Tag: obstetrics and gynecology

Bioethics News

Pre-embryo. This term is no longer used in current discussions regarding the nature of the embryo

Everything suggests that the term has been artificially created to justify the use of embryos for IVF and biomedical experiments
A recent article has studied the use of the term “pre-embryo” (see “Determining whether the preimplantation human embryo is a living being of our species“) since its origin in June 1979 until the end of 2014, in both the scientific and bioethical literature. Its evolution over time was compared with other terms generally used in embryology. The authors also studied in which journals this term most frequently appeared, its impact factor within journals in its field, and which authors used it most. The term “pre-embryo” first emerged in the scientific literature in 1979, but it was 6 years before it next appeared. Then, after an increase in articles in the 1990s, its use began to decline, although the term never completely disappeared. This study also shows that the use of the word “pre-embryo” has not increased over time; in contrast, it is becoming less frequently used in the biomedical literature. This has not happened with other terms that refer to the pre-implantation embryo, which have continued to increase over these years, in relation to both the human and other animal species. In addition, this word has abnormally high use in humans for no apparent reason, which supports its artificial nature. Finally, the term “pre-embryo” very seldom appears in journals in the area of reproductive biology, unlike the fields of obstetrics and gynecology, where many articles on assisted reproduction are published. In conclusion, instead of substituting classical embryological terms, the word “pre-embryo” seems not to affect the use of them, while in current discussions regarding the human nature of the embryo, this term is no longer used, everything suggests that the term has been artificially created to justify the use of embryos for IVF and biomedical experiments.

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

Artificial Womb Maintains Lamb Preemie Lives, Signals Hope for Human Preemie Care

Using an artificial womb, a team of researchers affiliated with the University of Western Australia have effectively incubated premature lambs for seven days, signaling potential future advancements for human preemie care options. The American Journal of Obstetrics and Gynecology published a paper this past week detailing the ex-vivo uterine environment (EVE) therapy technique devised by the researchers, which involves putting the premature lamb in a bath of amniotic fluid that includes an artificial placenta.

The conditions of EVE therapy mimic those of an actual womb, including increased gas exchange and nutrient delivery for the prematurely delivered lamb. For an infant developing outside the womb prematurely, the unfavorable conditions can lead to adversely affected development or complications.

“At its core, our equipment is essentially is a high-tech amniotic fluid bath combined with an artificial placenta. Put those together, and with careful maintenance what you’ve got is an artificial womb,” Local Chief Investigator and UWA Associate Professor Matt Kemp said. “By providing an alternative means of gas exchange for the fetus, we hoped to spare the extremely preterm cardiopulmonary system from ventilation-derived injury, and save the lives of those babies whose lungs are too immature to breathe properly. The end goal is to provide preterm babies the chance to better develop their lungs and other important organs before being brought into the world.”

Sparking bioethical questions regarding pregnancy, abortion, and perhaps even conception, the research is certainly promising for infant health, yet consequently complex in its potential ramifications. The paper follows one published in April by the Center for Fetal Research in Philadelphia, in which premature lambs survived for four additional weeks  prior to delivery.

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

Embryo-Screening Project May Reduce IVF Miscarriages

February 17, 2017

(The Japan Times) – The Japan Society of Obstetrics and Gynecology has announced the launch of clinical research aimed at preventing miscarriages by genetically screening eggs that are fertilized in vitro before implanted in the womb. Preimplantation genetic screening of embryos is aimed at detecting potential abnormalities in chromosomes. The group intends to examine whether selecting for lack of abnormalities can lower the miscarriage rate.

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

The Formation of the Global Bioethics Initiative Featured in IMPAKTER

In this series of global leaders, we will highlight an international non-profit healthcare organization that provides a bridge between patient care and the complexities of medicine. This area of healthcare is often referred to as Bioethics and in 2011, Dr. Ana Lita and Dr. Charles Debrovner co-founded Global Bioethics Initiative (GBI). This organization offers an all-inclusive resource that allow young and established healthcare professionals a place to learn about essential information about the ethical dilemmas in medicine. GBI is unique in their approach in that they make Bioethics approachable and tangible to everyone. This first installment of this series will layout the reasons behind making bioethics global, the reasons for forming GBI, and their educational programs.

WHY GLOBAL BIOETHICS?

People are beginning to appreciate more deeply the bonds between human well-being and the unrelenting pace of medical and technological advances. The progress made in life sciences, medicine and biotechnology in recent years has provided us with exciting and novel ways of treating, preventing, and curing human diseases. Some (relatively) recent notable and controversial developments in medical science and biotechnology include: markets in organs and transplantation therapy, the accessibility of biotechnological developments in reproductive healthcare, genetic testing and gene therapy, the End-of-Life, the “right to die” and palliative care, as well as life extension, healthy aging and regenerative medicine. While the positive impact of these advances on individuals and societies must be applauded, the ethical consequences of such developments necessitate our attention. The increasing power that new biotechnologies offer us requires that we consider not only whether something can be done, but whether it should it be done.

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

GBI excited to ​announce new President, Dr. Bruce Gelb

Global Bioethics Initiative is pleased to announce the election of Dr. Bruce Gelb, M.D., F.A.C.S, as President of the Board of Directors. Dr. Gelb is an Assistant Professor of Surgery at NYU Langone Medical Center, School of Medicine, and the Surgical Director of Renal Transplantation of the NYU Langone Transplant Institute. He also performs liver transplant surgery and is a key member of the Face Transplant team. He has a vested interest in the field of bioethics, especially the ethics of transplantation.

“As a transplant surgeon, bioethics encompasses virtually every aspect of my work. I had the honor of joining GBI’s Board of Directors three years ago and served as the Interim President of the organization since July 2016. It has been an honor to serve as a lecturer in both Manhattan and Dubrovnik schools and symposiums on the ethics of organ transplantation alongside with world experts in various other fields. I am strong supporter of the mission and educational programs of this young organization.”

Since March 2016, he serves as the Chair of the Quality Improvement Committee at the NYU Langone Medical Center and holds an appointment as a Representative of the United Network for Organ Sharing (UNOS) Ethics Committee for a three-year term. Dr. Gelb has received the multiple clinical awards, including: Castle Connolly Top Doctor, New York 2016, NY Top Docs 2015, Super Doctors “Rising Star” 2013 and 2014, and Alpha Omega Alpha Medical Honors Society. He holds board certification in General Surgery and is certified in Liver, Kidney, and Pancreas transplantation, and Living Donor Surgery.

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

Sentimentality in Medical Professionalism

By James Smith

As we navigate current and future health care transitions, I am skeptical that our conventional understanding of medical professionalism will assist us.  We have defined and organized medical professionalism into list of codes, behaviors, and collective “group-think” to serve as an aegis to transient threats to the central role of the medical practitioner in historic and contemporary healthcare.  Or at least physicians have.  Professionalism, as a movement in medicine, arguably had its inception in this country with the organization of the American Medical Association (AMA).  The AMA’s initial agenda included a proprietary defense to the threat of “irregular” practitioners—those from alternative medical education pathways.  The central role of physicians in modern healthcare has been eroded by payers, the government, and the healthcare systems in which physicians find employment.  Or so physicians think.  In response, physicians have conveniently deployed “professionalism” as a shield against these threats, and the general threat of commercialism in medicine.1 Furthermore, professionalism has been nuanced, expanded and rolled out as a discipline to be taught in medical education in order to protect and retain a collective identity, resistant to oversight or intrusive engagement from the outside.  The self-serving nature of the call for renewed professionalism and its incorporation into medical education is thinly veiled by the allure (and illusion) that it may actually be effective.  All we are accomplishing is the depersonalization the very nature of the relationship between healer and patient upon which we “profess” our social vocation…

Professionalism cannot be taught. Medical educators do not know how to teach professionalism2 and medical students do not like to be taught professionalism.

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

Contraceptives. Latest findings on their efficacy

Aside from the ethical and moral issues that accompany the use of contraceptives, one biomedical and social aspect of interest is to determine their efficacy, particularly when this is compared with natural fertility regulation methods, and most especially when it involves choosing contraceptives that acts through an anti-conception or anti-implantation mechanism.

Contraceptives latest findings:

A recent article in the American Journal of Obstetrics and Gynecology, published in July this year, compared the efficacy of different contraceptive methods in a group of 9,252 women over a period of 2 to 3 years. In the first part, they evaluated the pregnancy rate at 1, 2 and 3 years, and the mean pregnancy rate. For the methods used as a whole, the overall mean rate was 3.1 pregnancies when the 3 years were evaluated jointly, and 2.7, 5.9 and 9.1 if evaluated at 1, 2 and 3 years, respectively. When the pregnancy rate per 100 women-years is considered, naturally, the contraceptive failure rates are lower. Although efficacy is high, we must not forget their negative side effects and, especially, the moral difficulties entailed in their uses.

La entrada Contraceptives. Latest findings on their efficacy 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 News

More gay couples using surrogates in US

An informal study by a fertility data service suggests an increasing number of gay couples in the US are turning to surrogacy.

The study — conducted by Fertility IQ on behalf of the Chicago Tribune — involved data from fertility clinics in more than 10 cities.

The results, as reported in the Tribune, “indicate that 10 to 20 percent of donor eggs are going to gay men having babies via surrogacy, and in a lot of places the numbers are up 50 percent from five years ago.”

Surrogacy for gay men in the US was “unheard of” five years ago, according to Eve Feinberg, an assistant professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine.

But Jake Anderson, Fertility IQ co-founder, says the practice will become increasingly common.

“We think this is going to be pretty darn commonplace…Maybe not tomorrow, but five years from now, 10 years from now, everybody will know a few people who have built their families through gay surrogacy.”

Surrogacy for gay men typically costs between $100,000 to $200,000, Anderson told the Tribune.

Statistics released earlier this year by the Treasury Department indicate that the income of same-sex married male couples with children is roughly $275,000 on average, more than double the pretax income for heterosexual couples and same-sex married female couples with children.

This article is published by Xavier Symons and BioEdge under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation.

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

Dangers of an Unscientific Policy Process: Why the UK

Several researchers around the world have now turned the CRISPR genome editing craze towards human embryos, reigniting questions around the feasibility, legality, and morality of creating genetically modified humans. Some have suggested that we look for guidance to the United Kingdom’s policy process for “mitochondrial replacement,” also known as “three-person IVF,” which culminated in the world’s first legalization of a procedure that is technically a form of heritable human genetic modification in 2015.

How did the UK come to enable techniques that arguably contradict a policy in force throughout Europe for more than 15 years?

Having followed the process for several years, I would argue that we can learn a great deal from its history, but more specifically in what not to do moving forward in the CRISPR policy debate. In this blog, I will try to explain why.

I am a UK citizen who generally respects Britain’s regulatory models. However, I believe this process failed to live up to its self-image of openness and transparency. The experience taught me that science and technology hold such ingrained cultural and economic capital that people often hear any concern raised – even when it comes from other scientists – as “anti-science” or “anti-technology.” Moreover, it taught me that simple stories can become so compelling and satisfying that they do not bend, even in the presence of critical new information.

In this case, a consequential law was altered on the basis of a group of scientific methods whose human health and safety consequences have not been vetted, and could end up harming those they were designed to help.

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

Rural Nepal: Despite Evidence That Hospital Births Are Safer, Poverty Keeps Women Home

September 5, 2016

(Eurekalert) – Encouraging hospital births are an important component of reducing maternal mortality in low-resource settings. Now, new research shows certain factors, including age and income, determine whether women living in rural Nepal have home births or hospital deliveries. Sheela Maru ,MD, an instructor in Obstetrics and Gynecology at Boston University School of Medicine and a team of researchers at Possible and Nyaya Health Nepal, interviewed 98 women shortly after birth to understand why they delivered their babies at home or in a hospital. The majority of women acknowledged that giving birth in a hospital was safer than giving birth at home.

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.