Tag: bioethics

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Opioid Overdoses Leading to More ICU Admissions and Deaths

August 17, 2017

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“People who use injection drugs should obtain naloxone, the overdose reversal drug, and use drugs with partners who can help them,” said Brendan Saloner, a researcher at the Johns Hopkins Bloomberg School of Public Health in Baltimore who wasn’t involved in the study.

In many states, family members can get naloxone, sometimes without a prescription, Saloner said by email. Two medications, buprenorphine and methadone, can also help reduce drug use.

“There is unfortunately a lot of stigma about medication treatments, but they are safe and work,” Saloner added. “Long-term change is possible and recovery is a realistic goal, but it requires time and patience.”

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Image: By Bullenwächter – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17856929

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Reuters

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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.

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China’s Embrace of Embryo Selection Raises Thorny Questions

August 16, 2017

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Getting time with Qiao Jie is not easy. At 7:30 a.m., the line coming out of the fertility centre that she runs blocks the doorway and extends some 80 metres down the street. Inside, about 50 physicians on her team are discussing recent findings, but Qiao, a fertility specialist and president of Peking University Third Hospital in Beijing, is still in an early-morning consult.

When she finally emerges, she jumps to the topic at hand: spreading awareness of preimplantation genetic diagnosis (PGD), a procedure that helps couples undergoing in vitro fertilization (IVF) to avoid passing on genetic mutations that could cause disease or disability in their children. Qiao typically refuses interview requests, but she’s concerned that people aren’t getting the message about PGD fast enough. “Now, more and more diseases can be stopped — if not immediately, in the generation after next,” she says.

Early experiments are beginning to show how genome-editing technologies such as CRISPR might one day fix disease-causing mutations before embryos are implanted. But refining the techniques and getting regulatory approval will take years. PGD has already helped thousands of couples. And whereas the expansion of PGD around the world has generally been slow, in China, it is starting to explode.

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Image: By Zephyris at the English language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=5971161

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Nature News

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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.

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China Launches Brain-Imaging Factory

August 16, 2017

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Neuroscientists who painstakingly map the twists and turns of neural circuitry through the brain are about to see their field expand to an industrial scale. A huge facility set to open in Suzhou, China, next month should transform high-resolution brain mapping, its developers say.

Where typical laboratories might use one or two brain-imaging systems, the new facility boasts 50 automated machines that can rapidly slice up a mouse brain, snap high-definition pictures of each slice and reconstruct those into a 3D picture. This factory-like scale will “dramatically accelerate progress”, says Hongkui Zeng, a molecular biologist at the Allen Institute for Brain Science in Seattle, Washington, which is partnering with the centre. “Large-scale, standardized data generation in an industrial manner will change the way neuroscience is done,” she says.

The institute, which will also image human brains, aims to be an international hub that will help researchers to map neural connectivity for everything from studies of Alzheimer’s disease to brain-inspired artificial-intelligence projects, says Qingming Luo, a researcher in biomedical imaging at the Huazhong University of Science and Technology (HUST) in Wuhan, China. Luo leads the new facility, called the HUST-Suzhou Institute for Brainsmatics, which has a 5-year budget of 450 million yuan (US$67 million) and will employ some 120 scientists and technicians. Luo, who calls himself a “brainsmatician”, also built the institute’s high-speed brain-imaging systems.

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Nature News

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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.

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Can We Feed The World With Farmed Fish?

August 16, 2017

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But new research suggests there is space on the open ocean for farming essentially all the seafood humans can eat. A team of scientists led by Rebecca Gentry, of the University of California, Santa Barbara, found that widescale aquaculture utilizing much of the ocean’s coastal waters could outproduce the global demand for seafood by a staggering 100 times.

Their paper, published Monday in the journal Nature Ecology & Evolution, could have significant implications for a planet whose human population is projected to reach 10 billion by 2050. Nearly every coastal country has the potential to meet its own domestic demand for seafood, “typically using only a minute fraction of its ocean territory,” write the authors.

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Image: By Asc1733 – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=47649920

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NPR The Salt

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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.

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A Start-Up Suggests a Fix to the Health Care Morass

August 16, 2017

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In Congress, a doomed plan to repeal the Affordable Care Act, President Obama’s health care law, has turned into a precarious effort to rescue it. Meanwhile, President Trump is still threatening to mortally wound the law — which he insists, falsely, is collapsing anyway — while his administration is undermining its being carried out.

So it is surprising that across the continent from Washington, investors and technology entrepreneurs in Silicon Valley see the American health care system as the next great market for reform.

Some of their interest is because of advances in technology like smartphones, wearable health devices (like smart watches), artificial intelligence, and genetic testing and sequencing. There is a regulatory angle: The Affordable Care Act added tens of millions of people to the health care market, and the law created several incentives for start-ups to change how health care is provided. The most prominent of these is Oscar, a start-up co-founded by Joshua Kushner (the younger brother of Mr. Trump’s son-in-law, Jared Kushner), which has found ways to mine health care data to create a better health insurance service.

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NYTimes

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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.

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Artificial Womb Maintains Lamb Preemie Lives, Signals Hope for Human Preemie Care

Using an artificial womb, a team of researchers affiliated with the University of Western Australia have effectively incubated premature lambs for seven days, signaling potential future advancements for human preemie care options. The American Journal of Obstetrics and Gynecology published a paper this past week detailing the ex-vivo uterine environment (EVE) therapy technique devised by the researchers, which involves putting the premature lamb in a bath of amniotic fluid that includes an artificial placenta.

The conditions of EVE therapy mimic those of an actual womb, including increased gas exchange and nutrient delivery for the prematurely delivered lamb. For an infant developing outside the womb prematurely, the unfavorable conditions can lead to adversely affected development or complications.

“At its core, our equipment is essentially is a high-tech amniotic fluid bath combined with an artificial placenta. Put those together, and with careful maintenance what you’ve got is an artificial womb,” Local Chief Investigator and UWA Associate Professor Matt Kemp said. “By providing an alternative means of gas exchange for the fetus, we hoped to spare the extremely preterm cardiopulmonary system from ventilation-derived injury, and save the lives of those babies whose lungs are too immature to breathe properly. The end goal is to provide preterm babies the chance to better develop their lungs and other important organs before being brought into the world.”

Sparking bioethical questions regarding pregnancy, abortion, and perhaps even conception, the research is certainly promising for infant health, yet consequently complex in its potential ramifications. The paper follows one published in April by the Center for Fetal Research in Philadelphia, in which premature lambs survived for four additional weeks  prior to delivery.

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.

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Pregnant Women Absent from Zika Vaccine Trials

August 15, 2017

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This uncertainty is a major reason behind researchers’ hesitancy to expose pregnant women to newer vaccines. Women do indeed get vaccinated while pregnant—against the flu or tetanus, diphtheria, and pertussis (Tdap), for example. But “the overall safety for flu and Tdap vaccines was established in very large populations prior to being administered to pregnant women,” says August.

Some vaccines—such as the flu vaccine—included pregnant women in clinical trials. And, notably, pregnant women were included in Phase 3 trials for the new respiratory syncytial virus (RSV) vaccine that prevents a devastating, potentially fatal infection that targets infants.

But recommendations for vaccination during pregnancy are not always backed by clinical trials. “Historically, many of the recommendations have relied on observational data,” writes Johns Hopkins bioethicist Carleigh Krubiner in an email to The Scientist. She, along with August, is part of the working group who wrote the Wellcome Trust-funded guidelines for Zika vaccine administration in expectant moms. In these cases, pregnant women were either intentionally or unintentionally given vaccines, then mother and child were observed.

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See also: PREGNANT WOMEN & THE ZIKA VIRUS VACCINE RESEARCH AGENDA: ETHICS GUIDANCE ON PRIORITIES, INCLUSION, AND EVIDENCE GENERATION

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The Scientist

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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.

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Review of countries where Euthanasia has been legalised. Increaing of involuntary euthanasia, without consent by patients

Euthanasia a Slippery slope that could end in involuntary euthanasia

Euthanasia was legalised in Belgium in 2002, where is defined as “the intentional termination of a patient’s life by a physician at the patient’s request”, so that only voluntary euthanasia may be legally carried out in Belgium (J Med Ethics 41; 625-629, 2015). However, this legal requirement of voluntarism is not always fulfilled.

Thus, a study conducted in Flanders in 1996 found that 3.3% of cases of euthanasia had occurred without the prior request of the patient. In other words, they were involuntary euthanasias. Another study (also in Flanders) found that there had been 1796 cases of involuntary euthanasias (3.2%). A more recent study from 2007 found that the percentage of involuntary euthanasia was 1.8%, while another in 2013 found 1.7%.

However — and we believe this is important — the percentage of involuntary euthanasia in patients who were 80-years-old or over rose to 52.7%, while in those with diseases other than cancer, this figure reached 67.5%. The decision was not discussed with the patient in 77.9% of cases (J Med Ethics 41; 625-629, 2015).

Canada experience

A Recent statement of Professor Somerville, who spent 40 years living and working in Canada,  has recently returned home to Australia to take up the position of Professor of Bioethics in the School of Medicine at The University of Notre Dame Australia, Sydney where she says claims by Australian pro-euthanasia advocates, including media personality Andrew Denton, that euthanasia and assisted suicide is working safely overseas don’t stand up to basic scrutiny.

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.

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The Robot That Staves Off Loneliness for Chronically Ill Children

August 14, 2017

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As a rule of thumb, the best ideas are the simplest. That’s easy to forget in an age of rapid technological innovation, when the tendency is to be led by capability rather than need.

For as Karen Dolva, co-founder of the Norwegian startup No Isolation, says: “There are a lot of engineers who don’t want to make something useful – they want to make something cool.”

Dolva, a 26-year-old who studied computer science and interaction design at Oslo University, is not one of them. She and her two co-founders – Marius Aabel and Matias Doyle – are all about utility. As their company name suggests, they are looking to end human isolation. It’s a massive undertaking, but they’ve started with a distinct and overlooked group: sick children.

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The Guardian

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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.

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Drugs that Go Through FDA’s Expedited Review Might Be Better Drugs

August 14, 2017

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A new paper in the latest issue of Health Affairs is worth a look. “Drugs Cleared Through The FDA’s Expedited Review Offer Greater Gains Than Drugs Approved By Conventional Process“:

We investigated whether drugs approved by the Food and Drug Administration (FDA) through expedited review have offered larger health gains, compared to drugs approved through conventional review processes. We identified published estimates of additional health gains (measured in quality-adjusted life-years, or QALYs) associated with drugs approved in the period 1999–2012 through expedited (seventy-six drugs) versus conventional (fifty-nine) review processes.

The FDA has a strict process for drug approval, requiring a number of phases of testing to establish safety and efficacy. It can, however, expedite this process when it thinks a drug may address an unmet clinical need. Of course, you want such a process to be fair and work. You want it to be focused on “better” and “more important” drugs. The 21st Century Cures Act moved even further. Some worry that loosening standards will lead to increased exposure to harm, especially if there isn’t proof that these drugs provide more benefits.

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The Incidental Economist

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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.