- Aging
- Bioengineering
- Cloning
- Electronic Patient Records
- ethicsmatters Columns
- Human Rights
- Organ Transplants
- Reproductive Technologies
- Stem Cell Research
- Synthetic Biology
Call for Debate on Dementia
Hugh Whitthall from the Nuffield Council on Bioethics discusses the issues that accompany dealing with dementia patients in a brief interview with BBC. Alzheimer’s Disease International states that 24 million people suffer from dementia, and so Whithall is calling for stronger guidance for those caring for dementia patients.
For a video clip of the interview, go to the BBC at http://news.bbc.co.uk/2/hi/health/7400425.stm.
ID Badges store Medical History
The FDA has approved the use of a subcutaneous ID badge that carries a code permitting access to a patient's medical
records in an electronic database. The ID badges will help emergency room staff give appropriate care to unconscious or
confused patients, but the technology raises privacy concerns. According to Dr. Steven Miles, professor at the Center
for Bioethics and the Department of Medicine at the University of Minnesota, people may not have long-term control over
who has access to the secret code implanted in the arm. Eventually, information that a patient may want to keep
private-such as a family history of mental illness- may end up in the hands of health insurance companies or employers.
To read more about the controversial use of RFID (radio frequency ID) chips in humans, read the story,
" RFID: Getting Under Your Skin?" online at:
http://money.cnn.com/2004/08/05/commentary/ontechnology/rfid/
For more on ID tags and brain biotech - Read
"Implanting ideas to store medical history" by Jeffrey P. Kahn, Ph.D., M.P.H. and Director of the Center for
Bioethics at the University of Minnesota. Available from the CNN ethics matters archives online at:
http://edition.cnn.com/2002/HEALTH/05/13/ethics.matters/index.html
Heart Pump Creates Life-Death Ethical Dilemmas
Surgically implanted heart pumps called Left Ventricular Assist Devices (LVAD) were first introduced as a temporary option to keep transplant candidates alive while waiting for a donated heart. They have become more than temporary as researchers have discovered the device’s ability to lengthen patients’ lives up to a few years. However, most doctors compare the LVAD to a ventilator or feeding tube, creating dilemmas surrounding the choice to discontinue or ‘unplug’ the device. Some doctors and bioethicists believe that just like other life support devices, the LVAD may be turned off if a patient’s condition deteriorates. Others say that turning off the device serves to take the patient’s life, equating it with assisted suicide.
The ethical considerations of the use of the LVAD device are discussed in an article from the Washington Post, found at, http://www.washingtonpost.com/wp-dyn/content/article/2008/04/23/
AR2008042303534_pf.html.
Debate on Interspecies Cloning Re-ignites
In response to a lack of women’s eggs available for the purposes of cloning research, British scientists are
pursing the procedure of inserting human DNA into animal eggs. The process of inserting human DNA into animal cells
circumvents the problem of a shortage of women’s eggs as well as the risks that are associated with women donating
eggs to research. By creating a model of a disease in a dish, such as Alzheimer’s or Parkinson’s,
researchers are able to study their development and test drugs. Researchers claim it will enable them to better
understand the genetic causes of diseases and begin to design personalized medicines. However, the ethical concerns
surrounding cloning and the use of human embryos for research are still present.
For the full article, go to
http://www.washingtonpost.com/wp-dyn/content/article/2007/03/25/AR2007032500553.html
E-Record Introduction
Electronic patient records have been slowly introduced to the healthcare world, but usage is not increasing as fast
as some advocates would like. They stand to improve patient care by reducing human error, cutting down on administrative
work, and keeping medical histories organized for patients who switch doctors or see different specialists. However,
ethical concerns arise as privacy advocates point out the risk of personal information being leaked or misused.
Read "Doctors Slow to Adopt E-Records for Patients" online at
http://www.washingtonpost.com/wp-dyn/content/article/2006/10/11/AR2006101101720.html.
Check out our archived feature, ethics matters, written by Jeffrey Kahn, Ph.D., M.P.H. and Director of the Center for Bioethics at the University of Minnesota. Find out about controversies related to genetic testing, organ transplants, reproductive technology, healthcare data privacy and more...
Abu Ghraib: its legacy for military medicine
Based on his study of how prisoners were treated at Abu Ghraib prison in Iraq and elsewhere, Dr. Steven Miles of the
Center for Bioethics at the University of Minnesota has become a leading voice in the opposition to physician
involvement in torture of U.S. military prisoners. In his article, "Abu Ghraib: its legacy for military medicine,
" he points out that military physicians in prisons and detainee camps have a responsibility to prevent torture by
abiding by the ethics of medicine. And when interviewed by Agence France-Presse, Miles talked about the results of
torture on the political situation at hand: "There's a huge body of literature showing not only that torture
doesn't work, but that it's counterproductive. Any intelligence system has more data than it has analytical capability.
And what torture does is to flood the analytic system with bad data. You wind up making very bad policy decisions from
that kind of advice. You also wind up alienating potential informants or potential recruits who are in the population.
"
To find out more about Miles work, you can read "Abu Ghraib: its legacy for military medicine,
" published in the Lancet and available online.
The article "Amid CIA Prisons Row: Torture doesn't work, experts say," from Agence France-Presse, is available
online at
http://news.inq7.net/breaking/index.php?index=3&story_id=59251 .
Broader Torture Definitions Needed
Stemming from the abuses by the U.S military in Guantanamo Bay, Iraq and Afghanistan, new studies show that a broader
definition of torture needs to be created. Researchers say the current definition is too narrow and "excludes
mental pain and suffering created by acts that do not cause severe physical pain, such as blindfolding, hooding, force
nudity, isolation and deprivation of sleep or light". Many of the accepted forms of extracting information are
not currently considered under the definition of torture but do result in prolonged suffering, depression or
post-traumatic stress disorder. The study was published in the Archives of General Psychiatry.
For the full article about this study, go to
http://www.cbsnews.com/stories/2007/03/05/national/main2537758.shtml.
Organs Advertised over the Internet
The number of patients on the waiting list for organ donation far exceeds the number of available donors. In the
U.S., on average, 17 patients die each day while awaiting an organ and 110 people are added to the waiting list.
Many of those whose loved ones need organs are now advertising over the Internet in order to find and obtain organ
donations.
Some question whether the internet advertising masks an illegal commercial market for human organs, one that buyers and
sellers take great pains to cover up. Moreover, bioethicists are concerned that the internet activity results in unfair
distribution of the few organs available for transplant.
For more, read
"
Search for Transplant Organs Becomes a Web Free-for-All", available online from the Washington Post.
You can read the Associated Press story, "More patients turning to Internet for organs: Longer waiting lists for
transplants sparks online boom," online at
http://www.msnbc.msn.com/id/6326205/ or
"Transplants: Is system
fair?," from the St. Louis Post-Dispatch.
For additional information on organ transplantation and related ethical issues, read the Center for Bioethics Overview,
"Ethics of Organ Transplantation
,
" and the short summary, "Organ Transplants."
New machine keeps ‘heart in a box’ beating
A machine called the Organ Care System, made by TransMedics Inc. is able to keep a heart beating for up to 24 hours after being
removed from a cadaver. It functions by pumping donor blood through the heart without the need for cold temperatures or
preservative fluids. Three patients have been successful recipients of hearts that have been kept in the Organ Care System and more testing and research is underway.The development allows a heart to last longer so that is can be transported further in order to
reach more potential recipients. For discussion of this technological development, go to
http://www.msnbc.msn.com/id/18742817/.
New York Planning Special Ambulance to Recover Organs
The number of patients on a list waiting for an organ transplant is near 100,000 according to the United Network for Organ Sharing. The federal Health Resources and Services Administration of the Department of Health and Human Services is funding a 3-year project for a pilot program that will provide ‘rapid-organ-recovery ambulances’ that will be sent out to procure viable organs if paramedics fail to revive a patient. Currently there is no system in place to procure organs from patients that die suddenly and outside of a hospital, potentially missing 35,000 transplant opportunities. Bioethicists raise the critical issues that accompany this pilot program citing the potential threat to the public’s trust in the healthcare system, suggesting that some in the public will perceive this program as an overzealous attempt to gain organs without focusing on saving a life.
For the full article from the Washington Post, go to http://www.washingtonpost.com/wp-dyn/
content/article/2008/05/23/AR2008052303006.html.
Idea of 'designer' babies with 'defective' genes stirs ethics questions
The topic of so-called 'designer babies' and the ability to select embryos based on genetic characteristics
comes with many ethical considerations. Yet, a new concept of using pre-implantation genetic testing of embryos for the
purpose of trying to have a child with a defect similar to his or her parents has led to a host of new ethical
questions. Parents with conditions such as deafness or dwarfism are seeking the technique to have children that are
like them so that they can fully join in and share their lives and culture. This challenges our society's concept of
normality and the term 'defect'
For the full article, go to http://www.cnn.com/2007/HEALTH/parenting/01/18/designerd.disability.ap/index.html.
'Do not revive' earliest babies
The Nuffield Council on Bioethics has released a report about the ethical considerations of resuscitation or
intensive care administered to babies born at or under 22 weeks. The report addresses the fact that despite medical
advances many premature babies do not live long and have high chances of developing severe disability. Medical experts
argue that each case needs to be assessed individually and that no cut-off points for administering care can be
determined. Without individual assessment, experts say these recommendations can be considered discriminatory and a
breach of human rights.
Read an article on this report online at
http://news.bbc.co.uk/2/hi/health/6149464.stm.
To access the full report by the Nuffield Council on Bioethics, go to
http://www.nuffieldbioethics.org/fileLibrary/pdf/CCD_web_version_8_November.pdf.
Pre-Implantation Genetic Diagnosis
Nearly half of fertility clinics in the U.S offer a screening process that allows parents to choose the sex of their
child and is not used for any other medically related reason. In clinics that offer pre-implantation genetic diagnosis
(PGD), part of in vitro fertilization, in which an embryo 3-5 days old is removed and analyzed, 42 percent said that
they used PGD solely for sex selection. Many ethicists see the increased use of screening as a movement towards a
society that is seeking 'designer babies' - babies not just free of diseases and defects, but possessing
chosen traits and characteristics.
"Half Fertility Clinics Allow Parents to Pick Gender" can be found online
at: http://www.msnbc.msn.com/id/14929492/.
The New "Egg Money"-Paying off student loans through egg donation
The US is one of the few industrialized nations where payment for egg donation is legal. (Canada banned the practice
in 2004.) As a result, women from other countries who seek to become pregnant using donated eggs come to the U.S. These
reproductive tourists have increased demand for egg donations and clinics are advertising on the internet and in college
newspapers to attract their target donors: attractive and high-achieving female college students. These women may
decide to donate eggs in exchange for fees of $8000 or more-money they could use to pay off student loans. Harvard
Business School professor Debora Spar, author of The Baby Business, is calling for a national debate on the estimated $3
billion a year fertility business. "We are selling children," Spar told USA Today.
For more, read "
Egg-donor business
booms on campuses".
Safeguards for Savior Siblings
The Human Genetics Commission, which advises the United Kingdom government on social, ethical, and legal impacts of
advances in human genetics, has issued a report calling for research on savior siblings, who are conceived with the
intent of providing life-saving tissue donations to an existing child. The report says there should be research into the
wellbeing of children born in this way and that there must be safeguards for family relationships and the wellbeing of
the child in such circumstances.
For more information, read "Concern over 'spare part' babies," online from
BBC News at
http://news.bbc.co.uk/2/hi/health/4663396.stm.
‘Egg rebate’ cracks open an ethics mess
British scientists have introduced a concept of offering rebates to women seeking fertility services in exchange for
‘donating’ their eggs for the purpose of stem cell research. Proponents of the rebate approach claim that women
already sell their eggs to couples in need and so the concept is not new. However, tying the "donation" to discounts for reproductive medicine services makes many uneasy. Ethicists point out the great difference in donating spare embryos
for research and selling eggs for money.
For the full article, go to
http://www.msnbc.msn.com/id/16740643/.
IVF as the first option
Couples in Australia are choosing IVF as a first resort when they encounter fertility problems as opposed to exploring lifestyle
changes, the Research Centre for Reproductive Heath at the University of Adelaide reports. Instead of looking to reduce smoking
habits or address weight problems, couples are going straight for the IVF option. This raises the question of whether this is
considered overuse of reproductive technologies and considering them a right as opposed to an option. It also raises the issue of
the financial burden that comes with IVF and the increased costs and risks that are associated with multiple births. Should IVF be
allowed to be the first option considered when it comes at a high cost with potentially higher risks?
For the full article, go to
http://www.bionews.org.uk/new.lasso?storyid=3572.
Stem Cells from Dead Embryo
Scientists in Spain claim they have developed a way to harvest stem cells from a human embryo that had stopped
dividing naturally and so could be considered dead. If accurate, this could resolve some of the major ethical concerns
associated with destroying an embryo for the purpose of harvesting stem cells. Some experts consider the process
ethically on par with the process of procuring organs from a dead donor. However, others question the assumption that
death can be determined when a cell ceases to divide. In addition, if the cell has stopped dividing, this could indicate
a defect in the cell and as a result, harvesting it for stem cells may be problematic.
To find out more, read "Scientists create stem cells from 'dead' embryo" online at
http://www.msnbc.msn.com/id/14958292/.
Stem Cells without Destroying Embryo
The biotech company, Advanced Cell Technology claims to have discovered a way to harvest stem cells without
destroying an embryo. Though this would serve to resolve the main ethical debate surrounding stem cell research,
scientists are skeptical that the achievement is credible or efficient.
To find out more about the new method, read "Stem Cells that won't Destroy and Embryo?" at
http://www.msnbc.msn.com/id/14481692/.
Also, read Arthur Caplan's opinion piece, "Stem cell 'breakthrough' more hype than hope" that claims
the new method raises more ethical issues instead of resolving them. The story is online at
http://www.msnbc.msn.com/id/14502237/.
New surveys on America's views of stem cell research
The Genetics and Public Policy Center at Johns Hopkins University conducted a public opinion survey on stem cell
research in September, 2005. The survey of 2,212 Americans "found wide support for embryonic stem cell (ESC)
research that cut across political, religious and socio-economic lines, with two-thirds of respondents either approving
or strongly approving of human embryonic stem cell research. Even Fundamentalist and Evangelical Christians long
considered to be the most hard-line opponents of embryonic stem cell studies -- split evenly on approval for embryonic
stem cell research." Results of a June, 2005, phone survey of 1000 Americans reveal that a majority of Americans
(58%) favor embryonic stem cell research and that a core minority (18%) strongly oppose it. The people responding to the
survey questions represented the country's demographics in geography, gender, and ethnicity, according to the Charlton
Research Company, which conducted the survey. The survey was commissioned by PARADE magazine and Research! America, a
nonprofit public education group that advocates for commitments to health research funding.
Complete survey results are available online from Research! America at
http://www.researchamerica.org/polldata/2005/stemcell(parade).pdf
Human-animal "cybrid" embryo green light
Scientists in England have been granted permission to create human-animal embryos (termed "cybrids") for stem cell
research, according to the Human Fertilization and Embryology Authority (HFEA). Though scientists need to make individual
applications for permission, this method of creating hybrid embryos opens the door for exploring different methods of obtaining
stem cells. Currently, scientists rely on excess human embryos from fertility treatment, but many claim this supply is not
sufficient. Scientists in support of the method and the decision to allow the research recognize the controversy but stress the
controlled nature of the work. Critics of this decision call it disrespectful and a threat to the dignity of humans and animal.
Further, they object to HFEA’s claim to authority on this topic and say the decision should be left to parliament.
For more discussion on the moral and ethical discussions surround the decision, the full article can be found at http://news.bbc.co.uk/1/hi/health/6978384.stm.
Skin cells made into stem cells
Research groups in the US and Japan have reported new methods of reprogramming human skin cells to mimic embryonic stem cells
’ pluripotent nature. By introducing another process of creating stem cells that does not involve the controversial use of
human embryos, this development has the potential to alter the ethical debate about current stem cell procurement techniques.
Using skin cells to procure stem cell for treatment is a way of personalizing treatment for individual patients and reduces the
risk of rejection. Further, the new technique does not require creating embryos in the lab and is more controlled and precise than cloning technology. Researchers caution that this technique is in its beginning stages and it could be years before it is refined
and safe enough for use in humans. Nonetheless, scientists have called the development as "significant as the first
derivation of human embryonic stem cells."
For more information on the new developments go to,
http://news.bbc.co.uk/2/hi/health/7101834.stm
http://www.npr.org/templates/story/story.php?storyId=16466265
The report was also published on the website for Science on November 20, 2007,
http://www.sciencemag.org/cgi/content/abstract/1151526.
First genome transplant turns one species into another
Scientists have performed the first genome transplant - moving toward the ability to create synthetic forms of life. The team hopes to create new microbes to produce environmentally friendly fuels. However, opponents of these advances fear that the field of synthetic biology is progressing too fast and recognize the potential for this knowledge to be used by terrorists to create bioweapons. For the full article, go to http://www.guardian.co.uk/science/2007/jun/29/genetics.uknews.
Creating Artificial Life, Declares US Gene Pioneer
DNA researcher, Craig Venter recently announced the construction of a synthetic chromosome, and has announced he has made further progress with the pending creation of a new artificial life form. Venter acknowledges the ethical debate surrounding creating new species, but claims the process could have implications for combating global warming with the ability to create new energy sources. Venter calls his work a "very important philosophical step…going from reading our genetic code to the ability to write it". Bioethicists recognize the need to acknowledge the ethical debate, and the need for regulation because the advancement could be a huge contribution or a huge threat to humanity. For the full article, go to http://www.guardian.co.uk/science/2007/oct/06/genetics.climatechange