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May 30, 2007

Kenya: Team for ‘tube’ baby laws unveiled

A taskforce to formulate laws to govern reproduction of test-tube babies has began work, a year after it was set up. (The Standard)

May 29, 2007

Terri Schiavo: A Life of “Indelible Impact”


USA Today has named Terri Schiavo one of the top 25 people who “moved us” in the last 25 years. Hmmm. I know her family would rather she hadn’t made such an impact, that instead, she were still alive and being cared for in the bosom of their love.

It is undeniable though that Terri did profoundly impact the world. As I travel nationally and internationally speaking, she remains very much on people’s minds and in some of their hearts.

And that impact continues. Her brother Bobby Schindler, with whom she was very close in life, continues to hold her flame aloft throughout the world. Bobby has become a very good friend. I have watched, deeply moved, as he has harnessed his profound and continuing grief to grow from a somewhat shy individual into an eloquent advocate and speaker on behalf of disability rights and the sanctity/equality of all human life. I have often appeared with him, most recently last week at an anti-euthanasia conference in Edmonton, and his personal decency and abiding love for Terri never fails to deeply move his audiences. Both loved and loathed for their desperate fight to save Terri’s life, Bobby and the entire Schindler family also, in my view, continue to make an important and indelible impact.

USA Today opines that Terri’s contribution concerns living wills. I disagree. I think her most profound legacy is that after Terri, no one can now say they are unaware that we dehydrate people to death because they have profound cognitive disabilities.

In the end, I think, Terri is a mirror upon whom we project our own deepest feelings about life, death, disability, helplessness, personal control, and mortality. People who are capable of moving the world as she unquestionably did are few and far between. There was clearly something very special about Terri Schiavo that surpassed the bitter politics of her death. So, yes: USA Today got this one right. Her life had–and continues to have–a profound and indelible impact on us all.

Bursting the Myth of Assisted Suicide Inevitability

We often hear that more than 60% of Americans favor assisted suicide. I have never believed it because the polls that count–elections–mostly show narrow disapproval of legalization (except Michigan where an assisted suicide legalization bill lost 71-29% in 1998, hardly narrow, and Oregon, which approved legalization in 1994, 51-49%).

This most recent public opinion poll (AP) indicates that Americans are closely divided on the issue. A non-whopping 48% supported assisted suicide and 44% opposed. What makes me even more cheered by this poll is that the media tends to write stories that are distinctly sympathetic to assisted suicide, and most major newspapers editorialize in its favor. And still, Americans are justifiably wary. I credit the disability rights movement for much of this, because they have effectively punctured the myth that only religious conservatives oppose euthanasia.

So, the debate rages on. And if we don’t tire, we can preserve ethics in American medicine.

I think A.B. 374 May Be In Some Trouble

Methinks A.B. 374, the bill to legalize assisted suicide in California, may be in some trouble. The authors have–sort of–amended the bill to require a three months left to live rather than a six months left to live standard, before a lethal prescription can be written in the “Safeguards” section. I say “sort of” because the bill still defines a terminal illness as six months left to live in the definitions section. Also, the application form still has the 6 month time. To me, this indicates a rushed effort to convince reluctant assembly persons to go along, as time to pass the bill out of the Assembly this year is running out.

The issue isn’t the time, but the principle. Assisted suicide is bad medicine and worse public policy. I just hope resisting legislators don’t get seduced by this newest gambit.

Dutch TV Contestants Vie for Kidney


The Dutch continue to stun with their fall off a vertical bioethical cliff: In this installment, a television show will soon air in which three ill contestants vie for the right to the kidney of a terminally ill woman. From the story in the UK’s Guardian:

In the show, due to be broadcast on Friday, a woman identified only as Lisa, 37, will select a recipient based on their history, profile and conversations with their families and friends. Throughout the 80-minute show, viewers will be invited to send Lisa text messages to advise her.

This is voyeurism on a scale that boggles the mind. It turns the serious issue of the ethics of organ transplant into a game show. It denies intrinsic human dignity in that it pits desperate people against each other, clawing and kicking–metaphorically speaking–for life. What kind of a physician would be willing to be part of such a spectacle?

Hey! Here’s an idea: Maybe in the next show they can tie the organ contest with a televised assisted suicide! That would garner the ratings.

But, why worry: It’s just “choice,” right?

Swiss Worry About Their High Suicide Rates


The Swiss suicide rate is apparently quite high and a matter of great concern. The Swiss have vowed to fight it, but they have a problem: Opposing “suicide” while legally permitting assisted suicide sends a decidedly mixed message that would seem to make prevention advocacy less effective. Of course the Swiss don’t see it that way: They blame the ready availability of guns because their ubiquitous use in self killing.

But its the end that is the societal problem, not the means. Moreover, how do you tell suffering, suicidal people that some suicides are fine and dandy–if you have a physical or mental illness or disability–and others aren’t? And get this from the Reuters story:

The Swiss suicide rate stands at 19.1 suicides per 100,000 inhabitants, a 2005 study by the country’s Federal Health Office said, well above the World Health Organization’s global average of 14.5 and of 14.1 in the European Union. That figure may be inflated by assisted suicides– about 10 percent of suicides are through the suicide-assistance groups for which the country has built up some fame.

Good grief: Assisted suicide is suicide. Including the data from those deaths does not inflate the suicide rate, it accurately reports it. (In Oregon, assisted suicides aren’t “suicide” and so that state actually undereports its suicide statistics.)

Reuters’ reporting is further proof that we have entered the world of 1984 Newspeak: If you use a gun it’s suicide. If you use an overdose of drugs supplied by an assisted suicide group it’s not suicide? Good grief.

Do these world-first images hold key to cancer cure?

A breakthrough in imaging techniques could enable scientists to watch the moment that cancer first strikes, holding out the prospect of radical new treatments.

In a world first, researchers at Dundee University managed to film healthy, live cells within an embryo dividing and redividing after developing a new way of using a powerful microscope. The film shows the birth of neurons – which form the brain and nervous system – as cells in a chicken’s egg divide into two, a nerve cell and a “mother cell” that goes on to divide again. (The Scotsman)

New Study Finds Morning After Pill Can Work as an Abortion Drug

A new study published in the medical journal Fertility and Sterility finds that the Plan B drug, known as the morning after pill, can work to cause an abortion of a human being after her life has started. Abortion advocates have claimed the drug only prevents conception but the study appears to contradict that claim.

Dr. Rafael T. Mikolajczyk of the School of Public Health at the University of Bielefeld in Germany and Dr. Joseph B. Stanford, who teaches public health at the University of Utah, are the senior authors of the paper. (Lifenews.com)

Hacking My Kid’s Brain: How a Child’s Neurons Were Rewired

Three months ago I took my 7-year-old son through a neurological treatment designed to hack his brain. It’s been 90 days since his treatment ended, and I am happy to report the hack has made a huge difference.

Friends and family inevitably ask, “Did it work?” While a simple “yes” might suffice, the specifics of Caleb’s results show just how effectively a brain can recalibrate itself. Caleb is experiencing the world in a whole new way. (Wired)

May 28, 2007

Media Kevorkian Time Line Misses the People

Our media love the outlaw, as demonstrated in this “Kevorkian time line” that omits information about his victims. They are the truly forgotten ones in this travesty of egotism and sensationalism.

Along the Kevorkian front, Rita Marker and I have a piece comparing Kevorkianism and Oregon’s assisted suicide regimen out in the current Weekly Standard. It isn’t linkable at the moment. When it is, I will post it here. It’s pretty good if I don’t say so myself.

P.S. Rita is the executive director of the International Task Force on Euthanasia and Assisted Suicide. She knows more about euthanasia/assisted suicide than anyone I know. If I were asked to pick the one person in the world who has done the most to prevent euthanasia from sweeping the Western world, I would name Rita without hesitation. She is also my mentor on these issues who dragged me kicking and screaming into this line of work. If you don’t like me, blame her.

New Issue of Journal of the American Geriatrics Society

The June 2007, 55(6) issue of the Journal of the American Geriatrics Society is now available. Full content is available by subscription only.

Articles that may be of interest from the TOC:

Mark Lachs, MD, MPH, Ronet Bachman, PhD, Christianna S. Williams, PhD, and John R. O’Leary, MA, “Resident-to-Resident Elder Mistreatment and Police Contact in Nursing Homes: Findings from a Population-Based Cohort.” p 840–845

Holly Biola, MD, MPH, Philip D. Sloane, MD, MPH, Christianna S. Williams, PhD, Timothy P. Daaleman, DO, MPH, Sharon W. Williams, PhD, and Sheryl Zimmerman, PhD, “Physician Communication with Family Caregivers ofLong-Term Care Residents at the End of Life.” p 846–856

Sabrina Winona Pit, PhD, Julie Ellen Byles, PhD, and Jill Cockburn, PhD, “Medication Review: Patient Selection and General Practitioner’s Report of Drug-Related Problems and Actions Taken in Elderly Australians.” p 927–934

May 27, 2007

Nanoparticle Self-Assembly Triggered by Tumor-Associated Enzyme

There is a growing recognition among cancer researchers that the most accurate methods for detecting early-stage cancer will require the development of sensitive assays that can identify simultaneously multiple biomarkers associated with malignant cells. Now, using sets of nanoparticles designed to aggregate in response to finding more cancer biomarkers, a team of researchers funded by the Alliance for Nanotechnology in Cancer has developed a multiplexed analytical system that could detect cancer using standard magnetic resonance imaging (MRI). (Nanotechwire.com)

Researchers Engineer Stem Cells to Make Insulin

Study using umbilical cord cells gives hope to future diabetes cure. Stem cells taken from the umbilical cords of newborns can be engineered to produce insulin and may someday be used to treat diabetes, U.S. and British researchers reported on Friday. They said they were able to first grow large numbers of the stem cells and then direct them to resemble the insulin-producing cells of the pancreas that are damaged in diabetes. (CNN)

Implanted Medical Computers

Not in a flying car, but in biomedical implants, the future is racing toward us. It looks less like The Jetsons and more like Holy Fire—but it’s a near-future that could only be viewed as science fiction just a few years ago.

Researchers at Harvard University and Princeton University have made a crucial step toward building biological computers, tiny implantable devices that can monitor the activities and characteristics of human cells. The information provided by these “molecular doctors,” constructed entirely of DNA, RNA, and proteins, could eventually revolutionize medicine by directing therapies only to diseased cells or tissues. (IEET)

Experimental Gene Therapy ‘Abolishes’ Arthritis Pain and Lessens Joint Damage

Early-stage research has found that a new gene therapy can nearly eliminate arthritis pain, and significantly reduce long-term damage to the affected joints, according to a study published today in the journal Arthritis and Rheumatism. While the study was done in mice, they are the first genetically engineered to develop osteoarthritis like humans, with the same genetic predisposition that makes some more likely to develop the disease, the authors said. If all goes well with a follow-up study currently underway, researchers will apply to the U.S. Food and Drug Administration for permission to begin human trials next year. (Science Daily)

May 25, 2007

May 2007 Newsletter of the Genetics & Public Policy Center now available

The May 2007 (19) issue of the Genetics & Public Policy Center is now available. The primary focus of this issue of the newsletter is policy regarding genetic discrimination and the advocacy to approve the Genetic Information Nondiscrimination Act.

New Issue of The American Journal of Bioethics

Issue 7(5) of The American Journal of Bioethics is now available. (bioethics.net)

TOC:
Editorial:
Judy Illes, Emily R. Murphy, “Chimeras of Nurture” p. 1
Target Articles:
Turhan Canli, Susan Brandon, William Casebeer, Phillip J. Crowley, Don Du Rousseau, Henry T. Greely, Alvaro
Pascual-Leone, “Neuroethics and National Security” p. 3
Henry T. Greely, Mildred K. Cho, Linda F. Hogle, Debra M. Satz, “Thinking About the Human Neuron Mouse” p. 27
Open Peer Commentary:
David B. Resnik, “Neuroethics, National Security and Secrecy” p. 14
Luis Justo, Fabiana Erazun, “Neuroethics and Human Rights” p. 16
John Lunstroth, Jan Goldman, “Ethical Intelligence from Neuroscience: Is It Possible?” p. 18
Stephen G. Morris, “Neuroscience and the Free Will Conundrum” p. 20
Leah Rosenberg, Eric Gehrie, “Against the Use of Medical Technologies for Military or National Security Interests”
p. 22
Sheri Alpert, “Total Information Awareness-Forgotten But Not Gone: Lessons for Neuroethics” p. 24
Francoise Baylis, Jason Scott Robert, “Part-Human Chimeras: Worrying the Facts, Probing the Ethics” p. 41
Cynthia B. Cohen, “Beyond the Human Neuron Mouse to the NAS Guideline” p. 46
William P. Cheshire, “The Moral Musings of a Murine Chimera” p. 49
Mark Sagoff, “Further Thoughts About the Human Neuron Mouse” p. 51
Jason T. Eberl, “Creating Non-Human Persons: Might It Be Worth the Risk?” p. 52
Bernard E. Rollin, “Of Mice and Men” p. 55
Robert R. Lavieri, “The Ethical Mouse: Be Not Like Icarus” p. 57

New Issue of The Journal of Law, Medicine & Ethics devoted to Genetics Testing, Discrimination & Insurance

The Journal of Law, Medicine & Ethics, Summer 2007, 35(s2). Articles are available by subscription only.

TOC:
Jeffrey P. Kahn & Susan M. Wolf, “Understanding the Role of Genetics in Disability Insurance.” p 5
Susan M. Wolf & Jeffrey P. Kahn with input from the Working Group on Genetic Testing in Disability Insurance,
“Genetic Testing and the Future of Disability Insurance: Ethics, Law & Policy.” p 6–32
John H. Dodge & David J. Christianson, “Genetic Testing and Disability Insurance: An Alternative Opinion.” p 33–35
John H. Dodge, “Predictive Medical Information and Underwriting.” p 36–39
David J. Christianson, “Disability Income Insurance: The Private Market and the Impact of Genetic Testing” p 40–46
Paul Steven Miller, “Genetic Testing and the Future of Disability Insurance: Thinking about Discrimination in the
Genetic Age.” p 47–51
Anita Silvers, “Predictive Genetic Testing: Congruence of Disability Insurers’ Interests with the Public Interest.”
p 52–58
Mark A. Rothstein, “Genetic Exceptionalism and Legislative Pragmatism” p 59–65
Nancy Kass & Amy Medley, “Genetic Screening and Disability Insurance: What Can We Learn From The Health
Insurance Experience?” p 66–73
Kathryn J. Sedo, “Workers’ Compensation, Social Security Disability, SSI, and Genetic Testing.” p 74–79
Robert H. Jerry, II, “Life, Health, and Disability Insurance: Understanding the Relationships.” p 80–89

Issues in Biomedicine and Ethics: Free articles from Zygon

Blackwell Publishing has made available a number of free articles from Zygon 42(1) as a promotional of their e-journal service. These articles are usually available by subscription only.

TOC: (Free Articles)
Ann Milliken Pederson, “South Dakota and Abortion: A Local Story about how Religion, Medical Science, and Culture
Meet.” p 123–132
Byron L. Sherwin, “Golems in the Biotech Century.” p 133–144
Mohammad Motahari Farimani, “Islamic Philosophy and the Challenge of Cloning.” p 145–152
Fatima Agha Al-Hayani, “Biomedical Ethics: Muslim Perspectives on Genetic Modification.” p 153–162
Stephen M. Modell, “Genetic and Reproductive Technologies in the Light of Religious Dialogue.” p 163–182
Philip Hefner, “Genetic Frontiers: Challenges for Humanity and Our Religious Traditions.” p 183–192

Another article that may be of interest, but is available by subscription only is:
Michael S. Hogue, “Theological Ethics and Technological Culture: A Biocultural Approach.” p 77–96

Texas Futile Care Law Bill Fails


I am not happy: But my ire was raised before the ultimate failure of the bill to outlaw futile care theory in Texas. The “good” bill, which would have required hospitals to maintain treatment pending a transfer to another hospital would have breezed to passage, and in the process given a body blow to Futile Care Theory. Then, inexplicably, the Catholic Bishops (I believe at the behest of the organization representing Catholic hospitals) opposed the bill and threw its considerable heft behind a bill extending the 10-day cut off to 21-days. That sounds impressive, until you realize that the extra time would have been meaningless, since it appears that Texas hospitals are honoring each other’s futile care determinations and refusing transfers! Remember, Andrea Clark’s family desperately searched as far as Illinois to find a hospital to accept her. (I spoke to one person on the ground, who told me that advocates are now looking to Mexican hospitals to take these patients!) The one good provision in the alternative bill, declaring tube supplied food and fluids to be ordinary care, should be passed anyway.

So, now it will be up to the courts. And we have to get other states to pass laws requiring continued care pending transfer in futility disputes. Otherwise, we are on the road to explicit health care rationing and an implicit duty to die.

Georgia: Governor signs stem cell donation bill

Pregnant women eventually will be asked to donate umbilical cord blood and other placental fluids when they give birth. (Savannah Now)

 

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