The digital smart pill is not a magical answer, say researchers

Enthusiasm for an emerging digital health tool, the smart pill, is on the rise but a paper in the American Journal of Bioethics cautions health care providers and policymakers to slow down when it comes to allowing this technology in patient care settings.

Smart pills, or digital pills, are prescription medications equipped with edible electronic sensors that send wireless messages to devices, like patches and smartphones or tablets, outside the body when they are ingested. The first of its kind, which is used to treat patients with schizophrenia, bipolar disorder and major depressive disorder, was approved for use in humans… MORE

Where does palliative sedation become euthanasia?

A special issue of the journal Theoretical Medicine and Bioethics is devoted to the controversial issue of palliative sedation. As the editor, bioethicist Daniel Sulmasy, points out, palliative sedation has special relevance for Christians. For them, the relief of unnecessary suffering is a duty, but euthanasia is wrong. Identifying the right response to suffering at the end of life is often perplexing, especially since some doctors use palliative sedation as terminal sedation – rendering patients unconscious and withdrawing hydration and nutrition until they die.

Sulmasy says that the articles in the June issue bring to the topic “an almost… MORE

Would you pay to participate in a clinical trial?

Imagine this scenario. You are terminally ill with cancer when you hear about a clinical trial with a miracle drug. You make inquiries and discover that you can participate but it will cost you $10,000.

This is the controversial “pay to play” model for funding clinical trials. While it sounds completely unconventional, it is already being used in allied health fields like sleep clinics, physiotherapy, and weight management. A couple of years ago bioethicist Ezekiel Emanuel and colleagues argued that it should not be considered as a funding model in times of shrinking budgets. They believed that it would… MORE

Should all newborns receive genome sequencing?

As the cost of genome sequencing decreases, doctors are debating whether all newborns should be sequenced, facilitating a lifetime of personalized medical care.

A report from The Hastings Center, The Ethics of Sequencing Newborns: Recommendations and Reflections, examines the pros and cons. It concludes that while sequencing the genomes of some infants may sometimes be appropriate, genome-wide sequencing of all newborns should not be pursued at this time. Health professionals should tell parents not to use direct-to-consumer genetic sequencing to diagnose or screen their newborns.

"Genomics is a powerful tool, but the results it returns are still not fully… MORE

Another step closer to legal abortion in Ireland

On Tuesday, Ireland’s president, Michael D. Higgins, signed into law legislation amending the Constitution to remove constitutional protection for the unborn, following May’s constitutional referendum. A couple of predictably ineffectual legal challenges had delayed this.

The way is now open for abortion legislation. Minister for Health Simon Harris says that the government will aim to enact a law by the beginning of 2019 at the latest.

Medical Council guidelines will reflect the new law in due course. 

The government’s draft legislation is currently being discussed in the parliamentary Health Committee. Apparently the proposed three-day waiting period is going… MORE

13-year-olds given mastectomies at California clinic

How old does one have to be to consent to a mastectomy? Only 13, it appears. An article in JAMA Pediatrics on “Chest Dysphoria in Transmasculine Minors and Young Adults” at a US clinic was based on a survey which included 2 girls (transmale) who were 13 years old and had both breasts removed and 5 who were only 14.

According to the authors, who are based at the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, “All postsurgical participants (68 of 68; 100%) affirmed the statement, ‘It was a good decision to undergo chest reconstruction.’”


British grandparents use dead son’s sperm to create child

Another fascinating chapter in the unfolding history of the Reproductive Revolution, this time about posthumous sperm extraction.

A few years ago an unnamed 26-year-old unmarried man was killed in a motorcycle accident in the UK and his body was not discovered for two days. His wealthy parents, who are in their 50s, immediately set to work. He had been their only son and they desperately wanted a male heir.

They engaged a urologist to extract sperm from their son’s corpse. This was frozen and a year later couriered to the California IVF clinic of Dr Jeffrey Smotrich. The man’s parents… MORE

Amend law to allow organ donor euthanasia, say Canadian doctors

Canadian legislation and medical protocols need to be tweaked to allow euthanasia with organ donation, according to an opinion piece in the New England Journal of Medicine. Two doctors from Western University, in Ontario, and Robert Truog, a Harvard Medical School bioethicist, outline the changes that will be needed to ensure that patients can give as many healthy organs as possible.

Euthanasia offers significant advantages for transplant surgeons. The normal protocol is to wait for a couple of minutes after blood circulation ceases (donation after cardiac death). But even in that brief space of time the quality of the… MORE

Most Quebec doctors in survey favour euthanasia for demented patients

Most Quebec doctors are in favour of euthanasia for incompetent patients with dementia in a terminal stage, according to a survey conducted by researchers at Université de Sherbrooke and institutions in Belgium and the Netherlands.

Current legislation requires that patients be competent and request euthanasia, but there is a movement to allow it for incompetent patients as well.

The results, which were published in the Canadian Journal of Public Health, were based on responses from 136 French-speaking physicians in Quebec involved in end-of-life decisions.

Physicians favoured continuous deep sedation over euthanasia for relieving suffering if patients were in an… MORE

One drug manufacturer’s moral universe

It’s important to establish an ethical framework before launching into debates on specific issues. And although he is being reviled on Twitter, at least Nirmal Mulye, the CEO of Nostrum Laboratories, a small pharmaceutical manufacturer based in Missouri, has a firm and clear ethical framework: to maximise profit.

In an interview with the Financial Times, he defended his decision to raise the price of an antibiotic for urinary tract infections from US$474.75 to $2,392, a 400% hike. “I think it is a moral requirement to make money when you can  . . . to sell the product for the highest… MORE

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