October
24
 

House of Lords debates assisted suicide—again

Baroness Meacher / screenshot GBNews

Once again, the House of Lords in the UK is debating a bill to legalise assisted suicide. Lord Joffe introduced a bill in 2003 and Lord Falconer in 2014. Now it is the turn of Baroness Meacher of Spitalfields, who is also chair of Dignity in Dying UK. According to Hansard, in the last 20 years, more than 482,000 words have been spoken on this issue, taking up 62 hours of noble Lords' time. Following its Second Reading debate, her bill was referred to a committee for further study.

According to The (London) Telegraph, the bill is not expected to pass because of parliamentary time constraints and the opposition of ministers in Boris Johnson’s cabinet. However, there have been some surprising interventions and commentary.

Several peers said that they had changed their minds and will support assisted dying. As Dignity in Dying pointed out, no peers have moved from support to opposition.

Lord [Frank] Field of Birkenhead, a former Labour MP and minister who was made a peer after losing his seat in the 2019 general election, announced he is terminally ill and has spent time in a hospice. He is backing the bill.

The Archbishop of Canterbury, Justin Welby, told the BBC: “What we want is assisted living, not assisted dying. … Sadly people make mistakes in their diagnosis. It leaves people open to very, very intangible forms of coercion and pressure. I have sat in places where I have known that people were having pressure put on them in ways that would never come out.”

The former Archbishop of Canterbury, George Carey, is part of a religious coalition for assisted suicide, argued in the BMJ that there was “nothing holy about agony” and cited a verse from the Hebrew Bible that states: “Death is better than a miserable life, and eternal rest than chronic sickness.”  

Baroness [Julie] Smith of Newham is a Liberal Democrat but firmly opposes the bill. "Supporters of the Bill say that it is about choice—about those with mental competence within six months of death," she declared. "However, if we look at other jurisdictions, legislation has repeatedly been changed. The noble Baroness, Lady Meacher, exhorted us not to look at Canada or the Netherlands; she told us that those cases did not matter—but why do they not matter? They are the only examples that we have in front of us, and we have seen changes. In the Netherlands, there is euthanasia for children. I know that this Bill is not about euthanasia—it is about assisted suicide—but how can we be assured that taking a decision on this legislation would not then lead to incremental views about extending the legislation again and again?"

Former Prime Minister Gordon Brown wrote in The Times: “If death were to become not just an option but something close to an entitlement through the bureaucratic processes that an act of parliament’s provisions impose, we would, in my view, be altering fundamentally the way we think about mortality … The risk of pressures, however subtle and indirect, on the frail and the vulnerable, who may feel their existence burdensome to others, cannot ever be entirely excluded. And the inevitable erosion of trust in the caring professions — if they were in a position to end life — would be to lose something very precious.”

Simon Jenkins, an influential journalist who writes in The Guardian nowadays, said that it was pathetic, illiberal and undemocratic for British politicians to ignore public opinion polls which suggest that most voters favour assisted suicide. “As with its drug laws and inhumane prisons, Britain is falling fast down the league table of progressive nations.” And, in an acute bit of cultural analysis, he observed that the bill “ranks with past laws on divorce, abortion and sexuality in the canon of social liberalism. It is unfinished business of the 1960s.”

Michael Cook is Editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
24
 

Spanish government tries to restrict conscientious objection

Right sentiment, wrong country: a demonstration in Buenos Aires  in 2020

The Spanish government is considering measures to restrict conscientious objection for doctors. An editorial in El Pais complains that “in recent years there have been growing signs of a counter-reformist reaction in social sectors that put their own intolerance ahead of other people’s legally protected freedoms, or even prioritize their nostalgia for the days when individual and intimate beliefs, such as religious faith, claimed to exercise an improbable superiority over the beliefs of others.”

The problem is that abortions have been legal in Spain since 1985 – but many doctors still refuse to do them. Most are done in abortion clinics and very few in public hospitals.

The equalities minister has proposed the creation of a mandatory register of healthcare professionals who are conscientious objectors. This already exists for euthanasia.

The General Council of Official Medical Colleges (CGCOM) has declared that “Forcing the conscience of physicians in order to expand the number of physicians available in all communities is, in addition to being unconstitutional, a bad solution, which from the perspective of the medical profession would be considered unacceptable, illegal, and unjust.”

However, the Equality Minister, Irene Montero, would like to see abortion decriminalised and says that “the right of physicians to conscientious objection cannot be above women’s right to decide.”

Michael Cook is Editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
24
 

Pig kidney transplanted to human patient

NYU Langone Health / photo by Joe Carrotta 

The first transplant of a genetically engineered, non-human kidney to a human body was recently completed at NYU Langone Health, marking a major step forward towards an alternative supply of organs.

The kidney was obtained from a genetically engineered pig and transplanted into a brain-dead donor, a woman, who had been kept alive on a ventilator. The donor’s family gave its consent for the procedure.  Doctors studied the kidney’s function and watched for signs of rejection for 54 hours.

Additionally, the pig’s thymus gland, which is responsible for “educating” the immune system, was transplanted with the kidney to stave off novel immune responses to the pig kidney.  

The study was observational, not functional. The kidney was attached to the blood vessels in the upper leg and was outside the abdomen for 54 hours. No signs of rejection were detected 

To some extent, this is science by press release, as the study has not been peer reviewed or published in a journal.

Dr Robert Montgomery, the lead surgeon, described the procedure at a press conference as a “major step forward in creating a sustainable supply of lifesaving organs and hopefully ending the current paradigm that someone has to die for someone to live.”

“The potential here is incredible,” he said. “If the science and experimentation continue to move ahead positively, we could be close to kidney xenotransplantation into a living human being. And the future of this work is not limited to kidneys. Transplanting hearts from a genetically engineered pig may be the next big milestone. This is an extraordinary moment that should be celebrated—not as the end of the road, but the beginning. There is more work to do to make xenotransplantation an everyday reality.”

Others were more guarded in their assessment of the procedure. Similar experiments with primates have also shown promising results, but as Parsia Vagefi, a transplant surgeon at UT Southwestern Medical Center in Dallas, commented, “It’s a proof of principle but it didn’t really move the needle in terms of the science.” The real test is whether a pig’s kidney can survive for years in a human recipient. “Nobody needs a kidney for three days,” said Dr Vagefi.

Is it ethical to genetically engineer pigs and harvest their organs? Some say No. “Pigs aren’t spare parts and should never be used as such just because humans are too self-centered to donate their bodies to patients desperate for organ transplants,” the organization People for the Ethical Treatment of Animals, or PETA, declared.

Michael Cook is Editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
24
 

Non-invasive prenatal testing is becoming a growth industry

A fascinating article in the journal Annual Reviews examines the uptake of non-invasive prenatal testing (NIPT) in Australia, Canada, China and Hong Kong, India, Israel, Lebanon, the Netherlands, the United Kingdom, and the United States.

NIPT one of the world’s fastest-spreading genetic technologies. The global market was US $3.9 billion in 2019 and will reach US $7.3 billion by 2024. It is non-invasive, safe and reliable, although it is only a screening test and results should ideally be followed by a diagnostic test.

At the moment it can accurately screen for Down syndrome, as well as several other less common genetic anomalies: Edwards syndrome, Patau syndrome, Turner syndrome, Klinefelter syndrome and triple X syndrome.

There are problems with equitable access – NIPT is too expensive to use in poor countries and even wealthier countries are reluctant to fund it as part of the public health system. Only in the UK is the cost government-funded.

Effective counselling is also problematic. NIPT is not diagnostic and mothers should not make decisions about terminations without confirming the results. But often this does not happen.

But from an ethical point of view, the most controversial feature of NIPT is that many women will abort their child after learning of the abnormality. A cynic might even argue that NIPT is basically a marketing tool for abortion clinics. As the authors note, this is sometimes factored into studies of the cost-effectiveness of public funding. In other words, economists assess the life of a person with a disability as a drain on the economy.  

Looking to the future, they write: “Additional challenges will emerge from the gradual expanded use of NIPT to generate an increasing amount of genetic information, potentially toward less severe conditions and even nonmedical characteristics. Nuanced and contextualized discussion of socio-ethical implications is indispensable as countries cope with decisions regarding what uses of NIPT they wish to allow or fund.”

Michael Cook is Editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
24
 

Benin and El Salvador go in opposite directions on abortion

Parliamentary committee votes / La Prensa Grafica 

It is odd to see how countries can differ so radically on the fundamental issue of abortion.

The parliament of the West African country of Benin (population 12 million) voted this week to legalise abortion. It was already permitted under very restricted conditions.

The new law provides that women can have an abortion within the first three months if a pregnancy is likely to “aggravate or cause material, educational, professional or moral distress, incompatible with the woman or the unborn child’s interest”.

Previously, women could only have an abortion if the pregnancy “threatened the life of the mother”, was “the result of a rape or incest” or when “the unborn child has a particularly severe affection”.

Minister of Health Benjamin Hounkpatin explained that complications from abortions accounted for 20% of maternal deaths in the country. (No source for this figure was given in an Al-Jazeera article.)

On the other side of the world, a committee of the El Salvador (population 6.5 million) parliament voted against reforming one of the world’s strictest laws on abortion. Elective abortion is banned in all cases, including rape, incest and foetal deformity. The penalty for the mother and for doctors is 2 to 8 years in prison.

The El Salvador constitution recognises “as a human person every human being from the moment of conception”.

Supporters of abortion called the proposed constitutional reforms “La Reforma Beatriz”, after the 2013 case of Beatriz, a pregnant 22-year-old woman whose unborn baby was anencephalic. She requested an abortion, but permission was refused by the Supreme Court. In the event, doctors performed a Caesarean at about 7 months.

El Salvador is under immense international pressure to liberalise its ban on abortion from Western governments, international groups and NGOs.

Michael Cook is Editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
24
 

A mammoth resurrection

Life restoration of fauna during the Pleistocene epoch in northern Spain, by Mauricio Antón, 2004 / Wikimedia 

The thought of seeing woolly mammoths lumbering across the Siberian tundra is incredibly exciting. And Harvard geneticist George Church hopes to make it a reality. Cashed up with US$15 million from an AI entrepreneur, he plans to recreate enough elephant-mammoth hybrids to  protect the changing Siberian ecosystem.

The difficulties are gigantic – which fits the name of his company, Colossal. The website states:

In the minds of many, this creature is gone forever. But not in the minds of our scientists, nor the labs of our company. We’re already in the process of the de-extinction of the Woolly Mammoth. Our teams have collected viable DNA samples, and are editing the genes that will allow this wonderful megafauna to once again thunder through the Arctic.

It won’t happen tomorrow. Before creating a single mammoth, Church and his team have to create breakthrough technologies to enable a calf’s gestation. At best, a mammoth hybrid is six years away; a self-sustaining herd decades.

Two prominent bioethicists are on Church’s scientific advisory board: R. Alta Charo of the University of Wisconsin at Madison, and S. Matthew Liao of New York University..

“It’s not just about having them exist, but making sure that once they do exist that they can thrive and live a flourishing life,” says Liao, a New York University. “Otherwise, you’re being cruel to these animals.”

However, another bioethicist has delivered a broadside at the project in a commentary in Nature. Victoria Herridge, an evolutionary biologist at the Natural History Museum in London, says that she was invited to join the board but refused on ethical grounds.

She believes that the project lacks openness and public participation. She points out that “Both geoengineering and synthetic biology have a poor track record when it comes to people taking matters into their own hands.”

The ethical road to de-extinction has to include informed citizen voices, alongside experts and activists. This might mean that the process takes longer than five years, but private enterprises working for the common good shouldn’t shy away from the views of those they seek to serve. Let the people decide the future world they want to build.

Michael Cook is Editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
24
 

Prominent Australian assisted suicide campaigner dies

Rodney Syme / Dying with Dignity screenshot 

The Grand Old Man of assisted suicide in Australia, Dr Rodney Syme, died this week at the age of 86, after suffering a stroke.

He began campaigning for “Voluntary Assisted Dying” (VAD) in 1974 after a patient died with intractable pain.

He not only gave advice to hundreds of people about dying, he also provided them with lethal medications when it was still illegal. “I’m not doing it quietly anymore,” he told a radio host in 2005. “I’ve sailed close to the wind, no doubt about it, but the law is hypocritical and I’m not the only doctor who is operating in this murky terrain. It’s just that I’m prepared to say so publicly.”

In 2016, the Australian Medical Board banned him from providing advice to terminally ill patients although he successfully appealed against the ruling.

In 2019, after euthanasia was legalised in Victoria, where he lived, he was made a Member of the Order of Australia for significant service to social welfare initiatives and to law reform.

His defiance of the law made him a hero to the right-to-die movement. As right-to-die campaigner Andrew Denton, wrote:

I don’t know – and perhaps only Rodney’s careful records will reveal – how many people he provided with medication which gave them control over their final weeks and months. I do know that, every time he did it, he was breaking the law. And I also know, from having met some of those people, that his courage, compassion and ‘due care’ made a profound difference to their lives.

In 2018 Dr Syme told the TV program 60 Minutes that he had assisted 300 people to die.

Mr Denton eulogised Dr Syme on the Go Gentle Australia blog as if he were Mahatma Gandhi: “the mighty oak has fallen. There seems a vast, empty space in the forest where he once stood. That familiar, comforting shadow no longer cast.”

But with his defiance of the law and lack of transparency about the patients he helped to die, Rodney Syme seems an odd patron saint for legalised euthanasia. That’s exactly what its opponents complain about.

Michael Cook is Editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
17
 

Debate begins on NSW euthanasia bill

Parliament of New South Wales 

A euthanasia bill will be tabled soon in the parliament of the Australian state of New South Wales. Alex Greenwich, an independent MP, introduced the “Voluntary Assisted Dying Bill 2021” earlier this week.

In his speech to the lower house, he said that he had been touched by “heart-breaking” stories of people who had “slow and agonising deaths”: “Stories of people who died choking on their bodily fluids, who slowly suffocated to death … who were unable to swallow, whose bodies were covered in painful open sores.”

Euthanasia lobbyists have run a thoroughly professional campaign. A petition has been signed by 100,000 supporters. The bill is backed by a record 28 MPs, including members of the government, crossbench and the Labor opposition – which is said to be the highest number of co-sponsors to a bill in the history of any Australian parliament.

It’s hard to predict the outcome. Momentum is with supporters, as NSW is the only state in the country where euthanasia is not legalised. However, a new Premier, Dominic Perrottet, is a staunch opponent.

Although the bill has not been passed yet, supporters are already grumbling that it is far too restrictive and will not permit enough people to be killed.

Writing in the Sydney Morning Herald, award-winning journalist and novelist Malcolm Knox kvetches that too many concessions have been made to opponents in order to sweeten the bill. Australian states have already passed laws that are amongst the most restrictive in the world. “What has eventuated in the other states, and what is proposed for NSW, is a compromise that leaves nobody happy,” he writes.

“Assisted dying became legal in mid-2019; Victoria’s law has 68 safeguards, the most of any in the world. The review found that those safeguards had been so restrictive that many patients were dying while waiting for access, were thwarted by unworkable logistics, and were discriminated against by the under-resourcing of the approvals process.”

He also contends that conscience votes are not in the public interest. “Many of us would like to see more conscience votes, as they free the representatives from party discipline. But really, they serve only the major parties’ own interests, for there are some issues, such as VAD [voluntary assisted dying], that would tear the parties limb from limb if debated internally. Best for them (but not necessarily for us) if the debate liberates the members to speak as individuals.”

It is still early days – but if the bill passes, it’s possible that supporters will begin campaigning immediately to dismantle the vaunted safeguards. That is, of course, what happened in Canada.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
17
 

‘Fake news’ from Malawi about unsafe abortions

The London Telegraph published a confronting statistic about abortion this week: 12,000 women die every year in Malawi after a back-street abortion. “These women die like chicken and sadly, no one seems to care about them,” said a local gynaecologist. And the Royal College of Obstetricians and Gynaecologists has endorsed this by tweeting a link to the article. “We've said it before and we'll say it again, restricting access to #safeabortion risks lives,” said the RCOG.

However, Dr Calum Miller, an ethicist and psychiatrist at Oxford University, has just published a peer-reviewed article in the International Journal of Environmental Research and Public Health which raises serious questions about the number of deaths from illegal abortions.

To put it in non-academic language, he believes that it is “fake news”.

He claims that “the latest evidence—itself from 15 to 20 years ago—suggests that 6–7% of maternal deaths in Malawi are attributable to induced and spontaneous abortion combined, totalling approximately 70–150 deaths per year.” So the number of deaths from backstreet abortions is very small indeed – a tiny fraction of the 12,000 mentioned in The Telegraph.

“Claims in the mainstream media of thousands of women dying from unsafe abortion in Malawi each year have no empirical foundation,” he writes.

Does liberalisation of abortion laws decrease the number of maternal deaths? Surprisingly, an article in the journal BMC Women’s Health observed that “There is little or no research about abortion laws and their impact on maternal mortality.” Dr Miller believes that “Once socioeconomic and infrastructural factors are taken into account, there appears to be little to no relationship between abortion legislation and abortion mortality.”

This is an important health issue. In the case of Malawi, foreign aid from the UK has been disproportionately given to family planning programs, rather than strengthening health systems.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
17
 

WHO calls for better palliative care world-wide

The topic of this year’s World Hospice and Palliative Care Day on October 9 was “Leave no one behind: Equity in access to palliative care”. The provision of palliative care in most countries lags far behind the need.

Each year, more than 56.8 million people, including 25.7 million in the last year of life, need palliative care, of whom 78% live in low- and middle-income countries. It is estimated that only about 12% receive it.

WHO predicts that global demand will grow as populations age and the burden of noncommunicable diseases rises. By 2060, the need for palliative care is expected to nearly double.

Palliative care is one of the most inequitable areas of healthcare. There is strong evidence that the poor and marginalised are less able to access it. Of 25,000 palliative care services globally, only 30% are in lower and middle-income countries.

People are less likely to access pain treatment if they live in low- and middle-income countries. Morphine-equivalent opioids are an important aspect of pain treatment. Of the 298.5 metric tonnes distributed globally per year, only 0.1 metric tonne is distributed to low-income countries. This is despite the fact that the greatest need for palliative care and pain treatment is in low- and middle-income countries.

Palliative care is often not financed as part of the health system. Health care workers and community carers are not trained in palliative care and pain treatment is often not part of health training curricula.

The WHO has identified about seven areas of concern for palliative care:

The elderly: Older people are more likely to have untreated pain, less access to palliative care and more information needs than younger people. The specific palliative care needs of older people include issues such as management of frailty, disability and multi-morbidity, and dementia.

Children and teenagers: 21 million children globally need palliative care, including 8 million with specialised needs. Nearly all live in low- and middle-income countries, but palliative care servers are rarely available. Even in high income countries, there are significant barriers to access. The result is unnecessary pain and suffering for children and their families and carers.

Women: 57 million people have palliative care needs annually. A conservative estimate suggests that there are also 114 million family carers, mostly women. Women also do 50% more care than men. Nurses and social workers in palliative care are more likely to be women.

Poverty: deprivation impacts on many end-of-life symptoms. Pain, breathlessness, psychological and spiritual wellbeing are negatively impacted when people live in deprivation. Family carers living in poverty are more likely to experience moderate to severe depression.

The disabled: People with intellectual and physical disabilities are less likely to access palliative care than those without disabilities.

LGBTQI+: Barriers for LGBTQ + people include discrimination, criminalisation, persecution, fear, distress, social isolation, disenfranchised grief, bereavement, tacit acknowledgment, homophobia and mistrust of healthcare providers.

The incarcerated: Prison populations in many counties are rapidly ageing; by 2030, older prisoners are expected to account for one-third of the incarcerated population in the US. Incarceration shortens life expectancy and hastens physiological ageing, compounding existing health issues and heightening the risk that prisoners will develop palliative care needs. For many prisoners with serious illness, palliative care is not available.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
17
 

BMJ champions ‘assisted dying’

The editors of the BMJ recently put the prestige of their publication squarely behind “voluntary assisted dying”. In a long editorial with 30 footnotes, “Assisted dying: a question of when, not if”, they argued that Oregon’s model has worked smoothly and that “there is no evidence that palliative care deteriorates if assisted dying is available”.

They conclude that: “No professional should be obliged to participate in assisted dying. But doctors who oppose it should not stand in the way of colleagues who find it ethically justifiable to assist a dying patient’s death. Nor should they stand in the way of terminally ill patients who reasonably ask for doctors’ help to end their life.”

The editorial only attracted 13 comments, but the interesting thing is that all of them opposed the proposal. It’s obvious that Britain’s doctors are deeply divided on the issue.

Some of the comments are worth reporting:

‘Assisted dying’ is not widespread. The number of people with access to an assisted death is 2% of the world’s population. To put this in perspective, 41 states in the US do not allow assisted deaths, many have laws against it and the US has a federal law against euthanasia. (Claud Regnard, Retired Consultant in Palliative Care Medicine)

The claim that legislatures such as Oregon are ‘strictly monitored’ is a caricature; little data is collected, the decision-process is not monitored, and any documents are destroyed after one year.(6) Other legislatures collect even less data. (Claud Regnard, Retired Consultant in Palliative Care Medicine)

Once trust is lost it will be almost impossible to restore. With most doctors [in the UK] being employed by the state, the next step will be to bring doctor participation in this activity up to a standard of care. (Anthony M Brooks, Retired consultant anaesthetist)

This reflects a response to the significantly partisan stance of the BMJ, which is not proportionately representative of Membership views. (John E Etherton GP)

There is a real difference between palliative care -- which is motivated to make a person's last days as comfortable and bearable as possible -- and mercy killing -- which is motivated to actively and consciously terminate a life. (Eugene Breen, Psychiatrist)

In Oregon, official data document progressive increases in both the number and proportion of patients who receive a medically assisted death because of concerns about being a burden on others. (H Lucy Thomas. Consultant in public health and specialty doctor in palliative care)

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
17
 

China responds to allegations of organ harvesting

Falun Gong protesters against organ harvesting in China 

BioEdge and many other publications have highlighted claims by the NGO Doctors Against Forced Organ Harvesting (DAFOH) that the Chinese government permits involuntary organ donation by political and religious prisoners. The Chinese government has responded with indignation, denying all allegations. 

More stinging, perhaps, was a report published in June by UN human rights experts.

The experts said they have received credible information that detainees from ethnic, linguistic or religious minorities may be forcibly subjected to blood tests and organ examinations such as ultrasound and x-rays, without their informed consent, while other prisoners are not required to undergo such examinations. The results of the examinations are reportedly registered in a database of living organ sources that facilitates organ allocation.

“Forced organ harvesting in China appears to be targeting specific ethnic, linguistic or religious minorities held in detention, often without being explained the reasons for arrest or given arrest warrants, at different locations,” they said. “We are deeply concerned by reports of discriminatory treatment of the prisoners or detainees based on their ethnicity and religion or belief.

“According to the allegations received, the most common organs removed from the prisoners are reportedly hearts, kidneys, livers, corneas and, less commonly, parts of livers. This form of trafficking with a medical nature allegedly involves health sector professionals, including surgeons, anaesthetists and other medical specialists.”

The Chinese government has flatly denied all these allegations. In a recently published note, it said that the UN’s report “is based on false information, makes groundless accusations against China and is filled with malice and prejudice”. Its response is short on specifics about organ harvesting. Instead, it simply asserts that “China has a sound system of laws and regulations for the donation and transplantation of human organs. Human‐organ donation is governed by the principle that such donation is voluntary and non-remunerative; organ trading and involuntary organ harvesting have been criminalized.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
17
 

Pope Francis insists on right to conscientious objection for abortion refuseniks

Pope Francis 

Health workers have a non-negotiable right to conscientious objection if they are asked to participate in an abortion, Pope Francis told a conference of hospital pharmacists this week.  

CO is actually “fidelity to your profession, if validly motivated,” he said.

“Today there is something of a tendency to think that perhaps it would be a good way to approach conscientious objection,” he said. “But this is the ethical intimacy of every health professional and this should never be negotiated, it is the ultimate responsibility of health professionals. It is also a denunciation of the injustices done to the detriment of innocent and defenceless life.”

However, he acknowledged the complexity of CO, which “requires both great competence and great rectitude”.

And, pushing back against accusations that Catholic doctrine is harsh and unyielding, he said that “our duty is to be close to people, our positive duty: to be close to situations, especially women, so that they do not come to think of abortion as the solution.”

The Pope, who is often viewed as a progressive because of his views on the environment, on greater tolerance of LGBTQI+ people, and on inflexible clergy, is still vehemently opposed to abortion.

It was at least the third time in a month that Francis has denounced abortion, which has become a major political issue in many countries, especially the United States.

In an in-flight press conference in September he declared: “Abortion is more than an issue. Abortion is murder … It’s a human life, period.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
09
 

Sexual abuse by WHO staff in DRC Ebola epidemic shattered community trust

Fighting Ebola in the DRC / Médecins Sans Frontières 

Trust is emerging as an ethical pillar for medicine. Not that it was overlooked in the past, but it has been shaken so often in recent times. Lack of trust is one of the main reasons for vaccine hesitancy in the Covid-19 pandemic.

Today an editorial in The Lancet laments well-founded allegations of sexual abuse by staff of the World Health Organization working in the Democratic Republic of the Congo an Ebola epidemic between August 2018 and June 2020. “The trust people place in WHO to do the right thing is being squandered, and without trust WHO cannot fulfil its mission.”

An independent report on the abuse was published on September 28. It described dozens of “appalling allegations”, especially of sex for jobs. “These allegations raise serious questions about the integrity, trust, and governance of WHO. How it responds to these findings will surely impact the organisation's future,” says The Lancet.

(Just as well that the WHO did not receive the Nobel Peace Prize this week – it was rumoured to be one of the leading contenders.)

The Lancet’s editorial said that this directly impacted health care:

A key lesson of the tenth Ebola epidemic in DRC was that, no matter what technical resources are available, a response cannot succeed without the trust of the community. Vaccinations were refused and treatment centres attacked. 450 acts of violence or threats against health workers occurred. 25 health workers were murdered and a further 27 were kidnapped. Abuses like those documented in the report will destroy community trust. By being the vehicle for sexual abuse and exploitation, in a situation in which mistrust is already rife following centuries of colonial exploitation, WHO places its employees, its mission, and its mandate at risk.

The Lancet suggested that there would be less abuse if women played a more active and prominent role in WHO.

Michael Cook is editor of BioEdge    



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
09
 

Bioethicist group supports vaccine mandates

A leading association of bioethicists has come squarely behind the idea of mandated vaccination. A statement issued by the Association of Bioethics Program Directors (ABPD) declared that “To protect the health, safety and future prosperity of humankind, mandated vaccination is now necessary.” It was supported by two-thirds of ABPD members.

There are about 100 members.

In an explanatory note, well-known bioethicist Art Caplan said that “I fervently hope the position statement from an organization representing moral expertise in matters of health care ethics will counter flawed moral objections to vaccine mandates so that the threat from Covid-19 can be greatly reduced in North America and around the world.”

Caplan dismisses the two main objections to vaccine mandates.

First, compulsion is necessary. “Covid-19 with its 4.5 million deaths, untold numbers of people with disabling complications, psychosocial havoc and burdens on health systems is recognized as a very serious public health emergency. It makes sound ethical sense to permit restrictions on both liberty and personal choice including mandating vaccination.”

Second, it’s not really compulsion anyway, as people are still free to make choose. While normally people have a right to bodily integrity, including a right to refuse vaccinations, the government has a responsibility to sanction them. “One may reject vaccination but then be subjected to penalties including fines, loss of employment, loss of benefits, restrictions on travel, restrictions on accessing certain businesses and services and denial of entry to government positions.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
09
 

Bioethicist refuses to comply with vaccine mandate

Aaron Kheriaty 

Not all doctors – or bioethicists -- support vaccine mandates. Internationally, prevalence of Covid-19 vaccine hesitancy in healthcare workers ranges from 4.3 to 72%. The average is 23%. A study in Italy that found that 33% of health workers were unsure or did not intend to vaccinate.

The association for Australian general practitioners (RACGP) issued a position statement strongly backing mandatory vaccination last month. As an example of the scepticism with which some of its members regard the idea, read the comments beneath an article in the RACGP news magazine. One doctor summed up his colleagues’ concerns: “The RACGP all of a sudden flushed down the toilet the cornerstone of all ethical principles AUTONOMY."

One bioethicist feels much the same. At the University of California Irvine, Aaron Kheriaty, a psychiatrist and medical ethicist, has been stood down after refusing to be vaccinated and suing UCI.

He is documenting his case in a Substack blog, Human Flourishing. UCI has banned him from working on campus or working from home.

Kheriaty is not opposed to vaccination. However, he and his family have had Covid and he claims that he has natural immunity. His case is that he is already immune and that vaccination involves a small risk. He writes: “How can I continue to call myself a medical ethicist if I fail to do what I am convinced is morally right under pressure?”

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
09
 

Need a kidney? No deal, unless you’re vaccinated

A Colorado hospital has refused transplant surgery to a woman who is unwilling to have the Covid-19 vaccine. Leilani Lutali, 56, is a born-again Christian of no particular denomination, who believes that the vaccines are morally compromised because foetal cell lines were used in developing some vaccines.

Her hospital, UCHealth, informed her that she would be “inactivated” on a kidney transplant waiting list unless she were vaccinated within 30 days. A spokesman, Dan Weaver, explained that other transplant centres in the United States have adopted similar policies or will soon do so.

According to the Washington Post, “Weaver noted that transplant centres around the country may require patients to get other vaccinations, stop smoking, avoid alcohol or demonstrate that they will take crucial medications in an effort to ensure that people do well post-surgery and do not ‘reject’ organs for which there is fierce competition.”

UCHealth seems to be consistent. Earlier in the week it fired 119 employees who did not have a religious or medical exemption. (It employs 26,500.)

Some other hospitals encourage, but do not require, vaccination.

The lack of consistency frustrates Dr Kapilkumar Patel, director of the lung transplant program at Tampa General Hospital in Florida, where Covid vaccinations aren't required. "We mandate hepatitis and influenza vaccines, and nobody has an issue with that," he told NBCNews. "And now we have this one vaccination that can save lives and make an impact on the post-transplant recovery phase. And we have this huge uproar from the public."

Transplant patients are a special sub-category. A number of studies indicate that Covid-19 is particularly lethal for kidney recipients. Weaver told the Post that their mortality rate ranges from about 20% to more than 30% — far higher than the 1.6% rate for the US as a whole.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
09
 

Antiquated Belmont principles must be scrapped, say bioethicists

Three generations of Havasupai members demonstrate against uranium mining

In order to cater for the needs of American Indian and Alaska Native (AI/AN) communities, the principles of autonomy, beneficence, non-maleficence and justice should be scrapped, according to an editorial in the American Journal of Bioethics.

These principles were created for Western-oriented people without a strong sense of community. But AI/AN people are much more oriented toward communitarian decision-making and the autonomy-based Belmont principles are proving inadequate.

An example to which bioethical observers return again and again is the abuse of blood samples belonging to the Havasupai tribe, in Arizona, by researchers from Arizona State University in 1990. The subjects of the research thought that they were giving bloods for diabetes research, but the scientists used them to study schizophrenia. (The facts of this story are, by the way, disputed.)

While the lack of attention paid to tribal sovereignty or the oppression of indigenous persons in the Belmont Report may not be surprising given its historical context, it is the document’s focus on Western moral traditions and commitments to the preservation of individual rights that is perhaps most at odds with indigenous perspectives on biomedical research. By affirming the importance of scientific knowledge and individual choice, the Belmont Report implicitly rejects non-Western moral traditions that celebrate communitarian values tied to solidarity, fraternity, and community benefit

“Scrapped” is the right word. According to the editorial, “It is only through an entirely new approach that the residue of Western moral traditions and scientific epistemologies can be washed from the bioethical guidance and regulations that currently shape researcher engagement with tribal communities.”

What will emerge is unknown – but the authors hope that “a more useful and culturally appropriate set of ethical guidelines regarding the conduct of biomedical research involving AI/AN communities can be developed.”

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
09
 

Covid religious exemptions in the US are a tangled mess

Rev Jackson Lahmeyer at Sheridan Church

Many Americans who refuse to be vaccinated request an exemption because of their religious beliefs. A blog post in The Hastings Center Report throws cold water on their claims.

Bernard Prusak, a philosopher at Kings College, in Wilkes-Barr, Pennsylvania, points out that “This latest conscience war within our culture wars presents a minefield of legal and philosophical complexities for states and health care systems that want to take a hard line against religious exemptions, whether by excluding them altogether or by scrutinizing requests for them closely.”

Here is an only-in-America example of what he has in mind. In Tulsa, Oklahoma, an evangelical minister, Jackson Lahmeyer, displays a “religious exemption” form on his church’s website. (He is also running for the US Senate as a Republican.) Anyone can download the form after liking the church’s Facebook page and making a donation (of any size). Lahmeyer told AP that more than 35,000 people downloaded the form in three days.

Prusak questions whether religious exemptions even deserve to exist:

There are now so many religions in nations like the United States that it is increasingly hard to say what counts as religion. In addition, there are so many people professing no religion that it appears unfair for the law to accommodate religious beliefs in particular. Egalitarians may seek to solve this problem in two ways: either by denying that religious citizens should enjoy exemptions from generally applicable laws, or by denying that exemptions should be exclusive to religious citizens.

“Sincerity”, he argues, is fundamental to the argument – although by sincerity, he seems to mean complete consistency. The religious beliefs of refuseniks cannot be a shield for “an unsubstantiated health concern or ideological commitment” but must be consistent with their other choices.

This is the tack taken by the Conway Regional Health System in Arkansas. It requires employees who want a religious exemption to "truthfully acknowledge and affirm that my sincerely held religious belief is consistent and true and I do not use or will use any of the medications listed as examples or any other medication … that has used fetal cell lines in their development and/or testing." It lists 30 medications, including Benadryl, Sudafed and Tylenol.

Michael Cook is editor of BioEdge    



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

‘The Lancet’ enters the transgender word wars

The word “bizarre” is becoming increasingly shop-worn in articles about the transgender movement, but it’s difficult to find a more accurate and less offensive synonym. The latest incident concerns the hitherto inoffensive word “woman”.

This week the American Civil Liberties Union was pinged for censoring texts from the late Supreme Court Justice and feminist icon Ruth Ginsberg. In tweeting snippets from some of her writing, the ACLU substituted the word “women” with the gender-neutral word “people”. There was an outcry and the ACLU vowed never to do it again.

More creative substitutions under the banner of trans-inclusive language have included “individuals with a cervix”, “people who menstruate”, “menstruators”, “birthing parents”, “pregnant people”, or “gestational parents”.

The most significant was a single sentence on the September 25 cover of The Lancet, one of the world’s leading medical journals: “Historically, the anatomy and physiology of bodies with vaginas have been neglected.”

Is that all women are, many people asked -- “bodies with vaginas”?

The editor, Richard Horton, was forced to issue a less than heartfelt apology for conveying “the impression that we have dehumanised and marginalised women”. He explained:

At the same time, I want to emphasise that transgender health is an important dimension of modern health care, but one that remains neglected. Trans people regularly face stigma, discrimination, exclusion, and poor health, often experiencing difficulties accessing appropriate health care. The exhibition review from which The Lancet cover quote was taken is a compelling call to empower women, together with non-binary, trans, and intersex people who have experienced menstruation, and to address the myths and taboos that surround menstruation.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

‘Science’ apologises for complicity in spreading the philosophy of eugenics

The logo of the Second International Eugenics Congress

This year marks the centenary of the Second International Eugenics Congress in 1921, an event supported by the best and brightest of American scientists of the early 20th Century. The opening address was given by Henry Osborne, the president of the American Museum of Natural History for 25 years. He declared that the terrible losses of the First World War made eugenics all the more necessary. “In certain parts of Europe the worst elements of society have gained ascendancy and threaten the destruction of the best.”

The Congress was an endorsement of eugenic policies such as forced sterilisation.

One hundred years later, the journal Science has acknowledged that it and its publisher, the American Association for the Advancement of Science (AAAS): “played a shameful and notable role in the scientific acceptance of eugenics in the United States and the world”.

It is clear that AAAS, Science, and many in the scientific community supported the biggest proponents of eugenics in the early 20th century, when the ideology started gaining wider traction. We must never forget that the unwavering march toward scientific progress is sometimes built on a problematic past. Unless we understand the depths of these problems, we will continue building on rotting foundations.

In another article, a contributor to Science points out that there are abundant opportunities for a new kind of eugenics to take hold:

With modern genetic techniques, including precision gene editing, we are inventing unprecedented possibilities for control of human biology, and society should proceed with a clear understanding not just of the limitations of this science, but of its grim history. Today, we hear frequent discussions about ideas such as embryo selection—not just to reduce disease risk but to enhance traits—and indeed, companies are emerging in the US with this as a potential service offered by their future businesses. Before embracing such technologies, it’s critical to remember that these techniques are both scientifically dubious and share an ancestry with the racist history of eugenics.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

UK court upholds legality of aborting Down Syndrome babies

A woman with Down syndrome lost a court challenge against the UK government last week contesting the legality of abortion up until birth of a foetus with her condition.

Heidi Crowter, 26, and two others sued the Department of Health and Social, arguing that part of the Abortion Act is discriminatory and violates the European Convention on Human Rights.

Abortions in England, Wales and Scotland are permitted up till 24 weeks of pregnancy. But if there is “a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped”, abortions can be performed until birth.

Crowter lives independently and was recently married. She described the law as “offensive” and disrespectful.

Inspiring speech from Heidi Crowter outside the High Court today ????⚖️ pic.twitter.com/1bSLFzYojq

— Don't Screen Us Out (@dontscreenusout) September 23, 2021

Judges Rajinder Singh and Nathalie Lieven said that the case raised emotional issues but declared that it did not violate international human rights law.

"The fundamental difficulty … is that the European Court has never decided that a foetus, even one post-viability, is the bearer of Convention rights," concluded the High Court. "The fact that both domestic legislation and courts, and the European Court itself, have recognised that there may be circumstances in which the foetus has interests which the State is entitled to protect does not lead to the proposition that it enjoys rights under Article 2."

“The evidence is also clear that, although scientific developments have improved and earlier identification may be feasible, there are still conditions which will only be identified late in a pregnancy, after 24 weeks,” the judges added.

In an article in the London tabloid Metro, Heidi Crowther wrote:

I don’t see why some people think there’s anything wrong with having an extra chromosome! I went to mainstream schools, got some qualifications and then went on to a hairdressing college where I gained an NVQ. I worked part time in a hairdressers which I loved, until Covid-19 came along and the salon had to shut.

When mum told me about the discrimination against babies like me in the womb, I felt like a knife had been put into my heart. It made me feel less valued than other people.

Michael Cook is editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

An even darker side to fertility fraud in the 60s and 70s

Dispatches from the Reproductive Revolution. Fertility fraud is becoming a ho-hum story, but just for the record, a woman in Louisville, Kentucky, discovered recently that her mother’s gynaecologist, Dr Marvin Yussman. used his own sperm when she requested artificial insemination back in 1975. Using online genealogy sites, Erin Crowder has discovered that she has at least seven half-siblings. Her mother, Susan Crowder, 73, called Yussman’s conduct “unconscionable and depraved”.

Dr Yussman, now retired, has admitted to using his own sperm to inseminate patients "about a half a dozen times."

Dr Jody Madeira, an expert in fertility fraud at Indiana University, says that this is highly unethical. "He inserts himself into your family tree, he inserts his semen into your body -- so it’s not just a physical violation, it’s a genetic violation."

The Yussman case is a typical instance of fertility fraud. But an exposé in The Guardian suggests that some doctors had even more perverse and callous practices. Some doctors not only deceived women, but also men. Journalist Jenny Kleeman uncovered several instances in which men gave sperm samples for fertility testing which unscrupulous doctors in the 60s and 70s secretly used for some of their patients. In other words, their sperm was stolen.

“Clinics would say or do anything to get the business,” observes one man who has become an amateur sperm donor detective. “They thought whatever they said was probably never going to get back to them.”

The stories of their offspring are heart-rending. A search for a sperm donor father online shows that an elderly man is almost certainly the father. When he is finally contacted, he denies – truthfully -- that he ever donated sperm.

One woman commented: “I actually don’t really consider myself as donor conceived any more. My husband calls it ‘donor conthieved’. It just feels as if I’m in a different category. And there must be a lot of other people in this category.”

As a footnote, Kleeman interviewed Michael Beeney, a medical student who donated regularly at the Harley Street clinic of Dr Reynold H. Boyd.

“Beeney is likely to have fathered hundreds of children, but has never put his DNA on any database so they can find him. ‘It could cause all sorts of emotional issues,’ he says. ‘At the time, I don’t think any of us gave it a thought. The prime purpose was getting money.’”

Hundreds of children? Dr Beeney, now retired, has written a steamy novel, Children of Eden, which draws upon his experience as donor and doctor. “Those involved in the unregulated infertility business of the 70s—donors, patients and offspring alike—may need to re-evaluate the consequences of the part they played after reading this story,” says the publication blurb.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

Mexico’s Supreme Court dismantles conscientious objection

Mexico's Supreme Court of Justice building

The Supreme Court of Mexico is dismantling the right of doctors to conscientious objection, after its recent decision that the states must decriminalise abortion.

In its decision on September 20, eight members of the 11-member court declared that the exercise of women’s reproductive rights must not be thwarted by doctors who appeal to their consciences. Somewhat confusingly, it also asserted that conscientious objection was a constitutional right.

The president of the Supreme Court, Arturo Saldivar, explained in El Pais that “We cannot issue a blank cheque that denies health services, particularly the right to abortion.”

"Conservative and religious groups are pressuring this Court to recognise the right of unlimited conscientious objection because they know that this is the end of the right of women to have a dignified abortion,” Zaldívar said. “I find it unacceptable to recognise a right that women have struggled to win, and then allow its exercise to become bogged down in the hands of conscientious objectors and political groups."

Pro-life groups have called for public protests.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

Embryos in Amsterdam clinic possibly infected by bacteria

Photo by CDC on Unsplash

IVF treatment has unsuspected dangers. A clinic in Amsterdam placed embryos which may have been infected with a bacterium which can cause meningitis in the wombs of 16 women.

The bacterium, Sphingomonas koreensis, was discovered in checks of the Petri dishes where the embryos are placed at the VU University teaching hospital. All IVF treatment has been halted until the clinic identifies the source of the infection.

Normally the bacterium is not dangerous, even to embryos, according to a spokesman for the clinic. “We have reported this more as a precaution than because we are concerned something could go wrong,” embryologist Sebastiaan Mastenbroek told broadcaster NOS.

Marjolein Grömminger, from the infertility support group Freya said the news is “terrible for all the women involved and their partners”.

Michael Cook is editor of BioEdge    



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
October
03
 

Illegal euthanasia of infants continues in Belgium

Photo by Charles Deluvio on Unsplash

It is well-known that eligibility for euthanasia in Belgium is elastic. However, there are limits. The law only permits the euthanasia of minors who are capable of discernment and who are conscious.

But, according to a recent brief report in the Archives of Disease in Childhood Fetal and Neonatal edition, Flemish doctors euthanise 10% of newborns for whom there is "no hope of a bearable future".

This statistic is taken from a study based on 24 babies who died in Flanders between September 2016 and December 2017. The numbers are small, admittedly, but the proportion of new-borns who died after a deliberate injection of a lethal drug seems to have increased from 7% to 10% since a survey conducted in 1999-2000 (before any euthanasia was legal). An article in the European Institute of Bioethics observes that “the term euthanasia does not appear anywhere in the article”. It goes on to say:

Doctors who euthanized new-borns with lethal injection indicated in 91% of the cases that the main reason for their action was that there was no hope of a "bearable future" for the child. In other words, these children had a real chance of survival, but the medical team -- no doubt in agreement with their parents -- considered that their lives were not worth living to the end.

Why do practitioners deviate from the legal framework when it comes to children who are unable to express themselves?

The authors suggest that Belgium needs a Groningen Protocol (the Dutch model for treating critically ill newborns), as the Dutch percentage of euthanasia deaths is much lower. However, they point out that while official monitoring of the practice could be helpful, “it could limit neonatologists in making decisions they think are justified and in the best interest of the child”. In other words, doctors would feel more comfortable without oversight.

Using the same data, the same Belgian researchers also reported the incidence of continuous deep sedation until death amongst critically ill newborns in the journal Neonatology. In nearly 2 out of 5 deceased newborns and infants, death was preceded by CDS. In 92% of the cases, the doctors continued to provide nutrition and hydration – which seldom happens in CDS for adults. As in the cases of euthanasia by lethal injection, there was an explicit intention to hasten death in 11% of cases.

The ethics and legality of CDS for infants is very fraught. There are no guidelines at all, the authors point out. H/T to Alex Schadenberg.

Michael Cook is editor of BioEdge     



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

Another Australian state legalizes ‘assisted dying’

Banana-benders back 'assisted dying' 

Another Australian state, Queensland, legalised assisted dying this week. The bill passed in the unicameral parliament by an impressive margin -- 61 to 30 -- on Thursday afternoon.

Although 55 separate amendments were proposed, all of them were rejected and the legislation passed as drafted by the state’s independent law reform commission. The law will be operation from January 2023.

The premier, Annastacia Palaszczuk, was a strong supporter of the bill. “Dignity is a word that I hold dear,” she said. “There is dignity in work. There is dignity in the family and friends that surround you. And there should be dignity in death.”

Now five out of Australia’s six states have lawful assisted suicide and euthanasia: Victoria, Western Australia, Tasmania, South Australia and Queensland. A bill will probably be introduced soon in the parliament of New South Wales. Opposition to assisted dying is strong there, but the momentum is clearly with supporters of “assisted dying”.

Similar legislation in the two federal territories: the Australian Capital Territory, where Canberra, is located, and the Northern Territory will probably pass if the federal parliament repeals a 1997 law which expressly bans them from enacting it.

In fact, the Northern Territory, a vast but sparsely populated area, became the first jurisdiction in the world to legalise euthanasia, in 1995, before the Netherlands. But after a fierce nation-wide debate the federal parliament stepped in and banned it.

Critics of the Queensland legislation have identified at least three serious flaws. First, health practitioners are permitted to initiate a discussion of “assisted dying” with patients. Second, doctors who have a conscientious objection to “assisted dying” are obliged to refer to a compliant doctor. And third, healthcare facilities must permit “assisted dying” on their premises, even if it violates their “institutional conscience”.

Michael Cook is the editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

British Medical Association goes neutral on ‘assisted dying’

The British Medical Association, the lead group for doctors in the United Kingdom, no longer opposes euthanasia and assisted suicide. After a vote at its annual representative meeting on Tuesday, the BMA altered its official stance from opposition to “neutrality”.

The vote was close, with 149 for, 145 against, and 8 abstentions. It followed a survey of BMA members last year; of the 30,000 doctors who responded, 40 percent supported a change in the current law, 33 percent favoured opposition, and 21 percent backed neutrality.

Sarah Wootton, of Dignity in Dying, Britain’s lead lobby group for assisted dying, was exultant. She commented: “This is an historic decision and a victory for common-sense.

A position of neutrality signals that British doctors will not oppose legislation when the House of Lords begins a debate on October 22 on a bill to be introduced by the chair of Dignity in Dying, Baroness Meacher.

As one doctor, Gillian Wright, said in the BMA debate: “neutrality means tacit approval and has enormous political significance.”

Michael Cook is the editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

Medical students moonlighting as sex workers need support not judgement, says BMA

Another resolution was carried at the same BMA annual conference: that medical students moonlighting as sex workers should be shielded from censure by universities and professional bodies.

The BMA, the delegates declared, must work with medical schools to develop specialised support services for student sex workers. They deserve an “environment free from judgment” and completely confidential.

The head of the BMA Medical Students Committee, Becky Bates, proposed the motion. She explained that: “The high cost of studying medicine and unacceptably low levels of financial support in the UK are a major part of why these medical students feel forced to choose this type of high risk work.”

This is a concern which emerges from time to time in the media. In 2012 the editor of the Student BMJ wrote that one in ten trainee doctors claims to know another student who has resorted to prostitution because of increased living costs and rising tuition fees.

Last month, ahead of the vote, Laura Watson, of the English Collective of Prostitutes, told the Daily Mail that the number of students contacting them for support had risen by a third over the last 12 months. “This is undoubtedly related to the costs of medical school, but also speaks to the scarcity of part-time jobs that students might, in the past, have used to supplement their income,” she said.

Michael Cook is the editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

China cracks down on cosmetic surgery to stop ‘appearance anxiety’

Global Times 

The Chinese government has been cracking down on conspicuous consumption and tall poppies in recent months. Billionaires have disappeared; movie stars have become unpersons; at least one scientist, He Jiankui, has been jailed.

The latest target is China’s huge cosmetic surgery industry.

The official People’s Daily declared this week that it was “imperative and urgent” to regulate advertising. “From posters at bus stops and in subways, to introductions on social websites and content platforms, from advertisements planted in films and television variety shows to promotions by live-streamers, medical beauty advertisements are overwhelmingly pervasive,” it said.

Some advertisements associate good looks with “high quality”, “diligence” and “success”, fabricating stories about “plastic surgery changing one’s destiny” and distorting aesthetic perceptions.

The market for plastic surgery in China could reach US$46 billion by 2022 and $201 billion by 2030, according to a report by the Chinese Association of Plastics and Aesthetics.

Deng Liqiang, director of the China Health Law Society and an expert in plastic surgery, told the Global Times this week that the boom in the beauty care industry is due to the crass exploitation of "appearance anxiety".

"The young trend in the cosmetic surgery field will continue distorting the values of younger generations if the authorities do not conduct a strict crackdown," he declared.

Michael Cook is the editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

Appeals court overturns landmark gender ruling in UK

Keira Bell 

A landmark British case about transgender treatment for under-16s has been overturned. The Tavistock Trust, which runs the UK’s only gender identity development service (GIDS) has won an appeal against a 2020 High Court ruling.

Doctors can now judge for themselves whether children under 16 can give informed consent to puberty blockers, without seeking permission from a judge.

The decision from the Court of Appeal reverses the High Court’s decision that under-16s lacked capacity to give informed consent to puberty blockers.

The judges acknowledged "the difficulties and complexities" of the issue, but they said that "it is for the clinicians to exercise their judgement knowing how important it is that consent is properly obtained according to the particular individual circumstances".

A spokesperson for the Tavistock told the media: “The judgment upholds established legal principles which respect the ability of our clinicians to engage actively and thoughtfully with our patients in decisions about their care and futures. It affirms that it is for doctors, not judges, to decide on the capacity of under-16s to consent to medical treatment.

Keira Bell, a young woman who embarked upon transitioning to a male at the age of 16, was the human face of the case against Tavistock gender clinic. She says that she is very disappointed by the decision and will seek leave to appeal to the supreme court, “A global conversation has begun and has been shaped by this case,” she said. “There is more to be done. It is a fantasy and deeply concerning that any doctor could believe a 10-year-old could consent to the loss of their fertility.”

Michael Cook is the editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

Another case of fertility fraud in the US

Oops, not again. Another American gynaecologist using his own sperm to impregnate his patients? Yup, sorry. Dr Morris Wortman, of Rochester, New York, is being sued by the 35-year-old daughter of a woman who was treated in the 1980s.

According to the Washington Post, 35-year-old Morgan Hellquist knew that her biological father had been a sperm donor. She began checking on-line genealogical records and found that she had at least nine half-siblings.

A lawsuit filed this week alleges that the doctor falsely told Ms Hellquist’s mother that the sperm came from a medical student. It accuses the doctor of medical malpractice, lack of informed consent, battery, fraud, negligence and infliction of emotional distress.

Worse, to Ms Hellquist’s dismay, she discovered all this after she had been the doctor’s patient for several years. Hellquist “was in shock and disbelief that he would continue [to] treat her as her gynecologist if she were his biological daughter,” the lawsuit states.

“An interesting dichotomy is feeling gratitude for your existence and knowing at the same time that you are the product of something that should have never happened,” a 36-year-old man whose father is also allegedly Dr Wortman told AP.

“It became a tougher pill to swallow,” he said. “On one hand you’re grateful for your existence and the people you’re sharing the experience with. On the other, I don’t know how you forgive the violation of confidence and trust that a woman puts into her physician in the most intimate of settings.”

Michael Cook is the editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

Is fear of burdening the planet driving a rise in vasectomies?

Vasectomies for childless Australian men in their 20s and 30s are rising steeply, according to doctors interviewed by The Australian. One Sydney doctor who specialises in vasectomies says that between one-half and one-third of his patients are childless. He has started requiring counselling for men under 30 to make sure that they fully understand the implications of the procedure.

Many of the men, says Dr Justin Low, are worried about harming the environment by fathering children.

“Then there are the ones who say to me: ‘I just don’t want to bring children into a world like this,’ … It’s about sustainability for them, it’s about climate change and the future of the planet, and if anything, Covid-19 and the pandemic has only reinforced that feeling, that dread, and we’ve had more and more guys coming in talking about that.

“I’ve also had people get very fired up about sustainability issues. They’ll say to me, ‘But doctor, surely you know, surely you’ve read the studies! The single best thing you can do for the planet is not to have a child.’ I mean, we’ve all been influenced by our times, so I can understand that thinking – but still. That’s what’s so shocking, these are people who don’t say, ‘I just don’t want kids’, they’re people who, at a different time in history, in another era, they might have wanted them.”

Kain Harris, from Canberra, told The Australian that he had a vasectomy at 36. He explained:

“It is incredible to me that, even now, this year, in the middle of a global pandemic, people still want to have kids – talk about different priorities,” Harris says. “There is this sense of existential dread at the moment, you look at the future that’s coming and you just think, what are the next generation going to be left with? There are going to be limitations on how we live, there are going to be struggles, and why put another life through that unnecessarily?”

Michael Cook is the editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
18
 

UPitt hires independent investigator to review its foetal research program

For months the University of Pittsburgh has been under pressure from pro-life groups over its foetal tissue research programs. There have been allegations that UPitt scientists have harvested the kidneys of unborn babies while their hearts were still beating.

The University has heatedly denied any wrong-doing. “As we have repeatedly noted, the University of Pittsburgh does not perform medical procedures and is not part of the tissue collection process,” David Seldin, Pitt’s vice chancellor for news, told Fox News in August. “All of the University’s research is closely supervised to ensure compliance with strict and rigorous federal and state laws and regulations.”

Earlier this month the University took the unusual step of hiring an outside investigator to prove that its research practices are within the bounds of the law. It has retained a respected Washington DC law firm, Hyman Phelps & McNamara.

“Fetal tissue research is subject to robust internal controls at Pitt and highly regulated at the state and federal level,” said a statement from the UPitt. “The University routinely conducts reviews to ensure that its research activities — across all areas of research — comply with internal policies as well as all relevant federal and state laws.”

The foetal tissue research has become a lightning rod for political controversy. According to the Pittsburgh Post-Gazette, a Republican state legislator declared that he didn’t want to spend taxpayer money on a university that commits “deplorable, grotesque and morally offensive” atrocities in the name of research to aborted babies. His reaction typified the allegations made against the University.

“Faced with a relentless barrage of baseless attacks, the University of Pittsburgh is fighting bad faith lies with openness and honesty,” said Dan Frankel, the state governor’s representative on the UPitt board. “I have total confidence that the school will show itself to be what it always has been: a champion for science and research.”

Michael Cook is the editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

Hundreds of medical journals call for climate change policies to protect health

More than 230 medical journals have put climate change at the top of the world’s health agenda as the November COP26 climate conference in Glasgow approaches. They have published the biggest joint editorial in history to warn everyone that the greatest threat to public health is failure to keep the global temperature rise below 1.5°C. The signatories include The BMJ, the NEJM, The Lancet and numerous other top journals (with the notable exception of JAMA).

The terms of the editorial are apocalyptic: “The science is unequivocal; a global increase of 1.5°C above the pre-industrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.”

“Indeed,” they write, “no temperature rise is ‘safe’.”

The role of governments is fundamental, they say. “Governments must make fundamental changes to how our societies and economies are organised and how we live.” Everything has to change: “transport systems, cities, production and distribution of food, markets for financial investments, health systems, and much more”.

And it is going to be very expensive. “Many governments met the threat of the covid-19 pandemic with unprecedented funding. The environmental crisis demands a similar emergency response. Huge investment will be needed, beyond what is being considered or delivered anywhere in the world.”

Missing from the editorial are the nuts and bolts of how global temperatures will impact on health – or simply some guesstimates of how many people will die if the temperature rises 1.5°C.

Climate gadfly Bjorn Lomborg is sceptical of the claims in the letter. He points out that the number of climate-change related deaths has plummeted since 1920:

Over the past hundred years, annual climate-related deaths have declined by more than 96%. In the 1920s, the death count from climate-related disasters was 485,000 on average every year. In the last full decade, 2010-2019, the average was 18,362 dead per year, or 96.2% lower.

He concludes that “we are now much less vulnerable to climate impacts than at any time in the last 100 years. It is possible that climate change has made impacts worse over the last century … but resiliency from higher living standards has entirely swamped any potential climate impact.”

Chances are, this letter will have no impact whatsoever on climate change policy. But it might make people sicker. Experts recently warned of “an impending epidemic of mental health related disorders such as eco-anxiety, climate disaster-related post-traumatic stress disorder (PTSD), and future-orientated despair.” Nothing makes people suffering from eco-anxiety more anxious than eco-doctors predicting an apocalypse.

Michael Cook is editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

Biden mandates vaccination of 100 million American workers

US President Joe Biden is mandating the vaccination of 100 American million workers. In a forceful speech on Thursday, he said that all companies with more than 100 workers need to have vaccination or weekly testing. He has mandated vaccination for health care workers, federal contractors and the vast majority of federal workers, who could face disciplinary measures if they refuse.

He said that he was deeply upset by the reluctance of millions of people to get vaccinated. About 80 million people are eligible but still have not received a jab.

Mr. Biden also moved to mandate shots for health care workers, federal contractors and the vast majority of federal workers, who could face disciplinary measures if they refuse.

“We’ve been patient,” Mr. Biden said in a cranky message to those who refuse to be vaccinated. “But our patience is wearing thin. And your refusal has cost all of us.”

“In a country as large as ours, that’s 25 percent minority. That 25 percent can cause a lot of damage, and they are. The unvaccinated overcrowd our hospitals or overrun the emergency rooms and intensive care units, leaving no room for someone with a heart attack or pancreatitis or cancer.”

A number of people have excused themselves by saying that they were waiting until a vaccine was fully approved by the FDA. But late in August the FDA gave full approved to the Pfizer-BioNTech’s coronavirus vaccine for people 16 and older. “So, the time for waiting is over,” the President said sternly.

“If you break the rules, be prepared to pay — and by the way, show some respect,” Mr. Biden said, referring to airline passengers who refuse to mask up. “The anger you see on television toward flight attendants and others doing their jobs is wrong. It’s ugly.”

Biden’s mandate is being introduced in an extremely polarised environment. Several Republican governors have blocked attempts to mandate masks, close schools, or require vaccines. The President is setting the stage for a tough political fight. “If they will not help,” he said, “if those governors won’t help us beat the pandemic, I’ll use my power as president to get them out of the way.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

What do we owe victims of dementia or brain injury?

Jean-Pierre Adams and his wife Bernadette / Affrik.com

Dementia is on track to becoming a growth area in bioethics. How should we treat someone who is no longer in touch with reality, cannot recognise even his loved ones, and is no longer a productive citizen?

While we await a definitive tome on the subject, the resident ethicist of the New York Times Magazine, Kwame Anthony Appiah, has stepped into the gap. He is a distinguished figure, not a mere “Dear Abby” stand-in -- a British-Ghanaian post-modern philosopher, cultural theorist, media star, and novelist, who has taught at Princeton and New York University.

Last weekend a reader sought guidance about her mother’s love life. Her stepdad has early-onset Alzheimer’s. Her mother was a full-time carer until a few months ago, when her husband was moved into a nursing home.

Suddenly single and lonely, her mother started dating a man in his 70s who is, according to “name withheld”, a sleazy character with no money and a string of divorces. “My mother seems hellbent on dating this man and is not receptive to hearing our concerns.” What should she do?

Like a good philosopher, Professor Appiah first of all distinguishes. There are two ethical issues: (a) should she date this man and (b) should she date anyone at all. As for the former, it’s a matter of taste and prudence. As for the latter, his advice is unconventional.

We talk of marital commitments as running “until death do us part.” We also know that many marriages end in divorce. Having a living, divorced spouse who no longer recognizes you falls into neither category. Your stepfather did not break his vows or re-evaluate them. Nonetheless, he has effectively left the relationship — been removed from the relationship — in a permanent and irretrievable way. Your stepfather’s advanced dementia has, in short, robbed your mother of her husband …

But we should not want our spouses to abjure the companionship of others once we are no longer available to them. Indeed, nobody in your family has the right to expect this of her. The painful truth is that her status is ethically equivalent to that of a widow.

Hmmm. The idea that a person with Alzheimer’s is, for all intents and purposes, no longer a person brings with it many consequences, not only social, but also legal and moral. It probably needs to be considered a bit more deeply.

A recent counter-example comes from France, where a former player on the French national soccer team passed away on September 6 at the age of 73. Jean-Pierre Adams was born in Senegal, migrated to France, played for Nimes, Nice and Paris St-Germain and represented his new country 22 times.

He married a French national, Bernadette, and had two sons. In 1982 a routine operation on his knee went wrong. Under an inexperienced trainee and an over-worked anaesthetist during a strike of doctors and nurses, his brain was starved of oxygen. He never woke up and spent the next 39 years in a vegetative state. His wife cared for him loyally all those years – changing his clothes, preparing his food, exercising him and conversing with him. She believed that he was dimly aware of the people around him.

Euthanasia? “Unthinkable!” Bernadette told a journalist in 2012, “And it's not for me to decide for him. I'm not going to deprive him of eating anyway ... At first, when he was in a coma, it was my fear every time I went to the hospital, I was afraid that I would be asked if I wanted to unplug it.”

After his death, he was honoured with a minute's applause before a World Cup qualifier between France and Finland. His wife deserves at least that and more. To date, their story has not appeared in the New York Times.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

Biden begins his ‘all of government’ response to restrictive Texas abortion law

Attorney-General Merrick Garland  /  Global News screenshot   

Last week US President Joe Biden promised an “all-of-government” response to aa new Texas law which effectively bans abortion after 6 weeks.

This week his plans became a bit clearer. On Thursday, the Justice Department announced that it would launch a lawsuit to declare the abortion ban unconstitutional and issue an injunction which would block its enforcement. At a news conference, Attorney-General Merrick Garland declared the ban “is clearly unconstitutional under long-standing Supreme Court precedent.”

“This kind of scheme to nullify the Constitution of the United States is one that all Americans, whatever their politics or party, should fear,” the Attorney-General said. He warned that the law’s “bounty hunter” feature could become “a model for action in other areas by other states and with respect to other constitutional rights or judicial precedents.” The federal government has a responsibility “to ensure that no state can deprive individuals of their constitutional rights.”

A spokeswoman for Texas Governor Greg Abbott defended the law and accused the Biden administration of acting for political reasons — to distract Americans from the Afghanistan debacle and illegal migration from Mexico. “We are confident that the courts will uphold and protect that right to life,” press secretary Renae Eze said in a statement.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

Mexican Supreme Court declares that anti-abortion laws are unconstitutional

Screenshot / Al Jazeera 

Mexico's Supreme Court has ruled that criminal penalties for abortions are unconstitutional. Its ruling applies, for the moment, only to the northern state of Coahuila but it could be applied to all other states as well. The ruling was unanimous.

“From now in deciding all future cases they (the judges) will have to keep in mind that all State laws that criminalize abortion in a complete way are unconstitutional, including those that do not allow abortion in the earlier stages of pregnancy,” according to a press release from the Supreme Court. The ruling also applied to transmen:

The Supreme Court understood that the product of pregnancy deserves protection that increases over time, as the pregnancy progresses. However, it specified that this protection cannot ignore the rights of women and pregnant persons to reproductive freedom.

Ironically, Coahuila shares a border with Texas, where abortion is after about 6 weeks was recently banned. Some critics of the Texas law predict that American women will be crossing the border for abortions.

According to the BBC, “The decision to decriminalise abortion in what is Latin America's second largest Catholic nation might appear surprising. However, the debate in Mexico has been gradually moving towards removing the illegality for some time.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

What turns ordinary people into torturers?

Article 5 of the United Nations’ Universal Declaration of Human Rights states: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” Nonetheless, governments still torture people in police stations and prisons. How do the torturers feel about it?

Since torture has such bad press, torturers are normally reluctant to talk about their profession. But researchers at De Paul University, in Chicago, who are creating an oral history of Iraq, have interviewed 14 men who were employed as torturers under Iraqi dictator Saddam Hussein.

Other research has suggested that torturers were forced to do their grisly work. But the De Paul academics found that their subjects volunteered and sometimes even paid bribes to get a secure job as a security officer. They were psychologically normal. When they discovered that they would be employed as torturers, they were shocked, but they needed the job.

They were trained by experienced torturers in how to inflict pain and extract confessions. They were told to repress feelings of compassion. One said that he was told was told “never to show any mercy to those who would want to harm the country or the President Saddam Hussein, who was like the father of our house.”

They were told about the prisoners that “Their sins are huge and cannot be forgiven! Their sins are that they want to topple the regime, disturbing our government and dispersing chaos, terrorism, looting and killing. Don’t you ever believe that any one of those is a victim! We are the victims of them.”

Two of the men refused and were themselves tortured until they agreed to return to work.

There has been relatively little research done in this dark area of human experience. The De Paul researchers backgrounded themselves with information from American soldiers who tortured Filipinos in the war of 1899 to 1902, Greek soldiers under the military junta of 1967 to 1974, Chilean soldiers under Pinochet, Brazilians during the 1964–1985 period of military rule in Brazil, and American soldiers at Abu Ghraib.

The De Paul researchers basically found that torturers are made, not born. Many of the Iraqi men regretted their involvement. They trusted that God would forgive their sins, but one had given up that hope, saying, “I know that God will never forgive me for all the ugly crimes that I had committed toward all those innocent people, and so I really deserve all I am suffering now.”

As a footnote, the Amna Suraya museum in in the Iraqi city of Sulaymaniyah, in the Kurdistan Region, has become a major tourist attraction. It was once the northern headquarters of the Mukhabarat, Iraq's intelligence agency, and a venue for the torture. It is, according to an article in Vice magazine, “the world’s most depressing museum”, with life-size mannequins of torturers at work.

Michael Cook is editor of BioEdge    



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

Danish ethicist opposes euthanasia in BMJ

A former chair of the Danish Council of Ethics has published a broadside on legalised euthanasia in The BMJ. Ole Hartling, a doctor, author and co-author of several books, was a member of the Council between 2000 and 2007 and its chair for five years. During that time, the Council carried on extensive debates on end-of-life issues. In 2006 the Council “disrecommended” euthanasia.

His focus in The BMJ is on the illusion of autonomy. Euthanasia is often described as the ultimate expression of autonomy but Hartling is deeply sceptical. He recently published a book (in English) on the topic: Euthanasia and the Ethics of a Doctor’s Decisions: An Argument Against Assisted Dying, published by Bloomsbury. He stresses in this book that he does not rely upon “sanctity of life” arguments. “These lines of thought are metaphysical and easily become dogmatic and hence unconvincing,” he writes. His arguments are secular and aim to  show that legalisation is simply untenable.

In his essay in The BMJ, he writes:

Decisions about your own death are not made in normal day-to-day contexts. The wish to die arises against a backdrop: of desperation, a feeling of hopelessness, possibly a feeling of being superfluous. Otherwise, the wish would not be there. Thus, it is under these circumstances that the right to self-determination is exercised and the decision is made. Such a situation is a fragile basis for autonomy and an even more fragile basis for decision making. The choice regarding your own death is therefore completely different from most other choices usually associated with the concept of autonomy.

The essay is thought-provoking and well-worth reading.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
11
 

‘A pure act of altruism’: organ donation after euthanasia

Organ donation after euthanasia is possible in the Netherlands, Belgium and Canada. However, it still is not a very popular option. It seems to have been performed only 70 times in the Netherlands. Most people prefer to be euthanised at home and by the time their body arrives at hospital, the organs are no longer in a state to be used.

However, several physicians and a bioethicist have published a paper in BMC Medical Ethics recording how they successfully managed to carry combine dying at home and organ donation. The man who was euthanised was the husband of one of the authors of the article.

Logistically, it is a bit tricky. The 63-year-old man, who was suffering from multiple system atrophy, was sedated at home surrounded by his family and then transported to a nearby hospital. There he was euthanised by his family doctor. The transplant specialists waited for the mandated 5 minutes and then extracted the organs. They were able to retrieve both kidneys, the liver and the pancreas.

Legally, the authors acknowledged that the procedure stretched the letter of the law. In the Netherlands, a patient must be suffering hopelessly and unbearably. However, after being sedated, he is no longer suffering. How can he consent to euthanasia? However, everyone involved agreed that the procedure honoured the spirit of the law.

Ethically, the authors ticked off all of the Belmont principles of autonomy, beneficence, non-maleficence, and justice. “From a utilitarian perspective,” they say, “the decision to honour the last wishes of the patient produced the greatest good for many other patients.”

They conclude that “From the patient’s perspective, falling asleep in the intimacy of his own home and with his loved ones present appears to be a good alternative to the medicalisation of organ donation after euthanasia in the hospital.”

 “Organ donation after euthanasia,” they declare, “is a pure act of altruism.”

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Is Roe v Wade at risk after SCOTUS declined to void Texas heartbeat bill?

The US Supreme Court has declined to hear a challenge to a Texas law which bans abortions after a foetal heartbeat is detected. This has effectively closed abortion clinics in Texas, as a heartbeat can be detected at about 6 weeks. Women who want abortions will have to travel to neighbouring states.

For abortion supporters this is Armageddon. Writing in The Guardian, two feminist activists declared: “Since Roe v Wade was decided nearly 50 years ago, abortion opponents have been plotting its demise. Now the end may be near. Feminists need our own plan to advance reproductive freedom. That means preparing for a post-Roe world.”

President Joe Biden denounced the law as “extreme”. He declared that he would launch a "whole-of-government" response to oppose the law.

For abortion foes, it is a sweet victory. "We want to give that little Texan in the womb who has a heartbeat, a chance to see their full potential," said Lieutenant General Dan Patrick. The media reported that politicians in Arkansas, South Dakota and Florida are considering a version of the Texas six-week abortion ban in their states.

But much of the reaction to the ban is hyperbolic. While Roe v Wade, which made abortion a constitutional right in the US in 1973, is clearly under threat, the Supreme Court clearly declared that its decision was made on procedural grounds and did not touch upon constitutional issues.

The problem for pro-abortion groups in Texas is that the new law has been very cleverly drafted. It does not criminalise abortion or abetting an abortion. Instead, it permits private citizens, even non-residents of Texas, to launch a civil suit against abortion clinics. This tactic removes the state government from the complaint and makes it difficult for abortion clinics to create a test case to bring before the Supreme Court. At the same time anyone involved in an abortion is in danger of copping a US$10,000 fine plus substantial legal costs.  

So the pro-life legal victory is a temporary one. Litigation will continue in lower courts. A more substantial case has been brought by the state of Mississippi, which will be probably heard later in December with a decision handed down next year.

In the meantime, lawyers are fretting about the legal fall-out of this unusual tactic.

“I confess that I have very serious reservations about the Texas legislation,” wrote David French, a pro-life pundit at The Dispatch. “The reason why is simple—it represents a clever way to engineer temporary deprivations of constitutional rights.”

Imagine a different scenario. Let’s imagine that a state or city bans the sale of, say, all semiautomatic rifles or handguns. But instead of enforcing the ban directly, it states that citizens can sue any person or corporation who sells a gun and any person or corporation who aids or abets the sale of a gun. Such a provision would be blatantly unconstitutional, but it may take time to resolve the issue—time that could cost a person the ability to defend themselves from deadly violence.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Pete Buttigieg and partner welcome twins

A member of President Joe Biden’s cabinet and his partner have acquired two babies. Pete Buttigieg, a former presidential rival and now Secretary of Transportation, and Chasten Buttigeig welcomed Penelope Rose and Joseph August Buttigieg to their family. They will be one of the world’s highest profile gay-parent households.

First lady Jill Biden shared his tweet and gushed: “Congratulations to you and Chasten! Welcome to parenthood!”

“As parents, they will now shine a national spotlight on LGBTQ families, who often face daunting challenges because of outdated policies that narrowly define what families are,” said Annise Parker, the president of the Victory Institute, a group which gives professional development to aspiring LGBTQ politicians.

Chasten and I are beyond thankful for all the kind wishes since first sharing the news that we’re becoming parents. We are delighted to welcome Penelope Rose and Joseph August Buttigieg to our family. pic.twitter.com/kS89gb11Ax

— Pete Buttigieg (@PeteButtigieg) September 4, 2021

Details of the arrangement are sketchy. Chasten Buttigieg told the Washington Post earlier in the year that they were seeking to adopt a child but had been unsuccessful.

But the couple’s statement did not make it clear that they had actually adopted the children, leaving open the possibility that they had employed a surrogate mother. The fact that the family photo which they posted on social media appears to have been taken in a hospital setting suggests that the mother was a surrogate.

Whether the children are biological twins born to a woman who agreed to an adoption or whether one of the two men is the biological father and the mother a surrogate, the children will have to be legally adopted. So the word “adoption” is correct in either case.

However the babies were acquired, the biological and/or gestational mother has been erased, not just from the glowing publicity radiating from the hospital room, but from the babies’ lives. 

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Biden Administration to launch an ‘Apollo mission’ to defeat future pandemics

The Biden Administration has announced a US$65 billion plan to prepare for the next pandemic. “There is a reasonable likelihood that another serious pandemic that could be worse than COVID-19 will occur soon, possibly even within the next decade. And the next pandemic will very likely be substantially different than COVID-19,” White House science advisor Eric Lander told a press conference.

The funds are to be spend over the next 7 to 10 years on improving vaccines, therapeutics, and diagnostics, creating early warning systems, strengthening public health systems, stockpiling equipment and strengthening supply chains. It will be, said Dr Lander, a new Apollo mission for the nation.

And like those kinds of efforts, it is likely to yield benefits far beyond the initial mission — in this case, advances in human health and providing tools that can help overcome health inequities and ensure equitable access to innovative products for all Americans.

According to a report in Stat, the White House plan also includes measures to ensure that R&D with dangerous biological agents is done safely – “a potential nod to the unproven theory that Covid-19 originated from “gain-of-function” research performed in a Chinese laboratory, a long-running controversy in U.S. and global politics.”

Michael Cook is editor of BioEdge    



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Has Hawaii forgotten that it legalised assisted suicide?

The indefatigable Wesley J. Smith, the bioethics correspondent for the National Review, has noticed a significant policy recommendation in the annual report on assisted suicide to the Hawaii legislature. It passed unnoticed even in local media.

Since legalisation, a total of 59 people has died after taking advantage of the Our Care Our Choice Act: 27 in 2019 and 32 in 2020.

Hawaii reports even less information than Oregon. Nothing about the time to unconsciousness or the time to die. Nothing about the reasons for choosing assisted suicide. Nothing about who was present.

Surprisingly, despite the novelty and transcendental importance of legalised suicide, the report is extremely casual and is sloppily written. A table lists 25 cases of people who died following self-administration with some sketchy information about their age, race, sex, education, and underlying condition. The table is not labelled but presumably relates to the year 2020. However, there were 32 deaths in 2020, not 25. A note says that information from 4 people is missing. But 25 + 4 is 29, not 32. Did the other 3 die of natural causes befor they took the drug? It's not clear. 

The figures can be interpreted differently. Richard Egan, an Australian observer of euthanasia trends, says, "the four people with missing data means that it is unknown whether or not they have died so it should be added to the 32 reported dead to equal 36 out of the 37 for whom prescriptions were written. It is unclear what the status of the 37th person is -- perhaps they know the person is still alive."

The Our Care Our Choice Act was not very prescriptive about how the health department was supposed to monitor deaths under the Act. An “advisory group” is supposed to “provide advice to the department” – but no board meetings were held in 2019 or 2020, according to the annual reports. Who is looking after compliance with the legislation? Is anyone?

Notwithstanding the lack of information and lack of supervision, in both years the Department of Health recommended relaxing the legislation:

In closing, the DOH recommends the following changes to the OCOCA. 1. Waiver of any waiting periods if the attending provider and consulting provider agree that patient death is likely prior to the end of the waiting periods. 2. Given access to health care providers is limited, the DOH recommends authorizing advance practice registered nurses to serve as attending providers for patients seeking medical aid in dying.

Smith’s blistering comment was: “Please understand, dear readers, that when assisted-suicide advocates promise strict guidelines to protect against abuse, they don’t really mean it. The promise’s purpose is to get the law passed, not to be kept … Calling Hawaii’s bureaucrat death-pushers the “Department of Health” is akin to the totalitarian government in 1984 calling its torture and brainwashing department theMinistry of Love’.”

Given the lackadaisical standards of the Hawaii Department of Health, that seems like a fair comment.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

American doctors are fighting ‘compassion fatigue’ as they treat Covid patients

Depending on your point of view, conservative US media identity Candace Owens is either one of the most exasperating people on the planet, or an exhilarating and charming breath of fresh air. Part of her shtick is opposition to vaccines.

For example, she once tweeted to her 2.8 million followers: "If you do not understand that there is something purely evil involved right now in terms of these vaccines you will never understand. It will NEVER enter my arm."

The inevitable happened. The irresistible force collided with the immovable object. Owens needed to get a Covid test and was turned away by a doctor who said in an email that "We cannot support anyone who has proactively worked to make this pandemic worse by spreading misinformation, politicizing and DISCOURAGING the wearing of masks and actively dissuading people from receiving life-saving vaccinations."

Just finished my live on Instagram here: https://t.co/lPjhqVYaGO

As promised— here is the email from the rabid activist declining to give me a test, plus my response to her. She clearly isn’t stable enough to work in health and is a danger to the Aspen community. pic.twitter.com/nV7xMGqVN3

— Candace Owens (@RealCandaceO) September 2, 2021

Nothing could have burnished Ms Owens’s image more than being turned away from a test, especially when she is black and the doctor is white.

However, this is a serious medical ethics issue not just a political dust-up. Some doctors who support vaccination are succumbing to “compassion fatigue”.

In an emotional article in The Atlantic, New York doctor Chavi Karkowsky’s smouldering anger against the anti-vaxx movement erupted in volcanic resentment. “By refusing the most effective intervention, people are risking not only their own life but the lives of many around them. That includes those who cannot get vaccinated—my children among them,” she writes.

“To many medical providers working today, the rejection of lifesaving COVID-19 vaccines feels like a giant ‘Fuck you’ from 29 percent of American adults. We will keep providing the best care possible, but they are making our job much harder.”

She has some support for her anger. Back in July, the head of the CDC said that “this is becoming a pandemic of the unvaccinated.” Dr Karkowsky said that the work of treating sick and unvaccinated Covid patients was making her lose her faith in humanity.

Another angry doctor took a more compassionate line in an opinion piece in Stat. Jay Baruch, who is also a bioethicist, says that doctors need to communicate better with their patients.

“The anger I feel toward vaccine-hesitant people becomes a more complicated emotion when I witness them reckoning with their choices. Many of the unvaccinated people I’ve talked with are hard-working, loving individuals struggling to catch a break in a life that hasn’t been fair. They’re unmoored and don’t know what to believe when truth itself has supply-chain problems and the health care system has been letting them down for years.”

He points out that doctors have always treated patients who appear to be responsible for their illness with the same care.

An article in the blog of The Hastings Center teases out some of the ethical principles that doctors should bear in mind when treating people who have refused to be vaccinated.

First, patients whose lifestyle choices have made them suffer from heart disease, kidney disease, or lung disease have always been treated the same as other patients. Why should unvaccinated Covid patients be any different?

Second, discriminating against anti-vaxxers could increase systemic inequalities in American medicine. “Members of particular communities in the U.S. face systemic disadvantages in health care access and generally lack trust in health or governmental authorities because of current and historical injustices perpetrated by these authorities” – like black or Native American communities.

Third, not being vaccinated against Covid may be risky behaviour. But there are other kinds of risky behaviour, like not complying with public health measures. How can doctors untangle the skein of moral responsibility?

Fourth, although vaccination could be seen -- as Dr Karkowsky does – as a kind of moral reciprocity for the risk and pain of healthcare workers, how can doctor distinguish between people who are ideologically opposed and people who lacked access to a vaccine or had a legitimate reason not to be vaccinated?

The authors conclude:

While reciprocity might be used to justify vaccination status as a tiebreaker between patients with similar likelihoods of survival, such an approach raises questions about why vaccination is being treated differently than other behaviors that increase the risk of severe illness, and it will likely be couched as a narrative of punishment that further divides society at a time when cohesion is needed to combat a virus threat.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Should aesthetic surgeons give patients an ‘alienized’ look?

A normal face (left) and a digitally manipulated visage (right) showing the “alienized look” DR. STEVEN HARRIS/HARRIS CLINIC

Cosmetic surgeons in Hollywood are concerned that their colleagues are giving clients a bizarre “alienized” look which could lead to mental illness.

“Our industry is fast becoming a breeding ground for mental health illness. … What sort of twisted standard of beauty are we creating for the younger generations and how does it affect those with mental health disorders such as Body Dysmorphic Disorder?” writes London cosmetic surgeon Dr Steven Harris on Instagram.

“Things have gone really wrong in the field of aesthetics,” he told Hollywood Reporter.

“The practitioners who are performing this outrageously excessive work have very vivid imaginations. What they’re doing is trying to create new anatomy that doesn’t exist, and patients wind up looking like another species,” says another doctor, Ben Talei. And Dr. Julius Few of The Few Institute in Chicago, commented: “Our anatomy is designed to sit in a certain way, and the goal is to subtly restore and enhance. Conversely, what this extreme look is doing is manipulating the face well past the natural boundaries of a given area, and it’s an absolute mistake.”

The fad is partly motivated by social media, the doctors believe. “Consumers can look at before and after photos and videos all day long,” says one. “They are inundated with these images, and it drives insatiable interest.”

Dr Harris is campaigning for change – although whether his colleagues will listen to him is uncertain. “Those of us in aesthetics are in the midst of a war against alienizing patients,” he says. “We as practitioners need to take responsibility — our duty is to first do no harm, and that is not being fulfilled now.”

Michael Cook is editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Scotland could be close to legal assisted suicide

Will Scotland become the first jurisdiction in the United Kingdom to legalise “assisted dying”? According to a report in the BMJ, a bill introduced in June in Holyrood has better chances than previous attempts.

Scottish Liberal Democrat MSP Liam McArthur’s proposal would permit terminally ill and mentally competent adults the option of medically assisted dying. Other MSPs declared in an open letter, “The [present] law does not work and should be replaced with a safe and compassionate new law that gives dying people the rights they need to have a good death. It is incumbent upon us to provide a solution.”

In 2010 an assisted dying bill was defeated by a margin of 85-16 and in 2015 by a margin of 82-36. However, MSPs elected in May may be more sympathetic.

The bill has formidable opponents.

A group called Our Duty of Care (ODOC) is lobbying against it. A letter opposing the bill has been signed by doctors including David Galloway, the recently retired consultant surgeon and previous president of the Royal College of Physicians and Surgeons in Glasgow, and Professor Marie Fallon, a palliative medicine professor from Edinburgh.

It states: "The shift from preserving life to taking life is enormous and should not be minimised. The prohibition of killing is present in almost all civilised societies due the immeasurable worth of every human life. Everyone has a right to life under Article 1 of The Human Rights Act 1998 such that no-one should be deprived of that life intentionally."

Although the position of medical organisations is gradually shifting towards legalisation, the British Medical Association, the Royal College of General Practitioners, the Association for Palliative Medicine, and the Church of Scotland remain opposed.

Change is not imminent. There will be a public consolation in the coming months and then details of proposed bill will published. Voting is unlikely before early 2022. If it is successful, it would become effective before 2023.

MSPs will probably have a conscience vote.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
September
05
 

Online conference to discuss alleged organ harvesting in China

Critics of alleged organ harvesting are maintaining their relentless campaign against the Chinese government. A group called Doctors Against Forced Organ Harvesting (DAFOH) has organised an online conference from September 17 to 26.

More than 35 international experts will discuss the practice from medical, legal, political, news media, civil society and policy-making perspectives. “The systematic killing of people to harvest their organs on an industrial scope is a crime that is unprecedented and should not have a place in the 21st century,” says DAFOH.

DAFOH claims that forced live organ harvesting affects Falun Gong members, Uyghurs, Tibetans, Muslims and Christians.

DAFOH executive director Dr Torsten Trey, says: "Forced organ harvesting from living people is an unfathomable, unspeakable disgrace to humankind. Never before in history has an authoritarian regime persecuted living people by killing them with the goal to eradicate them through the installation of a self-propelling, profit-driven organ harvesting infrastructure, potentially turning organ recipients into accomplices as their demand for a transplant surgery might have fueled the transplant abuse. This should be of concern to all humankind."

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Should Americans get Covid booster shots when most of the world is unvaccinated?

The United States will offer a third booster shot to Americans who received vaccination at least eight months earlier, the Department of Health and Human Services said in a statement.

"It’s the best way to protect ourselves from new variants that may arise," President Joe Biden told the media. "It will make you safer and for longer. It will help end this pandemic faster." The government expects to give out 100 million booster shots for free at around 80,000 locations nationwide, Biden said.

But is it ethical to strengthen the immunity of Americans when people in other countries remain unvaccinated? The World Health Organization says No. It says that vaccines should go first to poorer countries where many people remain unvaccinated.

"We are planning to hand out extra life jackets to people who already have life jackets, while we are leaving other people to drown without a single life jacket. That's the reality," Mike Ryan, WHO's chief emergency expert, said.

A recent article in JAMA by three experts, including bioethicist Ezekiel Emanuel, concurred. They wrote: “The US and other countries must take a broader global perspective when considering booster vaccination programs. While these countries may reasonably prioritize their own residents’ interests, they must not forget the vastly greater need for vaccines among those who are unvaccinated in other countries, as compared with those who have received 2 doses in their country.”

As of August 10, 6 of the 10 countries with the most recent fatalities per capita (Tunisia, Georgia, Botswana, Eswatini, Namibia, and South Africa) have fully vaccinated less than 10% of their population.

The US government’s argument is that the efficacy of the vaccine diminishes with time. “The current protection against severe disease, hospitalization, and death could diminish in the months ahead, especially among those who are at higher risk or were vaccinated during the earlier phases of the vaccination rollout.” So a booster is needed to maintain immunity.

Opponents of booster shots for the US and other wealthy countries with a high level of vaccination have a counter argument. Not only is it altruistic to look after other countries, but it will also ultimately save lives. If Covid-19 continues to rage and mutate in the poorer countries, it will eventually make its way back to the wealthier countries and cause another wave with more deaths.

As the JAMA article puts it: “sending the vaccine doses that would be used for booster vaccinations to places where they could do substantially more good in reducing transmission may decrease the likelihood that more dangerous variants could develop”.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Leading Australian brain surgeon sanctioned for ‘cowboy’ behaviour

from Charlie Teo Foundation website

Charlie Teo is probably the best-known doctor in Australia – and certainly the best-known brain surgeon. He is renowned for saying that there’s no such thing as false hope – he dares to do operations which colleagues are reluctant to do. His portrait hangs in the National Portrait Gallery and countless profiles of him have appeared in the media.

But the daring pioneer has just had his wings clipped. Medical authorities in New South Wales have restricted his ability to practice. He is forbidden to perform certain kinds of surgery without written approval from a colleague. The supervising surgeon must also verify whether Dr Teo has explained to the patient “all material risks” and has obtained “informed financial consent”.

Money is a major issue. Some of his colleagues have complained that he charged exorbitant fees for operating on patients in the private system and then left them stranded in the public system when their money ran out.

The Sydney Morning Herald claimed that desperate patients without health insurance were crowdfunding, mortgaging their houses or borrowing money to meet the A$100,000+ fee for a brain tumour operation.

Although Dr Teo claimed to work “miracles”, he also made mistakes. The SMH reported that he operated on the wrong side of a woman’s brain in 2003, a mistake that was only discovered years later. She has settled out of court.

He is a polarising figure. Thousands of people have signed a petition of support. One woman wrote: “I am sick of so-called specialists fobbing patients off because they have reached their capacity instead of referring on to someone more capable. Personally know a few people who have been to CT and had great success. It really is a conspiracy against the most talented…..those who outshine ! Jealousy and ego run amok!”

Dr Teo is now considering walking away from neurosurgery after the imposition of the humiliating conditions on his practice.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Trans bomber identifies as woman; wants more lenient sentence

Mug shots of Michael Hari 

In 2017 Michael Hari, the head of a ragtag white militia extremist group, participated in the bombing of a mosque in Bloomington, Minnesota. He was caught and convicted after pleading guilty. His lawyer is arguing that he should be given leniency because he now identifies as a woman. He wants to be known as Emily Claire Hari. 

While planning the bombing, he was suffering from the effects of gender dysphoria and online anti-Muslim propaganda. His lawyer told the court in a plea for a mitigated sentence of 30 years rather than life:

"Thus, as she formed a ragtag group of freedom fighters or militia men and spoke of missions to Cuba and Venezuela, Ms. Hari secretly looked up 'sex change,' 'transgender surgery' and 'post-op transgender' on the internet. As she purchased military fatigues for their 'missions,' she also purchased dresses and female clothing for a planned trip to Bangkok, Thailand, for male-to-female surgery. She was living a double life."

Hari also wants to be assigned to a female prison.

The gay press had little sympathy for him. According to LGBTQNation, his lawyer was “playing on old transphobic stereotypes that accuse trans identities of causing people to become psychopathic. These stereotypes play out in numerous films like Psycho, Dressed to Kill and The Silence of the Lambs. But Hari’s Islamophobia and right-wing ideology drove her actions, not her trans identity.”

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Bioethicist defends transgender puberty blockers

Within the broad debate about transgender medicine, the narrower issue of the use of puberty blockers is attracting the attention of bioethicists. A recent article in the journal Bioethics examines the two most commonly used defences.

The first is the possibility of self-harm, attempted suicide and suicide. Gender dysphoric young people often threaten to commit suicide if they go through puberty. So puberty blockers are often justified as literally a life-saving medications.

However, emphasising this might do more harm than good. If children see that puberty blockers are only given to young people who threaten suicide, they might become more extreme in their behaviours.

This creates “a system in which [ransgender, non-binary, and gender questioning] youth are left with the credible threat of suicide as the primary effective means of advocating for themselves.”

A more positive reason – the one favoured by the authors – is that puberty blockers give children time to consider their future gender identity more calmly. They offer a philosophical justification: the right to an “open future”. This means that as future autonomous adults, they have a right to keep their options open.

The defense of the right to an open future is fundamentally grounded in the values of self-determination and self-fulfillment—or the ideals of autonomy and personal well-being—which are particularly implicated in choices that are deeply impactful on the future adult's self-determination with respect to crucial and irrevocable decisions that will determine the course of their life.

The authors contend that puberty blockers are low-risk, reversible interventions and that if a child wants to discontinue them, puberty will recommence. They insist that this argument is based on the best available evidence:” Available evidence and clinical consensus bear this out: in the specific case of PBT, long-term risks and irreversible effects do not appear to present a major concern.”

However, in the next sentence, they acknowledge that “available long-term follow-up data on [puberty blockers] for trans youth are limited”. (This is strongly denied by transgender critics.)

They conclude: “A truly equitable and inclusive approach to trans care must do more than just recognize that interventions such as PBT are not as bad as suicide and self-harm. It should recognize transgender and cisgender life paths as equally legitimate, without holding the latter to laxer standards of legitimacy, and it should recognize the value of PBT as a tool for supporting trans and questioning youth through a process of healthy self-discovery and self-authorship.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Vitamin D clinical trial for kids may be unethical

A University of Pittsburgh clinical trial on the effects of Vitamin D on children with asthma has come under attack for being unethical.

The Vit-D-Kids trial of a proposed 400 children was meant to study whether very high doses of Vitamin D could help those with severe asthma. The children in a control group received only a placebo and no Vitamin D; the children in the other group received the high dose.

Bruce Davidson, a pulmonary and critical-care researcher in Seattle who helped perform a similar study with children in Qatar, believed that it was unethical to give no Vitamin D to children, who were often minority children living in poor neighbourhoods. The researchers, he said, should have compared maintenance levels of Vitamin D with high levels.

But Alan Fleischman, a bioethicist at the Albert Einstein College of Medicine in New York, told the Pittsburgh Post-Gazette a couple of years ago that even though giving kids known to have low levels of vitamin D a supplement would help them, it is not unethical under federal regulations to give them a no-dose placebo. “A placebo trial is ethical when children aren’t being asked to give up something,” he said. Giving them a placebo “does not increase risk to children who don’t get an active drug.”

The controversy has not gone away although the trial has already been cancelled. Science magazine has published a long article which uncovered new angles on the ethical questions.

“The advantages to society of this trial, because of the poor design, were likely none. And the risks did outweigh the benefits,” Charles Natanson, a physician and expert on trial design at the NIH Clinical Center told Science. “This trial did not, in my opinion, meet the standards set forth in The Belmont Report” (a 1979 study which set standards for human subject research).

Jill Fisher of the University of North Carolina, Chapel Hill, complained that the trial represented “structural racism” because minority children were already at risk of Vitamin D deficiency. “We shouldn’t say, ‘It’s unfortunate that there are these health and nutritional disparities, but it serves the interests of science to have placebo-controlled trials,’” she told Science.

The central issue in the controversy is “usual care”. It:

exemplifies the growing number of studies in humans that inappropriately reject control groups receiving “usual care”—current best practice treatments used by doctors. In a hunt for compelling results, many researchers favor using sharply divergent treatment arms in a trial. But such extreme comparisons mean doctors can’t learn whether a new treatment is better or worse than usual care,

“It’s just common sense,” says Charles Natanson, a physician and expert on trial design at the NIH Clinical Center. “Why study two things inside of a trial that nobody does outside of the trial?”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Canada’s politicians go MIA in debate over conscientious objection for doctors

Conscientious objection to abortion and euthanasia has emerged as an election issue in Canada’s 2021 federal election – and politicians are refusing to defend it.

The pro-choice leader of the Conservatives, Erin O’Toole, has walked back from a promise in his party’s platform to “protect the conscience rights of health-care professionals.”

Does this mean that the Conservatives will defend the right not to refer patients for Medical Aid in Dying? O’Toole fudged an answer, but he was clearly not in favour.

The governing Liberal Prime Minister, Justin Trudeau, jumped on an opportunity to score points: “Pro-choice doesn’t mean the freedom of doctors to choose. It means the freedom of women to choose. Leaders have to be unequivocal on that,” he said last week.

The politicians’ reluctance to support doctors who do not want to refer for abortion or euthanasia is mirrored in the reluctance of the professional associations to defend refusal to refer. The College of Physicians and Surgeons of Ontario requires doctors to provide an “effective referral” within a “timely manner” to another professional or agency, should they consciously object. “Physicians must not impede access to care for existing patients, or those seeking to become patients,” reads the college’s policy.

Quebec’s Collège des médecins du Québec says that: “In Quebec, doctors cannot abandon patients or even ignore their request by invoking conscientious objections, particularly in matters of abortion or medical assistance in dying, without referring them to another colleague. It is an ethical obligation.”

However, Colleges in Newfoundland and Labrador, Nova Scotia and Manitoba all explicitly say that professionals who refuse to provide service are not required to make a referral. They cite the Canadian Medical Association’s Code of Ethics and Professionalism.

Michael Cook is editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Bioethicists joust over Canada’s ‘Medical Aid in Dying’

Photo by Priscilla Du Preez on Unsplash

The debate in Canada over euthanasia and assisted suicide – or, as it is called there, Medical Assistance in Dying (MAiD) – will have a huge impact upon developments elsewhere in the Anglosphere. As two of Canada’s stalwart defenders of MAiD, Jocelyn Downie and Udo Schuklenk, pointed out in a recent article in the Journal of Medical Ethics, “other countries will confront the same questions if they contemplate changing their assisted dying law”.

This makes their pushback against critics of MAiD even more interesting. (Schuklenk, by the way, is a trenchant opponent of conscientious objection over abortion and euthanasia. He has even proposed that medical schools screen out potential objectors.)

The two bioethicists home in on two weighty criticisms of Canada’s MAiD regime: “social determinants of health” and slippery slopes. “Social determinants of health” is a WHO term for the non-medical factors which influence health outcomes – which range from racism to disability and mental illness to unemployment.

They argue that it is discriminatory to deny people with mental illness and disability access to MAiD. Patient rights would be sacrificed on the altar of paternalism.

As for the slippery slope argument, they dismiss it as illusory.

The change from Carter to C-14 moved Canada in a more restrictive direction. The entire scene is that Canada has not become more permissive as between the Supreme Court of Canada decision in Carter and Bill C-7. Rather, there was a period during which Canada had an unconstitutional tightening of the eligibility criteria. Canada is simply back where the Supreme Court of Canada put it through Carter.

This sets the scene for a vigorous response in the JME from another Canadian academic, Tom Koch, of the University of British Columbia.

He says that the “social determinants of health” argument remains valid. “Inadequate control of pain and control of other symptoms was a rationale in over half of all MAID cases. This outcome reflects the limited number of palliative and rehabilitative physicians in Canada.” In his view, the availability of MAiD means that bioethicists and others no longer feel the moral urgency of clamouring for more and better palliative care.

As for the slippery slope argument, Koch simply points to the numbers.

An expanding class of persons eligible for MAID has resulted in an exponential increase in the number of reported cases. Total reported cases of MAID across Canada increased from 1018 in 2016 to 21,589 in 2020. This is by definition the slippery slope: a relaxation of requirements resulted in an expanding class of eligible persons and an ever increasing number of medically induced deaths.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
29
 

Italy may hold a referendum on euthanasia

Photo by Mauricio Artieda on Unsplash

Right-to die activists are hoping that Italy will follow Spain and legalise assisted suicide and euthanasia. A petition to reverse a ban on assisted suicide has collected more than 750,000 signatures, more than enough to force a referendum. Only 500,000 were needed.

It is believed that about 50 Italians already die in Swiss suicide clinics every year. Activists claim that 8,000-10,000 Italians will take advantage of the law if it succeeds.

Doctors can already stop nutrition and treatment if patients request it with a living will, under rules introduced in 2018, but activists argue that this is little-known and rarely used. The proposed referendum would enable doctors to kill a consenting person without fear of being hauled into court.

The euthanasia lobby is framing the decision as a battle between humanity and heartless Catholic fundamentalism.

Pope Francis said in 2019 that doctors faced with legislative changes around the world, “must reject the temptation, to use medicine to support a possible willingness of the patient to die, providing assistance for suicide or directly causing death by euthanasia.”

"A vitalistic conception of life is gradually being wedged into the sensitivity of the majority, a youthful and healthy conception based on which everything that does not correspond to a certain level of well-being and a certain conception of health is rejected" was the comment of the president of the Pontifical Academy for Life on the prospect of a referendum.

Marco Cappato , of the Luca Coscioni Association, a leading right-to-die group, responded:

“Monsignor Paglia does not seem to give any value to the fundamental right to freedom and individual responsibility … With the affirmation of the referendum, no one will be forced to choose euthanasia, and indeed it will be possible to prevent what is happening now: clandestine euthanasia, made up of loneliness and desperation and practiced in the most terrible conditions, also due to the responsibility of the criminalization desired by a law of 1930 and supported by the Vatican.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

Gender transition services are ‘reckless’, say medical and legal experts

If informed consent is one of the pillars of clinical bioethics, puberty blockers fail the test, according to a leading psychiatrist and constitutional lawyer writing in the magazine Commentary. Paul McHugh, an emeritus professor of psychiatry at Johns Hopkins, and Gerard Bradley, of Notre Dame, argue that neither young people nor their parents can possibly understand what they are missing by delaying puberty, one of the most mysterious aspects of human physiology.

Their immediate purpose is to support a recently passed law in Arkansas which bans “gender transition services” for people under 18 because they are too young to give their informed consent. The law has been struck down by a federal appeals court. Seventeen other states wrote in support of the law claiming that legislation is needed because “The medical establishment has abandoned the field to the political zeitgeist”.

The article in Commentary covers too much ground to summarise adequately, but McHugh and Bradley target two failings involved in transgender medicine for children and teenagers.

The first is “recklessness”. Puberty, they contend, is mysterious and little understood. Tinkering with a young person’s physiology is dangerous.

In other animals, all that they shall be is in place at puberty. For us, puberty amounts to a kind of second birth; it is the start of our becoming contributing members to our times. To block puberty and then artificially redirect its course is to tamper with a vital human developmental matter with no reason for confidence in what will emerge beyond a lifetime preoccupied with medico-surgical interventions to maintain the illusion that one’s sex has changed.

The second is “thoughtlessness”. Consent must be informed; people must understand the consequences of their actions. But a prepubescent person can hardly grasp what a life of sterility, childlessness and perpetual medication involves.

They predict that a single successful case against transgender treatment – like the UK’s Bell v. Tavistock –will cause the experiment with transgender medicine to crumble.

With the appearance in the United States of even one well-publicized case such as Kelsey’s, with its obvious potential for a major lawsuit, the transgender misadventure will come to a close. A public outcry will start, insurance companies will cease malpractice support as lawsuits emerge, and reputations of doctors and health systems will sink.

The damage to the victims will nonetheless be irreparable and (as Abigail Shrier’s 2020 book on this subject has it) irreversible. Their sense of betrayal will be matched by the shame of everyone capable of feeling it.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

Queensland close to legalising euthanasia

City of Gold Coast, Queensland 

Legal euthanasia is drawing closer in the Australian state of Queensland. A committee has recommended a bill for voluntary assisted dying (VAD) to the unicameral parliament in a 327-page report. It will be debated in Parliament in September.

MPs from both major parties will be granted a rare conscience vote on this legislation.

The parliamentary committee received more than 6000 submissions from individuals and organisations. Most were in favour, according to the chair, Labor MP Aaron Harper, although he acknowledged that "As a democratic society, we must respect that some will be opposed to a voluntary assisted dying scheme for a variety of reasons that are important to them.”

Mr Harper said that “It is my firm view that the issue of voluntary assisted dying is above politics and religion, this is about people.”

The committee made one important recommendation to the Commonwealth. It said that the federal law banning advice on suicide should be amended to allow doctors to advise people in remote areas how to access VAD. Queensland is a vast and largely empty state and some people will find it difficult to see doctors face to face.

One contentious issue is whether hospitals or aged-care homes could be forced to allow VAD on their premises.

Catholic hospitals indicated that they would defy the legislation, if necessary. “We will not tolerate non-credentialed doctors coming on site, nor will we assist in the provision of voluntary assisted dying in any of our facilities,” the chair of the Mater group told The Australian.

This is an important detail, as Catholic organisations provide 20% of hospital and aged care beds in Queensland.

“Allowing unaccredited doctors to enter hospital rooms, with no notice or permission needed, to assist in a medical procedure to help a patient die is a radical and dangerous undermining of patient safety and should be rejected,” said the CEO of St Vincent’s Health Australia. “It’s partly why the Queensland Australian Medical Association is so strongly against the lack of protection for faith-based hospital providers.

“It’s also about fairness. The Queensland government is forcing Catholic hospital providers – against our values and beliefs – to open up our facilities to assisted dying. That’s deeply unsettling and shocking to us.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

University of Pittsburgh in hot water over foetal tissue research

The use of foetal tissue at the University of Pittsburgh is becoming a hot political issue. Several Republicans are calling for an investigation into the use of foetal organs.

Based on documents published by UPitt researchers, anti-abortion activists have claimed that organs are being removed from still-living foetuses in programs using federal funding. But UPitt vehemently denies the allegations.

Rep. Kelly said in a statement to Fox News: "Any American whose moral compass points true north should be outraged that the organs of alive, unborn children may have been harvested for medical research at the University of Pittsburgh, and that taxpayers were unwittingly forced to pay for it by Washington bureaucrats."

UPitt spokesman Kevin Zwick responded: "These are irresponsible and false accusations about vital, life-saving research using techniques that are common at universities and medical institutions throughout the world. The University of Pittsburgh does not perform abortions and complies with all laws and regulations concerning this tightly regulated research."

Pitt has since circulated a list of assertions, such as that "[t]here is no heartbeat and no blood flow at the time the tissue sample is collected."

They also acknowledge that "to remove organs from a fetus or baby while its heart was still beating would be immoral and unethical and a felony offense, illegal under both state and federal law."

The rhetoric around the claims is volcanic – that is, heated and full of blinding dust. Very little detail is available on the internet other than allegations and accusations and protestations of innocence.

David Daleiden, of the Center for Medical Progress, says that “Pitt and the Planned Parenthood abortion providers responsible for its ‘research’ abortions are allowing babies, some of the age of viability, to be delivered alive, and then killing them by cutting their kidneys out.”

But his assertions seem to be based on interpretations of the language of grant applications rather than testimonies from researchers or eyewitness accounts.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

Should children have the right to die in Canada?

Canada’s euthanasia legislation is under constant pressure to expand the grounds for eligibility for medical assistance in dying. The latest incident is a plea from a single mother of four boys in Quebec to allow doctors to kill her severely disabled four-year-old son.

Abel Tremblay-Pelletier, the son of Karie-Lyn Pelletier, of the tiny town of L’Islet in southern Quebec, suffers from Mednik (or Kamouraska) syndrome, an extremely rare and incurable genetic disease which is mostly found in Quebec. It has left him intellectually and physically disabled. He often has crises which bring him to the brink of death.

Quebec media reported that two local politicians had a meeting with Ms Pelletier to discuss Abel’s future. At the moment, children are not able to access MAiD, but she is calling for a change in the law. “What we all want is for this to happen in the best possible conditions, both for Abel and for us, because seeing our boy slowly fade away is even more difficult than having to accept the end," she said.

Michel Bureau, a Quebec doctor who represents the Commission sur les soins de fin de vie (Commission on end of life care), a right-to-die group, says that it is becoming obvious that there need to be protocols for children as well.

A federal parliamentary committee investigating various aspects of end-of-life eligibility held its first meeting on June 21.

Dr Bureau acknowledges that a slippery slope into eugenics is possible. “That's what's dangerous; a slippery slope that lets only those who are beautiful and perfect live," he warns.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

Brain organoids grow rudimentary eyes

Brain organoids with optic cups at day 60 of development. (Gabriel et al., Cell Stem Cell, 2021)

The new stem cell technique of growing brain organoids is producing some unsettling results. In a study in Cell Stem Cell, scientists in Germany used human induced pluripotent stem cells (iPSCs) to create brain organoids with an eye structure called the optic cup.

The organoids spontaneously developed bilaterally symmetric optic cups from the front of the brain-like region, demonstrating the intrinsic self-patterning ability of iPSCs in a highly complex biological process.

“Our work highlights the remarkable ability of brain organoids to generate primitive sensory structures that are light sensitive and harbor cell types similar to those found in the body,” says Jay Gopalakrishnan of University Hospital Düsseldorf. “These organoids can help to study brain-eye interactions during embryo development, model congenital retinal disorders, and generate patient-specific retinal cell types for personalized drug testing and transplantation therapies.”

The human brain organoids formed optic cups, which appeared as early as 30 days and matured as visible structures within 50 days. This time frame parallels that of retinal development in the human embryo and could make certain types of developmental neurobiology experiments more efficient.

Across 16 independent batches from four iPSC donors, the researchers generated 314 brain organoids, 72% of which formed optic cups, showing that the method is reproducible. These structures contained diverse retinal cell types, which formed electrically active neuronal networks that responded to light. The optic cup brain organoids also contained lens and corneal tissue and exhibited retinal connectivity to brain regions.

“In the mammalian brain, nerve fibers of retinal ganglion cells reach out to connect with their brain targets, an aspect that has never before been shown in an in vitro system,” Gopalakrishnan says.

In future studies, they plan to develop strategies to keep the optic cups viable for long time periods, using them to investigate mechanisms that cause retinal disorders.

Writing in The Niche, a well-informed commentary on stem cell research, Paul Knoepfler, of UC Davis School of Medicine, asks whether there should be limits on growing embryo-like structures which are becoming increasing complex. He is of two minds:

As to the human embryo models that are starting to be so similar to actual human embryos, I think limits make sense. For human brain organoids not so much. These structures are fairly far removed from actual human brains and reports of neural activity in them don’t show anything like coherent function on a consistent basis.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

Massachusetts begins to issue 3-parent birth certificates

Massachusetts, a bellwether state for social change, has issued its first three-parent birth certificate.

Joyce Kauffman, a family law attorney, explained to the abovethelaw.com website that state courts already recognise three-parent family structures through adoption. But this is the first time that the Massachusetts Registry of Vital Records and Statistics (RVRS) has issued birth certificate which records three parents.

Ms Kauffman believes that this paves the way for other children to be registered with multiple parents. With increasing recognition of polyamory in the Bay State, there could be a real demand for multiple-parent certificates.

A revised version of the national uniform parentage act has been introduced to the Massachusetts legislature which purports to bring greater clarity and protection to the modern realities of family formation, especially those turning to assisted reproductive technology.

The LGBTQI+ lobby is actively promoting the proposed Massachusetts Parentage Act (MPA). According to Mombian, a site for lesbian parents, Massachusetts “is now the only New England state that has not comprehensively reformed its parentage laws to protect children regardless of the circumstances of their birth or the gender or marital status of their parents.”

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
22
 

Nitschke’s new podcast about assisted dying could be scary for some listeners

Arguments for assisted dying, or voluntary assisted dying, or voluntary euthanasia, or medical aid in dying nearly always take place within a legislative framework. However, there are some prominent figures in the right-to-die movement who believe in rational suicide – that anyone capable of informed consent should be able to exit at any time, painlessly, without the interference of meddling doctors.

The leading exponent of this point of view is Dr Philip Nitschke, an Australian activist who now lives in the Netherlands with his partner Fiona Stewart. His organisation, Exit International, manufactures suicide devices and dispenses advice about rational suicide.

Together Nitschke and Stewart run a regular podcast about a range of issues linked to rational suicide – the methods, the politics, Covid-19, legislation, and so on. It’s called the Doxit Podcast Conversations. He is quite candid about his ambitions.

In the latest, for instance, the hosts discuss the so-called “Azide Wars”, a dispute over access in the Netherlands to sodium azide, a powerful and lethal drug which is better known as “Middel X”.

The podcasts give an interesting insight into a “third way”, a completely different ethical outlook from either the right-to-die lobby or the pro-life movement.

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
15
 

Germans shocked by fake vaccinations

(translation: Covid lies) 

If anyone need a reminder of how much medicine depends upon personal trust, look this week to Germany.

A 40-year-old nurse in Friesland, in the north of the country, may have given thousands of people a shot of saline rather than a COVID-19 vaccine. Authorities announced that around 8,600 people may need to be revaccinated. The injections were given in March and April by a woman who had expressed anti-vaccination views on social media.

CNN reported that the nurse had access to the vaccines because she was "responsible for the preparation of vaccines and the preparation of syringes during her working hours in the vaccination center”.

The nurse’s lawyer spoke to the media and admitted that she had given saline injections at least six times. She said that she had panicked after she broke a vial of vaccine and did it only to keep her job. However, authorities fear that it could have happened many more times. Police are investigating.

A spokesperson for Lower Saxony's health ministry said that it seems that no severe COVID-19 infections had occurred as a result of the saline injections.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
15
 

British House of Lords debates plastinated bodies exhibitions

A bill has been introduced into the British House of Lord to ban exhibitions of plastinated corpses of anonymous Chinese prisoners.

In a debate, Lord Philip Hunt of Kings Heath told Parliament that he wants “to put a stop to the dreadful travelling circus of body exhibitions, which sources deceased bodies from China … those deceased human bodies and body parts are ‘unclaimed bodies’, with no identity documents or consent, sourced from Dalian Hoffen Biotech in Dalian, China. The commercial exploitation of body parts in all its forms is surely unethical and unsavoury. When it is combined with mass killing by an authoritarian state, we cannot stand by and do nothing.”

Lord David Alton, an independent, gave the bill his whole-hearted support. “The plastinated cadavers indicate that many are young people,” he says. “The Minister should establish whether it is possible to extract DNA from the corpses to discover something of their origins and their ethnic identity? The law did not require the Coroner to determine how the corpses exhibited in Birmingham had died. It should.”

Baroness Ilona Finlay of Llandaff, a palliative care physician, also supported the bill. She compared the “Real Bodies” exhibition to the notorious Burke and Hare of the early 19th Century, who murdered people to supply medical students in Edinburgh with bodies for dissection. “These bodies on display included a woman in advanced pregnancy. Did she give fully informed consent when dying in pregnancy? The evidence of proper consent processes should be open to international scrutiny. It is not.”

The government spokesman, Lord Bethell, said that the government would oppose the bill. “This is an important issue, but it is one that our laws already address, although we can do a lot more to increase awareness of the dangers involved.”

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
15
 

Bioethicist could be next head of FDA

The name of controversial bioethicist Ezekiel Emanuel is being floated as the Biden Administration’s choice to head the US Food and Drug Administration. At any time the FDA is a lightning rod for criticism, and during the Covid-19 pandemic its role has become even more essential and even more scrutinised.

Dr Emanuel, who is currently at the University of Pennsylvania, has no experience in drug policy, but he is a government insider with a high media profile who has worked for both President Obama and President Biden in different roles. Dr Anthony Fauci, who heads the Administration’s Covid-19 policy, is rumoured to support his Emanuel’s nomination.

"They are just having a tough time landing on somebody who is not only good but who wants it, and that you won't have trouble getting confirmed," an informed source told Politico. "The people who are really good are not particularly interested in it."

An Administration spokesman poured cold water on the rumours and Emanuel told Politico that no one had contacted him.

Dr Emanuel is a dartboard for conservatives. Wesley J. Smith, a bioethics writer, wrote a column in The Epoch Times fiercely criticising him as a potential FDA head. “Not only does he lack substantial administrative experience, but even more worrying, he’s a hyper-partisan left-wing Democrat,” he says.

Emanuel was the architect of the Affordable Care Act; he has backed vaccine mandates and lockdowns; he views on end-of-life care are controversial; and he opposes conscientious objection for procedures like abortion. “Emanuel isn’t only the wrong man for the job, but his nomination would lead to even greater distrust than already exists in the fight against COVID-19.”

More than six months have passed since Biden entered the Oval Office, and the job of Commissioner of the FDA is still vacant.

Michael Cook is editor of BioEdge



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
15
 

A utilitarian’s Apocalypse?  

Gerard Butler sees extinction coming / 'Greenland' 

Australia’s most erudite columnist is probably Henry Ergas, an economist who spent many years at the OECD in Paris before returning to Australia. In a recent article, “It’s the end of the world as we know it – again”, he galloped through Western visions of the apocalypse – the Greeks’ myth of the eternal return, the Last Coming of Christ, Jean-Baptiste Cousin de Grainville’s Last Days of Humanity (a new one to me), H.G. Wells’s The World Set Free (which predicted the A-bomb), and nowadays, environmental collapse.

His point was that the modern Western imagination is easily captured by visions of ultimate catastrophe – as in the Covid-19 pandemic, climate change, or nuclear warfare. His premise was that extinction is obviously a bad thing.

But what if extinction is really not a bad option in the light of the alternative?

Writing in the Practical Ethics blog (republished from the New Statesman), philosopher Roger Crisp, of Oxford University, muses that immediate extinction would at least put an end to the collective pain of existence:

Perhaps one reason we think extinction would be so bad is that we have failed to recognize just how awful extreme agony is. Nevertheless, we have enough evidence, and imaginative capacity, to say that it is not unreasonable to see the pain of an hour of torture as something that can never be counter-balanced by any amount of positive value. And if this view is correct, then it suggests that the best outcome would be the immediate extinction that follows from allowing an asteroid to hit our planet….

The question of whether extinction would be good or bad overall is obviously very important, especially in the face of potential catastrophic events at the hinge of history. But this question is also very difficult to answer. Ultimately, I am not claiming that extinction would be good, only that, since it might be, we should devote a lot more attention to thinking about the value of extinction than we have to date.

Crisp is a utilitarian and the purpose and value of suffering poses a conundrum for those who balance pleasure against pain. It’s interesting to get a glimpse of utilitarian eschatology.

Michael Cook is editor of BioEdge  



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
15
 

Australian fertility clinics complain about ‘sperm drought’  

Australian fertility clinics are reporting a “sperm drought”. According to a feature on ABC News, “With travel plans delayed and people having more time on their hands to ponder their future due to the COVID-19 pandemic, fertility clinics have reported a surge in demand for their services, while an increasing number of people are also going online to fulfil their baby dreams.”

A number of clinics across the country say that the number of single women and lesbian couples is increasing while the number of sperm donors is decreasing. To the dismay of the clinics, this is driving some women to seek donors through unregulated channels like Facebook. This means that women cannot be sure of the medical history of the donor or whether the sperm is disease-free.

Adam Hooper, who manages the Sperm Donation Australia Facebook page, is trying to give more certainty to women. He is launching a his own baby register to keep a formal record of donors so that they will eventually be able to track down their biological fathers and siblings. "Online donation is continuing to evolve in terms of making it more of a professional experience and we are looking at ways to reinvent ourselves to offer a better experience," he says.

The state of Victoria plans to set up Australia’s first public gamete bank for sperm and egg donors. It “will proactively recruit donors, store eggs, sperm and embryos and educate the public about the need for donations.”

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
14
 

Bollywood tackles surrogacy

This is more in the ”just for fun” category than bioethics: a Bollywood film about surrogacy. Western films tend to be sober and problematic even if they are garnished with some wry humour. Mimi manages to turn commercial international surrogacy into a musical comedy which still touches on some of the core ethical questions involved when a woman rents out her womb for money.

The plot is simple. An American couple visiting Rajasthan are struck by the good looks of Mimi, a local dancer (very important for the subsequent routines with acres of dancing girls) and approach her through a roguish cabbie. He persuades her to sign a contract. Her parents are horrified when they find out and Mimi is devastated when an ultrasound shows that the child has Down syndrome. The couple order her to abort the child (not a good look for American family values) but she refuses and decides to raise the child herself.

The child is born healthy and the American couple offer to adopt him, but Mimi refuses. The Americans find another child to adopt and everyone lives happily ever after.

The film was criticised for taking an anti-abortion stand. “Mimi … is an attempt to roll Indian society back by decades, by denouncing a woman’s right to choose an abortion enshrined in the Medical Termination of Pregnancy (MTP) Act, 1971,” Anna Vetticad wrote in Firstpost. “Contrary to the false impression created by India’s English news media that Muslim and Christian conservatives alone are anti-choice, the truth is that religionists across communities take this stand.”  

Michael Cook is ediitor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
08
 

Should all medical research be regarded as ‘untrustworthy’?

The middle of the Covid-19 pandemic is not an auspicious moment to cast doubt upon the reliability of scientific research. However, writing in a BMJ blog, Richard Smith, editor of The BMJ until 2004, launched a withering attack, saying that the system is riddled with fraudulent studies. “ It may be time to move from assuming that research has been honestly conducted and reported to assuming it to be untrustworthy until there is some evidence to the contrary,” he says.

Dr Smith does not mention the pandemic, but it would come as no surprise if Covid-19 research did not have problems. A study published in the journal Scientometrics found that 87,000 papers had been published between the beginning of the pandemic and October last year. Tens of thousands must have been added to that figure by now. The highly-respected blog Retraction Watch is keeping a tally of retracted Covid-19 papers – so far there are well over 100.

In a recent webinar (see below) conducted by Cochrane, an independent group which reviews healthcare data, Professor Ian Roberts, of the London School of Hygiene & Tropical Medicine, said that he has become sceptical about all systematic reviews, particularly those that are mostly reviews of multiple small trials.

In an article in Reason journalist Ronald Bailey cited years of research which suggest that this issue is nothing new:

How bad is the false-positive problem in scientific research? As I earlier reported, a 2015 editorial in The Lancet observed that "much of the scientific literature, perhaps half, may simply be untrue." A 2015 British Academy of Medical Sciences report suggested that the false discovery rate in some areas of biomedicine could be as high as 69 percent. In an email exchange with me, [Stanford professor John P.A.] Ioannidis estimated that the nonreplication rates in biomedical observational and preclinical studies could be as high as 90 percent.

This by no means invalidates the scientific method, or science itself. But there are immense problems of which most people are blissfully unaware. Ioannides says that “Science is the best thing that can happen to humans, but doing research is like swimming in an ocean at night.” As Otto von Bismarck might have said: “If you like science and sausages, you should never watch either one being made.” 

Michael Cook is editor of BioEdge   



This article is published by and BioEdge.org under a Creative Commons licence. You may republish it or translate it free of charge with attribution for non-commercial purposes following these guidelines. If you teach at a university we ask that your department make a donation. Commercial media must contact us for permission and fees. Some articles on this site are published under different terms.

comments powered by Disqus
 
August
07
 

A star is born: ‘dignity neuroscience’

The Code of Hammurabi. The Ten Commandments. The Beatitudes. The Magna Carta. The Declaration of Independence. Throughout history, statements such as these have proclaimed that people deserve freedom, security and dignity. Why have universal human rights remained largely unchanged?

According to an article in the Annals of the New York Academy of Sciences, it's because humans share the same nervous system. “Universal rights are thus based on fundamental features of human brain structure, function, and development,” they contend. This is the foundational principle of what they call “dignity neuroscience”.

The authors argue that numerous studies in developmental psychology and neuroscience bolster notions that people thrive when they enjoy basic rights such as agency, self-determination, freedom from want or fear, and freedom of expression. And when societies fail to offer their citizens such rights, allowing them to fall into poverty, privation, violence and war, there can be lasting neurological and psychological consequences.

"I think the average person on the street sees universal human rights as an international law concept that has more to do with trade than about individual lives," says lead author Tara White, of Brown University. "But this stuff is not pie-in-the-sky, and it affects us all. We want to show people that ensuring universal human rights is a crucial foundation for a society that is healthy -- not only socially and physically, but also psychologically and neurologically."

Five core concepts underlie most universal rights declarations: agency, autonomy and self-determination; freedom from want; freedom from fear; uniqueness; and unconditionality. All five, they argue, reflect fundamental features of human brain structure, function and development.

"The idea of universal human rights as a foundation for a healthy society isn't just a social phenomenon but also a deeply empirical and scientific one," Gonsalves said. "Applying scientific studies and hard evidence to universal human rights can help demonstrate why these rights need to be defended and respected across the world."

Understanding and considering "dignity neuroscience" could also, White said, help lawmakers and voters appreciate the simultaneous importance of providing each person with the same basic rights whi