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.

“It… MORE





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





Fertility tourism: Australians travelling to US to have ‘designer babies’

Australian intended parents are spending A$20,000 to select the sex and eye colour of yet-to-be-born babies via with IVF at American fertility clinics. Blue is the favourite eye colour. Compared to headline features like high IQ, Olympic athletic ability or freedom from Alzheimer’s, these are modest product specs. But when all is said and done, these parents are still creating “designer babies”.

This is forbidden under Australian law. Unlike the United States, where the fertility industry is very lightly regulated, gender selection is banned throughout Australia. According to the Ethical Guidelines on the use of Assisted Reproductive Technology in Clinical Practice and Research 2017 (ART Guidelines), sex selection is only permitted for medical reasons, when a genetic disease is sex-related.

While these guidelines are not legally enforceable, Australian fertility clinics cannot practise without accreditation. And the Reproductive Techology Accreditation Centre (RTAC) Code of Practice requires fertility clinics to comply with the ART Guidelines.

In addition, in three states ie.… MORE





Misreporting science is unethical and even dangerous

I work in the field of bioprinting, where the aim is to build biological tissues by printing living cells into 3D structures.

Last month I found my Facebook news feed plastered with an amazing story about “the first 3D printed heart using a patient’s own cells”. A video showed a beautiful, healthy-looking heart apparently materialising inside a vat of pinkish liquid.

Big news. According to an impact tracking algorithm, the story has been picked up by 145 news outlets, tweeted 2,390 times to 3.8 million followers (as of May 27, 2019). Articles on Facebook have at least 13,000 shares, and videos about the story have been viewed well over 3 million times.

Unfortunately, many of these media reports don’t match up well with the original science.

Over-reporting of medical science is unethical, and occasionally dangerous. It’s a problem all of us who work in the creation and telling of science can act to fix.

How they printed… MORE




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