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Bioethics 101

Recommended Reading

September 30, 2007

A New Issue of Nanotechnology Is Now Available

Nanotechnology Issue 1(2) August 2007 is now available by subscription only.

Articles include:
“Nanotechnology – Steps Towards Understanding Human Beings as Technology?” by Armin Grunwald and Yannick Julliard, 77-87.
“Social and Ethical Interactions with Nano: Mapping the Early Literature” by Kamilla Kjølberg and Fern Wickson, 89-104.
“Nanotechnology Bound: Evaluating the Case for More Regulation” by Patrick Lin, 105-122.
“Introduction: Engaging with Nanotechnologies – Engaging Differently?” by Tee Rogers-Hayden, Alison Mohr and Nick Pidgeon, 123-130.
“On Nanotechnology and Ambivalence: The Politics of Enthusiasm” by Matthew Kearnes and Brian Wynne, 131-142.
“Deliberating Risks Under Uncertainty: Experience, Trust, and Attitudes in a Swiss Nanotechnology Stakeholder Discussion Group” by Regula Valérie Burri, 143-154.

A Warning Too Little and Too Late: Watch Out for Stem Cell “Therapeutic Misperception”

File this in the “talk about Chutzpah!” folder: Two Stanford bioethicists, Mildred Cho and David Magnus, have written a column in Nature Reports Stem Cells bemoaning the hype and exaggeration that may have led people to have unreasonable expectations for embryonic stem cell research. From their paper (citations omitted):

The term “therapeutic misconception” was originally coined in 1982 to describe a fundamental confusion among research subjects and researchers alike between the goals of research (generalisable knowledge) and the goals of clinical care (improving the health of an individual patient)…

The therapeutic misconception is a particular concern for stem cell researchers for two reasons. First, like gene transfer (formerly misleadingly known as “gene therapy”), stem cell research is a frontier field. The potential for therapeutic misconception is especially large because of the promises already made, such as promotion of California’s Proposition 71 to fund stem cell research by slogans such as “save lives with stem cells”, and use of the term “therapeutic cloning” before any therapies exist.

Slogans such as “save lives with stem cells” boost the risk that people will overestimate the benefits and underestimate the risks of participating in stem cell research.

Well, no kidding! Funny, when Proposition 71′s boosters were spending $35 million promoting therapeutic misconception so thick you could cut it with a knife throughout California, I didn’t see Cho or Magnus–whose university is going to be a huge beneficiary of Proposition 71 money,–voicing strong objections to the propaganda that caused voters to swallow that particular white elephant whole.

Cho and Magnus continue:

Second, some stem cell research will depend upon participation of a class of individuals who are not patients and also not research subjects–egg donors–and for whom a different type of therapeutic misconception can exist. We have argued that this group be called research donors to distinguish them from research subjects.

Apparently, Cho and Magnus aren’t above shoveling a little misconception of their own. ESCR and SCNT (cloning) are non synonyms, even though the authors write as if the terms are indistinguishable. ESCR does not require eggs to conduct: It requires embryos from which to derive stem cells. SCNT does require eggs with which to (in theory) manufacture embryos, one potential use for which would be to derive stem cell lines.

Yes, women should be told, as the authors note, that by engaging in the potentially dangerous egg procurement process, they may not directly benefit from cloning or stem cell research. But, like the feminists involved in Hands Off Our Ovaries, I don’t believe researchers should be allowed to obtain eggs from women at all for this purpose. There is no reason to risk death, infertility, and illness so someone at Stanford can strike it rich by learning how to reliably create cloned human embryos.

September 29, 2007

Good Anti Assisted Suicide Column by Disability Rights Activists

Next year, Washington voters may decide whether to legalize assisted suicide. Already, the argument has begun. Here’s a good piece published in the Olympian by Joelle Brouner, a member of paper’s Diversity Panel and a disability rights activist, arguing why voters should reject legalization–as they did in 1991. Here is a powerful paragraph that nails its target:

Physician-assisted suicide is less about choice or pain management than power. If legalized, physician-assisted suicide will inevitably align the power of the state, big money interests and a broken medical system. If the state sanctions the participation of medical professionals in the killing of patients, the matter transcends the individual who dies. We cannot divorce ourselves from policy decisions made in our name. As citizens, we would all be complicit, by extension, in these deliberate deaths.

Read the whole thing. It is an excellent example of how disability rights activists are making the difference in the assisted suicide debate.

September 28, 2007

Report Assails F.D.A. Oversight of Clinical Trials

In a report due to be released Friday, the inspector general of the Department of Health and Human Services, Daniel R. Levinson, said federal health officials did not know how many clinical trials were being conducted, audited fewer than 1 percent of the testing sites and, on the rare occasions when inspectors did appear, generally showed up long after the tests had been completed. (New York Times)

Building Better Implants

Most orthopedic implants–artificial devices like hip and knee joints–last from ten to fifteen years, which means that many patients require several surgeries to replace the parts during their lifetime. Now scientists at Brown University have started working on superior implants that may be easier to monitor and better able to integrate with the surrounding cells of the body. (Technology Review)

Stem cells trial for MS patients

Six patients at Frenchay Hospital are being injected with their own stem cells in the hope that they will repair damage to the brain. (BBC)

Stem cell therapy ‘could cut liver transplants’

The technique involves inserting stem cells into the damaged organ so that it is encouraged to repair itself and create new tissue. (Telegraph)

Hospices Are a Growing Venue for Drug Trials

Hospices are emerging as a new setting for drug trials as demand rises for medicines to address the needs of dying patients. Progenics Pharmaceuticals Inc., the small Tarrytown, N.Y. company seeking approval of methylnaltrexone, recently tested it among 287 patients, most of them in the final months of their lives and under the care of hospices. The constipation it aims to treat is often an agonizing side effect of opioid drugs such as morphine, commonly used to control pain in the terminally ill. (Wall Street Journal)

Remembrance or renewal: Nazi house highlights nation’s dilemma

The Jewish doctors intend to convert the house into an international centre to analyse and debate medical ethics. The plan is to cooperate with the Bar-Ilan university in Israel and the Israeli Medical Association. Young doctors would be offered courses, on ethics and a library would include historical profiles of infamous doctors such as Josef Mengele. Theologians, lawyers and doctors would come together to discuss the legal and moral basis of advanced medical research. (Times Online)

September 27, 2007

New Human Trial With Adult Stem Cells to Treat MS in the UK

The media will continue to squawk about how embryonic stem cells may years from now treat MS, but adult stem cells are already moving forward into human trials in the UK. (As I previously reported, adult stem cells have stopped MS from worsening in a Canadian human trial.) From the Telegraph story:

Neil Scolding, professor of clinical neurosciences for North Bristol NHS Trust, who is leading the trial, said: “We believe that bone marrow cells have the capability to repair precisely the type of damage that we see in the brain and spinal cord in MS.So by giving patients very large numbers of their own bone marrow cells we hope that this will help stabilise the disease and bring about some repair.”

The trial, which started six months ago, is one of the first to use patients’ own bone marrow stem cells to treat their MS. It involves six people with MS, aged between 30 and 60, having a pint of bone marrow extracted from their pelvises. The processed material, containing stem cells, is then injected on the same day into the patients’ arms.

Over a period of months, the patients will be monitored closely and given regular brain scans to see what impact the treatment has had on them.

This is very exciting. If it works–admittedly a big if–a lot of people are going to receive a lot of benefit.

Battin Assisted Suicide Report Demonstrates the Vapidity of “Scientific Studies”

The “scientific study” has become the modern-day equivalent to Biblical scripture: They can be made to support whatever result the “studier” desires.

Case in point: A just released study by Margarette P. Battin of the University of Utah, claiming that there is no assisted suicide “slippery slope.” Unmentioned (of course) in the stories about the study (such as this one on Scientific is that Battin has been an ardent euthanasia and assisted suicide legalization activist for more than 25 years, a woman so committed to the cause that she has long supported permitting assisted suicide for categories of people way beyond the terminally ill. Indeed, as reported in Rita Marker’s seminal book Deadly Compassion, Battin was published in the Hemlock Quarterly all the way back in 1982 promoting what has since come to be called “rational suicide.”

In 1985, she spoke at the Hemlock Society annual conference, where in addition to promoting assisted suicide and euthanasia, she suggested such deaths would be a splendid way to save money. From Marker’s account (page 150):

Those least capable of withstanding the pressure to request euthanasia or commit suicide would be people who have been the least self-determining throughout their lives, Battin suggested. She noted that particularly vulnerable would be a woman who has lived for her family and has always been concerned about the needs and comfort of others. There will be an interest in avoiding the burdens of care and large bills,” she pointed out. “We may wish to comply with this interest.”

This advocacy has continued steadily for more than 25 years. As I noted in Forced Exit: Euthanasia, Assisted Suicide, and the New Duty to Die (page190), Battin even supports the so-called “duty to die.” I wrote :

Other bioethicists have also weighed in on establishing a duty to die. University of Utah philosopher Margaret P. Battin, for example, has argued that global egalitarianism may one day require people in richer countries to forgo expensive life-sustaining treatment or even commit suicide to promote “the interests of justice in health care,” which would be “reflected in more nearly equal health prospects and life expectancies around the globe. Not surprisingly, Battins is an enthusiast for legalizing euthanasia.

Besides her clear bias, Battin’s so-called study acknowledges that elderly, disabled, and other non terminally ill people are indeed being euthanized in the Netherlands, including killings of patients who did not ask to be euthanized. If that isn’t the slippery slope, what is?

Singapore Gains as Bush Suppresses Growth of Stem Cell Research

The city-state has spent more than $3 billion in a bid to transform its economy into a knowledge-based one that relies less on manufacturing of products like cell phones and modems and more on fields such as research. (Bloomberg)

DNA unraveled

The science of life is undergoing changes so jolting that even its top researchers are feeling something akin to shell-shock. Just four years after scientists finished mapping the human genome – the full sequence of 3 billion DNA “letters” folded within every cell – they find themselves confronted by a biological jungle deeper, denser, and more difficult to penetrate than anyone imagined. (Boston Globe)

Drug Makers Seek Clues to Side Effects in Genes

Seven of the largest pharmaceutical companies have formed a group to develop genetic tests to determine which patients would be at risk from dangerous drug side effects. (New York Times)

Assisted suicide fear ‘unfounded’

Legalised “physician-assisted death” has not been used to kill people who may be “a burden to society”, US research suggests. (BBC)

Korea: Human Ova Trade to Be Banned

Limited scientific research on somatic cell nuclear transfers for possible cures of fatal diseases will be permitted following a revision of the relevant law.

The law will prescribe the bounds of the research, as well as ban human ova trading. (Korea Times)

Technocitizenship, innovation and the biopolitics of medical devices

Three hundred and fifty years ago, while pioneering the use of microscopes, the British scientist Robert Hooke foresaw that science would eventually create artificial organs and implantable devices to enhance sight, hearing and memory. He wrote “By the addition of such artificial Instruments and methods, there may be, in some manner, a reparation made for the mischiefs, and imperfection, mankind has drawn upon itself.” (IEET)

Right-to-die group barred from premises

Right-to-die group Dignitas has been barred from its premises in a Zurich suburb after neighbors objected to the use of the apartment for assisted suicides, the local council said Wednesday.

It was the second blow for the non-profit association this year, after it was forced to move from a previous suburban Zurich apartment when residents complained. (Reuters)

September 26, 2007

German Neighors Don’t Like Assisted Suicide Apartments Either

Dignitas, the assisted suicide facilitating organization from Switzerland is extending its tentacles into Germany. Just as the Swiss neighbors of the group’s suicide safe house objected to all of the corpses being carried out, so too now, have Germans:

ZURICH (Reuters) – Right-to-die group Dignitas has been barred from its premises in a Zurich suburb after neighbors objected to the use of the apartment for assisted suicides, the local council said Wednesday.

It was the second blow for the non-profit association this year, after it was forced to move from a previous suburban Zurich apartment when residents complained.

Last week, the local council ordered the charity to stop using the new apartment and apply to change its official function from a residence to an “assisted suicide flat.”

“Dignitas continued to ignore the ban and still carried out assisted suicides,” council official Daniel Scheidegger told Reuters. “So we decided to enforce the ban.”

The nihilism is so thick you can cut it with a knife.

Rethinking Neuroethics in the Light of the Extended Mind Thesis

by Neil Levy

The extended mind thesis is the claim that mental states extend beyond the skulls of the agents whose states they are. This seemingly obscure and bizarre claim has far-reaching implications for neuroethics, I argue. In the first half of this article, I sketch the extended mind thesis and defend it against criticisms. In the second half, I turn to its neuroethical implications. I argue that the extended mind thesis entails the falsity of the claim that interventions into the brain are especially problematic just because they are internal interventions, but that many objections to such interventions rely, at least in part, on this claim. Further, I argue that the thesis alters the focus of neuroethics, away from the question of whether we ought to allow interventions into the mind, and toward the question of which interventions we ought to allow and under what conditions. The extended mind thesis dramatically expands the scope of neuroethics: because interventions into the environment of agents can count as interventions into their minds, decisions concerning such interventions become questions for neuroethics. (The American Journal of Bioethics)

Therapy to slow down liver damage

Scientists have developed a new way to treat liver failure by dampening the immune response using stem cells taken from the bone marrow. (BBC)


The Bioethics Poll
Should individuals and/or institutions be allowed to patent human genes?
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