Bioethics on the campaign trail

Barack ObamaBioethics has hardly been on the radar so far in the US presidential campaign. All three major candidates are in favour of stem cell research, which was one of the most divisive policies of the outgoing Bush Administration. However, in the debate between Barack Obama and Hillary Clinton in Cleveland recently, Obama reflected on the bitter controversy over the death of Terri Schiavo. When he was asked which of his Senate votes he would take back, he responded:

"When I first arrived in the Senate that first year, we had a situation surrounding Terri Schiavo. And I remember how we adjourned with a unanimous agreement that eventually allowed Congress to interject itself into that decision-making process of the families. It wasn't something I was comfortable with, but it was not something that I stood on the floor and stopped. And I think that was a mistake, and I think the… click here to read whole article and make comments

British IVF clinics duped by desperate mothers-to-be

Bourn HallA British woman duped an IVF clinic twice and gave birth to two children without the consent of her estranged husband, even though it was legally required. After the couple separated, she forged his signature on consent forms at the Bourn Clinic, near Cambridge. The unnamed husband, who was surprised to discover that he had children, may sue the clinic. His lawyer told the Sunday Times that "It appears that clinics do not need to ensure they have valid consent at all -- they are protected just because they have a signed piece of paper."

Other clinics told the Times that they had also been hoodwinked occasionally in the past, but now they have stiffened their procedures to prevent women from having embryos implanted without the consent of their partner. But trickery may be widespread. Research by fertility specialists at St Bartholemew’s Hospital, in London, two years ago found that… click here to read whole article and make comments

Washington gears up for debate on assisted suicide

former Governor Booth GardnerSupporters of assisted suicide in the US state of Washington are gearing up for a campaign for legalisation, culminating in a referendum in November. The campaign is led by a 71-year-old former governor, Booth Gardner, who suffers from Parkinson’s disease and is a passionate supporter of "death with dignity". The proposed legislation mirrors the law in neighboring Oregon. Even the first step in what is sure to be a controversial campaign was controversial. Opponents protested when Initiative 1000 was officially described as a movement to allow terminally ill patients "to request and self-administer lethal medication" rather than as "physician-assisted suicide". However the lawyer for Initiative 1000, Jessica Skelton, successfully contended that the word "suicide" is "politicized language" that "implies a value judgment and carries with it a social stigma."

A 1991 initiative for assisted suicide in Washington failed, but supporters feel that they have a better chance this… click here to read whole article and make comments

Dangers of antibiotics for elderly demented

Say your 90-year-old severely demented grandmother in a nursing home has pneumonia. She has a fever and she could die. Should the doctor prescribe antibiotics, at least to control her coughing and laboured breathing? Most laymen would say Yes instantly. But a study in the most recent issue of the Archives of Internal Medicine urges caution. Antibiotics could be unwise for both the patient and for the rest of us. First of all, argue Erika D’Agata and Susan L. Mitchell, the antibiotics may not prolong life, it may be possible to control the symptoms with other methods, and elderly patients can react badly to antibiotics in some cases.

But the main reason they advance has little to do with the welfare of the individual patient. It is that antibiotic overuse is leading to the development of resistant strains of bacteria. Nursing homes can house superbugs and patients admitted to hospital can… click here to read whole article and make comments

What are real risks for kidney donors?

Zell KravinskyZell Kravinsky is a poster boy for bioethicist Peter Singer’s theories of utilitarian altruism. A real estate magnate, he gave away most of his fortune to health-related charities. Then he settled upon the ultimate donation. After calculating the risks, he donated a kidney to a total stranger, despite protests from his wife. Assuming that he has only a 1 in 4,000 chance of dying as a result of the transplant, not donating meant to him that he would be treating his life as 4,000 times more valuable than a strangers. This made him a highly attractive case for Singer, as he believed strongly in the equal value of all human life, one of Singer’s dogmas.

However an article in the latest Journal of Medical Ethics challenges Kravinsky’s calculations and the optimistic assumption that live donors give at very little risk to their health. "Recent data… click here to read whole article and make comments

More information needed about end-of-life care

New guidelines for end-of-life care admit that there is very little “high-quality information about palliative and end-of-life care”. The guidelines, issued by the American College of Physicians, focus on managing symptoms which might otherwise decrease quality of life for dying patients. For example, they urge physicians to regularly assess patients for pain, shortness of breath, and depression and prescribe appropriate medication. One limitation of the available knowledge about palliative care is that most studies have focused on cancer. But this information may not apply to patients dying of heart disease, lung disease or dementia. The guidelines also exclude many interventions that have not yet been adequately studied, such as nutritional support, complementary therapies, and spiritual care, without dismissing them as useless. They could be beneficial, but much more research is needed. ~ Annals of Internal Medicine, Feb 26

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Test of youtube videos

logo_e-fydThis is an article to test embedded videos from youtube.... Women's mental health may be at risk if they have an abortion, says the Royal College of Psychiatrists, in the UK. In a one-page statement it calls for "a full systematic review around [sic] abortion and mental health" and the revision of patient information leaflets. "Consent cannot be informed without the provision of adequate and appropriate information regarding the possible risks and benefits to physical and mental health," it says. Cautious as this may sound, it represents a major reversal of the College's position, "a shift from being pro-choice to being neutral," in the words of one psychiatrist.

The last time that the College dealt with the controversial issue of abortion and mental health was in 1994. It then described "the risks to psychological health from the termination of pregnancy in the first trimester… click here to read whole article and make comments

Luxembourg legalises euthanasia

Luxembourg has become the third country in the world to legalise voluntary euthanasia. By a vote of 30 to 26, the parliament of the Grand Duchy has adopted a law which permits euthanasia and assisted suicide. All of the Benelux countries – the Netherlands, Belgium and Luxembourg -- have now legalised euthanasia. As in the other two countries, it is now permitted for the terminally ill and those with incurable diseases or conditions. Patients must ask to die repeatedly and have the consent of two doctors and a panel of experts.

The passage of the bill was a moral setback for Prime Minister Jean-Claude Juncker, whose Christian Social Party opposed it. "The Christian Social Party and the Catholic Church were against the euthanasia law, calling it murder but we said no, it's just another way to go," Jean Huss, a Green Party MP and co-sponsor of the bill, told Reuters. The new… click here to read whole article and make comments

Americans wary of personalised medicine

Ah! the golden age of personalised medicine, when medicines will be tailored to your unique genetic make-up. Well, the time has come, and the New York Times reports that many consumers are too scared to use it. "It’s pretty clear that the public is afraid of taking advantage of genetic testing," says Francis S. Collins, director of the National Human Genome Research Institute at the National Institutes of Health. "If that continues, the future of medicine that we would all like to see happen stands the chance of being dead on arrival."

Although health insurance companies deny that they will discriminate against anyone on the basis of genetics, Americans do not believe them. As a consequence, they refuse to take tests which could spot whether they are at risk of ailments like breast cancer or colon cancer, or they pay for mail-order tests out of their own pocket. The Genetic Information Nondiscrimination… click here to read whole article and make comments

France recognises personhood of embryos

French now recognises human embryos as legal persons following a decision by the Cour de Cassation, France's highest appeals court. It ruled that three couples could register their miscarried foetuses to enable them to give them an official burial. Until now a foetus had to be viable before it could be registered -- older than 22 weeks of pregnancy or weighing more than 500 grams. The decision has been cheered by French Catholics, who believe human life begins at the moment of conception. "The Church's position is that we must act as if the embryo were a person," said the Archbishop of Paris, Cardinal André Vingt-Trois. "This means that a foetus has a status." However, the ruling will probably not affect the status of legal abortion in France, although abortion rights advocate Marie-Francoise Colombani, a columnist for the women's magazine Elle, said the court had opened a Pandora's box by trying to accommodate grieving… click here to read whole article and make comments

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