The bill was signed into law by governor Peter Shumlin on Monday. Vermont’s House passed the bill 75-65, after its passage through the Senate earlier this month.
The new law has had a mixed reception. Bob Ullrich, of Patient Choices Vermont said that “it means peace of mind and comfort to a lot of people… to know every day of your life that it’s there should such an occurrence happen.” Kathryn Tucker of Compassion and Choices told reporters that "support for patients to be empowered and choose aid and dying is growing… I think this is an important step in moving that forward."
But anti-euthanasia groups have expressed grave concern about the bill.“We now have state-sanctioned suicide in Vermont,” said Edward Mahoney of the Vermont Alliance for Ethical Healthcare.
The new law does not require hospitals to offer euthanasia. It requires at least two doctors to make the medical determination whether or not a patient qualifies for physician-assisted suicide. A patient wishing to end his life must make an initial oral request at least 15 days before receiving lethal drugs, and a written and oral request to die 48 hours before receiving them.
The Australian winner of the 2009 Nobel Prize in Medicine is leveraging her discovery to market a test which will help people know their true health status and biological age.
Elizabeth Blackburn won her award, along with two other researchers, for her work on telomeres, pieces of DNA which cap chromosomes and keep cells from ageing too soon. She discovered the telomerase enzyme which repairs the telomeres. Long telomeres are associated with longer life expectancy; short telomeres with shorter life expectancy.
She says that it is impossible to predict how much longer people have to live, but shorter telomeres may indicate bad health. Telomere length is associated with stress, for instance. Doctors could intervene earlier to prevent disease. Dr Blackburn has said that her discovery "sort of translates into a fountain of youth; the number of years of healthy living is related to telomere length. We don't think clocks will be turned back, but it is a question of whether we will extend our health span."
Full of enthusiasm, Dr Blackburn has helped formed a company, Telome Health, to market a test for telomere length.
But a controversy is brewing over whether the test is premature. Carol W. Greider, who shared the Nobel Prize with her, feel that the test is premature. Peter Lansdorp, another expert on telomere biology, told Macleans that he was sceptical. “It’s too early, and it’s not supported by scientific data.”
One problem is that interpreting the results is difficult because there is so much individual variability. A report of short telomeres could put patients on a merry-go-round of more and more tests to discover what the original test meant. “You worry about that,” she told the New York Times. “But that’s not the fault of the test, is it? That’s the fault of the way medicine is practiced. Let’s not blame the messenger here.”
“Alzheimer’s has been portrayed as the ‘disease of the century’ that is poised to have a near catastrophic impact on the world’s healthcare system as the population ages,” Professor Johnstone said.
“This representation of the disease—along with other often used terms such as ‘living dead’, a ‘funeral that never ends’ and a ‘fate worse than death’—places Alzheimer’s as a soft target in the euthanasia debate because it plays to people’s fears of developing the disease and what it symbolises. It positions Alzheimer’s as something that requires a remedy; that remedy increasingly being pre-emptive and beneficent euthanasia.”
Professor Johnstone acknowledges that euthanasia is a polarising and emotive issue, however she warns that the public could be unduly swayed by the way the media, and pro-euthanasia groups, to frame the issue as “simply a matter of choice” through the use of highly personalised, individual experiences.
“Euthanasia is far from a simple matter of choice, as choice itself is no simple matter; it is an extremely complex phenomenon. And Alzheimer’s disease cannot be adequately portrayed through highly publicised individual cases.”
A Montana man brain cancer diagnosis shows how difficult it is to determine whether or not a person has a “terminal illness”. Mark Templin was awarded US$59,000 for expenses and emotional stress after his doctor wrongly told him in 2009 that he had only six months to live. “It is difficult to put a price tag on the anguish of a man wrongly convinced of his impending death,” said the judge. “Mr. Templin lived for 148 days … under the mistaken impression that he was dying of metastatic brain cancer.”
One of Templin’s daughters asked the doctor how her father would die and “he explained one of the tumors would grow ‘like cauliflower’ and Templin would die from a brain bleed.”
After that disturbing diagnosis, Mr Templin sold his truck and quit his job. He put his affairs in order and displayed a large sign in his home saying “Do Not Resuscitate”. His family held a “last birthday” dinner for him and he paid for a funeral service. His son-in-law made a wooden box for his ashes. He entered a hospice for dying patients.
He even considered shooting himself to spare himself and his family the pain of a terminal illness.
However, Mr Templin began to get better, not worse. He booked himself out of the hospice and had more tests. These revealed that he had had a stroke and that he did not have a brain tumour.
A judge ordered that Fort Harrison Veterans Affairs Medical Center pay Mr Templin $59,000 for the distress that the diagnosis had caused and to reimburse him for his “last” birthday celebration and his pre-arranged funeral.
A fierce campaign is being carried out in Australia to strip Chinese doctor Huang Jiefu of his honorary professorship at Sydney University. Dr. Jiefu, who was Vice-minister for Health in China for 12 years, authorized the forced removal of organs from thousands of executed Chinese prisoners. He may have done some himself.
A group of academics, doctors and lawyers this week submitted a petition to the university to revoke the professorship. David Shoebridge, a member of the NSW legislative council and one of the signatories of the petition, stridently condemned Jiefu: “this is a man, who for more than a decade, day in day out, transplanted the livers of executed prisoners, without consent. That would be a crime in Australia.”
Dr Jiefu has hit back at his critics, emphasising that China is reforming its organ transplantation policy, and that it no longer authorizes the forced removal of organs. "Our government already has regulations related to recovering organs from death row inmates," he said. "Consent is not presumed consent -- written consent from the prisoner himself or herself as well as his or her family [is needed]."
Maria Fiatarone Singh, professor of medicine at Sydney University, is unconvinced by Dr Jiefu’s comments: “the real point is, if something is unethical, then you don't suggest you are going to move away from it in a few years, you stop doing it now.”
Canadian human rights lawyer David Matas, who co-wrote Bloody Harvest, an expose of the illicit Chinese organ transplant system, also signed the petition, calling Huang unethical and not deserving of the University honors.
Following the highly publicised pre-emptive double mastectomy of Hollywood celebrity Angelina Jolie, it has emerged that a 53-year-old British man has become the first in the world to have a pre-emptive removal of his prostate. He discovered that he had a “faulty” BRCA2 gene which is associated with breast and prostate cancer and asked his surgeon to remove it.
Initially the doctors were reluctant as he appeared to be completely healthy. The operation also entails some risk and has side-effects: infertility and possibly permanent incontinence and sexual dysfunction. However a biopsy did detect some microscopic malignant changes and the doctors went ahead.
The surgeon, Roger Kirby, told the London Sunday Times that even in this case, he would not normally operate.
“But given what we now know about the nature of BRCA2, it was definitely the right thing to do for this patient. A number of these BRCA families have now been identified, and knowing you are a carrier is like having the sword of Damocles hanging over you. You are living in a state of constant fear. I am sure more male BRCA carriers will now follow suit."
Dr Marc Garnick, editor-in-chief of the Harvard Annual Report on Prostate Diseases, agreed that the decision was driven by fear of the BRCA gene. This was based “predominantly on emotions, not data,” he told Medscape Medical News. “Medical science is charged with determining if this is ultimately the right thing to do, and only appropriately conducted clinical research can answer this question.”
Last week we reported that researchers at the Oregon Health and Science University had finally cloned human embryos and successfully extracted embryonic stem cells. The study was published in the leading journal Cell and greeted with great jubilation. This was a feat which scientists agreed was possible but was proving unexpectedly difficult. The last time the claim was made, by South Korean Hwang Woo-suk in 2005, it turned out to be a colossal fraud which embarrassed leading journals and dampened enthusiasm for “therapeutic cloning”.
Unfortunately, the most recent paper has also been criticised for image duplication, evoking the nightmarish Hwang scandal. "It's a shame that this important area of research has come under scrutiny once again," Kevin Eggan of Harvard University told ScienceInsider. The researchers say that the duplication was unintentional and that these minor errors will not affect the validity of the results.
Cell was also criticised for approving the paper so quickly – it was accepted in only four days and published in another 12. “The four-day review process was obviously inadequate,” Arnold Kriegstein, director of the stem-cell programme at the University of California, San Francisco, told Nature. “It's a degree of sloppiness that you wouldn't expect in a paper that was going to have this high profile. One worries if there is more than meets the eye and whether there are other issues with the work that are not as apparent.”
Even if the researchers did manage to create a cloned embryo, it is no longer the big news that it once was. As the Boston Globe pointed out, “The emergence of reprogrammed stem cells, the difficulty of the involved method, and the obstacles to obtaining donor eggs for the procedure all make the advance more an important technical feat than a game-changer for stem cell scientists or a platform for new therapies.”
As a sign of the times, the leading lobby group for “therapeutic cloning” wound itself up this week and merged with another organisation. The president of the Coalition for the Advancement of Medical Research (CAMR) told its members in an email, “"Given the progress we are seeing in the field of regenerative medicine, the policy issues we now see go beyond the historical focus of CAMR."
Inferno: Robert Langdon is back with a globe-trotting thriller in which the symbologist has to decode clues left in a map of Dante’s masterpiece by a recently-deceased evil genius before one-third of the world perishes. Oops, we are about to give away too much of the plot. Suffice it to say that the master of transmuting highbrow trivia, European travel guides and clunky prose into dollars has framed transhumanism as the most dangerous threat to the future of mankind.
Brown says that transhumanism is a movement to change the destiny of humanity through genetic engineering. In Inferno, the villain is obsessed with over-population and creates a virus which will make one-third of the world’s population infertile, thus reducing the population dramatically in a single generation. From an interview in Timet, it appears that Brown himself believes that the world is seriously over-populated and that extreme measures are needed to curb population growth.
The publisher describes Inferno as “one hell of a read”. Perhaps that is true in more senses than one.
Alder Gross had requested euthanasia on account of diminishing mental and physical capability and an isolated and lonely life. Swiss doctors denied her the treatment, even after she appealed to the Zurich Health Board. Swiss law does not explicitly limit assisted suicide to the terminally ill.
Gross appealed to the European Court of Human Rights. This court ruled that has that "the absence of clear and comprehensive legal guidelines violated the applicant's right to respect for her private life".
It said Switzerland must specify whether its laws are meant to include people not suffering from terminal illnesses and, if so, spell out the conditions under which they can end their lives.
It also said the lack of clarity "is likely to have a chilling effect on doctors who would otherwise be inclined to provide someone such as the applicant with the requested medical prescription". However, the court did not specify whether the law should allow assisted suicide for non-terminally ill patients.
Virtus has become a behemoth. It owns almost 50 fertility clinics, day hospitals, and laboratories across Victoria, NSW and Queensland. It has also established a low-cost clinic in each state that targets ''a new segment of the market for whom fertility treatments were previously unaffordable''. The company employs over 80 fertility specialists, supported by 650 staff. It performed about one-third of all of Australia’s 39,000 fertility cycles last year. According to Virtus’s prospectus, IVF cycles and other assisted reproductive services generated revenue of more than $350 million.
AFR finance expert Michael Stutchbury said that “Virtus is in a bit of a sweet spot as it’s a unique offering, IVF is not listed anywhere else in the world [and] healthcare is a strong growth area”. Even the Wall Street Journal is following Virtus’s growth with keen interest. As The Australian punned, this is “a fertile ground” for investment.