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Doctors Strive to Do Less Harm by Inattentive Care

February 18, 2015

(New York Times) – But now, reducing patient suffering — the kind caused not by disease but by medical care itself — has become a medical goal. The effort is driven partly by competition and partly by a realization that suffering, whether from long waits, inadequate explanations or feeling lost in the shuffle, is a real and pressing issue. It is as important, says Dr. Kenneth Sands, the chief quality officer at Harvard’s Beth Israel Deaconess Medical Center in Boston, as injuries, like medication errors or falls, or infections acquired in a hospital.

Block That Sperm!

February 18, 2015

(The Atlantic) – Every couple of months, starting in 2008, clinicians injected dozens of men across eight countries with a serum containing the hormones progestin and testosterone. The men then had unprotected sex with their female partners, as part of a male-birth-control trial orchestrated by Conrad, a Virginia-based nonprofit devoted to reproductive-health research. Three years into the trial, things appeared to be going well: just four women had gotten pregnant.

When US Debates Vaccines, Pakistan Is in High-Stakes Battle to Eradicate Crippling Polio

February 18, 2015

(Associated Press) – While vaccine distrust has sparked debates amid a measles outbreak in the United States, Pakistan is in a deadly battle to wipe out polio. Long eradicated in the West, polio remains endemic in Pakistan after the Taliban banned vaccinations, attacks targeted medical staffers and suspicions lingered about the inoculations.

A New Edition of JAMA Internal Medicine is Available

February 18, 2015

JAMA Internal Medicine (Volume 175, No. 2, February 2015) is now available online by subscription only.

Articles include:

  • “Ensuring access to health care for patients with disabilities” by Tara Lagu, Christine Griffin, and Peter K. Lindenauer
  • “Unintended influence: When our words mean more than we think” by Tom Bartol

Beyond the Genome

February 18, 2015

(Nature) – The Greek prefix epi- can signify upon, on, over, near, at, before, and after. Most of those could apply to its use in the term ‘epigenetics’ — particularly the last of them. It is some 14 years, almost to the day, that Nature published the draft sequence of the human genome. Now, in this issue, we publish results from a subsequent study on the non-genetic modifications to the genome — epigenetic modifications — that crucially determine which genes are expressed by which cell type, and when.

The Science Behind Many Antidepressants Appears to Be Backwards, Researchers Say

February 18, 2015

(Medical Xpress) – The science behind many antidepressant medications appears to be backwards, say the authors of a paper that challenges the prevailing ideas about the nature of depression and some of the world’s most commonly prescribed medications. The authors of the paper, posted by the journal Neuroscience & Biobehavioral Reviews, combed existing research for evidence to support the theory that has dominated nearly 50 years of depression research: that depression is related to low levels of serotonin in the gaps between cells in the brain.

Researchers Generate a Reference Map of the Human Epigenome

February 18, 2015

(Medical Xpress) – The sequencing of the human genome laid the foundation for the study of genetic variation and its links to a wide range of diseases. But the genome itself is only part of the story, as genes can be switched on and off by a range of chemical modifications, known as “epigenetic marks.” Now, a decade after the human genome was sequenced, the National Institutes of Health’s Roadmap Epigenomics Consortium has created a similar map of the human epigenome.

Elective Human Egg Freezing on the Rise

February 18, 2015

(Scientific American) – Human egg freezing is going mainstream. The biggest reason: it works. A handful of studies suggest the success rate for women undergoing in vitro fertilization (IVF) is just as high when using frozen eggs as fresh ones. The results increase the flexibility and control women can have in their reproduction and their careers.

Stopping HIV with an Artificial Protein

February 18, 2015

(Science) – For 30 years, researchers have struggled to determine which immune responses best foil HIV, information that has guided the design of AIDS vaccines and other prevention approaches. Now, a research team has shown that a lab-made molecule that mimics an antibody from our immune system may have more protective power than anything the body produces, keeping four monkeys free of HIV infection despite injection of large doses of the virus.

Have a Baby, Or Your Money Back

February 17, 2015

(The Guardian) – The plan – modelled on “shared risk” IVF, which is popular in the US – is offered by specialist company Access Fertility. Patients are charged a fixed upfront fee for three fresh embryo and unlimited frozen embryo IVF cycles, which they have to pay for in full only if they result in the birth of a live baby. Unsuccessful, and you receive a 70% refund. The catch? Have a baby on your first cycle and you will have paid double the cost of an ordinary IVF plan.

Even for Tiny Lumps, More Women Are Choosing Double Mastectomy

February 17, 2015

(Washington Post) – In a study published recently in the journal JAMA Surgery, researchers from Vanderbilt University Medical Center examined a national surgery database of 1.2 million patients with early-stage breast cancer and found that the percentage of women who opted for a mastectomy over a lumpectomy increased from 34 percent to 38 percent from 2003 to 2011. The rates of women having double mastectomies when they only had disease in one breast jumped from 1.9 percent in 1998 to 11.2 percent in 2011.

Bills Would Let Doctors Help Terminally Ill Patients End Their Lives

February 17, 2015

(The Wall Street Journal) – Ms. Colbert’s end-of-life options would expand under a bill in the New Jersey Legislature that would allow doctors to help terminally ill patients end their lives. Similar legislation is emerging this year in New York and Connecticut. While the bills in the three states reflect a growing movement in the U.S., their outcomes are far from certain. Such measures have drawn opposition from the Roman Catholic Church, the American Medical Association and some groups that represent people with disabilities.

In Hospitals, Board Rooms Are as Important as Operating Rooms

February 17, 2015

(New York Times) – If you or a loved one is having a heart attack, your most pressing concerns probably include how quickly you can get to the hospital and the quality of care you’ll receive. You’re probably not thinking about the hospital’s board room, even though quality of care for heart attacks and many other conditions may be determined in large part by decisions made there. Several studies show that hospital boards can improve quality and can make decisions associated with reduced mortality rates. But not all boards do so.

With Liver Donors in Short Supply, Cell Transplants Offer New Options

February 17, 2015

(Scientific American) – A new approach may provide a stopgap or, in time, an entirely new alternative. Called hepatocyte transplantation, the technique replaces approximately 10 percent of the liver with healthy cells from a deceased donor. The patient’s organ is not removed, decreasing recovery time, complications and cost. With fewer than 150 U.S. recipients so far, the approach is in its early days.

International Health Groups Say AIDS No. 1 Killer of Adolescents in Africa and 2nd Globally

February 17, 2015

(Associated Press) – Global health organizations said Tuesday that AIDS is now the leading cause of death for adolescents in Africa, and the second leading cause of death among adolescents globally. Road accidents and injury are the number one killer of adolescents globally, said Michael Hollingdale, a UNAIDS spokesman.

Violations in Pharmaceutical Industry Self-Regulation of Medicines Promotion

February 17, 2015

(Medical Xpress) – A discrepancy exists between the ethical standard codified in the pharmaceutical industry Codes of Practice and the actual conduct of the pharmaceutical industry in the UK and Sweden, according to a study published by Shai Mulinari and colleagues from Lund University, Sweden in this week’s PLOS Medicine. The researchers reached these conclusions by performing a qualitative content analysis of the documents outlining the rules and procedures governing the self-regulatory bodies overseeing medicines promotion in the two countries.

Researchers Reveal Link between Powerful Gene Regulatory Elements and Autoimmune Diseases

February 17, 2015

(Medical Xpress) – Investigators with the National Institutes of Health have discovered the genomic switches of a blood cell key to regulating the human immune system. The findings, published in Nature today, open the door to new research and development in drugs and personalized medicine to help those with autoimmune disorders such as inflammatory bowel disease or rheumatoid arthritis.

Cancer Gene Therapy Advances

February 17, 2015

(Union Times San Diego) – Tough blood cancers are responding to treatment with the patient’s own genetically engineered immune cells, according to a cancer specialist who is helping test the bold — and risky — approach. The treatment has produced complete remissions in large percentages of patients treated, up to 90 percent in one group of 30 patients. Moreover, these are all extremely sick patients, whose cancer has resisted other therapies, leaving them with virtually no options. The longest survivor has been in complete remission for more than 4 years, said Dr. David Porter of the University of Pennsylvania.

Fertility Specialists Urge Reevaluation of Current Concepts of Embryo Selection in IVF

February 17, 2015

(Digital Journal) – Investigators from The Center for Human Reproduction (CHR), a leading fertility research and treatment center in New York City, argue for reconsideration of currently popular methods of embryo selection in association with in vitro fertilization (IVF) in a recently published paper. In a large majority of patients, embryo selection methods do not improve IVF outcomes and in some patients may reduce pregnancy and live birth chances.

Genes Tell Only Part of the Story

February 17, 2015

(New York Times) – Skeptics point out that genetic medicine, for all its promise, has delivered relatively few clinical benefits. And straightforward analyses of lifestyle and environment effects on health may occasionally lead to clear-cut advice (don’t smoke), but more often sow confusion, as anyone curious about the best way to lose weight or the optimal quantity of dietary salt knows.

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