Coronavirus: should frontline doctors and nurses get preferential treatment?

It is mid-March 2020. James is a 29-year-old junior doctor working in a London hospital. Last week, James cared for a man who had become sick after returning from abroad. The man had been treated in isolation and is now improving. However, James has since become unwell. He developed a cough and fever, but then rapidly became breathless.

James has been admitted to his own hospital with signs of severe acute respiratory distress syndrome. Despite intensive treatment, James’ lungs are full of fluid and his oxygen levels are critically low. His kidneys have shut down, and his blood pressure is unstable.

The medical team caring for James has referred him to the regional extracorporeal membrane oxygenation (ECMO) centre – a potentially life-saving treatment that is used for some patients with severe organ failure.

But the ECMO centre has received several referrals. While James is young and fit, he also has features that suggest he may die even… MORE

In defence of Peter Singer

Peter Singer / photo by Leif Tuxen / 

Australia’s most famous – or most notorious – philosopher, Peter Singer, has been de-platformed in New Zealand. He was scheduled to speak about “effective altruism” at an event in Auckland in June. The disability community was outraged.

The venue, SkyCity, a casino and entertainment venue, released a statement saying, "Whilst SkyCity supports the right of free speech, some of the themes promoted by this speaker do not reflect our values of diversity and inclusivity." The organisers are scrambling to find a different venue.

The anger of the disability community is hardly surprising. Singer is a utilitarian ethicist and contends (this is a very rough summary) that consciousness is the touchstone of dignity. This compels him to support the infanticide of disabled infants. In a book that he published in 1979, Practical Ethics, he wrote:

[Being a member of he species] Homo sapiens, is not relevant to the… MORE

The complicity of health and medical personnel in post-9/11 torture is a stain on my profession

As the American psychologist and architect of the Bush-era torture programme, Dr James Mitchell, took the stand last week, I was reminded of Timothy Snyder’s Twenty Lessons on Tyranny. He wrote ‘If lawyers had followed the norm of no execution without trial, if doctors had accepted the rule of no surgery without consent…then the Nazi regime would have been much harder pressed to carry out the atrocities.’

Eighteen years have passed since the opening of Guantanamo Bay and implementation of the (now defunct) US ‘enhanced interrogation’ programme – a clinically friendly name for a torture house that included waterboarding and other forms of abuse. Was Mitchell finally standing trial for his crimes? No. He defiantly gave evidence to a pre-trial hearing in the American military war court; his testimony mirroring one of his earlier justifications: “I’m just a guy who got asked to do something for his country”.

Since 9/11 and the ‘war on terror’, a myriad of human rights abuses have… MORE

India continues to struggle with surrogacy

Indian author and activist Pinki Virani has been given a national award for her book Bitter Chocolate: Child Sexual Abuse in India, which ripped the lid off the extent of this secretive crime in Indian homes across class and gender (40 percent of girls and 25 percent of boys under 18 are sexually abused, 50 percent of this horror being perpetrated upon them in their own homes or by adults in position of the child’s trust). She has assisted on the laws against sexual abuse.

Her fifth book, Politics of the Womb: The Perils of IVF, Surrogacy & Modified Babies, is a meticulously detailed work on the hormonal-medical violence being benignly showered on women the world over by “fertility fairies, even though their failure rate is 75 percent”.

This “worldwide onslaught on the woman’s womb in the name of a child” is “reducing good men to not even realising that they are condoning reproductive slavery”. For “Politics of… MORE

Ethical issues surrounding egg donation in genome editing 

Genome editing enables scientists to modify the DNA, the building blocks of life. Different technologies are used, including an innovative technique called CRISPR-Cas/9, which involves cutting and splicing mutating genes that cause heritable diseases and conditions.

Like any novel technology, there are risks associated with CRISPR. For instance, a scientist may cut at the wrong area, known as off-target effects. Scientists are uncertain as to how this might affect patients. Moreover, mosaicism may also occur where only specific cells carry the edit but not others.

Hence, to develop genetic techniques which are safe and effective to be applied in humans, much research is needed. Primary research is necessary to check the safety and accuracy of genome editing. Clinical applications can then be performed after comprehensive studies have been conducted.

What could be missed in the debate surrounding human genome editing are ethical questions about the research that would precede clinical applications. Say a scientist wishes to experiment with human embryos.… MORE

In defence of conscientious objection

Photo by Hush Naidoo on Unsplash

Over the last few years there has been a vigorous and fascinating debate about the use of conscientious objection (CO) in healthcare. CO is when doctors (and other healthcare professionals) opt-out of providing a medical service because they have serious moral objections—abortion is a widely cited example.

If enough doctors object to abortions, there is a legitimate concern that some patients will have difficulty accessing them—for example in Italy 70% of obstetricians refuse to participate in abortions, even though this isn’t the intention of CO. Some ethicists have argued there is no place for CO at all in healthcare, in the strongest of terms.

Curiously, though—and this is what aroused our interest—these same ethicists usually recognise that there are still some instances when doctors should be permitted to object and withhold their services. But how can they allow some objections and not others? One… MORE

How should chimeric embryo research be regulated?

Experiments with chimeras will lead to greater knowledge and better health. Or that’s the argument of Japanese scientist Hiromitsu Nakuchi. He recently was authorised to create animal embryos which contain human cells and transplant them into surrogate animals under the Japanese guidelines amended in March 2019.

The amended rules remove a previous prohibition on the making of chimeras past fourteen days. They allow the transfer of chimeric embryos into animals while barring them into humans.

In his study, Nakuchi proposes to create an animal embryo with a missing gene required for the creation of an organ, e.g. a pancreas. He will then insert human IPS cells into the animal embryo. As the animal matures, the human IPS cells will create a human pancreas.

Nakuchi intends to begin with the creation of hybrid mice, followed by hybrid rats and hybrid pigs. His ultimate objective is to develop animals with human organs which could be transplanted into a human patient.

Making… MORE

Doctors fight legislation prompted by sex abuse scandals

Daniella Mohazab didn’t know what to expect from her first pelvic exam in 2016. The University of Southern California sophomore, then 19, was startled when her doctor examined her vagina for several minutes without gloves, but assumed it was standard procedure.

It wasn’t until two years later, when she read about Dr. George Tyndall’s alleged sexual abuse against USC students, that she realized she may have been sexually violated by him as well.

Driven by stories like Mohazab’s, California Assembly members Ian Calderon (D-Whittier) and Cottie Petrie-Norris (D-Laguna Beach) have proposed a bill to require doctors to give first-time pelvic exam patients a pamphlet about how the exams are supposed to be conducted, and a phone number should they want to report misconduct to the state medical board. Doctors would face a fine if they did not collect a patient’s signature confirming they received the pamphlet.

Mohazab said a pamphlet would have helped her immensely.


Fudged research results erode people’s trust in experts

Reports of research misconduct have been prominent recently and probably reflect wider problems of relying on dated integrity protections.

The recent reports are from Retraction Watch, which is a blog that reports on the withdrawal of articles by academic journals. The site’s database reports that journals have withdrawn a total of 247 papers with an Australian author going back to the 1980s.

This compares with 324 papers withdrawn with Canadian authors, 582 from the UK and 24 from New Zealand. Australian retractions are 1.2% of all retractions reported on the site, a fraction of Australia’s 4% share of all research publications.

Australian retractions have fallen from around 25 a year when Retraction Watch was launched in 2010 to an average of 11 in each of 2018 and 2017. This is in line with all retractions falling from 5,108 in 2010 to an average of 660 in the last two years. (However 2010 saw an usually high number… MORE

US doctors vote to oppose assisted suicide

In a move which has global repercussions, the American Medical Association has voted reaffirm its opposition to physician-assisted suicide.

The AMA’s official position is that legalized assisted suicide is contrary to the physician’s role as healer, puts vulnerable patients at risk, and would be difficult or impossible to control.

We asked Dr Frederick White, a Louisiana cardiologist and an AMA delegate, to explain what happened.

* * * * * * *

The AMA reaffirmed its opposition to physician-assisted suicide (PAS) last week. Can you fill us in on what happened?

Dr White: The votes taken at the AMA last week were the culmination of three years of debate on the issue of PAS. This debate began in 2016 when the AMA’s Louisiana delegation aske the AMA to reaffirm its opposition to PAS. The Oregon delegation objected and convinced the AMA to have its Council on Ethical and Judicial Affairs study the issue. After a year of intense… MORE

Page 2 of 6 :  < 1 2 3 4 >  Last ›

 Search BioEdge

 Subscribe to BioEdge newsletter
rss Subscribe to BioEdge RSS feed