Bioethics consultancies: the way of the future?

Informal bioethics consulting has been common in many countries for decades. But ethicists in the US are attempting to formalise the practice, creating independent ‘ethics consulting’ services for healthcare professionals and scientists. 

Ethics committees such as institutional review boards (IRBs) tend to have a narrow focus and their guidance is often binding on healthcare professionals.

Ethical consulting services can provide important advice that goes beyond the jurisdiction of IRBs. They provide “an open space for talking about research ethics in a way that is not driven by the regulatory environment”, says Marion Danis, chief of the bioethics consultation service at NIH Clinical Center, a research hospital in Bethesda, Maryland. The can also provide valuable ‘second opinions’ to IRB’s, Danis said.

Benjamin Wilfond, director of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Hospital in Washington, has set up the Clinical Research Ethics Consultation Collaborative, a group… click here to read whole article and make comments


Should all Ebola volunteers be quarantined?

Hundreds of foreign healthcare workers have been shuttling in and out of Ebola-affected countries in West Africa. They are altruistic, generous and brave. Should they be burdened with a 21-day quarantine when they return even if they do not have any symptoms of the disease? If so, fewer might go at a time when Liberia, Sierra Leone and Guinea need all the help they can get.

An example of the case for strict quarantine measures in the United States is Dr Craig Spencer, a 33-year-old physician who returned to New York City after working in Guinea. He felt fine, boarded a subway, went bowling with his fiancée and friends, and used a taxi. Then he developed a fever, which turned out to be Ebola.

Irresponsible, says Howard Markel, a medical historian at the University of Michigan, in The New Republic, but characteristic of energetic young physicians. who have a “sense… click here to read whole article and make comments


Radical measures to prevent the spread of Ebola in hospitals

At least three US hospital systems are currently considering whether they withhold certain treatments from Ebola patients, in a bid to protect their doctors and nurses.  

The move comes after two nurses from Dallas were infected with the virus whilst treating a patient who had recently returned from West Africa.

Executives at University of Chicago Medicine are considering whether procedures such as inserting a breathing tube or putting a ventilator on a patient should be avoided due to the potential of exposure to the virus.  

“We have very little experience with [those procedures] except for Mr Thomas Duncan, who didn’t do well,” said Dr Emily Landon, a bioethicist and epidemiologist from the hospital. 

Pennsylvania’s Geisinger Health System is also considering whether certain ‘risky’ procedures could be avoided, as are managers from Intermountain Healthcare, which runs facilities in Utah. 

Geisinger is paying close attention to directives from the Centre for Disease Control… click here to read whole article and make comments


Assisted suicide debate intensifies in Scotland

British Anti-euthanasia group Care Not Killing (CNK) has launched a major online campaign intended to derail a new assisted-suicide (AS) bill being debated in the Scottish parliament.

The proposed legislation, due to be discussed by the parliamentary justice committee next Tuesday, would make assisted suicide legal for people as young as 16 who suffering from “a terminal or life shortening illness”. 

The bill was originally moved by Margo MacDonald, an MSP who died in April following a long battle with Parkinson’s disease. 

CNK’s online petition labels the proposed changes “unnecessary, unethical and uncontrollable”. Extant penalties, the petition states, “act as a strong deterrent to exploitation and abuse whilst giving prosecutorial discretion in hard cases.”

CNK spokesperson Dr Gordon MacDonald said that a change to the law would “place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden… click here to read whole article and make comments


Nasal cells allow paralyzed man to walk again

Scientists who developed a treatment to allow a paralysed man to walk again have spoken of the possibility of healing other debilitating nervous system conditions.  

Prof Geoffrey Raisman, of University College London’s Institute of Neurology, said the successful operation on paralysed fire-fighter Darek Fidyka opened the door to treating nervous system damage throughout the body.  

Thirty-eight-year-old Mr. Fidyka has regained feeling in his lower limbs after doctors transplanted olfactory ensheathing cells (OECs) from his nose into his spinal cord. OECs are what allow the sense of smell to return when nerve cells in the nose are damaged. A few months after the transplant, Fidyka’s thigh muscles began to grow, and two years on he can walk with the help of a Zimmer frame. 

The ability to trigger nervous system repair has massive implications, says Professor Raisman. “There’s no reason to restrict this to spinal cord. We have… click here to read whole article and make comments


Italian nurse may have killed 38 nursing home patients

A 42-year-old Italian nurse has been arrested over one death in a nursing home in the northern city of Lugo. But she is suspected of killing as many as 38 because they annoyed her. According to Italian media Daniela Poggioli even took selfies with some of the dead patients. “In all my professional years of seeing shocking photos, there have been few like these,” said Alessandro Mancini, the chief prosecutor of Ravenna.

The police investigation will be difficult, as the alleged method was an injection of potassium chloride, which is undetectable after a few days.

Some of Ms Poggioli’s colleagues suspected that something was wrong because so many patients were dying, far more above the average. She was also uncooperative and gave some patients laxatives just before the next shift to inconvenience other nurses. She also used to give patients sedatives to ensure that they… click here to read whole article and make comments


Swedes succeed in first womb transplant

Doctors at the University of Gothenburg, in Sweden, have delivered the first baby to have been gestated in a transplanted womb. The child, a boy, is healthy and normally developed.

The goal of the Gothenburg project, headed by Professor Mats Brännström, is to enable women who were born without a womb or who have lost their wombs in cancer surgery to give birth to their own children.

Nine women in the project have received a womb from live donors – in most cases the recipient’s mother but also other family members and close friends. The transplanted uterus was removed in two cases, in one case due to a serious infection and in the other due to blood clots in the transplanted blood vessels.

The other women have in 2014 tried to become pregnant through a process where their own embryos, produced through IVF, are reintroduced to the transplanted uterus. Professor Brännström… click here to read whole article and make comments


Swedish feminists condemn surrogacy

Swedish feminists have issued a policy paper condemning commercial surrogacy and calling upon their government to ban the practice. The Swedish Women’s Lobby (Sveriges Kvinnolobby) argues that surrogacy is a health risk and violates poor women’s human rights.

“Allowing surrogacy is to make use of women’s bodies and reproductive organs for the enjoyment of someone else, to the detriment of the woman herself. We premiere the right to bodily integrity and fundamental human rights over the right to children, which is in fact not a human right, but has been treated as such in the discourse on surrogacy. We renounce the view of a liberal market- approach to surrogacy and the right of the paying buyers which are [privileged] whilst women’s rights are negotiated.
“ … we are seeing a trend towards a dismantling of these fundamental rights in favor of the will and want… click here to read whole article and make comments


What do we do when biohazards are human?

Bioethicists are debating the ethics of quarantine as governments around the world move to contain the spread of Ebola. The UN announced on Thursday that it is drafting guidelines to prevent human rights violations against people suspected of having Ebola. UN High Commissioner for Human Rights Zeid Raad al-Hussein cautioned against imposing criminal punishments on those who refuse isolation, saying that it might have the opposite effect.

A number of leading American bioethicists have defended the practice, arguing that it “takes precedence” over certain rights of the individual.

In a recent article in Time magazine, Art Caplan and Alison Bateman-House of NYU argued that freedom of movement must at times be restricted: “in the face of a threat of death, liberty can and should be, as we are watching in Dallas, limited so that you can’t move around freely and infect others.”

They did, however, stress the… click here to read whole article and make comments


US officials try to hose down Ebola fears

As the Ebola outbreak grows in scale – with cases now reported in Spain and the US – experts are becoming increasingly concerned about public hysteria. According to a new Washington Post-ABC News poll, two-thirds of Americans are now worried about an Ebola epidemic in the US, and more than 4 in 10 are "very" or "somewhat worried" that they or a close family member might catch the virus.

Some experts see the next few weeks as crucial to containing mounting anxiety. “Officials will have to be very, very careful,” said Paul Slovic, president of Decision Research, a non-profit that studies public health and perceptions of threat. “Once trust starts to erode, the next time they tell you not to worry — you worry.”

DuPont, a company that manufactures protective suits, said it has more than tripled its production since the start of the… click here to read whole article and make comments


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