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Viewing by month: July 2011
July 28, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Opponents of reproductive cloning fear that the resulting children will not be able to live fully independent lives. Opponents fear that these children’s choices will be constrained in numerous ways and assert that an open future — which is a right of every child — will never be possible for a child who is a clone. Reproductive cloning naysayers believe that the human rights of these children will be violated and therefore the process should be banned.

Various premises provide the background to these beliefs. Various mental constructs may significantly constrain the child's choices and development in ways that mitigate the possibility of an open future. In this regard, being a clone violates the child's rights as a human being.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 27, 2011 | Posted By Ricki Lewis, PhD

Like Alvy Singer, Woody Allen’s character in Annie Hall, I’m obsessed with books about the end of humanity, which sometimes involves the end of the world, and sometimes just that of Homo sapiens. Midsummer is a good time to contemplate how bioethics would come into play in such unlikely scenarios, which raise issues of utilitarianism, justice, paternalism, death and dying, and misuse of technology. 

I prefer the human-wrought disasters to the more celestial imagined ends, such as the film “Asteroid”, which was so bad that my husband dubbed it “Hemorrhoid”. My favorite, after many years of wallowing in these depressing depictions, is "Swan Song," by Robert McCammon, in which survivors of a nuclear holocaust stagger about, drinking wolf’s blood to avert starvation. I can still picture, practically smell, when 6-year-old Swan picks the first apple to grow after a nuclear winter. Another favorite is “The Road,” in which Cormac McCarthy recounts the journey of a father and son as they traverse post-apocalyptic terrain, searching for others. What led to the destruction of society? How does it rebuild? Is a messiah, like Swan, essential?

I also savor novels that alter the human life cycle, tweaking age cohorts. “The Children of Men,” an excellent book by P.D. James and a terrible film, envisions a world with no more children. Time ticks down to the inevitable end of our species, with the drama centering around a pregnant woman. That’s a scenario that would welcome reproductive cloning!

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 26, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

The various flavors of stem cell research continue to be in the news and continue to be featured in peer-reviewed literature and leading scientific publications. Recent reports describe the immunogenic rejection of transplanted induced pluripotent stem cells (iPSCs) even when they have been immunologically matched with the intended recipient

 

Research involving iPSCs has made remarkably rapid advances since their introduction in 2006. But research using embryonic stem cells (ESCs) remains of critical importantance. Reprogramming adult cells using a cocktail of transcription factors restores a primitive pluripotent state. However, reprogrammed cells are significantly different from the pluripotent cells of the embryo’s inner cell mass. Many of these differences have yet to be determined. It would be a grave mistake at present to believe that reprogrammed cells can substitute for pluripotent cells derived from embryos. Both lines of work need to go forward.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

 

July 22, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Procreative liberty — the freedom to make your own choices regarding procreation — encompasses a wide range of putative rights. Over the course of the last several decades, many landmark cases decided by the Supreme Court have defined and expanded the rights pertaining to procreative liberty.

But the right to reproduce does pose many deep questions across a range of issues, particularly those involving important state interests and potential harm to other persons. As well, the status of all parties involved, e.g., gamete donors in the case of IVF or DNA donors in the case of human cloning, needs to be formalized. These are a few of the concerns.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 21, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Many are not convinced the glittering promise of genetic manipulation implies the presence of a pot of gold. Science often moves faster than moral understanding. For some, the gift of life is paramount. Children should be appreciated as the gifts they are. If we are seduced by the sirens of science, the breakdown of society will ensue and social solidarity will dissolve.

There is a wider benefit. Good genes over time create fitter humans — the entire gene pool could become optimized over a handful of generations. Certainly, such humans would have genomes qualitatively and quantitatively different from the genomes of 10,000 years ago. But over evolutionary time, viruses infiltrate our nuclei and update our 3 billion base pairs. Again, systematization of this "creation"-based process could provide great benefit.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 20, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

In 2008 prescription medications accounted for $291 billion in sales in the United States. In 2000, the drug industry employed more than 625 lobbyists (there are only 535 members of Congress). Big business. Big money. Big power. Power versus principles — this is an eternal dialectic. If power rules, we might as well shred the Belmont Report right now.

Universal ethical standards are meant to apply universally — not locally and selectively, at the whim of the more powerful agency. They are designed to protect the more vulnerable among us — us referring to the international community. And in an ethical world, standards of care should refer to the highest, not the lowest, common denominator.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 19, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

For genetic analysis related to breast cancer and Huntington's disease, it is likely such investigations are initiated for an asymptomatic patient with a relevant family history. Testing for Down's syndrome is routine for pregnant women older than 35. With the advent of maternal serum markers, aggressive obstetricians may recommend such screening to all their patients.

The right to privacy — closely related to the bioethical principle of autonomy — is the main concern in genetic testing. With whom are the results to be shared? Many ethical questions confront individuals and physicians on a daily basis. Many more will arise as technology continues to advance. The fields of bioethics and jurisprudence need to be proactive and deeply consider these matters in advance of further scientific and technological developments.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 11, 2011 | Posted By Posted By David Lemberg, M.S., D.C.

Human cloning has long been demonized in popular culture. In cinema and literature, with few exceptions, clones are represented as mindless drones who serve their masters without question for good or evil. Cloning could also cause a great deal of damage for living, breathing human beings. From an individual perspective and from the broader perspective of society, the availability of cloning could lead to violations of the bioethical principle of nonmaleficence.

Cloning would make it possible for interested parties to have children for purely self-centered reasons. Also, cloning has substantial potential for harming society via alterations to the human genome and human physiology.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 11, 2011 | Posted By Ricki Lewis, PhD

”Dignity therapy" is a “novel psychotherapeutic approach” that gives patients with a 6-month life expectancy “an opportunity to reflect on things that matter most to them or that they would most want remembered.” In these days of medical experts such as Sarah Palin equating reimbursed end-of-life discussions to death panels killing granny, an outcomes evaluation of any such intervention is essential. Harvey Max Chochinov, of the University of Manitoba and colleagues in the U.S. and Australia did just that. Their impetus: “… although much progress has been made in our ability to achieve physical comfort for patients who are dying, few novel interventions have been designed to address the psychosocial, existential, and spiritual dimensions of end-of-life care.”

In an admittedly difficult-to-design study, the investigators randomized 326 patients (most of whom had cancer) to one of three interventions: dignity psychotherapy, palliative care, and client-centered care (which focuses on the “here and now” as opposed to the past and future perusal of dignity therapy). Their article in Lancet Oncology provides 9 questions that a trained dignity therapist might pose to a patient. Responses are recorded and typed up, then presented to the patient as a “generativity document.” Various before-and-after rating scales as well as patient comments revealed improvement in quality of life and family relationships with dignity therapy, although general distress was not significantly alleviated with any intervention. 

Oddly, for Dr. Chochinov is an award-winning palliative care expert, the report mentions “hospice” only as a possible physical setting! In fact, hospice volunteers have been providing dignity therapy for decades. 

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

July 7, 2011 | Posted By Bruce D. White, DO, JD

An NPR story this morning caught my attention. The Julie Royner report title is “Medicaid Makes ‘Big Difference’ in Lives, Study Finds.” It is available online by clicking here.

A new Harvard-National Bureau of Economic Research-State of Oregon project shows that Medicaid patients are happier with Medicaid coverage than they are when they are uninsured. But this wasn’t the principal point of the story. The report began with the notion that Medicaid patients themselves are not happy with their Medicaid coverage. Medicaid patients say they can’t find doctors who accept Medicaid patients, that the services they do receive when compared with those that have regular insurance are not as good, and there are strict limits on the services available. Moreover, politicians are not happy with Medicaid because the costs keep going up – taking a larger slice of the revenue pie – and it’s a very difficult program to manage.

Ms. Royer seemed surprised with the study findings because it contrasted so sharply with the commonly held view of the past 40 years that the Medicaid program didn’t really help patients as originally intended and it was for the most part a failure.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

 

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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