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October 31, 2008

Event: Public Meeting of the President’s Council on Bioethics

Public Meeting of the President’s Council on Bioethics

SUMMARY: The President’s Council on Bioethics (Edmund D. Pellegrino, MD, Chairman) will hold its thirty-fifth meeting, at which it will discuss three topics: exercises of conscience in the practice of the health professions, the problem of medical futility, and the future of public bioethics and national bioethics commissions in the United States. Subjects discussed at past Council meetings (although not on the agenda for the November 2008 meeting) include: therapeutic and reproductive cloning, assisted reproduction, reproductive genetics, neuroscience, aging retardation, organ transplantation, personalized medicine, standards for the determination of death, children and bioethics, and lifespan-extension among others. 

DATES: The meeting will take place Thursday, November 20, 2008, from 9 a.m. to 5 p.m., ET; and Friday, November 21, 2008, from 9 a.m. to noon, ET.

ADDRESSES: Hotel Palomar Arlington, 1121 North 19th Street, Arlington, VA 22209. Phone 703-351-9170.

FOR FURTHER INFORMATION CONTACT: Ms. Diane M. Gianelli, Director of Communications, The President’s Council on Bioethics, 1425 New York Avenue, NW., Suite C100, Washington, DC 20005. Telephone: 202/296-4669. E-mail: info@bioethics.gov. Web site: http://www.bioethics.gov.

SUPPLEMENTARY INFORMATION: The meeting agenda will be posted at http://www.bioethics.gov. The Council encourages public input, either in person or in writing. At this meeting, interested members of the public may address the Council, beginning at 11:45 a.m. on Friday, November 21. Comments are limited to no more than five minutes per speaker or organization. As a courtesy, please inform Ms. Diane M. Gianelli, Director of Communications, in advance of your intention to make a public statement, and give your name and affiliation. To submit a written statement, mail or e-mail it to Ms. Gianelli at one of her contact addresses given above.

Event: Translation of Stem Cells into Clinical Stem Cell Therapeutics

Translation of Stem Cells into Clinical Stem Cell Therapeutics

Public Symposium

Thursday, November 20, 2008
National Academy of Sciences

Washington, D.C.

The meeting will explore issues related to the translation of stem cells into clinical therapeutics, with a particular focus on the implications that translation may have on the oversight of stem cell research.  

 

 Sessions at the day-long meeting will include:

  • Overview of regulatory issues
  • Case study on cardiac applications
  • Case study on neuronal applications
  • Panel discussion on cross-cutting issues related to stem cell therapeutics
  • Opportunity for public comment and discussion

Speakers and panelists include Kenneth Chien (Harvard/MGH), Lawrence Goldstein (UCSD), Deborah Hursh (FDA), Insoo Hyun (Case Western/ISSCR), Richard Lee (Harvard/BWH), Jane Lebkowski (Geron), Olle Lindvall (Lund), Christine Mummery(Leiden), Amy Comstock Rick (Parkinsons Action Network/CAMR), Lorenz Studer (Sloan-Kettering), Jeremy Sugarman(Johns Hopkins), and Darin Weber (Biologics Consulting Group).

This event is organized by the National Academies’ Human Embryonic Stem Cell Research Advisory Committee.  It is free and open to the public, but advance registration is requested. 

For More Information or to Register

Ultrasound shown to exert remote control of brain circuits

In a twist on nontraditional uses of ultrasound, a group of neuroscientists at Arizona State University has developed pulsed ultrasound techniques that can remotely stimulate brain circuit activity. Their findings, published in the Oct. 29 issue of the journal Public Library of Science (PLoS) One, provide insights into how low-power ultrasound can be harnessed for the noninvasive neurostimulation of brain circuits and offers the potential for new treatments of brain disorders and disease. (Medicexchange)

Peter Singer Values Thriving

I try to be a realist and an idealist. I promote human exceptionalism, knowing that as an imperfect species, we are unlikely to ever fully achieve the dream of universal human equality. But the only way to get very close, it seems to me, is for our reach to exceed our grasp. That’s my idealism.

My realist side tells me that this ideal has been almost universally rejected at the level of the intelligentsia, and that our betters among the big brained intend to move us to a “quality of life” culture that will literally become a culture of death for the weak and vulnerable.

This is epitomized by the advocacy of Peter Singer. Alas, being a realist, I have to admit that Singer’s anti-human values are triumphing and becoming increasingly mainstream among society’s movers and shakers. Witness the appalling success of the Great Ape Project, about to become a legal reality in Spain only 15 years after it was launched. Witness the increasing respectability of infanticide, with the notion of killing babies for eugenic purposes not only occurring regularly in the Netherlands, but touted as a matter of respectable consideration in the New England Journal of Medicine, the Hastings Center Report, and the New York Times, among other places.

When Culture of Death first came out, my bioethicist critics claimed that it was all Peter Singer all the time and that he was a fringe thinker. That was bunkum, as I demonstrated in a letter reacting to one particularly caustic review. I wrote in part:

I am also criticized for quoting extensively from Joseph Fletcher and Peter Singer. I do make much of Fletcher, and with good reason. Based on the flow of events, it seems to me that he was, perhaps, the most influential American philosopher of the last half of the 20th century. (Would that Paul Ramsey had had such influence! Bioethics would have taken a far different path.) I am faulted for calling Fletcher the “patriarch of bioethics.” But I am not the first person to make that assertion. I was quoting Al Jonsen from his book on the history of bioethics. As to Peter Singer (who I like to call Son of Fletcher), he is probably the most publicly known and influential modern-day bioethicist, as painful as that may be to others in the movement. That is why he was brought from Australia to Princeton University, despite advocating the right of parents to kill unwanted infants during their period of nonpersonhood, among other travesties.

But to claim that I dwell almost exclusively on Fletcher and Singer is to do a real injustice to my work. I make it very clear that as important as these two are, they are not the sum and substance of bioethics. Indeed, I explore the thinking and advocacy of many prominent bioethics practitioners, including Callahan, Veatch, Harris, Glover, Beauchamp, Childress, Hardwig, Dworkin, Frey, Arnold, Youngner, Agich, and Caplan, among others. Most of these promote at least some “death culture” policies to one degree or another.

For example, while Callahan opposes assisted suicide, he is the nation’s foremost proponent of healthcare rationing and strongly supports futile care theory, both of which lead, at least implicitly in my view, to a duty to die. Meanwhile, Hardwig posited an explicit positive duty to die in a cover story for the Hastings Center Report. Battin also has supported the odious notion, among others. Frey believes that if we are going to vivisect animals we had better also be willing to vivisect those humans who have a lower moral status than animal subjects based on an inferior quality of life. Youngner believes in doing away with the dead donor rule in organ procurement. Veatch accepts redefining death to include a diagnosis of permanent unconsciousness. (I guess if such a person awakens, we would have to call it a resurrection.) Frankly, many among the general public are shocked and deeply disturbed when they learn that these are deemed respectable subjects in bioethics discourse.

If that was true then, it is even more true today. Indeed, proving the point, Singer will give the keynote address at the American Society for Bioethics and Humanities (ASBH), the primary professional organization in the field. This validation of Singer by the most important bioethics society in the country illustrates the radical direction in which the field is increasingly going. Fringe character my removed tonsils!

The answer, of course, is to never give up, but keep striving to let the greater population understand the wickedness that this way comes. As I alluded to in my letter, our hope lies in the common sense and decency of Main Street. The universities and similar environs are the problem, and are not likely to be the solution any time soon.

Alas.

China mother spared over mercy killing of daughter

A mother has been spared jail after admitting poisoning and smothering her 20-year-old mentally disabled daughter, a case that throws the spotlight on the plight of the mentally ill in China. (Reuters)

Immortalizing a Piece of Yourself

Scientists around the globe may soon be studying tiny bits of George Church. The Harvard Medical School professor of genetics will be one of the first people to have stem-cell lines created from his skin cells propagated and distributed worldwide–along with a record of the cells’ donor’s identity and genetic and medical quirks. (Technology Review)

The Mental Capacity Act 2: Patient advocacy and Ethics

It is important to respect patients’ wishes and be able to judge the occasions for their preferences – for example by not over-treating inappropriately – without compromise of long-accepted moral principles.

Patients near death will not benefit from burdensome and ineffective treatments, which can in such circumstances be inappropriate. Ethical issues will inevitably arise in practice. These will require understanding from all practitioners in the light of the wide-ranging effects of the act. The anticipated pressure felt by some patients who may already feel ‘a burden’ and a possible ‘drain’ on scarce resources should not be underestimated. (Nursing Times)

October 30, 2008

New Resource: “Health System Reform in China”

This Series marks an unprecedented scientific collaboration between The Lancet, Peking University Health Sciences Centre, and the China Medical Board. Health System Reform in China brings together the most recent scientific evidence on China’s major health challenges, strategies, and future. The Series was produced by a team of 63 scientists, with Chinese scientists constituting two-thirds of the authors, collaborating with an international team from 10 countries.  (TheLancet.com)

Interview: Rita Marker on I-1000

In this interview, Rita L. Marker, executive director of the International Task Force on Euthanasia and Assisted Suicide, discusses I-1000, the physician-assisted-suicide initiative on the ballot in Washington state in the 2008 elections, as well as the history of physician-assisted suicide over the past decade in the neighboring state of Oregon. (The New Atlantis)

Interview: Courtney Campbell on “Death with Dignity”

Courtney S. Campbell, the Hundere Professor in Religion and Culture at Oregon State University, is the author of the essay “Ten Years of ‛Death with Dignity’” in the Fall 2008 issue of The New Atlantis. In this interview, he discusses his essay and the lessons of the first decade of physician-assisted suicide in Oregon—as well as the lessons for the neighboring state of Washington, which is voting on a physician-assisted suicide initiative in the 2008 elections. (The New Atlantis)

Ten Years of “Death with Dignity”

The Oregon Death with Dignity Act (ODDA), which permits physicians to write a prescription for lethal drugs to qualified terminally ill patients, has been in effect for a little over a decade. It has, from October 1997 to the present, been the only such statute in the United States permitting what is variously called “physician-assisted suicide,” “physician aid in dying,” or “death with dignity” (the statute refers to the procedure as the ending of life in a “humane and dignified manner”). However, in the November 2008 election, citizens in the state of Washington will have an opportunity to vote on ballot initiative I-1000, a measure that is essentially the same as the Oregon statute. The advocacy group promoting I-1000 has drawn on features of the Oregon experience to indicate that the Oregon law is “very safe and effective” and that “aid in dying is working.” To weigh the claims made by supporters and opponents of the proposed Washington state initiative, we ought to carefully examine the first decade of Oregon’s experience with physician-assisted suicide. (The New Atlantis)

How High-Speed Gene Sequencing Works

The price of gene sequencing is falling fast and Helicos BioSciences is poised to push it down even further — perhaps below the $1,000 mark. (Wired)

Women Buying Health Policies Pay a Penalty

Striking new evidence has emerged of a widespread gap in the cost of health insurance, as women pay much more than men of the same age for individual insurance policies providing identical coverage, according to new data from insurance companies and online brokers. (New York Times)

Parents queue to select baby gender

A growing number of British couples are undergoing procedures at clinics overseas to determine the gender of their babies. However, as the BBC’s Colette McBeth reports, this service is often offered illegally. (BBC)

A New Issue of Journal of American Medical Association is Now Available

JAMA (Volume 300 Number 14, October 8 2008) is now available by subscription only.

Articles Include:

  • “Associations Between End-of-Life Discussions, Patient Mental Health, Medical Care Near Death, and Caregiver Bereavement Adjustment” by Alexi A. Wright, et al., 1665-1673
  • “Disclosing Genetic Research Results After Death of Pediatric Patients” by Adrienne C. Sexton and Syliva A. Metcalfe, 1693-1695
  • “Prenatal Genome Testing Sparks Debate” by Bridget M. Kuehn, 1637-1639
  • “Studies Address Racial and Geographic Disparities in Breast Cancer Treatment” by Tracy Hampton, 1641

Book Reviews Include:

  • “The Denial of Aging, Perpetual Youth, Eternal Life, and Other Dangerous Fantasies” by A. Mark Clarfield, 1701
  • “Beyond the Good Death The Anthropology of Modern Dying” by Michael B. Bevins, 1702
  • “Choosing to Die: Elective Death and Multiculturalism; Medically Assisted Death” by Ernie W.D. Young, 1703-1704
  • “End-of-Life Communication in the ICU: A Global Perspective” by Elaine C. Meyer, 1704-1705
  • “Euthanasia and Law in Europe” by Alan G. Williams, 1706

A New Issue of Cell Stem Cell is now Available

Cell Stem Cell (Volume 3, Issue 4, October 2008) is now available by subscription only.

Articles Include:

  • “Expandable Endodermal Progenitors: New Tools to Explore Endoderm and Its Derivatives” by Henrik Semb, 355
  • “Immune Privilege for Stem Cells: Not as Simple as It Looked” by Ann.P. Chidgey and Richard L. Boyd, 357
  • “Patterning Stem Cell Differentiation” by Gordana Vunjak-Novakovic, 359
  • “The Systematic Production of Cells for Cell Therapies” by Daniel C. Kirouac and Peter W. Zandstra, 369
  • “Extreme Makeover: Converting One Cell into Another” by Qiao Zhou and Douglas A. Melton, 382
  • “Dynamic Equilibrium and Heterogeneity of Mouse Pluripotent Stem Cells with Distinct Functional and Epigenetic States” by Katsuhiko Hayashi, Susana M. Chuva de Sousa Lopes, Fuchou Tang, and M. Azim Surani, 391
  • “Hematopoietic Stem Cell Quiescence Is Maintained by Compound Contributions of the Retinoblastoma Gene Family” by Patrick Viatour, Tim C. Somervaille, Shivkumar Venkatasubrahmanyam, Scott Kogan, Margaret E. McLaughlin, Irving L. Weissman, Atul J. Butte, Emmanuelle Passegué, and Julien Sage, 416
  • “Notch Signaling Regulates Mammary Stem Cell Function and Luminal Cell-Fate Commitment” by Toula Bouras, Bhupinder Pal, François Vaillant, Gwyndolen Harburg, Marie-Liesse Asselin-Labat, Samantha R. Oakes, Geoffrey J. Lindeman, and Jane E. Visvader, 429

A New Issue of Journal of Applied Philosophy is Available

Journal of Applied Philosophy (Volume 25, Issue 24, November) 2008 is now available by subscription only.

Articles Include:

  • “The Metaphysical Status of the Embryo: Some Arguments Revisited” by David S. Oderberg, 263-276
  • “Recognizing Humanity” by John Haldane, 301-313

Book Reviews Include:

  • “Choosing Between Possible Lives: Law and Ethics of Prenatal and Preimplantation Genetic Diagnosis by R. Scott” by John McMillan, 355-357

October 29, 2008

Op-Ed: The Business Case for Managed Death

Supporters and critics of physician-assisted suicide agree on at least one thing: terminally ill patients who take an early exit save the health care system money. (New York Times)

Op-Ed: Assisted dying laws do not always protect the vulnerable

End-of-life decisions made by doctors are not the same as ending-life decisions, says Ilora Finlay.

Simon Jenkins’s article on assisted dying contains so many misconceptions that it is difficult to know where to begin in refuting them (Denial of the right to die is sheer religious primitivism, October 22).

First, it is nonsense that “one third of all registered deaths are caused by morphine overdose”. Those of us who practise end-of-life medicine know the evidence that morphine, used correctly, is a very effective drug which can actually extend life by controlling pain and breathlessness and avoiding the exhaustion of unrelieved symptoms. Prescribing morphine properly is humane, compassionate and safe – it does not kill. Just because there is a last dose of a drug – or a last cup of tea – does not mean that either killed the patient dying of advanced disease. (Guardian)

IVF criminal checks ‘draconian’

Doctors have intensified their campaign against criminal checks for women seeking fertility treatment, blasting the State Government’s proposed laws as draconian, totalitarian legislation. (Melbourne Herald Sun)

Parents queue to select baby gender

A growing number of British couples are undergoing procedures at clinics overseas to determine the gender of their babies. However, as the BBC’s Colette McBeth reports, this service is often offered illegally. (BBC)

 

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