Tag: blood transfusions

Bioethics News

Abortion pills at home: the new sinister face of the global abortion business

Dutch website “Women on web” is offering to deliver abortion drugs based on mifepristone (RU-486) and misoprostol for use at home, through a simple request on their website (there are lots of sites like this, after which they ask for “a donation of at least 90, 80 or 70 euro”. The website literally states that “a medical abortion can be done safely at home as long as you have good information and have access to emergency medical care in the rare case that there are complications”. Both drugs legally require a medical prescription, so their sale on the internet is illegal.

Abortion pills at home

A woman who feels tempted to make an “abortion” request on this site should know that the side effects of RU-486 are common and objective (see HERE), particularly vaginal bleeding, abdominal pain, nausea, vomiting and fatigue [2]. In some cases, the intensity of the vaginal bleeding requires a blood transfusion  [3], [4]. A total of 607 adverse events were reported between September 2000 and September 2004 : 237 hemorrhages, which included 1 fatal, 42 life-threatening, 168 serious, and 68 requiring blood transfusions; 66 infections, which included 7 cases of septic shock, 3 of which were fatal while 4 were life-threatening; 513 patients required a subsequent secondary surgical intervention, 235 urgent and 278 non-urgent. The need to have a surgical abortion after failure of the chemical abortion can be considered a side effect, and occurs in between 1% and 10% of cases. This second surgical intervention can increase the risk of permanent sterility http://journals.sagepub.com/doi/pdf/10.1345/aph.1G481a.

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

Charlie Gard: Three Issues That Did Not Make Social Media

by Ann Mongoven, Ph.D., MPH

All hearts go out to the Gard family in this time of grief for their son, Charlie.

The legal wrangling over Charlie’s care became a political football–unfortunately, about many things having little to do with Charlie.

Despite the involvement of Pope Francis, this was not a case about abortion rights or the sanctity of human life. Catholic tradition warns both that quality-of-life arguments can dehumanize the disabled, and that unduly burdensome medical care can become assaultive. There is no “Catholic” view of the case, and Catholic moral theologians disagree about it.

Despite the involvement of Donald Trump, this was not a case about the relative merits of the U.K. National Health Service (NHS) versus other health systems. It was not a case of utilitarian ethics pitted against duty-based ethics or love. The NHS provided extremely expensive intensive care for Charlie for most of his life, and British courts governed cases related to his care solely by a “best interest of the child” standard– amidst heated disagreement between Charlie’s parents and doctors about his interests. The European Court of Human Rights backed the British court decision.

The case did address questions about who should decide when parents and doctors disagree about a child’s medical interest. But contrary to some portrayals in the American press, it neither changed conventional parameters for addressing those questions, nor exposed major differences in legal reasoning used to address them in the U.K. and the U.S.  Both countries appeal to “best interest” standards for resolution, and both reject an absolutist interpretation of parental rights.

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

Startup That Charges $8,000 for Young Blood Transfusions Swears They’re Worth Every Penny

June 1, 2017

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A month after receiving a transfusion of young plasma, Karmazin says, participants had fewer chemical biomarkers indicative of heart disease, Alzheimer’s, and certain types of cancers.

The results are extremely preliminary; they not published in a peer-reviewed, and there was no control study. Ambrosia got the US Food and Drug Administration’s approval to begin conducting a controversial clinical trial in May 2016, and participants essentially pay for the unproven treatment out of pocket. For $8,000, healthy individuals over 35 can have a transfusion of plasma from someone aged 16 to 25 as part of an ongoing clinical trial.

In the Ambrosia trial, roughly 80 participants with a median age of 60 had their blood tested for around 100 different biomarkers before receiving a single transfusion, and then again a month later. On average, patients had 21% fewer carcinoembryonic antigens, a compound associated with lung, colon, and ovarian cancer; 10% fewer apolipoproteins, associated with heart disease; and 20% fewer amyloid plaques, associated with Alzheimer’s. Speaking to Quartz, Karmazin said patient reported feeling like they had more energy.

It should be noted, though, that these biomarkers do not indicate disease itself; none of the participants who enrolled in the trial were seriously ill before receiving the transfusion.

… Read More

Image: By DiverDave – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11866692

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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.

Bioethics Blogs

Cross Post: Solomon’s frozen judgement

Written by Anders Sandberg

This post was originally published on Andert II

A girl dying of cancer wanted to use cryonic preservation to have a chance at being revived in the future. While supported by her mother the father disagreed; in a recent high court ruling, the judge found that she could be cryopreserved.

As the judge noted, the verdict was not a statement on the validity of cryonics itself, but about how to make decisions about prospective orders. In many ways the case would presumably have gone the same way if there had been a disagreement about whether the daughter could have catholic last rites. However, cryonics makes things fresh and exciting (I have been in the media all day thanks to this).

What is the ethics of parents disagreeing about the cryosuspension of their child?

Best interests

One obvious principle is that parents ought to act in the best interest of their children.

If the child is morally mature and with informed consent, then they can clearly have a valid interest in taking a chance on cryonics: they might not be legally adult, but as in normal medical ethics their stated interests have strong weight. Conversely, one could imagine a case where a child would not want to be preserved, in which case I think most people would agree their preferences should dominate.

The general legal consensus in the West is that the child’s welfare is so important that it can overrule the objections of parents. In UK law parents have the right and the duty to give consent for a minor.

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

Contraception and Reproductive Ethics: Constitutional Right vs. Right for the Country

Sophia Yin won the Reproductive Ethics category for our 2016 Bioethics Essay contest.  Our panel of judges thought Sophia’s essay presented a rigorous and clarifying analysis of a contentious and ongoing debate about reproductive rights.  We are pleased to publish Sophia’s essay, below. — The Editors

by Sophia Yin

Though the male condom seems almost ubiquitous in current American society, female contraceptive methods constantly seem to be the subject of controversy. While debates in the twentieth century centered on the legalization of contraception, the discussion now is over who should be required to pay for contraception. This question of funding may seem less pressing than the question of legality, however, ability to pay is directly tied to access: women who cannot afford contraception cannot freely use it. Though many supporters frame their case in terms of an infringement of women’s rights, this argument is inherently weak. Women should have open access to contraception regardless of whether they have the right to it. The issue of women’s access to contraception is most often viewed through a legal lens, but it should be discussed in terms of its benefits to public health.

Supporters of access to contraception argue that women have a right to contraception. This argument is based upon the rulings of Griswold v. Connecticut, in which the Supreme Court ruled that states cannot outlaw the use of contraception by married couples because of “the zone of privacy created by several fundamental constitutional guarantees.” Though the ruling did not directly state that women had a right to contraception, it did create a right to privacy in reproductive matters for married couples, which allowed them the freedom to decide, without state interference, whether they would like to use contraception.

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

Justice Cryogenically Delayed is Justice Denied?

Guest Post by Nils Hoppe

Re JS (Disposal of Body) [2016] EWHC 2859 (Fam)

This unusual and sad case concerns a court application by a 14 year old girl, JS.  In 2015 she was diagnosed with a rare form of cancer which proved terminal and, at the time of her application, she was receiving palliative care as an in-patient at a hospital.  The other parties involved in the application were JS’s parents, who were acrimoniously divorced.  JS had no direct contact with her father after 2008.

Knowing that she would soon die, JS carried out online research into commercial cryogenic preservation techniques, defined in the judgment as “the freezing of a dead body in the hope that resuscitation and cure may be possible in the distant future”.  Such techniques are not uncontroversial, being regarded with scepticism by the majority of the medical and scientific community.  They are also not cheap: the judgment describes the costs associated with the basic cryopreservation package as being in the region of £37,000, or, as Mr Justice Peter Jackson put it, “about ten times as much as an average funeral”.

Of most significance to the court application was the fact that the proposed procedure required the cooperation of the hospital in which JS was a patient.  This concern was described in the following terms by the judge:

The body must be prepared within a very short time of death, ideally within minutes and at most within a few hours.  Arrangements then have to be made for it to be transported by a registered funeral director to the premises in the United States where it is to be stored. 

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

Gene Therapy Offers Hope for Treatment of Sickle Cell Anaemia

October 3, 2016

(The Guardian) – Scientists are finalising plans to use gene therapy to treat one of the world’s most widespread inherited diseases – sickle cell anaemia. The technique could begin trials next year, say researchers. About 300,000 babies are born globally with sickle cell disease. The condition causes red blood cells to deform, triggering anaemia, pain, organ failure, tissue damage, strokes and heart attacks. In the west, patients now live to their 40s thanks to the availability of blood transfusions and other treatments. But in Africa most still die in childhood.

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

Testing Donated Blood for Zika: Politics or Prudence?

by Craig Klugman, Ph.D.

The FDA has announced that within the next 3 months, all donated blood in the United States should be screened for Zika virus. Puerto Rico and Florida are already conducting such screening. In the next four weeks, 11 more states should be screening (Alabama, Arizona, California, Georgia, Hawaii, Louisiana, Mississippi, New Mexico, New York, South Carolina and Texas) followed by nationwide testing within the next 3 months. The goal is to have a safe and trusted blood supply.

Although on this surface this looks like a preventive public health move, it is a political one. Consider that there have been 8,000 documented cases of Zika in the U.S. with only 2,000 of them locally acquired (meaning no history of travel to a country with Zika). Most of the local cases are in Puerto Rico. Eighty percent of those infected never have symptoms.

The emphasis seems to be more on trust than it is on safety. Only 1/3 of the 15 countries that reported confirmed infections have reported transmission through sexual contact. This could mean either that other countries aren’t aware or aren’t reporting, or that such transmission is only happening among certain strains of the virus. The FDA announcement, however, is aimed at protecting the blood supply. And data for blood transmission is also lacking, whether a lack of awareness or reporting. In fact, according to the CDC, Brazil is the only country that has seen any Zika in its blood supply. During the original French Polynesian outbreak, 2.8% of blood donors tested positive.

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

The Next Health Fad? Blood Transfusions from Young People

August 3, 2016

(MIT Technology Review) – The latest advancement in anti-aging therapies hardly sounds like modern medicine at all. Ambrosia, a startup based in Monterey, California, is launching a clinical trial to inject the blood of young people into just about anyone aged 35 and up—if they’re willing to pay $8,000. Young-to-old blood transfusions hit the limelight in 2014 when Harvard Stem Cell Institute researcher Amy Wagers discovered that the blood of young mice improved muscle, heart, and brain function in older mice. Scientists sewed the skin of two mice together, allowing their circulatory systems to merge. The surgery, called parabiosis, was first performed in the 1860s but has seen a resurgence of interest following Wagers’s study.

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.