Bioethics
j7uy5 | January 15, 2007
Everyone knows that HIV is American prisons is a huge problem, but we don't hear much about it. There are several reasons for that. For one, prisons are unpleasant places, and for the most part, we don't want to think about what goes on there. For another, many people figure that whatever happens to prisoners is their problem; some even assume that whatever happens to inmates is part of their well-deserved punishment. Perhaps homophobia is a factor, too. For some, it may be unpleasant for them to think about one of the modes of transmission of HIV/AIDS. Not that any mode is particularly nice…
oracknows | January 9, 2007It is with a bit of trepidation that I write about this.
The reason, for anyone who reads ScienceBlogs specifically or science blogs in general, should be obvious. Richard Dawkins is such a polarizing figure with a penchant for stirring things up with regards to the most deeply held beliefs of both the religious and atheists, that he has all too often served as a flashpoint for battles between secularism and religion or a convenient excuse for the two most popular of my fellow ScienceBloggers to indulge their mutual animosity publicly. Posting about Dawkins, whether you defend or criticize…
oracknows | January 8, 2007It was just last week that I was made aware of the sad news that Katie Wernecke, the 14-year-old girl with Hodgkin's lymphoma whose parents' battle to reject radiation therapy and additional chemotherapy made national news in 2005 and who ultimately went for high dose vitamin C therapy at an altie clinic in Kansas, had relapsed. (Even now, altie vultures are advertising their wares in the comments of the post in which Katie's father announced her relapse, and chastising a lone MD who posted a comment begging the family to try conventional medicine while there's still a chance.) As regular…
oracknows | January 6, 2007Before I move on to other topics, I can't resist one last comment about the corrupt and sleazy Andrew Wakefield, the man who, with the help of heaping piles of cash from lawyers, almost singlehandedly produced a scare over the possibility that the MMR vaccine causes autism so large that vaccination rates in the U.K. fell precipitously, leading to massive misery due to a resurgence of the diseases prevented by the MMR vaccine and at least one death. Brian Deer, as you may know, is the journalist who exposed the disgusting underbelly of Wakefield's activities and who also broke the story of…
j7uy5 | January 5, 2007(I know Shelly has
href="http://scienceblogs.com/retrospectacle/2007/01/post.php">already
posted about this on Retrospectacle.
Hopefully, you'll see there is a different slant to this.)
Significant controversy arose over the idea of using pharmaceutical and
surgical methods to permanently stunt the growth of children with
severe disabilities. The controversy arose with the
publication of stories in the media about "Ashley X."
The medical profession refers to this as
"growth attenuation treatment." In order to understand the
controversy, it first is necessary to understand what was…
sciencetolife | January 3, 2007New guidelines by the American College of Obstetricians and Gynecologists published in the January issue of the journal Obstetrics & Gynecology now recommend that every pregnant woman, regardless of age, should be offered a choice of tests for Down syndrome.
Down syndrome is a condition that occurs in one out of every 733 live births, according to the National Down Syndrome Society, and affects more than 350,000 people in the U.S. The condition is characterized by the presence of an extra chromosome which causes mental retardation, a characteristic broad, flat face and small head and,…
j7uy5 | January 2, 2007There have been stories and novels about the end of privacy.
1984, by George Orwell, comes to mind. I also
remember reading a science fiction short story once, about how
technology had made privacy so difficult to maintain, and so accepted
by society, that it was considered rude to want privacy. I
can't remember who wrote that one.
This post was inspired by an article in the Wall Street Journal, that
points out how little privacy there is when it comes to medical
records. More below the fold...
Time Magazine just published 25 "top-10" lists for 2006. One
of the lists is for
href="…
oracknows | January 1, 2007This should come as no surprise. Thanks to Brian Deer, the journalist who uncovered so much of Dr. Andew Wakefield's shady research and dealings, we now know that Wakefield was paid by lawyers before his infamous MMR study and that he failed to disclose this clear conflict of interest:
ANDREW WAKEFIELD, the former surgeon whose campaign linking the MMR vaccine with autism caused a collapse in immunisation rates, was paid more than £400,000 by lawyers trying to prove that the vaccine was unsafe.
The payments, unearthed by The Sunday Times, were part of £3.4m distributed from the legal aid…
oracknows | December 18, 2006You may recall how I've criticized the infiltration of woo into medical school and medical education in general. Such an infiltration threatens the scientific basis behind the hard-won success of so much of modern medicine over the last century. Unfortunately, woo isn't the only threat to scientific medicine. Now, there is a growing movement that insists that doctors should ask you about your spiritual life and make religious practices a part of medicine, as Dr. Richard P. Sloan described in an editorial in the L.A. Times that I can't believe I missed:
HOW WOULD you like your doctor, at your…
oracknows | December 14, 2006It appears that I'm even further behind in my reading than Abel Pharmboy, because he pointed me to a couple of articles in an issue of the Journal of Clinical Oncology that I haven't even cracked open yet. It's probably still sitting in the pile of journals on my desk that haven't been touched yet because I haven't gotten around to them. The issue contains two articles of interest, but I think I'll only touch on one of them for now because it's highly relevant to my previous posts about Abraham Cherrix, the 16 year old with relapsed Hodgkin's disease and refused additional chemotherapy in…
j7uy5 | December 7, 2006This has been a topic at ScienceBlogs before. Now, finally,
the New England Journal of Medicine is catching up. They have
an editorial on the ethics of vaccination against Human Papilloma
Virus. It turns out that there are many facets to this issue.
The background is this: HPV is a major factor in the
development of cervical cancer. About 10,000 women are
diagnosed with cervical cancer each year in the USA, and there are
about 3,700 deaths per year from the disease.
To put that in perspective, that is more than the total number of
deaths in the terrorist attacks on 9/11.
Previous…
oracknows | November 30, 2006When I wrote a post about how Richard Dawkins was being unjustly smeared as supporting Hitler-style eugenics by the religious blogosphere, I figured I might provoke some criticism, particularly since I didn't just stop there. No, in a bit of what some may consider blogging hubris, I couldn't resist trying to discuss under what circumstances eugenics might be morally justifiable and under what form. (Of course hubris is almost a job requirement to be a blogger; so none of this should be surprising.) In any case, not surprisingly Vox Day wasn't all that happy about what I wrote. (If you're…
oracknows | November 22, 2006A few days ago, I posted a response to another physician who was not happy with me, no, not happy with me at all. What made him unhappy was the vociferousness with which I criticized the creeping infiltration of woo that is insinuating itself into medical school curricula and expressed dismay at the threat that I see to evidence-based medicine (EBM) from it. He interpreted this vociferousness as "anger," but in reality it is more frustration, a dismay that was exacerbated by his defense of including unproven therapies in his practice. I did not respond so harshly somuch because I think that…
j7uy5 | November 15, 2006The Union of Concerned Scientists is concerned again. This
time,
they are concerned the possibility that a fourth-generation
cephalosporin,
href="http://www.intervet.co.uk/Products_Public/Cephaguard_Injection/090_Product_Datasheet.asp">cefquinome,
could be approved for use in animal feed.
It seems obvious that this could lead to more problems with antibiotic
resistance. If bacteria are exposed to these antibiotics in
sublethal amounts, in animals, those bacteria probably would develop
resistance to the antibiotics. If those same bacteria later
cause
infection in humans, the…
j7uy5 | November 6, 2006The people who support this policy are not only heartless, they are
idiots.
href="http://www.nytimes.com/2006/11/03/washington/03medicaid.html?ei=5090&en=12f703522d8d3a89&ex=1320210000&adxnnl=1&partner=rssuserland&emc=rss&adxnnlx=1162703532-so0p8YsoJEPd7rc82J6fjg">
href="http://www.nytimes.com/2006/11/03/washington/03medicaid.html?ei=5090&en=12f703522d8d3a89&ex=1320210000&adxnnl=1&partner=rssuserland&emc=rss&adxnnlx=1162703532-so0p8YsoJEPd7rc82J6fjg">Medicaid
Wants Citizenship Proof for Infant CareBy ROBERT PEARPublished: November 3,…
oracknows | October 30, 2006Last week, I wrote a couple of posts about Rush Limbaugh's despicable attacks on Michael J. Fox for appearing in an ad for a Democrat who supports loosening the federal ban on funding for embryonic stem cell research. Somehow, I missed the fact that Jon Swift also wrote on the topic. And, as is typical, he did it in a much more humorous fashion than I could.
oracknows | October 30, 2006Institutional review boards (IRBs) are the cornerstone of the protection of human subjects in modern biomedical research. Mandated by the federal government in the 1970's in the wake of research abuses of the 20th century, in particular the the horrors of the infamous Nazi biomedical experiments during World War II that were documented in during the Nuremberg trials and the Tuskegee syphilis experiment in which black men with syphilis in rural Alabama were followed without treatment in order to study the natural course of the disease, a study that lasted into the early 1970's. In the wake of…
j7uy5 | October 27, 2006It is never easy to make decisions about the use of medication by women
who are pregnant. For the vast majority of drugs, the
manufacturer's statement says something to like this: 'Product X should
only be used if the benefit outweighs the risk.' But there is
never any specific guidance about how to weight the risks and benefits.
It is hard to do when the risks are not known.
In the case of treating maternal depression in pregnant women, the
situation is complicated by the possibility that leaving the depression
untreated could have a negative impact on both the mother and the
fetus. …
j7uy5 | October 25, 2006Now, there is another element in the controversy. What
happens if a corporation essentially buys an undue degree of influence
in the formulation of treatment guidelines?
Treatment guidelines have always promoted controversy in medical
practice. Most physicians like the idea of a concise
guideline that is based upon empirical data and expert consensus.
But some resist the idea, thinking that a cookbook approach
is counterintuitive or contrary to their notions of the need to place
an emphasis on the quality of the physician-patient relationship.
Undue corporate influence is the subject of a…
j7uy5 | October 24, 2006Nature News reports on a preliminary study
href="http://www.chestnet.org/about/press/chest2006/briefing.php">presented
at the annual
meeting of the American College of Chest Physicians.
The study indicates that the cholesterol-lowering drugs in
the statin family may protect against lung damage caused by cigarette
smoking.
The study, presented by Walid G. Younis, MD, consisted of data analysis
of results from a survey done on 485 smokers and ex-smokers.
They found that those who took statins had much
less lung damage.
They compared medical tests of the patients' lung
health with those…