Category: Bioethics News

Bioethics News

Striking a Balance

By Peter Young

 

In April of this year, the Berman Institute and Johns Hopkins Hospital Ethics Committee held its monthly Ethics for Lunch case presentation focusing on how to manage patients who make racist, sexist, and otherwise offensive comments. The discussion, moderated by Dr. Joseph Carrese, featured panelists who have experienced racism/sexism in the clinic, and it allowed audience to gain insight from their perspectives.

 

During the discussion, there was mention that minority patients in an in-patient setting cannot choose their own doctor based solely on race, because Hopkins’ practice is to pair the best doctor with a patient’s medical needs. I was a bit confused how minority patients not being able to choose race-based concordance in an in-patient setting fits into the larger, nation-wide conversation of minority groups wanting safe spaces. For example, some argue the race of the physician affects the quality of care, and when the provider and patient’s race align, the provider can speak better to certain beliefs, religious practices, nutritional knowledge, and cultural norms. Also, there may be even subtler, yet equally important benefits of having your provider look like you, especially in our current political climate. This includes patient-compliance as well as the potential for less polarizing power dynamics in the provider-patient relationship.

 

Scholars like Dr. Dayna Bowen Matthew, author of Just Medicine and professor at University of Colorado, might argue that if a white, middle-class person tells an intercity, minority person to take their medication, that patient may be less likely to adhere.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Wisconsin Company to Implant Microchips In Employees

July 24, 2017

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The company designs software for break room markets that are commonly found in office complexes.

Just as people are able to purchase items at the market using phones, Westby wants to do the same thing using a microchip implanted inside a person’s hand.

“We’ll come up, scan the item,” he explained, while showing how the process will work at an actual break room market kiosk. “We’ll hit pay with a credit card, and it’s asking to swipe my proximity payment now. I’ll hold my hand up, just like my cell phone, and it’ll pay for my product.”

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Image: By Amal Graafstra (ishmell) – Flickr, CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=87190

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KTSP TV

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Source: Bioethics Bulletin by the Berman Institute of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

A DNA App Store Is Here, but Proceed with Caution

July 24, 2017

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A Silicon Valley startup called Helix is betting on the notion that not only do people want to learn more about their DNA, but they’ll also pay to keep interacting with it.

Today the company, which was founded in 2015 with $100 million from genomics giant Illumina, is launching its much-anticipated online hub where people can digitally explore their genetic code by downloading different applications on their computers or mobile devices. Think of it as an app store for your genome (see “10 Breakthrough Technologies 2016: DNA App Store”).

Personalized genetic information has become an affordable commodity. The early success of leaders like 23andMe and AncestryDNA, which sell DNA testing kits for $200 or less, has ushered in a wave of new companies offering direct-to-consumer genetic tests for everything from ancestry to the wine you should drink based on your DNA.

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MIT Technology Review

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Source: Bioethics Bulletin by the Berman Institute of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Companies Rush to Develop ‘Utterly Transformative’ Gene Therapies

July 24, 2017

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Companies and universities are racing to develop these new therapies, which re-engineer and turbocharge millions of a patient’s own immune cells, turning them into cancer killers that researchers call a “living drug.” One of the big goals now is to get them to work for many other cancers, including those of the breast, prostate, ovary, lung and pancreas.

“This has been utterly transformative in blood cancers,” said Dr. Stephan Grupp, director of the cancer immunotherapy program at the Children’s Hospital of Philadelphia, a professor of pediatrics at the University of Pennsylvania and a leader of major studies. “If it can start to work in solid tumors, it will be utterly transformative for the whole field.”

But it will take time to find that out, he said, at least five years.

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Image: By NIAID/NIH – NIAID Flickr’s photostream, Public Domain, https://commons.wikimedia.org/w/index.php?curid=18233598

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NYTimes

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Source: Bioethics Bulletin by the Berman Institute of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Charlie Gard’s Parents End Legal Fight As Time Runs Out for Baby

July 24, 2017

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The parents of terminally-ill baby Charlie Gard have ended their legal challenge to take him to the US for experimental treatment.

A lawyer representing Chris Gard and Connie Yates told the High Court that “time had run out” for the baby.

Grant Armstrong said Charlie’s parents had made the decision because an American doctor said it was too late to give him nucleoside therapy.

“The parents’ worst fears have been confirmed”, Mr Armstrong said.

“It is now too late to treat Charlie,” he continued.

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Image: By Kashmiri, based on earlier work by Domaina – Own work based on Autosomal dominant – en.svg and Autorecessive.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19018894

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BBC News

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Source: Bioethics Bulletin by the Berman Institute of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

New artificial species. Could they affect biodiversity?

An article was recently published in the blog Practical Ethics, defending the use of synthetic biology and gene editing to obtain new organisms that do not exist in nature. Its author argues that if biodiversity is valuable, then it should be promoted, adding new species instead of conserving it as it is.

Contrary to the commonly assumed idea that current levels are optimal, he says that global biodiversity has been deeply affected by the acts of humans, having lost countless species. Moreover, he denies that ecosystems are fragile and finely balanced units, arguing on one side that the interactions between organisms tend to undermine their stability and, on the other, that the introduction of a new species does not have a major biological impact, statements that seem contradictory.

Artificial species and biodiversity

The aforementioned article lacks references that support these novel views on biodiversity and ecosystems, which contrasts with what has so far been understood and observed from the biological and environmental sciences. Nevertheless, even if his statements were true, this does not lead to the conclusion that it is advisable to increase the present biodiversity by producing new artificial species.

Neither does it mention whether the species produced should be non-pathogenic, or whether the researchers should take into account the type of organisms produced, their number, place of release, evolution perspectives (never completely controllable), organisms with which they would interact, etc. We do not believe it necessary to explain why it would not be appropriate to introduce organisms into the natural environment without first taking into account these and other considerations.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

First case of deceased donor uterine transplantation. It is a relevant medical and social issue

Being able to resolve the reproductive problems suffered by women who have no uterus – whether due to an organic cause or functional abnormality of the uterus – is unquestionably a major medical and social issue.

The two possible solutions to this problem are uterus transplantation or surrogacy, the latter solution presenting objective ethical difficulties.

Uterus transplants to date have been performed using living donors, with unpredictable outcomes. Now, the first case of deceased donor uterine transplantation performed in the United States has been published. The recipient of the uterus was a woman with Mayer-Rokitansky-Kuster-Hauser syndrome, that is, she had no uterus.

The journal Fertility and Sterility has disseminated a video describing the essential steps in this transplantation process, particularly as regards selection of a suitable donor with no history of infertility or uterine malformations. The death of the donor should be determined by presentation of brain death but not cardiac death. The authors concluded that: “Uterine transplantation, although currently experimental, has gained the potential to become the first true treatment for uterine factor infertility. This procedure can become a promising option for the approximately 1.5 million women worldwide for whom pregnancy is not possible because of the absence of the uterus or presence of a nonfunctional uterus. Deceased donor uterine transplantation will further serve to broaden accessibility for this treatment.”

Ethical approach

For our part, as the organ donor is a deceased person with brain death (see true definition of this death HERE), we see no ethical issue for this practice; on the contrary, it seems an encouraging medical prospect to resolve the reproductive problem of women who have no uterus or whose uterus is not functionally useful, although the risk-benefit balance must always be taken into account, especially as regards the surgical act.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Recent findings. Children conceived through assisted reproduction, now adolescents, have more medical problems

These recent findings should be taken into consideration when making an ethical assessment of assisted reproduction.

An issue that often arises is whether children conceived through assisted reproductive technique – ART (see HERE) present more medical and/or mental health problems when they reach adolescence than those conceived naturally. A recent study (see Abstract) that evaluated the development of 253 adolescents conceived using assisted reproductive techniques compared to a similar group of adolescents conceived naturally found that “no differences were detected in general and mental health of ART adolescents or cognitive ability, compared with the reference group.” However, “follow-up […] revealed that male ART adolescents had significantly more doctor’s appointments compared with the reference group.” Nonetheless, the authors point out that further studies with larger cohorts are needed to confirm these results.

Findings detect a higher risk of cardiovascular disease and higher blood pressure

In a second study, also published in Fertility and Sterility, more metabolic and cardiovascular disorders were detected in children conceived by ART. This systematic review and meta-analysis examined 19 studies that included 2,112 ART-conceived and 4,096 naturally-conceived children, who were followed to adulthood. It found that the blood pressure of those conceived by ART was statistically higher than those conceived naturally. Furthermore, the cardiac diastolic function was suboptimal and blood vessel thickness was higher.

Conclusion

The authors conclude that their findings suggest a higher risk of cardiovascular disease in children conceived by ART, which calls for further research to be able to corroborate these data.

There is no doubt that these findings should be taken into consideration when making an ethical assessment of assisted reproduction.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

To Shrink Mosquito Population, Scientists Are Releasing 20 Million Mosquitoes

July 21, 2017

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This summer, scientists in California are releasing 20 million mosquitoes in an effort to shrink the population of mosquitoes that can carry diseases.

It sounds counterintuitive. But the plan is to release millions of sterile male mosquitoes, which will then mate with wild female mosquitoes. The eggs the females lay won’t hatch, researchers say.

The project is called Debug Fresno and it’s being undertaken by Verily, a subsidiary of Alphabet, Google’s holding company. It’s the company’s first field study involving sterile mosquitoes in the U.S.

Scientists say the goal is to cut the population of Aedes aegypti mosquitoes — the species responsible for spreading Zika, dengue and chikungunya. A. aegypti have been present in California’s Central Valley since 2013 and have been a problem in Fresno County.

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NPR The Two-Way

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Source: Bioethics Bulletin by the Berman Institute of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Neuroscience Offers Insights Into the Opioid Epidemic

July 21, 2017

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Most Americans say they’re interested in scientific discoveries, but they may be thinking of the kinds of findings that lead to new gadgets and wonder drugs. When it comes to discoveries about hazards and risks — especially the risks of those wonder drugs — Americans seem more likely to tune out.

Such ambivalence might help explain how opioid misuse became such a problem in America. Despite 20 years of warnings from scientists about the dangers of addiction, the rate of prescriptions has tripled between 1999 and today. It hit a peak around 2012 and has started to decline slightly, going from 81.2 per 100 people to a still-enormous 70.6 per 100, new data show. Indeed, according to the Centers for Disease Control and Prevention, U.S. doctors wrote 259 million prescriptions for potentially addictive painkillers in 2014 — enough for every adult in the country to have a bottle.

All the while, neuroscientists have found that opioids can cause long-term changes in the brain even after an addicted person experiences the severe nausea and other withdrawal symptoms typically associated with quitting. That lingering hazard might have given patients and prescribing physicians pause.

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Image: By PNAS – doi: 10.1073/pnas.1117206109, CC BY 2.5 br, https://commons.wikimedia.org/w/index.php?curid=18829817

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Bloomberg View

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Source: Bioethics Bulletin by the Berman Institute of Bioethics.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.