or spreading the AIDS virus.
    (AP)

    February 6, 2006

    Bioethics & Health News
    February 6

    Face Transplant Patient Goes Public

    The Frenchwoman who received the world’s first partial face transplant showed off her new features to the public Monday, saying in a heavily slurred voice that she now looks “like everyone else” and hopes to resume a normal life.
    (AP)

    DNA Kits Aim to Link You to the Here and Then

    THE past comes at a price for Georgia Kinney Bopp. Retired and living in Kailua, Hawaii, Ms. Bopp has spent about $800 on tests to trace her ancestry, using samples of DNA from inside her cheek and from possible relatives.
    (New York Times)

    Clone Scientist May Have Misspent Funds

    Hwang Woo-suk, the disgraced South Korean cloning scientist accused of faking his research results, may also have misspent government funds, South Korea’s state auditor said Monday.
    (AP)

    More Americans Struggling With Medical Debt

    heryl Smith’s life as she knew it ended abruptly one day in 1997. “I went from being an employed, normal person to being unemployed,” she recounted. “I lost my health insurance. I couldn’t afford the COBRA, and there was no other income.”
    (HealthDay)

    Journal Article a Wild Card in Federal Vioxx Trial

    A top medical journal’s criticism of a study cited in Vioxx lawsuits is expected to play a part in the retrial of the first federal Vioxx lawsuit — but it’s not clear if it will be a legal hand grenade or a nuclear warhead.
    (MSNBC)

    Doctors Back Needle Exchange Programs

    “I went from being an employed, normal person to being unemployed,” she recounted. “I lost my health insurance. I couldn’t afford the COBRA, and there was no other income.”
    (AP)

     

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