Bariatric surgery for teenagers?

American doctors are debating whether to offer bariatric surgery for severely obese young people. The market is huge: about 3 to 4 million teenagers are eligible, but only about 1000 a year have the operation. The proportion of adolescents who are severely obese has doubled nearly doubled between 1999 and 2014 – from  5.2% to 10.2 % of all people  aged 12 to 19.  But most doctors are deeply sceptical of the health benefits of the operation.

On the other hand, it is sometime the only thing that seems to work. “We’re at a point in this field where surgery is the only thing that works for these kids but we don’t know the long term outcomes,” Aaron Kelly, an expert in pediatric obesity at the University of Minnesota told the New York Times.

For many teens severe obesity is medically, socially and psychologically challenging.… click here to read whole article and make comments

Terrorism and triage

Imagine that you are a doctor responding to an emergency in Israel. A terrorist has attacked people in a shopping mall with a knife, stabbing some old women and children. A policeman has shot and seriously wounded the terrorist. Whom should you treat first?

This is a classical triage situation in which the worst are to be treated first. The conventional view is that doctors must be “colour-blind” in treating victims. If the terrorist is the worst injured, he should be treated first.

In an article in the Journal of Medical Ethics, two Israeli doctors question this. Value-neutrality can lead to injustice, they contend, even if “ the virtuous euphoria that accompanies the subjective neutrality-maintenance effort” seems ethically pure.

In any case, “value-neutrality” is a myth, they claim. Deciding which organ to treat is a neutral decision; deciding which person to treat always involves the invocation… click here to read whole article and make comments

Trump under fire from scientists

This week hundreds of scientists rallied in Boston’s Copley Square to protest against the anti-science forces which have allegedly captured Washington. Nearby, at the annual meeting of the American Association for the Advancement of Science, a talk titled “Defending Science and Scientific Integrity in the Age of Trump” attracted so many listeners that it had to be live-streamed into a spill-over room.

Although the organisers of the rally downplayed criticism of the President, stressed that reason and science were under threat. "It feels like there's been a breakdown of trust between science and the public, and so it's time for scientists to step up and start communicating directly to the public," an MIT post-graduate student said. Scepticism towards climate change is what most of the scientists had in mind.

Some medical professionals and scientists are more direct. The Union of Concerned Scientists published an article in the… click here to read whole article and make comments

Should Quebec’s Alzheimer’s patients be eligible for euthanasia?

Quebec is about to embark upon a debate on the involuntary euthanasia of demented elderly after a  55-year-old man in Montreal allegedly smothered his Alzheimer’s stricken wife and posted what he had done on Facebook. Michel Cadotte was charged with second-degree murder after his 60-year-old wife died in an assisted care facility.

He said on Facebook that he had "cracked" and "consented to her demands to help her die." Although the facts are not clear yet, the media has reported that the woman requested medical aid in dying but was refused.

Under Quebec’s 2015 law, euthanasia for the demented is specifically excluded. “A person who makes a request for medical assistance in dying must be capable of consent,” Jean-Pierre Ménard, a Montreal medical lawyer, told the Montreal Gazette. “This means the patient must understand their state of health and can express their will. A patient with… click here to read whole article and make comments

Peter Singer interviewed about, well, everything

The Journal of Practical Ethics recently posed 20 hardball questions to Peter Singer about his philosophy. It is a terrific insight into his thinking as his long career draws to a close.

About utilitarianism: Why do many intelligent and sophisticated people reject utilitarianism? Some people give more weight to their intuitions than I do—and less weight to arguments for debunking intuitions. Does that reduce my confidence in utilitarianism? Yes, to some extent, but I still remain reasonably confident that it is the most defensible view of ethics. I don’t know if everyone will accept utilitarianism in 100 years, but I don’t find the prospect frightening. It would only be frightening if people misapplied it, and I do not assume that they will.

On critics: There have been many critics of my views about euthanasia for severely disabled infants. I had some good discussions with the late Harriet McBryde… click here to read whole article and make comments

The gene-editing debate just got more complicated

As the debate over gene-editing intensifies, elite US universities are now fighting over a patent for CRISPR-Cas9 technology.

Last Wednesday the The US Patent and Trademark Office ruled that a CRISPR patent application from a researcher based at the Harvard-MIT Broad Institute ‘did not conflict’ with an earlier application by researchers from UC Berkeley.

The researchers who first discovered CRISPR technology, Emmanuelle Charpentier (Max Plank Institute) and Jennifer Doudna (Berkeley), filed a patent on behalf of UC Berkeley in 2012. That application covered the basic contours of the technology. Yet Chinese-American researcher Feng Zhang had filed a patent application shortly afterward, which described in further detail how to use the technology in the cells of higher organisms, i.e., "eukaryotic" cells.

The Patent and Trademark Office ruled that The Broad patent is “sufficiently distinct as to be separately patentable from the claims… click here to read whole article and make comments

Australian surrogacy booms after SEA crackdown

Surrogacy in Australia is experiencing a quiet boom, after yet another South-East Asian nation cracked down on the practice.

Last November Cambodia announced a ban on commercial surrogacy, and arrested an Australian nurse who was running a surrogacy clinic in Phnom Penh. Around ten Australian couples are currently stranded in the capital as the government drafts new legislation to regulate the practice.

Meanwhile in Australia, there has been a significant increase in the number of couples looking for surrogates, according to IVF experts.

Dr Glenn Stirling, the medical director of Brisbane IVF clinic Life Fertility, told the ABC that the number of patients they see has risen dramatically, and that new patients arrive almost daily.

"We'd be doing at least, two or three couples a week that are doing surrogacy," he said.

Commercial surrogacy is illegal… click here to read whole article and make comments

Anorexic and bulimic woman dies after court orders end to force-feeding

A 30-year-old anorexic and bulimic woman has died in a New Jersey hospital just three months after a court denied a request that she be force-fed.  

The women, identified as “Ashley G” in court papers, had suffered from anorexia nervosa for well over a decade, and had been in hospital since 2014. She had also been diagnosed with chronic depression, according to the state attorney general’s office.

Last year state Department of Human Health Services staff took her to court requesting that she be force-fed, yet Morris County Superior Court Judge Paul Armstrong ruled that she instead be moved to palliative care.

“Whether grounded in common law or constitutional law, our courts have uniformly recognized a patient’s right to refuse medical treatment as a fundamental tenet of respect for patient autonomy, dignity and self-determination,” Armstrong ruled last November.

The woman told the judge that she would resist… click here to read whole article and make comments

A quick look at immortality

Is immortality a good idea? This video from The Atlantic takes a brief look at a familiar figure for BioEdge readers, Zoltan Istvan. 

click here to read whole article and make comments

Calling Hollywood: have we got a script for you!

Liz Van Note acquitted   

Amongst the exiguous collateral benefits of the legalisation of assisted suicide and euthanasia are scripts for B-grade Hollywood films and TV dramas. On cable TV in Canada and the US “Mary Kills People” is currently being screened. This being is billed as “a provocative six-episode dark comedic drama series” about an ER doctor who illegally moonlights as an “angel of death” for the terminally ill.

But the best plots come from real life. This one from Missouri shows how family quarrels, criminal weaknesses and money intersect in advance directives.

Susan “Liz” Van Note has been found innocent of the murders of her father, William Van Note, and his partner, Sharon Dickson in 2010. They were shot and stabbed to death at their home. Ms Dickson died at the scene; Mr Van Note was unconscious and taken to hospital.… click here to read whole article and make comments

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