Tag: alcohol abuse

Bioethics Blogs

NIH Family Members Giving Back: Toben Nelson

Caption: Toben Nelson (back row, far left) celebrates with his Roseville Raiders after winning Gopher State Tournament of Champions.
Caption: Heather Hammond Nelson

What was Toben Nelson, a University of Minnesota epidemiologist who studies the health risks of alcohol abuse and obesity, doing this summer lugging around a heavy equipment bag after work? Giving back to his community. Nelson volunteered as a coach for the Roseville Raiders, a 13-year-old-and-under traveling baseball team that just wrapped up its season by winning the prestigious Gopher State Tournament of Champions in their age group.

In the fall, Nelson will gear up for hoops as the volunteer president of the Roseville Youth Basketball Association, which provides an opportunity for kids in this Minneapolis-St. Paul suburb to take part in organized sports. Nelson says volunteering grounds him as a scientist. It reminds him every single day that his NIH-supported research back at the office affects real lives and benefits real communities like his own.

Nelson is currently studying strategies to prevent alcohol-related injuries and violence. He also works on projects to promote physical activity and prevent childhood obesity. Over the years, he and his colleagues have collected a lot of data on teens and young adults, and they know a tremendous amount about their health status, their behaviors and their risks for excessive drinking or becoming overweight. Still, what’s often missing is a connection to the real faces and unique personalities of young people navigating these formative years.

So Nelson downregulates the keen analytical side of his brain on most evenings around 5:30 p.m.

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 Blogs

Sickle Cell Disease: Gene-Editing Tools Point to Possible Ultimate Cure

Caption: An electron micrograph showing two red blood cells, one normal (right) and the other (left) deformed by crystalline hemoglobin into the “sickle” shape characteristic of patients with sickle cell disease.
Credit: Frans Kuypers: RBClab.com, UCSF Benioff Children’s Hospital Oakland

Scientists first described the sickle-shaped red blood cells that give sickle cell disease its name more than a century ago. By the 1950s, the precise molecular and genetic underpinnings of this painful and debilitating condition had become clear, making sickle cell the first “molecular disease” ever characterized. The cause is a single letter “typo” in the gene encoding oxygen-carrying hemoglobin. Red blood cells containing the defective hemoglobin become stiff, deformed, and prone to clumping. Individuals carrying one copy of the sickle mutation have sickle trait, and are generally fine. Those with two copies have sickle cell disease and face major medical challenges. Yet, despite all this progress in scientific understanding, nearly 70 years later, we still have no safe and reliable means for a cure.

Recent advances in CRISPR/Cas9 gene-editing tools, which the blog has highlighted in the past, have renewed hope that it might be possible to cure sickle cell disease by correcting DNA typos in just the right set of cells. Now, in a study published in Science Translational Medicine, an NIH-funded research team has taken an encouraging step toward this goal [1]. For the first time, the scientists showed that it’s possible to correct the hemoglobin mutation in blood-forming human stem cells, taken directly from donors, at a frequency that might be sufficient to help patients.

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 Blogs

Suppression of Necessary Gun Violence Research

STUDENT VOICES | CHYNN PRIZE SECOND-PLACE WINNER

By Colette Berg

Late in July 2015, my mother asked a surgeon friend of hers his opinion on gun control. He shook his head sadly and said, “I’ve operated on good guys shot by burglars, I’ve operated on parents accidentally shot by their children and children accidentally shot by their parents. But never have I once operated on a bad guy shot by a good guy.” He does not buy the popular notion that “good guys” with guns can defend themselves from “bad guys” with guns. Of course, this an anecdote from the life of one surgeon. However, most peoples’ opinions on gun control are based on intuition and personal experience rather than data. Good data about gun violence is hard to find, because Congress has refused to provide funding for gun violence research since 1996.

In 1993, a study in the New England Journal of Medicine found a strong correlation between gun ownership and homicide. The conclusions stated, “Rather than confer protection, guns kept in the home are associated with an increase in the risk of homicide by a family member or intimate acquaintance.”1 This study was funded by the Center for Disease Control. Immediately after its publication, the National Rifle Association began to lobby for the “elimination of the center that had funded the study, the CDC’s National Center for Injury Prevention.”2 Their efforts to shut down the Center for Injury prevention failed, but “the House of Representatives removed $2.6 million from the CDC’s budget—precisely the amount the agency had spent on firearm injury research the previous year.”3

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 Blogs

In the Journals – August 2016 by Anna Zogas

Here are some of the articles published in the journals in August 2016. This post includes the abstracts from a special issue of Anthropology & Medicine, “Medical Pluralism and Beyond.” Enjoy!

American Ethnologist

The postneoliberal fabulation of power: On statecraft, precarious infrastructures, and public mobilization in Brazil
João Biehl

In Brazil’s hybrid government of social protection and market expansion, there is under way a fabulation of power, which ultimately serves to “de-poor” people seeking care, working infrastructures, and justice while also shoring up state politics as usual. This process became evident through the failure of a collaborative research project that I coordinated on right-to-health litigation. In rethinking that failure as an experiment in public ethnography, I draw on core disagreements with public officials over the interpretation of our findings from a legal database. Analyzing these disagreements provides an entry point into the mechanisms of veridiction and falsification at work in Brazil, whose government sees itself as providing public goods beyond the minimum neoliberal state. Countering state mythology, public ethnography thus illuminates the improvised quality of postneoliberal democratic institutions and opens up new avenues for theorizing power and the political field.

Royal pharmaceuticals: Bioprospecting, rights, and traditional authority in South Africa
Christopher Morris

The translation of international biogenetic resource rights to a former apartheid homeland is fostering business partnerships between South African traditional leaders and multinational pharmaceutical companies. In the case of one contentious resource, these partnerships are entrenching, and in some instances expanding, apartheid-associated boundaries and configurations of power. The state and corporate task of producing communities amenable to biodiversity commercialization and conservation is entangled with segregationist laws and spatial planning.

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 Blogs

In the Journals May 2016 Part II by Melanie Boeckmann

Part I can be found here. 

Social Science & Medicine 

Where the lay and the technical meet: Using an anthropology of interfaces to explain persistent reproductive health disparities in West Africa

Yannick Jaffré, Siri Suh

Despite impressive global investment in reproductive health programs in West Africa, maternal mortality remains unacceptably high and obstetric care is often inadequate. Fertility is among the highest in the world, while contraceptive prevalence remains among the lowest. This paper explores the social and technical dimensions of this situation. We argue that effective reproductive health programs require analyzing the interfaces between technical programs and the social logics and behaviors of health professionals and client populations. Significant gaps between health programs’ goals and the behaviors of patients and health care professionals have been observed. While public health projects aim to manage reproduction, sexuality, fertility, and professional practices are regulated socially. Such projects may target technical practices, but access to care is greatly influenced by social norms and ethics. This paper shows how an empirical anthropology that investigates the social and technical interfaces of reproduction can contribute to improved global health.

 Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes

Annegret F. Hannawa, Yuki Shigemoto, Todd D. Little

Rationale

This study investigates the intrapersonal and interpersonal factors and processes that are associated with patient forgiveness of a provider in the aftermath of a harmful medical error.

Objective

This study aims to examine what antecedents are most predictive of patient forgiveness and non-forgiveness, and the extent to which social-cognitive factors (i.e., fault attributions, empathy, rumination) influence the forgiveness process.

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 Blogs

Half-and-Half Wits May 6, 2016 Transgendered men and women have some of the highest rates of…

May 06, 2016

by Sean Philpott-Jones, Chair, Bioethics Program of Clarkson University & Icahn School of Medicine at Mount Sinai

I lost a friend last week. I didn’t lose her in the physical sense. She didn’t pass away or move to the other side of the globe. Rather, after a disturbing online exchange, I made the decision to, in the words of Gwyneth Paltrow, ‘consciously uncouple’ myself from her.

What happened was this: on her Facebook page she posted a popular Internet meme that read, “If Caitlyn Jenner went missing, would her picture appear on the back of a carton of half-and-half?” While some people might find a celebrity-mocking joke like this funny, I found it in exceedingly bad taste. 

I was also surprised that this joke was posted by someone who is herself a member of the LGBT (lesbian, gay, bisexual and transgender) community. I asked her to take the post down, explaining my concerns about the type of message that a joke like that sends. She refused and our online conversation quickly went downhill. I finally ‘de-friended’ her.

Now anyone who knows me well should know that I rarely take offense at jokes. I enjoy sarcastic, self-depreciating and (often) inappropriate humor, particularly of the type that skewers celebrities and politicians, or that calls out some of the absurdities of modern life. My snarky comment about Gwyneth Paltrow is proof of that. So what was it about this joke that got me so riled up?

The problem with a joke like the one about Caitlyn Jenner is it perpetuates ugly stereotypes about the transgender community.

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 Blogs

Neuroethics and the BRAIN Initiative

By Henry T. Greely

Hank Greely is the Deane F. and Kate Edelman Johnson Professor of Law and Professor, by courtesy, of Genetics at Stanford University. He specializes in ethical, legal, and social issues arising from advances in the biosciences, particularly from genetics, neuroscience, and human stem cell research. He directs the Stanford Center for Law and the Biosciences and the Stanford Program in Neuroscience in Society; chairs the California Advisory Committee on Human Stem Cell Research; and serves on the Neuroscience Forum of the Institute of Medicine, the Advisory Council for the National Institute for General Medical Sciences of NIH, the Committee on Science, Technology, and Law of the National Academy of Sciences, and the NIH Multi-Council Working Group on the BRAIN Initiative. He was elected a fellow of the American Association for the Advancement of Science in 2007. His book, THE END OF SEX AND THE FUTURE OF HUMAN REPRODUCTION, was published in May 2016.

Professor Greely graduated from Stanford in 1974 and from Yale Law School in 1977. He served as a law clerk for Judge John Minor Wisdom on the United States Court of Appeals for the Fifth Circuit and for Justice Potter Stewart of the United States Supreme Court. After working during the Carter Administration in the Departments of Defense and Energy, he entered private practice in Los Angeles in 1981 as a litigator with the law firm of Tuttle & Taylor, Inc. He joined the Stanford faculty in 1985.

On April 2, 2013, President Obama launched the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative®.

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 Blogs

Zika, Gandhi and the CDC

Guest Post by Agomoni Ganguli Mitra

Three pieces of news over the last weeks particularly troubled me.  In the first, and perhaps most radical of them all, Latin American governments began to urge women not to become pregnant over the next couple of years, as a public health measure to restrict the number of children born with microcephaly, potentially caused by the Zika virus currently plaguing the region.  The second came from the Indian Minister of Women and Child Development, Maneka Gandhi, one of the highest ranking officials in the current Indian government.  For years, India has struggled with non-medical sex-selective abortion (and female infanticide) in such significant numbers, that the sex-ratio for infants in certain regions has become heavily skewed.  Despite sex-determination being illegal since 1994, the practice has continued with the complicity of physicians and clinics, and in some cases without the consent of the pregnant women themselves.  At a conference in early February, Gandhi suggested that an alternative to the current, ineffective policy of criminalising those who provide ultrasounds and sex-selective abortions, would be to register and monitor every pregnant woman in the country to ensure that female foetuses are brought to term and female infants are not killed shortly after birth.  The last and most recent piece is perhaps the least shocking of them all, if only because we almost take it for granted that women’s health and lifestyles choices are seen to be closely related to their ability and inclination to produce babies.  The US government’s Centre for Disease Control and Prevention (CDC), in a bulletin patronisingly subtitled Why Take the Chance?

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

Should high school football be banned?

Bioethics is closing in on American football. An expert on concussion writing in the New York Times says that children should be allowed to play until they have reached the age of consent.

It is our moral duty as a society to protect the most vulnerable of us. The human brain becomes fully developed at about 18 to 25 years old. We should at least wait for our children to grow up, be provided with the information and education on the risk of play, and let them make their own decisions. No adult, not a parent or a coach, should be allowed to make this potentially life-altering decision for a child.

Dr Bennet Omalu, who first diagnosed  Chronic Traumatic Encephalopathy (CTE) in 2002 (and is the subject of the recent film Concussion), says that young players are at risk of  “major depression, memory loss, suicidal thought and actions, loss of intelligence as well as dementia later in life [and] drug and alcohol abuse as the child enters his 20s, 30s and 40s”.

In January the American Journal of Bioethics is to publish an even starker picture of the risks of football. Steven H. Miles and Shailendra Prasad argue in a pre-publlication blog post that public school tackle football programs should be banned because of the high prevalence of concussions.

The authors discuss two additional complications in addition to the possible harm that football can cause: consent and dual loyalty.

High school players are not capable of giving informed consent, they say. Existing consent forms do not quantity risk or minimize it.

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 Sheen’s reluctant bioethics script

The real lives of Hollywood stars often have just as much bioethical interest as their movies. This week Charlie Sheen, a popular actor in film and television with a colourful personal life, admitted that he was HIV positive on the Today show. He was diagnosed about four years ago and the disease is under control.

But this is not just another ho-hum personal tragedy. Apart from his self-destructive drug and alcohol abuse, compulsive promiscuity is part of Sheen’s public image and questions were immediately raised about whether he had infected one of his wives or many sex partners without informing them of his HIV status. Knowingly infecting a partner is a criminal offence in California. Prosecution is rare because a high bar has been set for the standard of proof but Sheen could be sued civilly for negligence, emotional distress or sexual battery.

The 50-year-old actor went public to protect himself against blackmailers who had extorted US$4 million from him over the past four years. “I release myself from this prison today,” he said.  “I have paid those people — not that many — but enough to where it has depleted the future. Enough to bring it into the millions.”

The bioethical take-away? The extreme importance of protecting medical record privacy.

According to the Washington Post, “opportunistic criminals are beginning to resort to similar schemes targeted at anyone who might potentially be hurt or embarrassed if others had access to information about their mental illness, nose job, abortion, or the fact that they’re going through bottles of Viagra”.

Now that doctors and health care institutions are digitising all of their medical records, hackers are having a field day.

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.