Theoretical Medicine and Bioethics (vol. 37, no. 2, 2016) is available online by subscription only.
- “What Is So Important about Completing Lives? A Critique of the Modified Youngest First Principle of Scarce Resource Allocation” by Espen Gamlund
- “The Challenges of Choosing and Explaining a Phenomenon in Epidemiological Research on the ‘Hispanic Paradox'” by Sean A. Valles
- “Surrogate Consent to Non-Beneficial Research: Erring on the Right Side when Substituted Judgments May Be Inaccurate” by Mats Johansson and Linus Brostrom
(The Washington Post) – Today, an average of 79 people receive organ transplants — heart, lungs, livers, you name it — every day in the United States. Most of these patients are seriously ill, facing death, or at least suffering dire health consequences because of their malfunctioning organ. But increasingly, a new kind of transplant patient is emerging. They’re undergoing some of the newest, riskiest transplant procedures in the world — and their lives don’t even depend on them. Charla Nash got a new face. Thomas Manning got a new penis. Zion Harvey got new hands. None of these patients were dying, but they’d suffered profound loses that were affecting their quality of life. And surgeons decided to do something about it.
(UPI) – Although telemedicine has been shown in some studies to be effective, as well as preferable for some patients, a recent experiment suggests there are limitations on the ability of doctors to diagnose or treat some conditions without an office visit. Researchers at the University of California San Francisco reviewed telemedicine services and report many doctors either misdiagnosed or entirely missed conditions that could be contagious or life-threatening, suggesting a combination of technological challenges and poor doctor qualification potentially being the cause.
(CNN) – Scientists have for the first time cloned the Zika virus, a development that could bring a desperately needed vaccine within closer reach. The mosquito-borne virus — which can also be sexually transmitted — has torn through Latin America in recent months, bringing an increase in microcephaly, a condition in which babies are born with abnormally small heads and underdeveloped brains.
(Nature) – A hallucinogenic drug derived from magic mushrooms could be useful in treating depression, the first safety study of this approach has concluded. Researchers from Imperial College London gave 12 people psilocybin, the active component in magic mushrooms. All had been clinically depressed for a significant amount of time — on average 17.8 years. None of the patients had responded to standard medications, such as selective serotonin re-uptake inhibitors (SSRIs), or had electroconvulsive therapy. One week after receiving an oral dose of psilocybin, all patients experienced a marked improvement in their symptoms. Three months on, five patients were in complete remission.
(NIH) – Four new grants from the National Institutes of Health will support research on the ethical, legal and social questions raised by advances in genomics research and the increasing availability of genomic information. The awards will fund researchers at interdisciplinary centers through the National Human Genome Research Institute’s (NHGRI) Centers of Excellence in Ethical, Legal and Social Implications Research (CEER) program. The projects will examine the use of genomic information in the prevention and treatment of infectious diseases; genomic information privacy; communication about prenatal and newborn genomic testing results; and the impact of genomics in American Indian and Alaskan Native communities.
(The Telegraph) – Half of all women prescribed fertility treatments do not need help getting pregnant and are at risk of exploitation by private clinics, a leading expert has warned. Dr John Parsons, founder and former director of King’s College Hospital’s assisted conception unit, said clinics were having a “free-for-all” at the expense of desperate couples. The criticism came as the UK’s fertility watchdog, the Human Fertilisation & Embryology Authority, said it was becoming “increasingly concerned” that private clinics were offering “add-on” treatments which have not been properly tested.
(New York Times) – The Supreme Court, in an unsigned unanimous opinion, announced on Monday that it would not rule in a major case on access to contraception, and instructed lower courts to consider whether a compromise was possible. The opinion is the latest indication that the Supreme Court, which currently has eight members, is exploring every avenue to avoid 4-to-4 deadlocks, even if it does not decide the question the justices have agreed to address. The case concerned an accommodation offered to religious groups that did not want to offer insurance coverage for contraception to their female employees as ordinarily required by regulations under the Affordable Care Act.
(The Atlantic) – But whether they intended to or not, these lawmakers exposed a set of difficult moral questions that pro-choice progressives tend to ignore in their quest to defend legal abortion. Should couples be able to abort their female fetuses—and it’s almost always female fetuses—in the hopes of having the boy they really wanted? Should a mom, ashamed at having a mixed-race baby, be able to abort because of race? Should parents give up on a baby with Down syndrome? What about Tay-Sachs, which almost always kills children by the time they turn four?
(STAT News) – Scientists are warning that a new proposal by the Obama administration could stifle medical research and undermine major initiatives being pursued by the White House. The controversial provision would require researchers to obtain consent from patients to use almost all biospecimens — blood samples, tumor biopsies, and organ tissue — even when those samples do not include information that could be used to identify the patients.
American Journal of Law & Medicine (vol. 42, no. 1, 2016) is available online by subscription only.
- “Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction?” by Kelly K. Dineen and James M. DuBois
- “Stopping Deceptive Health Claims: The Need for a Private Right of Action under Federal Law by Diane Hoffmann and Jack Schwartz
- “Mandating Disclosure of Conscience-Based Limitations on Medical Practice” by Nadia N. Sawicki
- “Bartering for a Compatible Kidney Using Your Incompatible, Live Kidney Donor: Legal and Ethical Issues Related to Kidney Chains” by Evelyn M. Tenenbaum
Journal of the Royal Society of Medicine (vol. 109, no. 5, 2016) is available online by subscription only.
- “Moving Patients to Create Bed Capacity” by Jim George and Iain Wilkinson
- “The Junior Doctor Contract—How Have Medical Students Been Affected and What Does This Mean for the NHS?” by Benjamin Langridge, et al.
- “An Alternative to NICE” by John P. Griffin
- “Public Health, Politics and the Stigma of Mass Hysteria: Lessons from an Outbreak of Unusual Illness” by Robert E. Bartholomew
- “The Revised Declaration of Helsinki: Cosmetic or Real Change?” by Aisha Y. Malik and Charles Foster
HEC Forum (vol. 28, no. 2, 2016) is available online by subscription only.
- “Ethical Tensions in the Pain Management of and End-Stage Cancer Patient with Evidence of Opioid Medication Diversion” by Arvind Venkat and David Kim
- “Developing an Evaluation Tool for Assessing Clinical Ethics Consultation Skills in Simulation Based Education: The ACES Project” by Katherine Wasson, et al.
- “Transplant Ethics: Let’s Begin the Conversation Anew” by David Shafran, et al.
- “Should Health Care Providers Uphold the DNR of a Terminally Ill Patient Who Attempts Suicide?” by Lisa Campo-Engelstein, Jane Jankowski, and Marcy Mullen
- “Towards Substantive Standardization: Ethical Rules as Ethical Presumptions” by Benjamin Chan
(The Guardian) – Advanced therapeutics for rare, so-called orphan diseases will be expensive. An extreme example is the price of Glybera, developed by the Dutch company Uniqure to combat a rare disease that causes pancreatitis, which was set at $1m per patient. Ionis-HTTRx will not be as expensive as Glybera – nowhere near – but it will still be so expensive that only governments and insurance companies will be able to afford it. Glybera is administered only once, whereas Ionis-HTTRx would be taken many times, meaning the drug company could recoup costs and make profit over a patient’s lifetime rather than in one lump sum.
(The Wall Street Journal) – “The Gene” is an ambitious attempt to explain how we arrived at this point. Its author, Siddhartha Mukherjee, is a cancer researcher who wrote a fine book on the topic, “The Emperor of All Maladies” (2010). In “The Gene,” he weaves together three narrative strands. One is the story of his own Indian family, in which one uncle was bipolar and another schizophrenic. Another is the history of discoveries about genetics. A third is the politics of biology from eugenics to gender differences.
(The Economic Times) – While statistics show donations are not nearly enough to meet the requirements, the issue is not just about getting more people to donate organs. The country needs to gear up its infrastructure to address shortages and also prevent wastage of organs that do get donated, said transplant specialists as well as government and non-government organisations. Cost is prohibitive in private hospitals and government hospitals often don’t have the facilities or trained manpower.
(Canadian Broadcasting Co.) – A global organization of scientists and bioethicists has released updated guidelines for research using stem cells, the so-called “holy grail” of regenerative medicine, stressing that the protection of patients must take precedence as the field continues to rapidly evolve. The guidelines developed by the International Society for Stem Cell Research (ISSCR) are aimed at assuring both the medical field and the public that research using these powerhouse cells is conducted with scientific and ethical integrity.
(Washington Post) – About 150 scientists assembled at Harvard on Tuesday for an off-the-record, no-media-allowed discussion of how to create, from scratch, an intact genome, including the genetic code of a human being. The idea is to go beyond “reading” genetic material to actively “writing” it, George Church, a Harvard Medical Scientist researcher who helped organize the event, told The Post in an interview Friday morning.
(Reuters) – When women have advanced breast cancer, the amount of comfort-oriented care they receive at the end of life may depend on the color of their skin, a small U.S. study suggests. Researchers examined data from Medicare, the U.S. government health program for the elderly, for 752 white and 131 black patients with final-stage breast cancer who died from 2007 to 2012. Black women were 49 percent less likely to receive certain medications for symptom relief than white patients, and they were also 14 percent less likely to get hospice care aimed at improving quality of life in their final days, the study found.
(News-Medical) – A team from the International School for Advanced Studies (SISSA) in Trieste has obtained very promising results by applying gene therapy to glioblastoma. Tests in vitro and in vivo on mice provided very clear-cut results, and modelling demonstrates that the treatment targets at least six different points of tumour metabolism. Gene therapy, a technique that selectively attacks a tumour, might provide hope in the fight against this type of deadly cancer, for which surgery is practically impossible and chemo- and radiotherapy are ineffective against very aggressive recurrences. The study was published in the journal Oncotarget.