Deliberately infecting healthy patients still happens—ethically

The most famous clinical trial of all time was Edward Jenner’s experiment with a smallpox vaccine. He had a hunch that exposure to cowpox would protect humans against smallpox. So he immunised James Phipps, the son of his gardener, and then deliberately infected him with smallpox after six weeks and later on as well, another 20 times. “Poor Phipps” did not die, at least not of smallpox, and his cooperation saved hundreds of millions of lives.

This is a milestone in modern medicine, but Jenner’s experiment would not pass an ethics review nowadays. For one thing, Phipps hardly gave his informed consent. However, unknown to most people, Jenner’s methodology is still used. Healthy people are being infected and observed to see whether they become ill (or die). Nowadays the technique is called a Human Challenge Study (HCS).

An article this week in Science profiled some of the leading… click here to read whole article and make comments

Big fallout from Little Sisters case

Commentators have clashed over the US Supreme Court’s decision not rule on a case involving the forced provision of contraceptives by Catholic order Little Sisters of the Poor.

On May 16 SCOTUS announced, in a unanimous decision, that it would not decide the case on its merits but instead sent the case back down to the lower courts for opposing parties to work out a compromise. The court said that in the course of litigation both parties had clarified their position and that they should be able to “arrive at an approach”.

Supporters of the plaintiffs saw the decision as a victory.

Bill McGurn of the Wall Street Journal suggested that the case represented a direct attack on religious groups in society:

“In short, the Obama administration’s goal was not just getting contraceptives to women. It was also to do so in a way designed to force… click here to read whole article and make comments

Patients don’t know their life is ending – new study

Doctors have clear ethical obligations to patients in an end-of-life situation. But what if those patients don’t realise they’re at the end of their lives?

A new study by US researchers suggests that advanced cancer patients have a very poor understanding of their own condition, and that they are typically in need of regular updates on their prognosis from doctors.

Dr. Holly G. Prigerson of New York Presbyterian Hospital worked with a team of three researchers to investigate how much terminal cancer patients understand about their own illness. The team interviewed 178 patients with advanced cancers whom oncologists expected to die within 6 months. Illness understanding scores were taken based on the patient’s acknowledgement of their terminal and advanced condition, and their expectation that they would live months instead of years. The results, published in The Journal of Clinical Oncology on Monday, were quite alarming.

“Results of this… click here to read whole article and make comments

Landmark UK decision broadens scope of surrogacy

In a landmark decision, the High Court in the UK has ruled that it is discriminatory to prevent single men or women from becoming the parents of babies born to surrogate mothers. The government will probably have to update its legislation to make it compatible with the ruling.

Until now, only couples in a stable relationship could become parents of a child born to a surrogate mother. Single people could adopt children, but they were not automatically entitled to be regarded as a parent if their child was born to a surrogate.

In this case an unnamed man used his sperm, a donor egg and a surrogate mother in Minnesota to create a child, who is called “Z” in court documents. But when he brought the baby back to the UK, he was not regarded as a parent, but rather the surrogate mother. (Ironically, in the US, the… click here to read whole article and make comments

Kiev becomes hub for international surrogacy market

Here’s an interesting promotional video for a Ukranian surrogacy clinic, BioTexCom. The company’s website advertises in Ukranian, Chinese, Italian, French, English, German, Spanish, Arabic and Romanian, which gives an idea of the breadth of its market. The promotional blurb declares, “There is no absolute infertility! We treat even the most hopeless infertility cases.”

BioTexCom is the epitome of commercial,not altruistic, surrogacy. There are three levels of service: economy (29,900 Euros), standard (39,900 Euros), and VIP (49,900 Euros). The “standard” service offers pre-implantation genetic diagnosis of embryos, a 4-hour babysitter, paediatric consultation, a hotel and gourmet lunches. For “the most fastidious customers” who enrol for the VIP package there is limousine transport, a 9am-6pm babysitter and on-call paediatric advice. Its marketing on the web and social media is professional and energetic. 

BioTexCom’s donors are “healthy, attractive and educated women”. Only two out of ten volunteers pass its rigorous tests. The outcome is “long-awaited… click here to read whole article and make comments

We need debate on germline modification, says leading UK scientist

Sir Venki Ramakrishnan / Andy Hall for the Observer    

The new president of the Royal Society, the most prestigious body of scientists in the UK, who is also the 2009 Nobel laureate in chemistry, says that a debate is needed about germline modification.

Sir Venki Ramakrishnan says that genetic engineering has great potential for curing genetic diseases and that society must weigh up the risks and benefits.

In an interview with the Guardian, Sir Venki took a broadly positive view of germline modification, even though it is currently banned in the UK.

“There is great potential in germline therapy. There are clearly diseases that you could help by editing the germline. This is a case of a new technology where there are significant potential benefits, but also significant ethical implications.”

However, he believes that it needs to be… click here to read whole article and make comments

Indonesia legalises chemical castration for sex offenders

A protest against sexual violence in Jakarta earlier this month.    

Chemical castration will be a sentencing option for judge in Indonesia. President Joko Widodo has signed a decree authorizing this penalty for convicted child sex offenders. Those who have been released on parole must wear electronic monitoring devices.  

The announcement follows outrage over the gang rape of a 14-year-old girl in Sumatra when she was on her way home from school. Mr Joko said that:

“The inclusion of such an amendment will provide space for the judge to decide severe punishments as a deterrent effect on perpetrators”.

“These crimes have undermined the development of children, and these crimes have disturbed our sense of peace, security and public order. So, we will handle it in an extraordinary way.”

Chemical castration is an increasingly popular response to sexual abuse around the… click here to read whole article and make comments

Extreme beliefs often mistaken for insanity

Insanity can be a legitimate defence in some criminal cases. But a team of US researchers are questioning whether criminals motivated by extreme views are of necessity insane.

In a paper recently published in the Journal of the American Academy of Psychiatrist and the Law, researchers from the University of Missouri argue that in some cases criminals should be said to have an “extreme overvalued belief” rather than being declared mentally ill.

Focusing specifically on the case of Norwegian mass murderer Anders Breivik, the researchers argue that extreme beliefs need not entail psychotic disorder. “… some people without psychotic mental illness feel so strongly about their beliefs that they take extreme actions.”, lead author Tahir Rahman said in an interview. “Our suggested term for criminally violent behavior when psychosis can be ruled out is ‘extreme overvalued belief.’”

The authors of the study draw upon the work of… click here to read whole article and make comments

Journal symposium explores brain death

A new edition of the Journal of Medicine and Philosophy explores a number of important debates about brain death.

The articles in the edition are the product of a Symposium on the Definition of Death held at The Catholic University of America in June 2014. That Symposium brought together scholars from a variety of disciplines— law, medicine, biology, philosophy, and theology—who all share a commitment to the dead-donor rule and to a biological definition of death, but who have differing opinions regarding the validity of neurological criteria for human death.

Significant figures in Catholic bioethics in the North America – including Maureen Condic, Melissa Moschella, Patrick Lee and E. Christian Brugger – offer their views on what sort of conditions signal the death of a patient.

Condic and Moschella suggest that brain death, which they take to be the end of mental function and of autonomous… click here to read whole article and make comments

A solution in search of a name

Legalisation of physician-assisted suicide in four American states left out one thing: a name for what happens. The laws in Oregon, Washington, Vermont and California specify only that what happens is not suicide. An English name for this phenomenon was a topic raised at the 2016 Conference World Federation of Right-to-Die Societies in Amsterdam earlier this month.

Members of the Alt-Suicide group, an American-based internet forum which includes some of the leading names in “choosing an early exit at the end of life”, considered 31 words and phrases in 2014. These included Cathartic Death, Deliberate Life Completion, Exiting, Rational Life Termination, Non Adscititious [sic] Death, Consensual Murder, and Rational and Loving Suicide. “Dying with Dignity” was the favourite in a small survey.

One of the members of the forum, Bill Simmons, a California real estate attorney, has been lobbying hard for the word “dignicide”,… click here to read whole article and make comments

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