Tag: risk

Bioethics News

What Is Moral Injury In Veterans?

On Memorial Day, Americans remember those who died in service to the country. In the past 5 years, a large proportion of these deaths have been suicides. Popular media often link military suicide with PTSD. However, clinicians have identified an additional cluster of symptoms that are related to both military deployment and suicide risk but do not fit the criteria for PTSD. These symptoms fit with what has been called “moral injury.”

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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

Silence = Death

May 18, 2017

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

Silence = Death

As Donald Trump fights for his political life following new revelations about wholly inappropriate disclosure of classified materials and potential obstruction of justice, he has quietly issued new orders that will condemn thousands of women and children around the world to death.

Largely overlooked given the media frenzy about the appointment of a special prosecutor to investigate Russian interference in the US Presidential election was an announcement that the TrumpAdministration will vastly expand the scope of the “Global Gag Rule”, the international anti-abortion policy first enacted by Ronald Reagan in 1984.

Also known as the Mexico City Policy, the rule prohibits organizations that receive family planning money from the United States Agency for International Development (USAID) from providing or promoting abortion. This is true even if they do so with private money. In fact, if they take so much as a single dollar from the US, they can’t even mention the word ‘abortion’ regardless of whether or not these organizations actually provide such services.

Every time a Democrat is in the White House, the global gag rule is rescinded. Every time a Republican enters the Oval Office, it is reinstated. President Trump himself did so just three days after assuming office. Until now, family planning organizations around the world have largely learned to deal with this ebb-and-flow. That is all about to change.

On Monday, Trump announced a new policy called Protecting Life in Global Health Assistance. That policy expands the scope of the Global Gag Rule.

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

Stem cell research. The two sides of the coin

Science facing market

The “heads” of stem cell research

Stem cells today represent a great hope for the future of regenerative medicine due to their ability to differentiate into cell lines of almost any tissue, making them a promising therapeutic option for many diseases.

These pluripotent cells are found in embryonic and also in adult tissues. Their isolation and culture in specific media may lead to the development of tissues that are useful in regenerative therapies for conditions such as heart disease, myelopathies, diabetes, nerve injuries, retinopathies, etc. After their isolation, they are injected directly into the tissues to be regenerated, so that the stem cells differentiate into cells of these same tissues.

A third way of obtaining pluripotent cells is that described by Yamanaka 10 years ago, a finding for which he was awarded the Nobel prize in Medicine. Starting from a differentiated adult cell, Yamanaka managed to find a way of “dedifferentiating” it so that it returned to its pluripotent state, to then “redifferentiate” it into a particular cell line with therapeutic utility. These are known as iPS or induced pluripotent stem cells.

Similarly, tissues that simulate the function of certain organs have been reproduced in vitro from stem cells, and could, in the future, be an alternative to current organ transplantation.

The current state of the clinical application of stem cells remains uncertain. Although successful outcomes have been reported in some fields, such as cardiology and haematology, many clinical trials and therapeutic applications have failed due to problems arising in the differentiation processes and the appearance of tumours.

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

Analytics and the Prevention of Suicide

Greg Horne describes how data on social media can be used to identify and concentrate resources on groups who are at risk of suicide.

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Suicide is the second leading cause of death among youth in Canada. According to Statistics Canada, in 2011, it accounted for approximately 20% of the deaths of people under the age of 25. The Canadian Mental Health Association claims that among 15 – 24-year-olds the percentage of deaths caused by suicide is even higher, a frightening 24%– the third highest in the industrialized world. Recent reports also suggest that the suicide rates for First Nations and Inuit youth in Canada are from five to eleven times higher than the National average. Yet, despite these disturbing statistics, it is difficult, if not impossible, for health care providers (or friends and family) to identify whether a young person plans to injure themselves or die by suicide.

The warning signs leading up to a suicide can be easy to miss. For example, consider the recent spate of suicides at the University of Guelph. Was there a possibility of identifying the warning signs of increasing mental health issues at the University? Were there indications of a potential spike in suicides?

Some warning signs may be found online. Many people use social platforms like Facebook and Twitter to post detailed personal information about their health and their mental wellbeing. This information could help to identify groups who are at risk of self-harm or suicide.

SAS Canada, a data management, software development, and analytics company, is using a new artificial intelligence software solution to identify social groups that are at increased risk of suicide.

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 hearts. Update on clinical use and ethical assessment

After 2500 artificial hearts implanted only in Europe. Until now it has been only implanted in patients with very severe heart failure, almost terminal.

The use of artificial hearts (a device that replaces the functions of the heart) is increasing worldwide, and in fact, they have already been used in 26 patients in Spain and in 2500 in Europe.

While this practice gives rise to exciting medical possibilities, it also raises some ethical issues that we addressed in a previous article (see HERE). We will now update the latest findings on this practice.

Technically, artificial hearts consist of a continuous flow pump that can pump approximately 10 litres per minute from the left ventricle. The healthy heart can pump around four.

These hearts have a wire that exits the body at the belly button and connects to a small computer powered by 2 batteries, which last for between 8 and 10 hours; their half life is around 10 years.

Artificial hearts are placed inside the chest and connected to the heart in order for it to pump the blood to the aorta. The surgical procedure is not very long — around 2 hours — and has now been substantially simplified, as only two small incisions are required: one at the lower end of the heart and another near the aorta.

There is no doubt that the artificial heart is a major medical advance for patients who require transplant and who, for some reason, especially due to a lack of donor organs, are unable to have one.

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

Welcome 2017 HIV and Drug Abuse Prevention Research Ethics Training Institute Fellows!

The Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI) is pleased to announce that the following individuals have been selected as 2017 fellows:

Dr. Stephanie Cook, New York University
Estreet
Dr. Anthony Estreet, Morgan State University
Fielding Miller
Dr. Rebecca Fielding-Miller, University of California, San Diego
Guta
Dr. Adrian Guta, University of Windsor
Pagano-Therrien
Dr. Jesica Pagano-Therrien, University of Massachusetts 
Pasipanodya
Dr. Elizabeth Pasipanodya, University of California, San Diego
Philbin
Dr. Morgan Philbin, Columbia University
John_S
Dr. John Sauceda, University of California, San Francisco

The Fordham University  HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI), now in its 7th year, is a training grant sponsored by the National Institute on Drug Abuse (NIDA) (R25 DA031608-07), Principal Investigator, Dr. Celia B. Fisher, Director, Center for Ethics Education). The RETI provides early-career investigators in the social, behavioral, medical and public health fields with an opportunity to gain research ethics training. In doing so, RETI addresses the urgent need for HIV and drug use investigators who can identify and address ethical issues, engage drug using and other at-risk communities in the construction and evaluation of population sensitive research protections, and generate empirical data to inform ethical practice and policies for HIV prevention science. Through their funded Mentored Research Projects (MRP), RETI fellows generate empirical data, publish their findings in a variety of high-impact academic journals, and are trained to apply for increasing grant opportunities.

The program’s aims are to: (1) increase trainees’ knowledge of and capacity to address key ethical issues in HIV and drug abuse prevention research; (2) increase trainees’ capacity to ethically engage participants and communities in the construction of participant protections that reflect the values and merit the trust of all stakeholders in HIV and drug abuse prevention research.; (3) increase trainees’ capacity to conduct research that will generate data to inform HIV and drug abuse prevention research practices and policies; and (4) create and sustain an information and communication network for trainees, faculty and others in the field for enhancing ethical knowledge, ethical dialogue and future professional collaborations in HIV and drug abuse prevention research ethics.

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

Welcome 2017 HIV and Drug Abuse Prevention Research Ethics Training Institute Fellows!

The Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI) is pleased to announce that the following individuals have been selected as 2017 fellows:

Dr. Stephanie Cook, New York University EstreetDr. Anthony Estreet, Morgan State University Fielding MillerDr. Rebecca Fielding-Miller, University of California, San Diego GutaDr. Adrian Guta, University of Windsor Pagano-TherrienDr. Jesica Pagano-Therrien, University of Massachusetts  PasipanodyaDr. Elizabeth Pasipanodya, University of California, San Diego PhilbinDr. Morgan Philbin, Columbia University John_SDr. John Sauceda, University of California, San Francisco

The Fordham University  HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI), now in its 7th year, is a training grant sponsored by the National Institute on Drug Abuse (NIDA) (R25 DA031608-07), Principal Investigator, Dr. Celia B. Fisher, Director, Center for Ethics Education). The RETI provides early-career investigators in the social, behavioral, medical and public health fields with an opportunity to gain research ethics training. In doing so, RETI addresses the urgent need for HIV and drug use investigators who can identify and address ethical issues, engage drug using and other at-risk communities in the construction and evaluation of population sensitive research protections, and generate empirical data to inform ethical practice and policies for HIV prevention science. Through their funded Mentored Research Projects (MRP), RETI fellows generate empirical data, publish their findings in a variety of high-impact academic journals, and are trained to apply for increasing grant opportunities.

The program’s aims are to: (1) increase trainees’ knowledge of and capacity to address key ethical issues in HIV and drug abuse prevention research; (2) increase trainees’ capacity to ethically engage participants and communities in the construction of participant protections that reflect the values and merit the trust of all stakeholders in HIV and drug abuse prevention research.; (3) increase trainees’ capacity to conduct research that will generate data to inform HIV and drug abuse prevention research practices and policies; and (4) create and sustain an information and communication network for trainees, faculty and others in the field for enhancing ethical knowledge, ethical dialogue and future professional collaborations in HIV and drug abuse prevention research ethics.

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

Widening Gap in U.S. Life Expectancy

Caption: Life expectancy at birth by county, 2014. Life expectancy into 80s (blue), 70s (green, yellow, orange), 60s (red).

Americans are living longer than ever before, thanks in large part to NIH-supported research. But a new, heavily publicized study shows that recent gains in longevity aren’t being enjoyed equally in all corners of the United States. In fact, depending on where you live in this great country, life expectancy can vary more than 20 years—a surprisingly wide gap that has widened significantly in recent decades.

Researchers attribute this disturbing gap to a variety of social and economic influences, as well as differences in modifiable behavioral and lifestyle factors, such as obesity, inactivity, and tobacco use. The findings serve as a sobering reminder that, despite the considerable progress made possible by biomedical science, more research is needed to figure out better ways of addressing health disparities and improving life expectancy for all Americans.

In the new study published in JAMA Internal Medicine, a research team, partially funded by NIH, found that the average American baby born in 2014 can expect to live to about age 79 [1]. That’s up from a national average of about 73 in 1980 and around 68 in 1950. However, babies born in 2014 in remote Oglala Lakota County, SD, home to the Pine Ridge Indian Reservation, can expect to live only about 66 years. That’s in stark contrast to a child born about 400 miles away in Summit County, CO, where life expectancy at birth now exceeds age 86.

Earlier studies suggested that Americans living in some parts of the country were living more than a decade longer than others [2].

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

Racial And Ethnic Disparities Persist In Sudden Infant Deaths

American Indian and Alaska Native families are much more likely to have an infant die suddenly and unexpectedly, and that risk has remained higher than in other ethnic groups since public health efforts were launched to prevent sudden infant death syndrome in the 1990s. African-American babies also face a higher risk, a study finds

Source: Bioethics Bulletin by the Berman Institute of Bioethics.

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

Are Incentives Corrupting? The Case of Paying People to be Healthy.

Written by Dr Rebecca Brown

Financial incentives are commonplace in everyday life. As tools of states, corporations and individuals, they enable the ‘tweaking’ of motivations in ways more desirable to the incentiviser. A parent may pay her child £1 to practice the piano for an hour; a café offers a free coffee for every nine the customer buys; governments offer tax breaks for homeowners who make their houses more energy efficient. Most people, most of the time, would probably find the use of financial incentives unobjectionable.

More recently, incentives have been proposed as a means of promoting health. The thinking goes: many diseases people currently suffer from, and are likely to suffer from in the future, are largely the result of behavioural factors (i.e. ‘lifestyles’). Certain behaviours, such as eating energy dense diets, taking little exercise, smoking and drinking large amounts of alcohol, increase the risk that someone will suffer from diseases like cancer, heart disease, lung disease and type II diabetes. These diseases are very unpleasant – sometimes fatal – for those who suffer from them, their friends and family. They also create economic harms, requiring healthcare resources to be directed towards caring for those who are sick and result in reduced productivity through lost working hours. For instance,the annual cost to the economy of obesity-related disease is variously estimated as £2.47 billion£5.1 billion and a whopping $73 billion (around £56.5 billion), depending on what factors are taken into account and how these are calculated. Since incentives are generally seen as useful tools for influencing people’s behaviour, why not use them to change health-related behaviours?

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.