Tag: culture

Bioethics Blogs

Patient Safety in the NHS:The Culture Change Agents

By John Tingle and Jen Minford  It is important to take a broad holistic approach when looking at patient safety policy development and practice in the NHS. There cannot be a one size fits all approach and a number of … Continue reading

Source: Bill of Health, examining the intersection of law and health care, biotech & 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 Blogs

Decades on from Henrietta Lacks, we’re still struggling to find an adequate consent model

The ‘immortal’ HeLa cells. Heiti Paves/Shutterstock

When 30-year-old Henrietta Lacks walked through the doors of a Baltimore hospital in 1951 to get a “knot in the stomach” checked, she couldn’t have known she was about to change the face of medical research.

After undergoing a biopsy on her “knot”, Lacks was diagnosed with cervical cancer; it was so aggressive that she died only a few months later.

Henrietta Lacks.
Oregon State University/Flickr., CC BY-SA

But that was not the end of Lacks’s “life”. A small part of the cervical biopsy was retained and conveyed to the hospital’s tissue culture laboratory. There Dr George Gey, head of the laboratory, had been working for a few years on a system whereby human cells would continuously divide and grow in culture dishes. Gey had had no success thus far, but when he placed Lacks’s cells in culture, they behaved very differently.

Lacks’s cells survived, multiplied, grew robustly, and continued to do so for weeks and months afterwards – subsequently generating the first immortalised human cell line.

Gey never made a profit from these “HeLa” cells – named after Henrietta Lacks – but did distribute them to other scientists. Since then, the HeLa cells have been grown in countless laboratories across the globe and have now lived for twice as long outside Lacks’s body as they did inside it.

HeLa cells have revolutionised medical research, made countless contributions to medicine – from vaccine production to fertility treatment – and have been the foundation of a multi-billion dollar industry.

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

We Aren’t Built to Live in the Moment

We are misnamed. We call ourselves Homo sapiens, the “wise man,” but that’s more of a boast than a description. What makes us wise? What sets us apart from other animals? Various answers have been proposed — language, tools, cooperation, culture, tasting bad to predators — but none is unique to humans

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 Blogs

Creative Minds: The Human Gut Microbiome’s Top 100 Hits

Michael Fishbach

Microbes that live in dirt often engage in their own deadly turf wars, producing a toxic mix of chemical compounds (also called “small molecules”) that can be a source of new antibiotics. When he started out in science more than a decade ago, Michael Fischbach studied these soil-dwelling microbes to look for genes involved in making these compounds.

Eventually, Fischbach, who is now at the University of California, San Francisco, came to a career-altering realization: maybe he didn’t need to dig in dirt! He hypothesized an even better way to improve human health might be found in the genes of the trillions of microorganisms that dwell in and on our bodies, known collectively as the human microbiome.

Fischbach is most interested in bacteria living in the human gut, especially the many species that generally live in harmony with us. These microbes produce thousands of small molecules, some so abundantly that they are absorbed into the bloodstream at levels comparable to a drug. Concentrations of these small molecules can vary dramatically from person to person, but researchers still don’t know exactly why.

Fischbach has received a 2016 NIH Director’s Pioneer Award to conduct research aimed at gaining a better understanding of the small molecules made by the human gut microbiome. He will begin by creating a “Top 100” list of its most-abundant molecules. Armed with this information, Fischbach’s team will set about assembling and growing beneficial communities of bacteria in the lab, with the ultimate aim of repopulating a sick person’s gut with a collection of microbes that make health-promoting small molecules.

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

Stem cell research. The two sides of the coin

Science facing market

The “heads” of stem cell research

Stem cells today represent a great hope for the future of regenerative medicine due to their ability to differentiate into cell lines of almost any tissue, making them a promising therapeutic option for many diseases.

These pluripotent cells are found in embryonic and also in adult tissues. Their isolation and culture in specific media may lead to the development of tissues that are useful in regenerative therapies for conditions such as heart disease, myelopathies, diabetes, nerve injuries, retinopathies, etc. After their isolation, they are injected directly into the tissues to be regenerated, so that the stem cells differentiate into cells of these same tissues.

A third way of obtaining pluripotent cells is that described by Yamanaka 10 years ago, a finding for which he was awarded the Nobel prize in Medicine. Starting from a differentiated adult cell, Yamanaka managed to find a way of “dedifferentiating” it so that it returned to its pluripotent state, to then “redifferentiate” it into a particular cell line with therapeutic utility. These are known as iPS or induced pluripotent stem cells.

Similarly, tissues that simulate the function of certain organs have been reproduced in vitro from stem cells, and could, in the future, be an alternative to current organ transplantation.

The current state of the clinical application of stem cells remains uncertain. Although successful outcomes have been reported in some fields, such as cardiology and haematology, many clinical trials and therapeutic applications have failed due to problems arising in the differentiation processes and the appearance of tumours.

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

Oxford Uehiro Prize in Practical Ethics:In It To Win It: Is Prize-giving Bad for Philosophy? Written by Rebecca Buxton

This essay received an Honorable Mention in the Graduate Category of the Oxford Uehiro Prize in Practical Ethics 2017

Written by University of Oxford student, Rebecca Buxton

INTRODUCTORY REMARKS
We live in a culture of prize-giving. The Nobel Prize, the Medal of Honour, the Man Booker and, not least, the Oxford Uehiro Prize in Practical Ethics. But, in giving such prizes, and indeed prize money, we operate under the assumption that prizes are ‘good’. However, the fact that I am offered a prize for writing
a practical ethics paper is itself a practical ethical conundrum. This essay takes a preliminary amble into the ethical problem of prize-giving with regards to Philosophy specifically, offering reasons as to why we should question current practice. Primarily, I will define what we mean by the term ‘prize’ noting its
necessary and sufficient features. Secondly, I discuss the impact of prize-giving on research, considering how the ramifications of ascribing value through prizes affects the course of academia, especially when focusing on the lack of diverse voices within the subject. I then consider the deeper question of philosophical value: does the very act of constructing an ethical argument for a prize diminish the value of the work?

THE IDEA OF ‘THE PRIZE’
Though prize-giving is prolific in our current institutional culture, we lack any analytically clear literature on what constitutes a ‘prize’. There is, however, some work focusing on the philosophical concept of ‘the gift’, most notably Derrida’s argument that the ‘true’ gift is impossible as we can never eliminate the possibility of the counter-gift.[1] Unlike gifts, prizes depend upon a reciprocal process; you receive a prize in virtue of being or doing something.

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

Snapshots of Life: Biological Bubble Machine

Credit: Chi Zhao, David Busch, Connor Vershel, Jeanne Stachowiak, University of Texas at Austin

As kids, most of us got a bang out of blowing soap bubbles and watching them float around. Biologists have learned that some of our cells do that too. On the right, you can see two cells (greenish yellow) in the process of forming bubbles, or plasma membrane vesicles (PMVs). During this blebbing process, a cell’s membrane temporarily disassociates from its underlying cytoskeleton, forming a tiny pouch that, over the course of about 30 minutes, is “inflated” with a mix of proteins and lipids from inside the cell. After the PMVs are fully filled, these bubble-like structures are pinched off and released, like those that you see in the background. Certain cells constantly release PMVs, along with other types of vesicles, and may use those to communicate with other cells throughout the body.

This particular image, an entrant in the Biophysical Society’s 2017 Art of Science Image Contest, was produced by researchers working in the NIH-supported lab of Jeanne Stachowiak at the University of Texas at Austin. Stachowiak’s group is among the first to explore the potential of PMVs as specialized drug-delivery systems to target cancer and other disorders [1].

Until recently, most efforts to exploit vesicles for therapeutic uses have employed synthetic versions of a different type of vesicle, called an exosome. But Stachowiak and others have realized that PMVs come with certain built-in advantages. A major one is that a patient’s own cells could in theory serve as the production facility.

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

The Unusual Case of Ian Paterson and Criminally Harmful Surgery

Guest post by Alex Mullock, University of Manchester

On 28th April 2017 in the case of breast surgeon, Ian Paterson, the jury in Nottingham Crown Court agreed that in carrying out unnecessary and mutilating surgery the defendant had done what no reasonable surgeon would do.  Paterson was convicted of seventeen counts of wounding with intent to cause grievous bodily harm (GBH) and three counts of unlawful wounding (under, respectively, sections 18 and 20 of the Offences Against the Person Act 1861) against nine women and one man. These ten victims, however, have been reported to represent a tiny proportion of all Paterson’s alleged victims, a group that might amount to hundreds from his many years of practice in the NHS and private sector.

The “obscure motives” that compelled Paterson may forever remain a mystery but it is interesting that the charges against him relate only to patients he treated in his private practice.  This enabled the prosecution to create a narrative that suggested that financial gain could have been the motivating factor for Paterson’s crimes.  Without greed as a possible motive his actions are baffling, and the prosecution’s case, in alleging that surgery which Paterson argued was performed in the patient’s best interests actually constituted GBH or unlawful wounding, would be more challenging because of the medical context of the allegations.  Importantly, the medical exception to the criminal law – the principle that consensual surgery carried out by qualified professionals is legitimate (“proper medical treatment”) – means that there is an assumption that harm caused by surgery is not a matter for the criminal law because it is a risk that we accept in order to enjoy the benefits of surgical medicine.

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

Aid in Dying Court Appeal Comes to New York Court of Appeals May 30; Strong, Diverse and Growing Support in Amicus Briefs

The right of terminally ill, mentally competent adults to achieve a more peaceful death is at stake in Myers v. Schneiderman, now before the New York Court of Appeals, NY’s highest state court.  Oral arguments will be held in Albany on May 30.


The appeal seeks to reverse lower court decisions that dismissed the case prior to trial.  The case seeks to establish the right of terminally ill patients to receive a prescription for medication which they can self ingest to achieve a peaceful death if confronted by suffering they find unbearable.


Wide support for the plaintiffs is demonstrated by a multitude of amicus briefs submitted to the court by diverse parties representing patients and their loved ones, medical, religious and civil liberties organizations as well as national legal associations.  Two of these organizations are supporting the legalization of aid in dying as an amicus for the first time.


Kathryn Tucker, Executive Director of End of Life Liberty Project, and co-counsel in the case, said, “We are very pleased to see a large number of important voices joining us in seeking reversal of the lower court dismissal of the case. It is especially interesting to note the appearance of new voices not previously involved in aid in dying cases.”


Ms. Tucker noted, “Two new ‘friends’ of end of life liberty are stepping forward in Myers. For the first time in a case seeking to establish access to aid in dying, a state chapter of the National Academy of Elder Law Attorneys (NAELA) is participating as an amicus in support of patients and physicians.

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

Aid in Dying Court Appeal Comes to New York Court of Appeals May 30; Strong, Diverse and Growing Support in Amicus Briefs

The right of terminally ill, mentally competent adults to achieve a more peaceful death is at stake in Myers v. Schneiderman, now before the New York Court of Appeals, NY’s highest state court.  Oral arguments will be held in Albany on May 30.


The appeal seeks to reverse lower court decisions that dismissed the case prior to trial.  The case seeks to establish the right of terminally ill patients to receive a prescription for medication which they can self ingest to achieve a peaceful death if confronted by suffering they find unbearable.


Wide support for the plaintiffs is demonstrated by a multitude of amicus briefs submitted to the court by diverse parties representing patients and their loved ones, medical, religious and civil liberties organizations as well as national legal associations.  Two of these organizations are supporting the legalization of aid in dying as an amicus for the first time.


Kathryn Tucker, Executive Director of End of Life Liberty Project, and co-counsel in the case, said, “We are very pleased to see a large number of important voices joining us in seeking reversal of the lower court dismissal of the case. It is especially interesting to note the appearance of new voices not previously involved in aid in dying cases.”


Ms. Tucker noted, “Two new ‘friends’ of end of life liberty are stepping forward in Myers. For the first time in a case seeking to establish access to aid in dying, a state chapter of the National Academy of Elder Law Attorneys (NAELA) is participating as an amicus in support of patients and physicians.

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.