Tag: communicable diseases

Bioethics Blogs

Missing Genes Point to Possible Drug Targets

Every person’s genetic blueprint, or genome, is unique because of variations that occasionally occur in our DNA sequences. Most of those are passed on to us from our parents. But not all variations are inherited—each of us carries 60 to 100 “new mutations” that happened for the first time in us. Some of those variations can knock out the function of a gene in ways that lead to disease or other serious health problems, particularly in people unlucky enough to have two malfunctioning copies of the same gene. Recently, scientists have begun to identify rare individuals who have loss-of-function variations that actually seem to improve their health—extraordinary discoveries that may help us understand how genes work as well as yield promising new drug targets that may benefit everyone.

In a study published in the journal Nature, a team partially funded by NIH sequenced all 18,000 protein-coding genes in more than 10,500 adults living in Pakistan [1]. After finding that more than 17 percent of the participants had at least one gene completely “knocked out,” researchers could set about analyzing what consequences—good, bad, or neutral—those loss-of-function variations had on their health and well-being.

Gene knockouts are expected to occur more frequently in certain countries, such as Pakistan, where people sometimes marry and have children with their first cousins. That makes it much more likely that a person carrying a loss-of-function gene variation will have inherited that same variation from both of their parents.

In the latest study, a team led by Sekar Kathiresan at the Broad Institute of Harvard and MIT, Boston, turned to the Pakistan Rise of Myocardial Infarction Study (PROMIS) in hopes of finding more gene knockouts.

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

DNA papers, please

Kuwait is planning to build a complete DNA database of not just citizens but all other residents and temporary visitorsThe motivation is claimed to be antiterrorism (the universal motivation!) and fighting crime. Many are outraged, from local lawyers over a UN human rights committee to the European Society of Human Genetics, and think that it will not be very helpful against terrorism (how does having the DNA of a suicide bomber help after the fact?) Rather, there are reasons to worry about misuse in paternity testing (Kuwait has strict adultery laws),  and in the politics of citizenship (which provides many benefits): it is strictly circumscribed to paternal descendants of the original Kuwaiti settlers, and there is significant discrimination against people with no recognized paternity such as the Bidun minority. Plus, and this might be another strong motivation for many of the scientists protesting against the law, it might put off public willingness to donate their genomes into research databases where they actually do some good. Obviously it might also put visitors off visiting – would, for example, foreign heads of state accept leaving their genome in the hands of another state? Not to mention the discovery of adultery in ruling families – there is a certain gamble in doing this.

Overall, it seems few outside the Kuwaiti government are cheering for the law. When I recently participated in a panel discussion organised by the BSA at the Wellcome Collection about genetic privacy, at the question “Would anybody here accept mandatory genetic collection?” only one or two hands rose in the large audience. When

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 July 2016 – Pt. I by Christine Sargent

Check out the first instalment of this month’s In the Journals!

 

Critical public health 

Global mental health and its critics: moving beyond the impasse (open access)

Sara Cooper

The field of Global Mental Health has very quickly engendered a new institutional and research landscape, having recently established a number of its own research centres and training programmes. Under the banner of this field, there has also been an explosion of international research programmes and interventions which have received significant financial backing from a range of international donors, development agencies, and governments.1 In sum, Global Mental Health has increasingly captured the imagination of a wide range of stakeholders and has made major strides in establishing mental health as a priority within the global health arena. Indeed, a recent Google search for ‘Global Mental Health’ on 1 November 2009 identified approximately 62,300 related sites, of which over 85% of them were registered since 2008 (Patel & Prince,2010). This increasingly powerful field has, however, also elicited a range of critical responses, with growing controversy over its conceptualisations, goals and imagined outcomes (Campbell & Burgess, 2012; Kirmayer & Pedersen, 2014; Mills & Fernando, 2014).

Stigmatizing surveillance: blood-borne pathogen protocol and the dangerous doctor

Valerie Webber, Janet Bartlett & Fern Brunger

HIV and hepatitis B and C are viruses that have been unduly set apart from other infectious diseases in terms of the symbolic pull they exert and the anxiety they produce. This is reflected in health care policy and protocol. Hospitals, health care regions and colleges of physicians and surgeons create guidelines and procedures that single out HIV or hepatitis B and C as requiring special attention.

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

Mark A. Largent, Vaccine: The Debate in Modern America, Johns Hopkins University Press, 2012; Mark Navin, Values and Vaccine Refusal: Hard Questions in Ethics, Epistemology, and Health Care, Routledge, 2016

Over the last twenty years or so, vaccines have developed as one of the standard examples of major public scientific controversies, alongside climate change and genetically modified foods. This public contention has attracted scholarly attention, and the current review examines two recent attempts at such scholarly intervention. While both books have their limitations, I recommend both to anyone interested in a sophisticated introduction to the vaccine controversy. Specifically, the first substantive chapter of each book would be an excellent set of readings for one-session discussion of the controversy in a bioethics class or science communication workshop.

Mark Largent’s Vaccine: The Debate in Modern America was published in 2012 by Johns Hopkins University Press (Largent 2012). Largent is a historian of science at Michigan State University, and most of the book takes the form of historical narratives of some key figures or moments in the development of the vaccine controversy. Mark Navin is a political philosopher at Oakland University in Auburn, Michigan, and so his Values and Vaccine Refusal—published in 2016 by Routledge—focuses on a more abstract analysis of arguments (Navin 2016). Both books are broadly accessible. While Largent’s book was published a few years ago, the two books work well together; thus the current, joint review.

Before getting into the details, let me introduce some terminology and provide a brief overview of the state of the vaccine controversy and vaccine compliance. Following Navin, vaccine denial is a denial of mainstream medical beliefs about the safety and efficacy of vaccines, while vaccine refusal is the behavior of refusing routine childhood vaccinations.

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

Introduction: The First Thousand Days of Life by Michelle Pentecost

(On behalf of the First Thousand Days Research Group (University of Cape Town))

“Good nutrition in the first 1000 days between a woman’s pregnancy and her child’s second birthday sets the foundation for all the days that follow.”

– ThousandDays.org

“The First 1,000 Days of being a parent are now accepted to be the most significant in a child’s development.”

– National Childbirth Trust, UK

“Researchers have identified the first 1,000 days of a child’s life—from pregnancy through a child’s 2nd birthday—as a critical window of time that sets the stage for a person’s intellectual development and lifelong health.”

– Lucy Sullivan, National Healthy Mothers, Healthy Babies Coalition

 

The focus of this series is the “the first thousand days”, a new field of enquiry that is radically reshaping understandings of health and heredity, with material consequences for policy, publics and concepts of life. The thousand days between conception and a child’s second birthday is presented in contemporary epidemiology and public media, shaped by new knowledge in neuroscience, epigenetics and Developmental Origins of Health and Disease (DoHaD) research, as a critical period that determines future health and potential. This imaginary – as captured by the excerpts from non-governmental organizations above – has been the object of study for The First Thousand Days Research Group at the University of Cape Town, chaired by Professor Fiona Ross, since mid-2013. Under the rubric of “the first thousand days”, we have conducted ethnographic research across a set of inter-related themes to interrogate the logics and implications of this imaginary. The sites of our research include antenatal clinics, soup kitchens, laboratories of reproductive technologies, places of worship, neonatal units, breast milk banks, middle class settings and informal settlements.

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

Why Zika Matters to Canada

Gaëlle Groux and Steven J. Hoffman discuss three ways that Canada can help stem the spread of the Zika Outbreak.

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The World Health Organization (WHO) recently announced that clusters of microcephaly that are possibly linked to the Zika virus constitute a “public health emergency of international concern.” This virus has captured the attention of the international community because thousands of babies are being born with underdeveloped brains to women who were infected with Zika during their pregnancy.

Should Canadians be worried? For now, WHO says no, because our country doesn’t harbour the mosquito types that spread the disease, aedes aegypti and albopictus. But Canadians shouldn’t be too complacent about the spread of the virus. Here’s why.

For starters, Canadians are not entirely off the hook within Canada. Mosquitoes carrying Zika could in the future spread here too. Aedes albopictus is an invasive species and increasingly warm climates could allow them to migrate farther north. Researchers are also investigating the possibility that a mosquito native to Canada, the Aedes culex which already transmits viruses of the same family as the Zika virus, could be a cause for concern.

And then there’s travel. The Canadian government has advised Canadians to “exercise a high degree of caution” in most South American travel destinations, and some travel doctors are advising pregnant women to avoid travel to affected countries altogether. Ontario’s Chief Medical Officer, when confirming the province’s first case of Zika recently, went so far as to advise all travelers heading to affected areas to first consult their healthcare providers.

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

2-24-16 PLOS Medicine AMA Preview: Looking toward the future of diabetes prevention with Dr. Sanjay Basu

In advance his PLOS Science Wednesday AMA, Sanjay Basu, Assistant Professor of Medicine at the Stanford University Prevention Research Center, answers questions from PLOS Social Media Associate Sara Kassabian. The burden of non-communicable diseases (NCDs) is growing globally, with

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, October 2015 – Part II by Sultana Banulescu

This month’s “In the Journals…” brings us a body of articles discussing pregnancy, childbirth, nursing, female anatomy, substance abuse, and addiction, with a focus on risk, secrecy, stigma, and strategies of coping and self-preservation.

Critical Public Health

What’s the story on addiction? Popular myths in the USA and Finland

Matilda Hellman & Robin Room

The study inquires into popular myths on addiction in two countries: Finland and the USA. It provides evidence of the manners in which the typical media narratives incorporate basic value traits from their context of origin. We distinguish some main features in the narrative set-ups that support different solution repertoires for dealing with addiction. Belief and hope are crucial story elements associated with the US emphasis on group formation and local empowerment. The individual is assigned obligations and can be morally condemned. In the Finnish journalistic prose, there seems to be an inherent belief that the agenda-setting in itself will propel the question into the institutionalised welfare state solution machinery. The occurrence of a story resolution was customary in the US stories, whereas the Finnish stories were typically left pending. The evidence produced has implications for the ongoing debate regarding the mainstreaming of both definitions of and solutions to addiction problems.

Low income, high risk: the overlapping stigmas of food allergy and poverty

Leia M. Minaker, Susan J. Elliott & Ann Clarke

The aim of this study was to explore experiences and coping strategies of low-income families affected by food allergies. Of particular interest were experiences of allergy-related stigma within the context of poverty stigma.

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, September 2015 (Part 1) by Anna Zogas

Here is the first round of “In the Journals” for September. Happy autumn reading!

American Anthropologist

Commitments of Debt: Temporality and the Meanings of Aid Work in a Japanese NGO in Myanmar
Chika Watanabe

The rise of debt as a mechanism of development troubles many scholars and aid practitioners. Contrary to these concerns, however, ethnographic research at a Japanese NGO in Myanmar showed that Japanese and Burmese aid workers found value in moral and monetary debt relations. In this article, I argue that these aid workers viewed indebtedness as a precondition for the making of voluntary actors, willing and committed to aid work. What they problematized was not indebtedness but, rather, competing understandings of the appropriate temporality of a debt’s repayment. The fault lines did not appear along cultural or moral-monetary boundaries; they existed in the ways that people conceptualized voluntary actors as emerging from either long-term forms of indebted gratitude or sequences of short-term contractual agreements. While the entrapment of the poor in cycles of debt remains an increasing concern in the world, I here ask how we might understand local aid workers’ professional commitments when they do not question indebtedness as a moral framework.

Rich Sentiments and the Cultural Politics of Emotion in Postreform Ho Chi Minh City, Vietnam
Allen L. Tran

Linking socioeconomic and personal transformations, recent scholarship on neoliberalism in East and Southeast Asia has examined the role of various emotional experiences in reconfiguring selfhood toward values of personal responsibility and self-care. However, studies rarely focus on how such experiences come to be understood as specifically emotional themselves.

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

Can epidemics be noncommunicable?

Reflections on the spread of ‘noncommunicable’ diseases

— Jens Seeberg, Lotte Meinert

This article argues that the concept of communicability that is central to the distinction between communicable diseases (CDs) and noncommunicable diseases (NCDs) is poorly conceptualized. The epidemic spread of NCDs such as diabetes, depression, and eating disorders demonstrates that they are communicable, even if they are not infectious. We need to more critically explore how they might be communicable in specific environments. All diseases with epidemic potential, we argue, should be assumed to be communicable in a broader sense, and that the underlying medical distinction between infectious and noninfectious diseases confuses our understanding of NCD epidemics when these categories are treated as synonymous with ‘communicable’ and ‘noncommunicable’ diseases, respectively. The dominant role accorded to the concept of ‘lifestyle’, with its focus on individual responsibility, is part of the problem, rather than the solution, and the labelling of some NCDs as ‘lifestyle diseases’ is misleading. Founded on a critical understanding of global health and globalized medicine, we propose to explore the dynamics of the phenomena of contamination and biosocial contagion in networks. An analytics of biosocial epidemics needs to be developed by a medical anthropology that is engaged in a critical dialogue with both medicine and biology.

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.