Tag: hepatitis

Bioethics Blogs

Talking back to science?

By Stephen Rainey

In June 2017, the European Court of Justice ruled that it was legal for a French citizen to sue a drug company for damages following a vaccination, and an illness. The ruling caused some consternation as it seemed a legal vindication of anecdote over scientific rigour.

This is a dramatic case, not least owing to the position in which vaccines find themselves, post Andrew Wakefield and the rise of the anti-vaxxer movement. Nevertheless, it forms a part of a wider narrative in which scientific activity is not always very open to questions from outside science. This broader theme is worth some scrutiny.

Vaccine injury

Shortly following a vaccination against Hepatitis B a French citizen, JW, found himself in declining health. Soon after the decline began, a diagnosis of Multiple Sclerosis (MS) was made. Having had no prior personal or family history of such an illness, and having been in good health prior to the inoculation, JW concluded that the injections must have been to blame for his developing MS. His assertion of this was not supported by scientific investigation. Rather, he could think of the vaccination as the only unusual event that preceded closely his sudden, unexpected development of the condition.

The French courts found themselves unable to agree on whether such a basis as this is sufficient to sue a pharmaceutical company. Eventually, the case was sent to the European Court of Justice (ECJ) which ruled,

“…that the temporal proximity between the administering of a vaccine and the occurrence of a disease, the lack of personal and familial history of that disease, together with the existence of a significant number of reported cases of the disease occurring following such vaccines being administered, appears on the face of it to constitute evidence which, taken together, may lead a national court to consider that a victim has discharged his burden of proof.

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 Opioid Epidemic is an Epidemic of Stigma

Kristie Serota and Daniel Z. Buchman argue that eradicating the stigma associated with opioid use is an ethical necessity and is critical for population health.

__________________________________________

The Government of Canada reports that over 2458 Canadians died of apparent opioid-related deaths in 2016 (excluding Quebec). Last November, an average of 4 people died from overdoses every day in British Columbia. Recent U.S. estimates project opioid-related deaths at over half-a-million people over the next decade. Interventions have been implemented in many jurisdictions to minimize opioid-related mortality, but each year the death toll continues to rise and shows no signs of relenting.

While people dying from opioids in large numbers is not new, the present epidemic arose due to several complex factors. For example, OxyContin was aggressively marketed and prescribed for chronic non-cancer pain. Doctors and the public were misled about OxyContin’s addiction risks. In addition, health professionals receive limited training on pain and addiction. There are also inequities due to the social determinants of health and the harmful effects of substance use-related stigmas.

Stigma, operating at individual, institutional, and social levels, has led to punitive legal, policy, and clinical responses toward people who use drugs. Stigma has also led to chronic underfunding of addiction research and treatment services relative to the burden of disease. Although the current epidemic does not discriminate across the social gradient, stigma disproportionately burdens people from less privileged social groups more frequently and harmfully than others. People with no history of a substance use disorder risk the pejorative label of ‘addicts’ when they are prescribed opioids for pain management.

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

Walk In or Get Out: Overcoming Distrust of Medicine to Improve Outcomes

by Jennifer Cohen                                         

“Get Out” Universal 2017    

“Get Out” Universal 2017    

“Get Out” Universal 2017    

“Frankenstein” Universal 1931

“Frankenstein” Universal 1931

“Frankenstein” Universal 1931

Popular culture has long provided an outlet for feelings of powerlessness toward medicine. 19th century novels Frankenstein and The Island of Dr. Moreau tapped into fears that medicine would cruelly pursue scientific knowledge at the expense of human life. Two recent films, The Immortal Life of Henrietta Lacks and Get Out, examine the anxieties and mistrust that African Americans, in particular, experience toward the medical community in the modern era.  

Henrietta Lacks depicts a historical breach of ethics by researchers at Johns Hopkins University, whose work obscured the identity of Ms. Lacks’ “immortal” cell line and withheld attribution both to Ms. Lacks and her family for decades. In the film, this wrong exacerbates over time as the family struggles emotionally to understand the uses of their mother’s cells and to accept their mother’s consent was never considered necessary. Indeed, the family believed that members of their community were routinely used for experimentation without their consent: they tell journalist Rebecaa Skloot that, as children, they were warned by their parents to get off the streets at night or “Hopkins people” would snatch them up.

In Get Out, a nightmarish surgical practice occurs in which a neurosurgeon and psychiatrist lure African Americans to their home for use as receptacles for white brains in a bid for white immortality. Both of these films explore the premise that African-Americans should be afraid medicine will treat them differently from white individuals.

The ugly history of abuse toward African Americans in the name of medical research was extensively documented in 2006 by the bioethicist Harriet A.

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

‘Miracle’ Hepatitis C Drugs ‘May Have No Clinical Effect’

Review concludes drugs, costing £30k per patient, hailed as cure for potentially fatal liver disease may clear virus from blood, but there is no evidence they prevent harm or save lives

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 – May 2017 by Livia Garofalo

Please enjoy the article round-up for the month of May! This post was put together in collaboration with Ann Marie Thornburg.

American Ethnologist

Plant matters: Buddhist medicine and economies of attention in postsocialist Siberia

Tatiana Chudakova

Buddhist medicine (sowa rigpa) in Siberia frames the natural world as overflowing with therapeutic potencies: “There is nothing in the world that isn’t a medicine,” goes a common refrain. An exploration of sowa rigpa practitioners’ committed relations with the plants they make into medicines challenges human-centric notions of efficacy in anthropological discussions of healing. Their work of making things medicinal—or pharmacopoiesis—centers on plants’ vital materialities and requires attention to the entanglements among vegetal and human communities and bodies. Potency is thus not the fixed property of substances in a closed therapeutic encounter but the result of a socially and ecologically distributed practice of guided transformations, a practice that is managed through the attentive labor of multiple actors, human and otherwise. In Siberia, pharmacopoiesis makes explicit the layered relations among postsocialist deindustrialization, Buddhist cosmologies, ailing human bodies, and botanical life.

Annals of Anthropological Practice

Special Issue: Continuity and Change in the Applied Anthropology of Risk, Hazards, and Disasters

Disaster vulnerability in anthropological perspective 

A.J. Faas

In the study of disasters, the concept of vulnerability has been primarily employed as a cumulative indicator of the unequal distributions of certain populations in proximity to environmental and technological hazards and an individual or group ability to “anticipate, cope with, resist and recover” from disaster (Wisner et al. 2004). This concept has influenced disaster research as a means to question how natural, temporary, and random disasters are and focused analysis on the human-environmental processes that produce disasters and subject some populations more than others to risk and hazards.

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

Pornography as a Public Health Issue

Jacqueline Gahagan advocates for a national sexual health promotion strategy.

__________________________________________

Pornography is concerned with the development and the circulation of sexually explicit books, magazines, videos, art, and music aimed at creating sexual excitement. Public health is concerned with keeping people healthy and preventing illness, injury and premature death. With the growing use of internet-based pornography and the relative ease by which it can be accessed, the effects of “online violent and degrading sexually explicit material on children, women and men” have become an important public health issue. This issue is best addressed through the development and introduction of a national sexual health promotion strategy – a strategy that includes current and comprehensive sexual health education in our primary, secondary, and post-secondary schools.

Health promotion, in concert with public health, involves encouraging safe behaviours and improving health through healthy public policy, community-based interventions, active public participation, advocacy, and action on key determinants of health. I am confident that several of these strategies can be used to address concerns about the ready access to internet-based pornography. For example, health promotion initiatives that take a harm reduction approach to healthy sexuality include an emphasis on screening and testing for sexually transmitted infections, the use of condoms, a shared understanding of consensual sex, as well as the use of other safer sex interventions.

A review of existing sexual health education in Canadian schools, however, reveals that many Canadian youth do not receive the level of sexual health education they need to help them make informed decisions about sexual risk-taking.

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

Big Pharma Quietly Enlists Leading Professors to Justify $1,000-Per-Day Drugs

February 23, 2017

(Pro Publica) – Over the last three years, pharmaceutical companies have mounted a public relations blitz to tout new cures for the hepatitis C virus and persuade insurers, including government programs such as Medicare and Medicaid, to cover the costs. That isn’t an easy sell, because the price of the treatments ranges from $40,000 to $94,000 — or, because the treatments take three months, as much as $1,000 per day. To persuade payers and the public, the industry has deployed a potent new ally, a company whose marquee figures are leading economists and health care experts at the nation’s top universities.

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

Human genome editing report strikes the right balance between risks and benefits

Gene therapy is growing in its capabilities, but there should be limits to its use. Shutterstock

If you recognise the words “CRISPR-mediated gene editing”, then you’ll know that our ability to alter DNA has recently become much more efficient, faster and cheaper.

This has inevitably led to serious discussions about gene therapy, which is the direct modification of someone’s DNA to rectify a genetic disorder, such as sickle cell anaemia or haemophilia. And you may also have heard of deliberate genetic enhancement, to realise a healthy person’s dreams of improving their genome.

Both of these issues have now been tackled in a comprehensive report on gene editing released today by the US National Academy of Science and National Academy of Medicine.

The message is fairly simple: relax, we’ve seen this all before, little if any harm has eventuated, and society is well placed to move forward together on this.

A definite maybe

Of all human technologies, recombinant DNA has arguably been one of the safest. There have been multiple benefits in both medicine and agriculture. And the legitimate concerns that arose when viruses were first mixed with bacterial genes, when cloning was first introduced, and when stem cells were developed, have not come to pass.

I cannot list all the benefits here, but if you have received the Hepatitis B vaccine or Australian Ian Fraser’s Gardasil vaccine, which protects against cervical cancer viruses, you have been protected from disease thanks to recombinant DNA technology.

However, you probably haven’t received somatic gene therapy, which is gene alteration directed at fixing one cell type, such as defective blood or liver cells.

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

Is it true that there are vaccines produced using aborted fetuses?

pdfSome of the vaccines currently used to prevent diseases such as rubella, measles, rabies, poliomyelitis, hepatitis A, chickenpox or smallpox are produced using tissues from human abortions.

The vaccines consist of dead or attenuated live viruses that are introduced into the patient’s body to activate the body’s defences against that virus without becoming ill. Thus, if the patient subsequently enters into contact with the live virus, it will be unable infect him, since he has the necessary defences to cope with it, i.e. he is immunised.

To prepare the vaccines, the viruses must be cultured in cells in the laboratory. The ethical difficulty appears when these cells come from surgically-aborted human foetuse. Similarly, the viruses themselves can be obtained from aborted foetuses that have been infected with a particular virus. An article published in 2008 in Cuadernos de Bioetica includes detailed information on the different cells and viral strains originating from these sources.

Cells used and vaccines produced using aborted fetuses

The most widely used foetal cells are WI-38 and MRC-5. The WI-38 cells were derived by Leonard Hayflick in 1962 from the lung of a 3-month female foetus [2].The initials WI refer to the Wistar Institute, a body of the University of Pennsylvania, Philadelphia, and number 38 to the foetus from which the cells were obtained. The MRC-5 cells were obtained in 1966 from the lungs of a 14-week male foetus [3].The initials MRC indicate Medical Research Council, a body from London. Other cells derived from surgically-aborted foetuses are: WI-1, WI-3, WI-11, WI-16, WI-18, WI-19, WI-23, WI-24, WI-25, WI-26, WI-27, WI-44, MRC-9, IMR-90, and R-17 (obtained from lung); WI-2, WI-12 and WI-20, (skin and muscle); WI-5 (muscle); WI-8 and WI-14, and WS1 (skin); WI-4, WI-9, WI-10, WI-13 and WI-15 (kidney); WI-6, WI-21 and WI-22 (heart); WI-7 (thymus and thyroids), WI-17 (liver); FHs74Int (small intestine); and PER.C6

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

Is it true that there are vaccines produced using aborted foetuses?

pdfSome of the vaccines currently used to prevent diseases such as rubella, measles, rabies, poliomyelitis, hepatitis A, chickenpox or smallpox are produced using tissues from human abortions.

The vaccines consist of dead or attenuated live viruses that are introduced into the patient’s body to activate the body’s defences against that virus without becoming ill. Thus, if the patient subsequently enters into contact with the live virus, it will be unable infect him, since he has the necessary defences to cope with it, i.e. he is immunised.

To prepare the vaccines, the viruses must be cultured in cells in the laboratory. The ethical difficulty appears when these cells come from surgically-aborted human foetuse. Similarly, the viruses themselves can be obtained from aborted foetuses that have been infected with a particular virus. An article published in 2008 in Cuadernos de Bioetica includes detailed information on the different cells and viral strains originating from these sources.

Cells used and vaccines produced using aborted foetuses

The most widely used foetal cells are WI-38 and MRC-5. The WI-38 cells were derived by Leonard Hayflick in 1962 from the lung of a 3-month female foetus [2].The initials WI refer to the Wistar Institute, a body of the University of Pennsylvania, Philadelphia, and number 38 to the foetus from which the cells were obtained. The MRC-5 cells were obtained in 1966 from the lungs of a 14-week male foetus [3].The initials MRC indicate Medical Research Council, a body from London. Other cells derived from surgically-aborted foetuses are: WI-1, WI-3, WI-11, WI-16, WI-18, WI-19, WI-23, WI-24, WI-25, WI-26, WI-27, WI-44, MRC-9, IMR-90, and R-17 (obtained from lung); WI-2, WI-12 and WI-20, (skin and muscle); WI-5 (muscle); WI-8 and WI-14, and WS1 (skin); WI-4, WI-9, WI-10, WI-13 and WI-15 (kidney); WI-6, WI-21 and WI-22 (heart); WI-7 (thymus and thyroids), WI-17 (liver); FHs74Int (small intestine); and PER.C6

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.