Tag: parents

Bioethics Blogs

Bathroom Bills, Bigotry, and Bioethics

In an eleven-hour emergency session on March 23, the North Carolina General Assembly passed the first statewide “bathroom bill” in the nation. The law, known as HB 2, or the Public Facilities Privacy and Security Act, requires that a person’s biological sex corresponds with the gendered public restroom they are permitted to use. This effectively prohibits transgender and gender nonconforming people from using public restrooms that match their gender identity. The  anti-transgender provisions of the law have been widely reported, and the New York Times editorial board condemns HB 2 as “appalling, unconstitutional” legislation.

The “emergency” that prompted the session was the February 22 passage of a transgender-inclusive antidiscrimination bill in the city of Charlotte. North Carolina Governor Pat McCrory wrote on Twitter that he “signed bipartisan legislation to stop the breach of basic privacy and etiquette, [and] ensure privacy in bathrooms and locker rooms.”  But the law invades the privacy it purports to protect. Rooted in the specter of men masquerading as women to enter and commit violent crime in women’s bathrooms, it instantiates surveillance over the genitalia of anyone using public restrooms who is not stereotypically masculine or feminine. Furthermore, the measure (which is part of broader legislation dealing with the relationship of local and state laws) bars local policy-makers from enacting municipal antidiscrimination laws that conflict with these new state-level restrictions.

HB 2 should incite the worry, and the anger, of bioethicists on several fronts. It is unclear how transgender people could even comply with the letter of the law, let alone its spirit.

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

Ethical assessment of mitochondrial replacement to prevent transmission of hereditary diseases

Are there any ethical differences to consider between the two existing mitochondrial replacement techniques? A recent article in Bioethics (Bioethics 29; 631–638, 2015) defends the advisability of using pronuclear transfer (PNT) compared to maternal spindle transfer (MST) to prevent the transmission of certain hereditary mitochondrial diseases.

MST consists of extracting the nuclear DNA from the ovum (egg) of the mother (whose mitochondria are “sick”) and placing it in a healthy enucleated ovum from a donor. Thus, the resulting ovum contains nuclear DNA from the mother and healthy mitochondria from the donor. The ovum is then fertilised in vitro. In contrast, in PNT, the replacement does not occur between ova, but between zygotes. In the first step, two ova are fertilised: one from the mother, containing the “sick” mitochondria, and one from a donor with healthy mitochondria. The DNA replacement occurs between zygotes, resulting in a zygote with the genetic contribution of the parents and the mitochondria of the donor; the other zygote is discarded.

The authors argue that, since MST is applied to the female gamete before fertilisation, it can somehow be said that the sole function of the technique is to allow the mother to have children of her own without the disease. In contrast, since PNT is applied to the zygote, this technique can be considered to act directly on the health of an already existing child, to cure it rather than to satisfy the mother’s desire to have healthy children. From this, the authors draw two conclusions. First of all, that the parents have stronger moral reasons to accept PNT than to accept MST, since not using PNT would directly harm their children, which would not be the case of MST.

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

As If We Don’t Have Enough to Think About

My work recently took me to the Multidisciplinary Symposium on Head and Neck Cancer.  Among the proceedings was a discussion of the epidemiology of oropharyngeal cancer—cancer of the throat.  Historically, this tumor typically occurred in people with long histories of smoking and drinking.  Treatment brings the prospect of disfiguring surgery, although the surgeons do great work these days, and/or a 6-7 week slog of radiation treatment, often with chemotherapy as well, and the risk of lifelong dry mouth and aspiration pneumonia, among other things.

But lately, throat cancer has a different cause—human papilloma virus, or HPV, the virus associated with cervical cancer in women, and other, less-common cancers.  HPV-related throat cancer is a sexually transmitted disease.  I don’t want to be indelicate here, but the mode of transmission is—ahem—oral sex.  And as one might expect, men (especially white men) are at greater risk, and the risk goes up directly with the number of (principally female) partners.  There are a number of things not yet fully understood, and HPV-related throat cancer has a better prognosis than smoking-related disease and may not need quite as aggressive treatment, but one still does not want to get it.  And the incidence is increasing sharply.  It’s sort of an epidemic in the U.S. and elsewhere.  Onset of the disease in one’s 40’s or 50’s, sometimes earlier or later.

Of course, one can control and greatly limit, if not eliminate, this risk by choice—specifically, chastity before marriage and monogamy afterward.  And so would and did we, like many fellow religious conservatives, raise our sons, with that council.  Or, there are vaccines, like Gardasil, initially introduced with reducing girls’ risk of cervical cancer in mind.  The Centers for Disease Control and Prevention recommend vaccination at age 11 or 12.

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

A Few Thoughts On Abortion and Valuing Human Life


Who could be against life? Ancient natural law theory in the
Catholic tradition tells us that human beings desire to live, and that life is
good, therefore humans have an obligation to live and not kill other human
beings. This ancient wisdom has been instilled into western ways of moral
thinking. So, who could not be prolife in terms of how we place value on all
individual human life?


 


Who could be against human freedom? Individual human beings
should be free to live peacefully in accordance with their own values and life
goals. This is a basic tenet of democracy that has shaped moral and political
thinking in the West for the past four centuries. So, who could not be against
the exercise of free choice, especially about something so basic as having
control over our bodies?


 


The two value perspectives contained in the prior two
paragraphs, all things equal, are eminently reasonable and most ethically unproblematic.
These two value positions represent two fundamental principles of ethics—the
intrinsic value of all individual human lives and the right of free individuals
to govern their own lives and bodies—that guide us in living an ethical life
and making ethical decisions. It is when these fundamental principles come into
direct conflict that a serious, a near irresolvable, ethical conflict arises.
There is no greater direct conflict of these two ethical principles than right
of women to have an abortion. It is commonly assumed that one is either on one
side of this moral abyss or the other and the twain shall never meet.

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

Resurgence of Measles, Pertussis Fueled by Vaccine Refusals

Credit: Centers for Disease Control and Prevention

I was born in 1950 and was home-schooled until the 6th grade. Thus, I missed exposure to several childhood illnesses that affected most of my generation. I never gave it much thought until, as a medical resident in North Carolina in 1979, I came down with a potentially life-threatening febrile illness that required hospitalization. Only after four days of 105 degree fever did a rash appear, and the diagnosis was made: measles. That was the sickest I have ever been. It turned out that one of my daughter’s school friends had developed measles in a small outbreak of unvaccinated kids in Chapel Hill, and I had been exposed to her. I was born too early to have been vaccinated.

But for most people born in the United States after the 1960s, they have never had to experience the high fever and rash of the measles or the coughing fits of pertussis, commonly known as whooping cough. That’s because these extremely contagious and potentially life-threatening diseases have been controlled with the use of highly effective vaccines and strong vaccination programs. And yet, the number of Americans sickened with measles and pertussis each year has recently crept back up.

Now, an NIH-funded report confirms that many of the recent outbreaks of these vaccine-preventable diseases have been fueled by refusal by some parents to have their children vaccinated [1]. The findings, published recently in JAMA, come as an important reminder that successful eradication of infectious diseases depends not only on the availability of safe and effective vaccines, but also on effective communication about the vaccines and the diseases they prevent.

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

Should Parents of Children with Severe Disabilities Be Allowed to Stop Their Growth?

March 22, 2016

(New York Times) – When I visited Cloudcroft two summers ago, Ricky was small for his age — just 42 inches tall and 37 pounds, about the size of an average 4-year-old boy. In part this was because of genetics and his various health problems, but it was also partly a result of his having been through a controversial medical intervention known as growth-attenuation therapy. From the time he was 4 until just shy of his 7th birthday, he received doses of estrogen high enough to stimulate the premature closing of the epiphyseal or “growth” plates, the thin wedges of cartilage found at the end of the long bones in children and adolescents.

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

Dinosaurs are Extinct, but Normalization is Alive and Well

My son hugs a stuffed dino.

This article was cross-posted on Disability Remix, the blog of the Paul K. Longmore Institute on Disability at San Francisco State University.

Lately, I’ve been learning a lot about dinosaurs. Or, I should say, my three-year-old son has been learning a lot about dinosaurs, and I have been caught in the crossfire. My mind is often churning to relate any new information I take in to my own passion of disability studies. I didn’t expect to find a link to dinosaurs… but I did.

Dinosaur science has advanced remarkably since my childhood. (Did you know, for example, that scientists now believe many dinosaurs had feathers?!)

But while our notions of what dinosaurs could have been is constantly evolving, we still cling to certain tenets of what I like to call “dinosaur normalization.” (I haven’t lexis-nexis’d it, but I think you just witnessed the birth of a completely original school of academic thought!)

Dinosaur normalization is the idea of prescribing what dinosaurs would have been like based on our own narrow worldview.

For a quick example of dinosaur normalization, when scientists first discovered the Iguanodon (see right), they assumed he had a rhino-like horn on his nose. After further skeleton discoveries, it turns out the Iguanodon actually has two horn-like thumbs, something we’ve never seen before.

But you don’t have to be an obscure dinosaur like the Iguanadon (that only three-year-olds and their parents are likely aware of) to be a victim of dinosaur normalization.

Here’s a children’s song about the stegosaurus:

My name is stegosaurus,
I’m a funny looking dinosaur….

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

Our Control Culture Strips Life of Joy: Column

March 21, 2016

(USA Today) – In other words, many parents are interested in choosing the sex of their child, which could have troubling long-term implications. A 2011 Gallup poll found that Teigen and Legend aren’t the norm: If told they could only have one child, 40% of Americans would choose a boy, only 28% a girl. If sex selection becomes more popular, the U.S. could drift into the direction of countries like China and India, which have significantly more boys than girls.

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.