April
18
 

Even for Ebola, unproven treatments are dicey, say bioethicists

In a target article in the latest edition of the American Journal of Bioethics, three bioethicists from the National Institutes of Health question the ethics of providing unproven interventions to Ebola victims and those at risk. 

Seema K. Shah, David Wendler and Marion Danis describe the detrimental effects of providing an unproven treatment – in particular (where the treatment fails to work) decreased trust in doctors and the medical profession generally.

The ethicists conclude that it may be more beneficial to focus on other methods of stemming the spread of the disease, such as building up healthcare infrastructure and providing healthcare workers to affected areas, rather than focusing energies on distributing what are potentially unbeneficial, or worse, harmful drugs.

Concerning patient trust in medical professionals, the authors observe: 

“The practice of medicine was once coloured by the public’s perception of physicians as peddling goods that… click here to read whole article and make comments




 
April
18
 

Feverish vaccine debate spreads to Australia

Last Sunday the Australian government announced a controversial new immunisation policy that makes welfare support for families conditional on child immunisation.  

“The no jab, no pay” welfare plan, which has by partisan support in the Australian federal parliament, will require of parents that they immunise their children against serious infectious diseases such as measles, mumps, rubella, tetanus and polio.

Parents who refuse to immunise their children could lose up to A$2100 per child per year in welfare payments.

Social services minister Scott Morrison, who announced the plan, said that the medical community was united in its support for universal vaccination, and that “objections” were no long acceptable.

“The overwhelming advice of those in the health profession is it’s the smart thing and the right thing to do to immunise your children.”

Federal opposition leader Bill Shorten agreed:

“We believe fundamentally in the… click here to read whole article and make comments




 
April
18
 

Unreported clinical trial data “unethical”

The World Health Organization (WHO) has called for the disclosure of results from clinical trials for medical products, whatever the result. The move aims to ensure that decisions related to the safety and efficacy of vaccines, drugs and medical devices for use by populations are supported by the best available evidence.

“Our intention is to promote the sharing of scientific knowledge in order to advance public health,” said WHO official Marie-Paule Kieny. “It underpins the principal goal of medical research: to serve the betterment of humanity.”

According to WHO, there is increasing empirical evidence to suggest that the results of many clinical trials are suppressed from the public. One study that analysed the reporting from large clinical trials (more than 500 participants) registered on ClinicalTrials.gov and completed by 2009 found that 23% had not reported any results. These unreported trials included nearly 300,000 participants.

Even where results are… click here to read whole article and make comments




 
April
18
 

Bad ideas never die; they just plea bargain

A series of cases in Tennessee suggests that women may be trading sterilization for reduced jail sentences in the US. According to a report by AP, Nashville prosecutors have done deals with women at least four times in the past five years.

In the latest case, a 36-year-old woman with a long history of mental illness, Jasmine Randers was charged with neglect after her 5-day-old baby mysteriously died during the night. Her lawyer alleges that the prosecution refused to discuss a plea bargain unless she agreed to be sterilized.

In conjunction with similar incidents in Virginia, West Virginia and California, lawyers think that many sterilizations may be organised out of view by the public and the courts. "It's always been more of 'If your client is willing to do this, then I might be inclined to talk about probation,'" one lawyer commented.

"The history of sterilization in this… click here to read whole article and make comments




 
April
18
 

Gene of the Week 2: voting preferences

According to researchers at TwinsUK, a registry of identical and non-idential twins, genes are the best predictor of how people will vote. “Our choices at the polling booth may not be as free or rational as we would like to believe,” they conclude in The Conversation.

“We found that voting Conservative (or not) is strongly influenced by genetics. When it came to voting Tory, we found that 57% of the variability (differences or similarity) between people’s voting preferences were due to genetic effects,” writes Professor Tim Spector, of Kings College London.  The percentages for UKIP were 51% and for both Labor and the Green Party 48%.

Only a vote for the Liberal Democrats could not be explained by genetics.

“Previous studies have also shown strong genetic influences on right-wing views – be they for or against. We and others have demonstrated consistent genetic influences… click here to read whole article and make comments




 
April
18
 

Gene of the Week 1: sex offending

The father of modern criminology, the Italian sociologist Cesare Lombroso (1835-1909) believed that criminality was genetically determined. A “born criminal” could be detected by the presence of a long list of “stigmata” such as an asymmetrical faces, sloping forehead, large ears or left-handedness. This idea has been largely discredited, but, it flowers as soon as water floods the desert sands.

Newspapers last week featured headlines like: “Sex crimes may run in a family's male genes” or “Genetic factors were found to increase the risk of a sex crime conviction” or “Sex offending is written in DNA of some men” after the release of a Swedish study of the genetic link to sex crimes.

Researchers at the Karolinska Institutet in collaboration with Oxford reported in the International Journal of Epidemiology that close relatives of men convicted of sexual offences commit similar offences themselves more frequently than comparison subjects.… click here to read whole article and make comments




 
April
18
 

Should medicine leave the gold standard of randomized trials?

When you google “randomized controlled trials”, you find an abundance of news stories and government agency websites which describe them as the “gold standard” of medical research. Take, for instance, a recent press release from Johns Hopkins University: “They found that only 11 of the programs met the scientific ‘gold standard’ for reliability in the studies—using randomized clinical trials.”

However, the medical profession is far less confident. Adding to the chorus of researchers and clinicians is an article in The Lancet which calls for a more “ecumenical” and flexible approach to acceptable study designs.

David S Jones and Scott H Podolsky, both from Harvard Medical School, point out that randomized trials do not have a long history. The first one took place in 1948 and the first instance of describing them as the “gold standard” dates back to only 1982.

While RCTs are clearly useful, they argue that… click here to read whole article and make comments




 
April
18
 

Canadian bioethicist attacks conscientious objection

The Canadian Medical Association is digging in its heels to protect doctors’ right of conscientious objection to euthanasia and assisted suicide, which will soon become legal. In an interview with the National Post, CMA president Chris Simpson  said recently, “we simply cannot accept a system that compels physicians to go against their conscience as individuals on something so profound as this.”

Don’t listen to him, warns one of Canada’s most prominent bioethicists. No doctor should have the right to conscientious objection, he says.

Professor Udo Schuklenk, of Queens University and editor-in-chief of the journal Bioethics, delivered a blistering attack on conscientious objection in medical practice in his blog:

The very idea that we ought to countenance conscientious objection in any profession is objectionable. Nobody forces anyone to become a professional. It is a voluntary choice. A conscientious objector in medicine is not dissimilar… click here to read whole article and make comments




 
April
12
 

Was the Boston bomber too young to be responsible?

As the trial for the Boston Bomber Dzhokhar Tsarnaev draws to a close, experts are debating whether the accused’s age diminishes his culpability. Together with his brother, 19-year-old Tsarnaev planned and executed the devastating Boston Bombings on April 15, 2013, which killed three civilians and injured 264 others. In a subsequent manhunt the Tsarnaev brothers killed a police officer and wounded 15 others.

Like Dzokhar’s defence lawyers, Temple University psychology professor Laurence Steinberg acknowledges that adolescence does not entail innocence. He does, however, believe it might diminish the defendant’s guilt:

“The issue is not whether adolescent immaturity excuses criminal conduct — it doesn’t — but whether it diminishes someone’s responsibility for his actions, in much the same way that coercion or unusually strong emotions might…

“Research… has identified the neural bases of adolescents’ intensified susceptibility to peer pressure and is revealing the period to be… click here to read whole article and make comments




 
April
12
 

US bioethics commission releases report on neuroscience and law

On March 26 the US Presidential Commission into the Study of Bioethical Issues released the second volume of its report in developments in neuroscience. Volume II of Grey Matters: Topics at the intersection of neuroscience, ethics, and society examines three key areas in which neuroscience intersects with ethics.   

Perhaps the most topical – considering media discussion surrounding the sentencing of Boston Bombing perpetrator Dzhokhar Tsarnaev, is the role of neuroscience in the courtroom. The report catalogues the various contributions that neuroscience could potentially make to our understanding of human action and the criminal mind, and also examines ethical concerns such as the potential for misinterpretation and overstatement of the implications of neuroscientific research.

Among a number of recommendations, the authors of the report call for educational tools to help judges and lawyers grasp the rudiments of neuroscience.

“Government bodies and professional organizations, including legal societies and nonprofit… click here to read whole article and make comments




 

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 Recent Posts
Even for Ebola, unproven treatments are dicey, say bioethicists
18 Apr 2015
Feverish vaccine debate spreads to Australia
18 Apr 2015
Unreported clinical trial data “unethical”
18 Apr 2015
Bad ideas never die; they just plea bargain
18 Apr 2015
Gene of the Week 2: voting preferences
18 Apr 2015