Tag: sexually transmitted diseases

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

Rise in sexually transmitted diseases according to WHO last report

Experts have warned in the 46th edition of the spanish journal EIDON of an upturn in sexually transmitted diseases, as a result of the social and cultural changes derailing the efforts and decline achieved after the “hardest” years of the HIV epidemic. According to the latest World Health Organization (WHO) report published in August 2016,

  • 131 million people contract chlamydia each year,
  • 78 million gonorrhea and
  • 5.6 million, syphilis.

In total, 357 million new cases are caused annually by one of the most prevalent sexually transmitted pathogens. It is also estimated that there are more than 500 million people with genital herpes simplex virus (HSV), and more than 290 million women are infected with human papillomavirus (HPV). In some cases, these diseases can have serious negative consequences for reproductive health, such as infertility or mother-to-child transmission. Specifically, according to the WHO, in the last year, over 900,000 pregnant women were infected with syphilis, which due to mother-to-child transmission can result in 350,000 fetuses with different degrees of impairment, including stillbirths. Furthermore, resistance to antimicrobials is a threat to controlling these diseases worldwide. The causes of the growth of STDs are complex and rooted in social and cultural changes, among them the loss of fear of contracting a disease considered as fatal, such as HIV. “Its solution ranges from improving sex education and culture from early stages in the education of individuals to improving rapid detection systems to easy access to counseling and health care of the entire population without discrimination as to whether or not they belong to a

La entrada Rise in sexually transmitted diseases according to WHO last report aparece primero en Bioethics Observatory.

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

Rise in sexually transmitted diseases according to WHO last report

Experts have warned in the 46th edition of the spanish journal EIDON of an upturn in sexually transmitted diseases, as a result of the social and cultural changes derailing the efforts and decline achieved after the “hardest” years of the HIV epidemic. According to the latest World Health Organization (WHO) report published in August 2016,

  • 131 million people contract chlamydia each year,
  • 78 million gonorrheas and
  • 5.6 million, syphilis.

In total, 357 million new cases are caused annually by one of the most prevalent sexually transmitted pathogens. It is also estimated that there are more than 500 million people with genital herpes simplex virus (HSV), and more than 290 million women are infected with human papillomavirus (HPV). In some cases, these diseases can have serious negative consequences for reproductive health, such as infertility or mother-to-child transmission. Specifically, according to the WHO, in the last year, over 900,000 pregnant women were infected with syphilis, which due to mother-to-child transmission can result in 350,000 fetuses with different degrees of impairment, including stillbirths. Furthermore, resistance to antimicrobials is a threat to controlling these diseases worldwide. The causes of the growth of STDs are complex and rooted in social and cultural changes, among them the loss of fear of contracting a disease considered as fatal, such as HIV“Its solution ranges from improving sex education and culture from early stages in the education of individuals, o improving rapid detection systems, to easy access to counselling and health care of the entire population without discrimination as to whether or not they belong to a healthcare system” (See HERE).

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

Fetuses and Full Disclosure

Medicine has a notoriously long history of paternalism, particularly with regards to reproductive health. The past century has seen everything from forced sterilization of people of color and those with intellectual disabilities to nondisclosure of sexually transmitted diseases. Physicians have fought to regain the trust of the community through disclosure of key medical information and shared decision making, both of which are essential underpinnings of the bioethical principle of autonomy. Given the incredible emphasis on these concepts in contemporary medical training, it is surprising that the following law has now passed Texas Senate approval:

SB 25. A cause of action may not arise, and damages may not be awarded, on behalf of any person, based on the claim that but for the act or omission of another, a person would not have been permitted to have been born alive but would have been aborted. (b) This section may not be construed to eliminate any duty of a physician or other health care practitioner under any other applicable law.

In short, there can be no legal penalty against physicians who knowingly choose to withhold information from pregnant patients if the physician thinks it will prevent an abortion. This does not absolve the physician in question from professional consequences, like action from the Texas Medical Board. However, it does set an important precedent – namely, that the belief structure of the physician takes precedence over the rights of the patient. From a bioethical standpoint, this is an inexcusable violation of autonomy. Disclosure of all relevant information is critical to informed decision making, which is the bedrock of autonomy in the complex, jargon-laden world of modern medicine.

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

Fetuses and Full Disclosure

Medicine has a notoriously long history of paternalism, particularly with regards to reproductive health. The past century has seen everything from forced sterilization of people of color and those with intellectual disabilities to nondisclosure of sexually transmitted diseases. Physicians have fought to regain the trust of the community through disclosure of key medical information and shared decision making, both of which are essential underpinnings of the bioethical principle of autonomy. Given the incredible emphasis on these concepts in contemporary medical training, it is surprising that the following law has now passed Texas Senate approval:

SB 25. A cause of action may not arise, and damages may not be awarded, on behalf of any person, based on the claim that but for the act or omission of another, a person would not have been permitted to have been born alive but would have been aborted. (b) This section may not be construed to eliminate any duty of a physician or other health care practitioner under any other applicable law.

In short, there can be no legal penalty against physicians who knowingly choose to withhold information from pregnant patients if the physician thinks it will prevent an abortion. This does not absolve the physician in question from professional consequences, like action from the Texas Medical Board. However, it does set an important precedent – namely, that the belief structure of the physician takes precedence over the rights of the patient. From a bioethical standpoint, this is an inexcusable violation of autonomy. Disclosure of all relevant information is critical to informed decision making, which is the bedrock of autonomy in the complex, jargon-laden world of modern medicine.

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

Sexually transmitted diseases found in 25% of sexually active teenagers in the United States

Programe based on creating a website, especially targeted at sexually active teenagers

Around 1 in 4 sexually active teenagers in the United States are infected with a sexually transmitted diseases, such as chlamydia or human papilloma virus; moreover, teenagers and young people aged between 15 and 24 years old accounted for two thirds of chlamydia infections in 2014. In an attempt to resolve this problem, the United States health authorities are promoting a programme that they have christened “Know the facts first“, which is essentially based on creating a website, especially targeted at sexually active teenagers, as well as public service announcements and videos aimed at preventing these infections. (JAMA, 315; 333, 2016).

La entrada Sexually transmitted diseases found in 25% of sexually active teenagers in the United States 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

Love by design: when science meets sex, lust, attraction and attachment

A version of this post was originally published in the Conversation 

You are on holiday with your partner of several years. Your relationship is going pretty well, but you wonder if it could be better. It’s Valentine’s Day and you find a bottle on the beach. You rub it. A love genie appears. He (or she) will grant you three special Valentine wishes. Here are some of your choices:

  • to have more or less sexual desire (lust);
  • to remain always as “in love” as you were when you first fell in love (romantic attraction);
  • to be more or less bonded to your partner emotionally (attachment);
  • to be (happily) monogamous or polygamous.

What would you choose? What should you choose? What would your partner choose? Would you choose together, if you could? What would you choose for your partner?

In August 2015, the US Food and Drug Administration (FDA) approved the first drug to specifically increase sexual desire. While not yet available from doctors in Australia, it is available on the internet. Flibanserin or “Addyi” is used to “treat” hypoactive sexual desire disorder (HSDD), or low libido, in premenopausal women.

Addyi acts on neurotransmitter receptors in the brain (serotonin receptors – the same receptors targeted by some antidepressants like Prozac which themselves lower libido). The beneficial effects are modest. Prior to treatment, these women experienced about two or three satisfying sexual events over a month. After a course, they got around one extra sexually rewarding experience a month, though in some individual cases the effects would have been greater.

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

Zika: An opportunity to improve pre-conception care.

by Andrea L. Kalfoglou, Ph.D.

The Zika virus is spreading rapidly throughout parts of South and Central America. Public health officials are concerned because there is a correlation between the emergence of the Zika virus and a dramatic increase in number of babies born in Brazil with a severe birth defect called microcephaly.

The CDC has warned women from the U.S. who are pregnant or thinking about becoming pregnant not to travel to certain areas in Central and South America. Additionally, infectious disease specialists are concerned that Zika may adapt to transmission by a type of mosquito common in 32 states in the U.S.

There is no commercial test available to diagnose Zika; however, there are testing protocols available through the CDC and some state health departments.

According to Francis Collins, Director of the National Institutes of Health, researchers are working to develop a diagnostic test that could be widely available. If such a test becomes available, pregnant women may seek out this test to determine whether they have been infected. Additionally, because microcephaly is such a severe birth defect, women considering pregnancy may begin to request diagnostic testing for Zika. This consumer-driven demand for pre-conception testing could create a window of opportunity to improve delivery of pre-conception care should primary-care providers seize on this opportunity.

Pre-conception care is not routinely provided to women of reproductive age. Primary-care providers have said this is because women do not seek out this care and primary-care providers do not have time to provide this care given all of the competing health-prevention needs.

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 CDC’s Graphic on Women and Alcohol is Flawed: Why That Matters

Last week, as part of its monthly Vital Signs report, the Centers for Disease Control and Prevention (CDC) released an infographic outlining the risks that drinking can pose for women, and advising that they avoid alcohol when not on birth control. On its face, this is a benign – intuitive, even – framework: alcohol is bad for fetal development, and may result in miscarriage, stillbirth, prematurity, fetal alcohol spectrum disorders, or sudden infant death syndrome. CDC’s likely intention was to present in an easily understandable fashion its new guidelines, which come out of the 2011-2013 National Survey of Family Growth. It found data-driven evidence to support the claim that “drinking any alcohol at any stage of pregnancy can cause a range of disabilities for [the] child.” In other words, the most charitable interpretation of what the CDC was trying to do here is to hammer home the idea that women should not drink while pregnant, period.

     

But the CDC’s graphic is not about fetal health: it highlights the risks of excessive drinking for women. The reason it does this is simple: since, according to the new recommendations, any amount of alcohol can harm even the least developed fetuses, and women often do not know that they are pregnant for several weeks after their first missed period, it follows that any woman who might become pregnant (to the CDC, that means any sexually active woman not on birth control) should abstain from alcohol.

The logical train that gets you from “alcohol is bad for fetuses” (which, let me be clear – nobody is questioning) to “sexually active women not on birth control should not drink” is more of a logical rollercoaster, but it’s worth the ride.

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

British man has fathered 800 children

Another chapter in the Wild West of reproductive technology: the British man who has fathered 800 children and hopes to reach 1000. Simon Watson, 41, has been helping desperate women for 16 years. Married twice, with three children of his own, he advertises his services on Facebook.

Bertold Wiesner,  an obstetrician in London in the 1940s, was the father of about 600 children at his own fertility clinic, but it now appears that Mr Watson has beaten him.

“Usually one [baby] a week pops out. I reckon I’ve got about 800 so far, so within four years I’d like to crack 1,000,” he told the BBC. “I’ve got kids all the way from Spain to Taiwan, so many countries. I’d like to get the world record ever, make sure no-one’s going to break it, get as many as possible.” Sperm donors at a conventional IVF clinic are limited to 10 children.

Typically Mr Watson meets his clients at a petrol station and hands over his donation. He charges 50 Pounds. “If you go to a fertility clinic people have to go through lots of hurdles – counselling sessions, huge amounts of tests and then charge absolute fortunes for the service – but realistically if you’ve got a private donor you can just go and see them, meet them somewhere, get what you want and just go,” he explained.

Mr Watson’s business is not illegal in the UK, but his clients risk sexually transmitted diseases and birth defects – apart from the fact that their child will not have a father.

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.