Tag: guidelines

Bioethics Blogs

Treatment of Premature Ejaculation: Alleviating Sexual Dysfunction, Disease Mongering?

by Brian D. Earp / (@briandavidearp)

An interesting new paper, “Distress, Disease, Desire: Perspectives on the Medicalization of Premature Ejaculation,” has just been published online at the Journal of Medical Ethics.  According to the authors, Ylva Söderfeldt, Adam Droppe, and Tim Ohnhäuser, their aim is to “question the very concept of premature ejaculation and ask whether it in itself reproduces the same sexual norms that cause some to experience distress over ‘too quick’ ejaculations.” To prime the reader for their project, they begin with a familiar story:

a condition previously thought of as a variant within the normal range, as a personal shortcoming, or as a psychological issue is at a certain point cast as a medical problem. Diagnostic criteria and guidelines are (re-)formulated in ways that invent or widen the patient group and thus create or boost the market for the new drug.

Those involved in developing the criteria and the treatment are sometimes the same persons and, furthermore, cultivate close connections to the pharmaceutical companies profiting from the development.

Sufferers experience relief from personal guilt when they learn that their problem is a medical and treatable one, whereas critics call out the process as disease-mongering.

Something like this pattern has indeed played out time and time again – methylphenidate (Ritalin) for ADHD, sildenafil for erectile dysfunction, and more recently the development of flibanserin for “hypoactive sexual desire disorder” (see the excellent analysis by Antonie Meixel et al., “Hypoactive Sexual Desire Disorder: Inventing a Disease to Sell Low Libido” in a previous issue of JME).

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

Three-parent babies green-lighted in the UK

A genetically engineered baby could be born in the UK before Christmas. The UK government has given a licence to Newcastle University to create three-parent embryos to combat mitochondrial diseases.

The UK’s fertility authority, the Human Fertilisation and Embryology Authority(HFEA), had already announced in December that licences for the controversial procedure were to be granted on a case-by-case basis. It appears that a number of couples have applied for the procedure, so the University will have no trouble in enrolling patients.

Sally Cheshire, chair of the UK’s fertility authority, said: “I can confirm today that the HFEA has approved the first application by Newcastle Fertility at Life for the use of mitochondrial donation to treat patients. This significant decision represents the culmination of many years hard work by researchers, clinical experts, and regulators, who collectively paved the way for Parliament to change the law in  2015 to permit the use of such techniques.

“Patients will now be able to apply individually to the HFEA to undergo mitochondrial donation treatment at Newcastle, which will be life-changing for them, as they seek to avoid passing on serious genetic diseases to future generations.”

Critics described the move as “ethically reckless”. Mark Bhagwandin, of the pro-life charity Life, told the Daily Telegraph:

“We had hoped that the HFEA would have listened to the thousands of people who have expressed concern about three parent embryos. Instead it has ignored the alarm bells and approved a procedure which will alter the human genome. It is at the very least reckless and irresponsible given that we have absolutely no idea what the long term consequences are to us interfering with the human genome.

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

New Zealand river declared a legal person

In the latest wrinkle in debates over personhood, a Māori iwi (tribe) in New Zealand has succeeded in getting Parliament to recognise the Whanganui River as a legal person.

“It’s not that we’ve changed our worldview, but people are catching up to seeing things the way that we see them,” Adrian Rurawhe, a Māori member of Parliament. The North Island river, New Zealand’s third longest, also known by its Māori name of Te Awa Tupua, will be represented by two legal guardians, one appointed by the iwi and the other by the government.

The settlement, which has been in dispute for at least 140 years, also includes NZ$80 million in financial redress and $30 million toward improving the environmental, social, cultural and economic health and wellbeing of Te Awa Tupua. 

Riverine personhood is an untested concept in a Western legal system. According to the government, Te Awa Tupua will now have its own legal personality with all the corresponding rights, duties and liabilities of a legal person. Lawyers say that the river cannot vote and cannot be charged with homicide if people drown in it. But it will have to pay taxes, if liable. The gender of the river is unspecified at the moment.

“I know the initial inclination of some people will say it’s pretty strange to give a natural resource a legal personality,” said New Zealand’s Treaty Negotiations Minister Chris Finlayson. “But it’s no stranger than family trusts, or companies or incorporated societies.”

As soon as the third reading of the bill passed, members of the gallery broke into a waiata (a song of celebration) which is well worth watching. 

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This article is published by Michael Cook and BioEdge under a Creative Commons licence.

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

When stem cell treatments go wrong, they really go wrong

Three elderly women in Florida have been blinded by an unproven treatment, as a reminder of how dangerous stem cell therapies can be. The New England Journal of Medicine reports that the women signed up for a purported clinical trial in 2015 – for which they had to pay US$5,000. Within a week, they experienced a variety of complications, including vision loss, detached retinas and haemorrhage. Before the surgery, the vision in their eyes ranged from 20/30 to 20/200. They are now blind.

The article is a “call to awareness for patients, physicians and regulatory agencies of the risks of this kind of minimally regulated, patient-funded research,” said Jeffrey Goldberg, of Stanford University School of Medicine and a co-author.

“There’s a lot of hope for stem cells, and these types of clinics appeal to patients desperate for care who hope that stem cells are going to be the answer, but in this case these women participated in a clinical enterprise that was off-the-charts dangerous,” said Thomas Albini, another co-author.

At the clinic, U.S. Stem Cell Inc, fat cells from the patients’ abdomens were processed to obtain stem cells which were injected into their eyes. Patients reported that the entire process took less than an hour. The patients had both eyes treated at once — even though most doctors would opt for a conservative approach to observe how the first eye responds.

“There is a lot of very well-founded evidence for the positive potential of stem therapy for many human diseases, but there’s no excuse for not designing a trial properly and basing it on preclinical research,” Goldberg said.

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

Costa Rica’s resistance to legal IVF crumbles

Ronald Reyes/The Tico Times    

A girl named Maria José has become the first IVF baby to be born in the Central American nation of Costa Rica. Her parents, Jenny Garbanzo y José Barana, had been lobbying for the right to access IVF in Costa Rica since 2007. However, under a ruling by the Supreme Court in 2000, IVF was banned because it resulted in the destruction of embryos. It took substantial international pressure to force the government to give in.

The first IVF procedures were carried out in middle of last year at two certified private clinics.

The Inter-American Court of Human Rights (IACHR) has also ordered the government to make IVF available at public hospitals. Construction of a public fertility clinic is scheduled to begin in August next to the National Women’s Hospital, near the Costa Rican capital of San José. The government is also funding overseas training of IVF specialists from Costa Rica for the clinic. The first procedures in public hospitals will begin in 2018. 

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Source: BioEdge.org.

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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

The Problem with Binary

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

The Problem with Binary 

Throughout his raucous 2016 campaign, President Trump repeatedly claimed that he would be an ardent defender of the lesbian, gay, bisexual and transgender (LGBT) community. During the Republican National Convention, for instance, he proclaimed that, “As your president I will do everything in my power to protect LGBTQ citizens.” Despite this statement (which stood in stark contrast to the Republican Party’s virulently anti-LGBT political platform), and diverging from the public comments and actions when he was still a private citizen, since gaining the nomination and later the presidency, Donald Trump has largely kowtowed to the more homophobic wings of his party.

Although he has yet to repeal an Obama-era order protecting LGBT federal employees from workplace discrimination, for example, he has repeatedly expressed support for the First Amendment Defense Act. Modeled on the anti-LGBT legislation passed in Indiana when Vice-President Pence was governor of the Hoosier State, that Act would allow individuals, businesses, and healthcare providers to deny services to LGBT individuals based on their religious beliefs.

More recently, in spite of prior comments that “people should use the bathroom that they feel is appropriate,” Trump rescinded existing protections for transgender students. Previously, the federal government had issued guidelines that, while not legally binding, required public schools to allow transgender students to use bathrooms that corresponded with their gender identity rather than biological sex. Under the Obama administration, the Departments of Justice and Education had taken the position that existing regulations like Title IX, the federal law that prohibits sex discrimination in schools, also applied to discrimination based on gender identity.

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

7th Annual Western Michigan University Medical Humanities Conference

The Western Michigan University Medical Humanities Workgroup and the WMU Homer Stryker MD School of Medicine Program in Medical Ethics, Humanities & Law is proud to announce the 7th Annual Western Michigan University Medical Humanities Conference


September 14-15, 2017

Kalamazoo, Michigan


Overview:  Proponents of medical humanities contend that the humanistic dimensions of medicine and health are a critical component of those disciplines; not only do these dimensions help us to understand the very nature of medicine and health, their apprehension allows caregivers to relate to their patients, to treat those patients with respect and dignity, and to provide more holistic and empathetic care. 



The 7th Annual Western Michigan University Medical Humanities Conference is committed to the creative, dynamic, interdisciplinary explorations of the range of themes within the broad theme of medical humanities. This highly interdisciplinary conference draws participants from a wide range of backgrounds, including those from academic, creative, and medical communities.



Keynotes: This year’s conference Keynote speakers will be Dr. Jay Baruch and Professor Katie Watson.



AbstractsAbstracts will be considered in the following categories:

  • Oral Presentations: 20 minute presentations by one or two authors
  • Panel discussions: 60 minute presentations by a panel of speakers (generally 3-5). Panel discussions are expected to be interdisciplinary and explore a single topic from multiple perspectives.
  • Workshops: 60-90 minute presentations with a focus on audience interaction and the creation of some artwork. Previous successful workshops have included mentored drawing, poetry writing, performance dance, etc.
  • Posters/Visual Arts: Displays of visual arts, and performances (including dance, musical, theatre, etc.) are welcome.

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 Problem with Binary March 10, 2017 Throughout his raucous 2016 campaign, President Trum…

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

The Problem with Binary 

Throughout his raucous 2016 campaign, President Trump repeatedly claimed that he would be an ardent defender of the lesbian, gay, bisexual and transgender (LGBT) community. During the Republican National Convention, for instance, he proclaimed that, “As your president I will do everything in my power to protect LGBTQ citizens.” Despite this statement (which stood in stark contrast to the Republican Party’s virulently anti-LGBT political platform), and diverging from the public comments and actions when he was still a private citizen, since gaining the nomination and later the presidency, Donald Trump has largely kowtowed to the more homophobic wings of his party.

Although he has yet to repeal an Obama-era order protecting LGBT federal employees from workplace discrimination, for example, he has repeatedly expressed support for the First Amendment Defense Act. Modeled on the anti-LGBT legislation passed in Indiana when Vice-President Pence was governor of the Hoosier State, that Act would allow individuals, businesses, and healthcare providers to deny services to LGBT individuals based on their religious beliefs.

More recently, in spite of prior comments that “people should use the bathroom that they feel is appropriate,” Trump rescinded existing protections for transgender students. Previously, the federal government had issued guidelines that, while not legally binding, required public schools to allow transgender students to use bathrooms that corresponded with their gender identity rather than biological sex. Under the Obama administration, the Departments of Justice and Education had taken the position that existing regulations like Title IX, the federal law that prohibits sex discrimination in schools, also applied to discrimination based on gender identity.

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

Using Inclusive Language Isn’t Enough

Celeste Orr and Erin Leigh Courtice respond to criticisms of the British Medical Associations’ guide on inclusive language which aims to ensure that trans, intersex, genderqueer, and non-binary people are not subjected to discriminatory language.

__________________________________________

Since January 2017, Hayden Cross has garnered a lot of media attention. He is the first publicly-known pregnant trans man in Britain. In response to the media attention, there has been considerable criticism of the 2016 British Medical Association’s “A guide to effective communication.” The guide recognizes that some trans men and intersex men may become pregnant and it calls for the use of more inclusive language. The guide recommends that medical professionals use the phrase “pregnant people” instead of “expectant mothers.”

While the guide was published in 2016, before Cross’ pregnancy, a connection between Cross and the guide persists. Many of the articles and people criticizing the guide assume or suggest that it was published since Cross’ pregnancy. In this way, Cross is being blamed for the apparently “Orwellian” instructions, which undoubtedly intensifies the cissexist violence being aimed at him.

According to Philip Davies, British Conservative MP, the guide is “completely ridiculous.” Laura Perrins, of The Conservative Woman, describes the recommendations as “anti-science, anti-women and anti-mother.” Similarly, Sarah Vine claims the guide is “an insult to mothers.”

These recent criticisms are deeply problematic. For example, Perrins’ claim that the guide is anti-science is not only ironic, but false. Her claim reproduces the scientifically unsubstantiated essentialist theory that bodies are innately sexed and gendered, as observable by various bodily characteristics and capabilities.

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

Lenore Manderson, Elizabeth Cartwright and Anita Hardon’s The Routledge Handbook of Medical Anthropology by Casey Golomski

The Routledge Handbook of Medical Anthropology

Edited by Lenore Manderson, Elizabeth Cartwright and Anita Hardon

Routledge, 2016, 393 pages.

 

This is not a run-of-the-mill medical anthropology reader. Thank Routledge, its editors, and contributors for it. As someone who regularly convenes intermediate-advanced courses in medical anthropology, I’m grateful for its readability, teachable qualities, and particular theoretical angles. I’m going to trace four areas where I think the new Routledge Handbook of Medical Anthropology is innovative among the current offerings of similar edited volumes on the market for our discipline.

 

Visual innovation :: contextualized photographic figures

Recently, there’s been hot and necessary discussion about the images used for anthropology book covers: Tunstall and Esperanza (2016) over at Savage Minds provide interesting practical guidelines for book cover image selection as a way to decolonize anthropology. Ethnographies of medicine, suffering, and war with nuanced photographic figures of belabored people arguably make these books more compelling and help them win awards (De Leòn with Wells 2015, Biehl with Eskerod 2007, 2013), and also raise ethical questions about the images we choose to give life to our writing. The Routledge Handbook contains 16 photographic figures, taken by both contributors and others selected from a global Internet-based call-for-submissions in 2015, each placed as a ‘prelude’ (xii) to its respective chapter. A thoughtful, roughly 150-175 word description by the photographer accompanies each figure, giving it fuller context beyond the usual one sentence caption.

I appreciate projects that aim to decolonize higher education, the academy and our respective discipline, and find Tunstall and Esperanza’s approach insightful.

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.