Tag: low birth weight

Bioethics Blogs

In the Journals–March 2017, Part I by Julia Kowalski

Here is Part I of our March article round-up.

American Anthropologist

A Dog’s Life: Suffering Humanitarianism in Port-au-Prince, Haiti

Greg Beckett

In the Bel Air neighborhood of Port-au-Prince, Haiti, most residents are dependent on humanitarian and foreign assistance for food, services, aid, and jobs. Yet, some residents feel that the conditions under which such aid is provided actively blocks their ability to live a life they find meaningful. In this article, I explore how some Haitians theorize this humanitarian condition through the figure of the dog, an animal that exemplifies, for Haitians, the deep history of violence, dehumanization, and degradation associated with foreign rule. I then contrast this with how foreign aid workers invoke the figure of the dog to illustrate their compassionate care for suffering others. Drawing on research among Bel Air residents and foreign aid workers in the years after a devastating earthquake destroyed much of Port-au-Prince, I show how the figure of the dog is central both to Haitian critiques of humanitarian aid and to the international humanitarian imaginary that responds to forms of suffering it deems cruel.

Biosocieties

“Let’s pull these technologies out of the ivory tower”: The politics, ethos, and ironies of participant-driven genomic research

Michelle L. McGowan, Suparna Choudhury, Eric T. Juengst, Marcie Lambrix, Richard A. Settersten Jr., Jennifer R. Fishman

This paper investigates how groups of ‘citizen scientists’ in non-traditional settings and primarily online networks claim to be challenging conventional genomic research processes and norms. Although these groups are highly diverse, they all distinguish their efforts from traditional university- or industry-based genomic research as being ‘participant-driven’ in one way or another.

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

Technologies of Care: Administering Donated Breast Milk in a South African Neonatal Intensive Care Unit by Miriam Waltz

This is the third installment of the series from the University of Cape Town’s First Thousand Day Research Group. My research traces out the pathways of donated milk from donor to recipient in a state neonatal unit in South Africa (Waltz 2015), to show how care and technologies are interwoven in complex and sometimes surprising ways.

Breastfeeding is widely seen as the best infant feeding option for mother and baby. The dominant discourse in both the public and the medical realm presents breastfeeding as a natural behaviour, best for babies, best for mums. In a recent series, The Lancet claims that increasing breastfeeding worldwide could prevent over 800,000 child deaths every year (Victora et al. 2016). This position is reflected in state policy and official declarations of the World Health Organisation (WHO) and UNICEF. In South Africa, after a decade of promoting the use of formula milk to offset possible vertical (mother to child) HIV transmission, the state re-committed to facilitating breastfeeding in the Tshwane declaration of August 2011 (see also Doherty et al. 2010 for the revised WHO guidelines on breastfeeding). Breast milk is even more important in the case of premature or low birth weight babies, who are highly susceptible to necrotising enterocolitis, (a serious gastrointestinal condition) if fed on formula milk (Neu and Walker 2011). Here, breast milk is critical in securing life; ‘breast is best’ (Murphy 1999). Where the birth mother’s breast milk is not available, donated breast milk is the best alternative.

My research on the milk’s trajectories was wide-ranging. I interviewed donor mothers; members of milk banks associated with the collection, testing, packaging and distribution of donated milk; hospital staff responsible for its prescription and distribution; and mothers whose infants were receiving donated milk.

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

Largest Study Yet Shows Mother’s Smoking Changes Baby’s Epigenome

Credit: Daniel Berehulak/Getty Images

Despite years of public health campaigns warning of the dangers of smoking when pregnant, many women are unaware of the risk or find themselves unable to quit. As a result, far too many babies are still being exposed in the womb to toxins that enter their mothers’ bloodstreams when they inhale cigarette smoke. Among the many infant and child health problems that have been linked to maternal smoking are premature birth, low birth weight, asthma, reduced lung function, sudden infant death syndrome (SIDS), and cleft lip and/or palate.

Now, a large international study involving NIH-supported researchers provides a biological mechanism that may explain how exposure to cigarette toxins during fetal development can produce these health problems [1]. That evidence centers on the impact of the toxins on the epigenome of the infant’s body tissues. The epigenome refers to chemical modifications of DNA (particularly methylation of cytosines), as well as proteins that bind to DNA and affect its function. The genome of an individual is the same in all cells of their body, but the epigenome determines whether genes are turned on or off in particular cells. The study found significant differences between the epigenetic patterns of babies born to women who smoked during pregnancy and those born to non-smokers, with many of the differences affecting genes known to play key roles in the development of the lungs, face, and nervous system.

In recent years, several smaller studies have provided evidence that maternal smoking can have epigenetic effects on an unborn child [2, 3, 4].

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

IVF twins. Monochorionic twins higher risks

Approximately 7.2% of pregnancies achieved through in-vitro fertilisation (IVF twins) are monochorionic twins pregnancies. Since these type of embryos have a higher risk of preterm birth and low birth weight in particular (Fertility and Sterility 104; 629-632, 2015), there seems little doubt that they should try to reduce their number, perhaps by promoting single embryo transfer in each procedure.

La entrada IVF twins. Monochorionic twins higher risks aparece primero en Observatorio de Bioética, UCV.

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 Ethics of Human Milk Exchange and Sale

Robyn Lee critiques the inequalities and social injustices that surround human milk exchange practices.

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Public milk banks provide human milk for premature infants because compared to formula feeding it is associated with lower rates of serious intestinal disease, a leading cause of illness and death. While public milk banks are very common in some countries, such as Brazil, there are only four currently operating in Canada. These are in Vancouver, Calgary, Toronto, and Montreal.

Public milk banks in Canada and the United States, are undersupplied and unable to meet high demand. As a consequence of widespread awareness of the benefits of human milk, some parents are trying to source human milk online through informal exchanges http://www.onlythebreast.com/; http://www.eatsonfeets.org/; http://hm4hb.net/. Public health agencies in Canada and the U.S. (along with national pediatric associations in those countries) have taken a strong position against any human milk exchange outside of milk banks, warning parents of the risks posed by transmission of pathogens and chemical residues. Nevertheless, the practice of human milk exchange is growing in popularity.

While some human milk exchange online forums such as “Human Milk for Human Babies” are based on sharing, others like “Only the Breast” also involve the sale of breast milk. Human milk has been described as “liquid gold” and costing “more than sushi” in media accounts because of its scarcity and high value. Human milk is becoming commodified and the high cost of obtaining milk may mean that access will be determined by socioeconomic status.

American biotech companies such as Prolacta Bioscience and Medolac have been processing human milk in order to create consumer products.

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

Cleveland Clinic Performs First U.S. Uterus Transplant

by Craig Klugman, Ph.D.

Almost like Aphrodite herself, surgeons at the Cleveland Clinic this week may have given fertility to a 26-year-old woman through a 9-hour uterus transplant operation. The transplanted uterus was from a deceased woman. This was the first such surgery in the United States, though it has been performed previously in Sweden and Turkey. Of the 9 women in Sweden who had the procedure, 4 have given birth.

The American patient had uterine factor infertility, which result from fibroids, scarification, genetics, or not having developed a uterus. For the surgeons and patients, this technique offers a way for the patient to potentially carry a child to term.

In the U.S., the Cleveland Clinic’s method involved the patient undergoing in vitro fertilization techniques to produce at least 10 frozen embryos. Then a donor was sought and her next of kin had to sign a special informed consent document for the procedure. The patient and her new uterus will be given a year to heal at which point an embryo will be defrosted and doctors will implant it. The embryos will be transferred one at a time. If one does implant, the resulting baby will be delivered by Caesarean section.

The benefit to this involved operation is clear, a woman is given the ability to gestate an embryo. She has a genetically-related child which she carried.

The risks are not slight. The potential mother will have to take immune suppressants—drugs that in the long term are known to include greater risk of infection, cancer, cardiovascular disease, and bone marrow suppression.

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

“Fetal assault” and later environment effects on child development: using neuroscience as a tool for political policy

By Carlie Hoffman

Premature infant, courtesy of Wikipedia
“Crack babies,” “crack kids,” and the “lost generation” were all terms used by the public and the press in the 1980s and 1990s to describe children born to mothers who used crack-cocaine during pregnancy. Supported and spurred on by the media’s interpretation of preliminary research performed by Dr. Ira Chasnoff, among others, these children were often born prematurely, had tremors and a small head circumference, and, based on their description in the press, were expected to have neurobehavioral deficits, reduced intelligence, and deficits in social skills. These children were also anticipated to cost educational and social systems thousands of dollars as they matured and entered into schools and eventually the workforce.
Yet, after additional studies have been conducted and as the “crack babies” have grown into adolescents and young adults, it has been found that the negative outcomes widely described by the media were overreaching and unsupported. “Crack babies” did not, in fact, present evidence of severe, broad problems with social development and cognitive functioning and did not prove to have the predicted detrimental social and financial effects on the school system. Instead, many of these children have grown into successful adults over the past two decades. Dr. Claire Coles, a researcher responsible for producing the first studies that challenged Chasnoff’s findings, thought the era of the “crack baby” had finally come to an end. However, as Coles discussed during the December Neuroethics and Neuroscience in the News journal club, “crack babies” and similar stories about children exposed to opiates, have resurged in recent media publications (seen here and here) and are rearing their heads once again.

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

Teenage pregnancy among 10 and 14 year olds remains high in USA

Teenage pregnancy rates remain high in the United States, with 3108 pregnancies among adolescents aged between 10 and 14 years in 2013. Extensive studies show that pregnancies in teenagers have more risks that those in women aged 20 to 29 years old, particularly in regard to premature births, low birth weight, hypertension, pre-eclampsia and eclampsia, anaemia and neonatal death (American Journal of Obstetrics and Gynecology 2015; 213: 95. e 1-8).

La entrada Teenage pregnancy among 10 and 14 year olds remains high in USA aparece primero en Observatorio de Bioética, UCV.

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

Intel Boosts Infertility Benefits or Incentives?

Miriam Zoll raises concerns about Intel’s employees’ fertility benefits.

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At first blush, last week’s announcement that Intel will be joining the ranks of Apple and Facebook in January 2016 by boosting its employees’ fertility benefits seemed like good news. The computer chip giant raised the lifetime cap of $10,000 for fertility services and $5,000 for medications to $40,000 and $20,000 respectively. To its credit, it also raised adoption benefits from $5,000 to $15,000.

Ogden Reid, Vice President and director of compensation and benefits at Intel was quoted by media as saying that the company considered data indicating that the average treatment cycle costs up to $20,000 and is 20 percent to 30 percent likely to succeed. “We’re hopeful that we can increase the odds by going from paying for half of one cycle to paying for two full cycles,” he said.

Intel’s position is a hopeful one, looking at the per cycle outcome glass as being 20 to 30 percent full, rather than 70 to 80 percent empty.

Intel has also dismissed the need for a medically indicated diagnosis of infertility to access fertility services. By doing so it is enabling healthy older couples facing natural fertility decline, as well as same-sex couples, to access what the industry calls “cutting-edge technologies” – in-vitro fertilization (IVF), intra-cytoplasmic sperm injection (ICSI), and embryo and egg freezing, among other techniques.

Intel Quark: a line of 32-bit x86 SoCs by Intel, designed for small size and low power electronics, such as wearable devices.

But there are serious concerns to be raised about the efficacy and safety of many of these fertility services.

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.