News from Bioethics.com

Childbirth in the Age of Addiction: New Mom Worries about Maintaining Sobriety

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(Kaiser Health News) – As recently as 2017, postpartum women were routinely being prescribed three- to five-day supplies of opioids — even after an uncomplicated vaginal delivery. A study published that year of 164,720 Pennsylvania women on Medicaid who gave birth vaginally found that 12 percent of them filled an opioid prescription after they gave birth — even though most did not have a clear medical need for a painkiller, such as vaginal tearing or an episiotomy.

Lethal Bacteria Help Power Kidney Drug to Beat 1-in-1,000 Odds

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(Bloomberg) – Doctors believe they’ve found an answer for patients like Romero in a protein that is produced by lethal bacteria. The protein, which temporarily wipes out antibodies, was crafted into an experimental drug called imlifidase to give donated organs a fighting chance against the immune system’s defenses. Developer Hansa Medical AB says imlifidase could make transplants possible for about 35,000 U.S. patients who currently have poor odds, and increase matches for others.

Protesters Take Anger Over Insulin Prices to Drug Makers, Some Bearing Children’s Ashes

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(STAT News) – Anger over insulin prices in the U.S. has swelled as the nation’s largest insulin makers have hiked the price of the drug. Those price increases are now the subject of a class-action lawsuit and have drawn the attention of lawmakers in Washington. But the price hikes are also fueling public outcry by patients, caregivers, and clinicians. Last month, patients and activists marched outside Lilly’s headquarters demanding “insulin for all.”

Cases of Mysterious Paralyzing Condition Continue to Increase, CDC Says

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(NPR) – The number of children being stricken by a mysterious paralyzing condition continues to increase, federal officials say. At least 252 cases of acute flaccid myelitis, or AFM, have been reported to the Centers for Disease Control and Prevention so far this year from 27 states, including 90 that have been confirmed through Nov. 9, the CDC reported Tuesday. Most of the cases have occurred among children between the ages of 2 and 8.

Kyoto University Performs World’s First iPS Cell Transplant for Parkinson’s

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(The Japan Times) – Kyoto University said Friday it has conducted the world’s first transplant of induced pluripotent stem cells to treat Parkinson’s disease. Nerve cells created from the artificially derived stem cells, known as iPS cells, were transplanted into the brain of a patient in his 50s in October in a treatment researchers hope to develop into a method that can be covered under Japan’s health insurance system.

US Has Highest Rate of Drug Overdoses Study Says

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(CNN) – The United States has more than double the rate of premature overdose deaths of at least 12 other countries, according to a new study. The research, published Monday in the Annals of Internal Medicine, says that there were an estimated 63,632 drug overdose deaths in 2016 in the US.

Smoke from California’s Fires Is Harming the State’s Most Vulnerable

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(The Atlantic) – The deadliest fire in California’s history continues to burn, and San Francisco is filled with smoke and ash. On Tuesday, for the fifth day in a row, air throughout Northern California contained high amounts of fine-particulate-matter pollution, and the Bay Area Air Quality Management District warned that the air was unhealthy for everyone. “The public should limit outdoor activity as much as possible,” the agency said Monday, urging residents to stay inside with their windows and doors closed. But for San Francisco’s thousands of homeless people, this warning is impossible to follow.

How Facebook and Twitter Could Be the Next Disruptive Force in Clinical Trials

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(Nature) – But Amber’s experience also shows how trial participants are disrupting the usual flow of information in clinical studies. As participants become more empowered, the natural tensions between their goals and those of the researchers become more pronounced. Online discussions threaten to compromise trial integrity when participants join forces to work out who is receiving a placebo. Discussing potential side effects can also influence results, particularly when the symptoms are subjective. Drug companies have yet to report any cases of such actions causing irrevocable damage to a trial, but some researchers worry that information-sharing by participants could sink trials or weaken their findings.

Private IVF Clinics Urged to Stop Charging for Expensive Add-Ons

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(The Guardian) – IVF clinics have been putting profits before patient care by charging clients for expensive treatment add-ons that have no proven effectiveness, according to a draft statement by fertility experts, practitioners and the sector’s regulator. The consensus statement agreed by 11 organisations, including the Human Fertilisation and Embryology Authority (HFEA), expresses concerns about how frequently patients are being charged for optional extras that do not increase the chances of pregnancy.

Pregnant Women Among 15 Arrested for Alleged Surrogacy in Cambodia

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(Australian Broadcasting Co) – Fifteen people have been arrested in Cambodia for allegedly taking part in illegal surrogacy, the Kingdom’s anti-trafficking authority says. According to Cambodia’s National Police website, 11 of those arrested are pregnant surrogates, along with two men and two other women working as cooks. Chou Bun Eng, from the National Committee for Counter Trafficking, confirmed the arrests were made on November 8.

Canada’s Message to Teenagers: Marijuana Is Legal Now. Please Don’t Smoke It.

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(New York Times) – Parents and grandparents jammed the small hall of Thornbury, a sleepy ski town north of Toronto, to glean tips on how to talk to their teenagers about the potential harms of marijuana. Held less than a week before Canada was set to legalize cannabis, the public health session had a message for parents: Marijuana would be legal for adults, but it was not safe for young people. And parents needed to instill in their children the idea that pot could be dangerous.

Eugenic Sterilization in Japan: ‘We All Have the Right to Live’

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(Al Jazeera) – Japan has more than seven million disabled people. This year, the government increased employment quotas for disabled people. Employees with a disability must now make up 2.5 percent of the public sector workforce and 2.2 percent in the private sector. But Japan’s own government has not always adhered to these quotas.
In August 2018, authorities were forced to admit they had given false information and inflated the number of disabled people employed in 27 government ministries and agencies.

Doctor to Face Dutch Prosecution for Breach of Euthanasia Law

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(The Guardian) – A doctor who slipped a sedative into a 74-year-old woman’s coffee before administering a lethal drug as members of her family held her down is to be the first medic to be prosecuted for breaching Dutch euthanasia laws. A public prosecutor in The Hague said in a statement that the doctor could not have unambiguously come to the conclusion that the patient wanted to die. It is the first prosecution since Dutch laws on euthanasia were drawn up in 2002 to allow a doctor to euthanise a patient if it could be shown they were experiencing unbearable suffering and making an informed choice to die.

Should Childhood Trauma Be Treated as a Public Health Crisis?

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(NPR) – When public health officials get wind of an outbreak of Hepatitis A or influenza, they spring into action with public awareness campaigns, monitoring and outreach. But should they be acting with equal urgency when it comes to childhood trauma? A new study published in the Journal of the American Medical Association suggests the answer should be yes. It shows how the effects of childhood trauma persist and are linked to mental illness and addiction in adulthood. And, researchers say, it suggests that it might be more effective to approach trauma as a public health crisis than to limit treatment to individuals.

Scientists Grow Beating Human Heart Tissue from Stem Cells

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(Newsweek) – Scientists have grown beating human heart tissue in a laboratory using stem cells. The engineered tissue could be used as a model of a human atrium (upper chamber), allowing researchers to test out new drugs as part of preclinical screening. This could lead to a faster, more efficient method of developing new treatments for heart conditions like atrial fibrillation—where a person has an irregular heartbeat that can increase the risk of stroke and heart failure.

Neuroscientists Make a Case Against Solitary Confinement

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(Scientific American) – There are an estimated 80,000 people, mostly men, in solitary confinement in U.S. prisons. They are confined to windowless cells roughly the size of a king bed for 23 hours a day, with virtually no human contact except for brief interactions with prison guards. According to scientists speaking at the conference session, this type of social isolation and sensory deprivation can have traumatic effects on the brain, many of which may be irreversible. Neuroscientists, lawyers and activists such as King have teamed up with the goal of abolishing solitary confinement as cruel and unusual punishment.

Dutch to Prosecute Doctor for Euthanasia on Woman with Dementia

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(Reuters) – Dutch prosecutors launched a criminal case on Friday against a doctor for performing euthanasia on an Alzheimer’s sufferer without adequately confirming she wanted to die, the first case of its kind since mercy killing was legalized in 2002. The 74-year-old woman, who had been diagnosed with Alzheimer’s disease four years before her death, had a certified living will stating her wish for euthanasia if her condition were to worsen significantly.

How Biologists Are Creating Life-Like Cells from Scratch

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(Nature) – Researchers have been trying to create artificial cells for more than 20 years — piecing together biomolecules in just the right context to approximate different aspects of life. Although there are many such aspects, they generally fall into three categories: compartmentalization, or the separation of biomolecules in space; metabolism, the biochemistry that sustains life; and informational control, the storage and management of cellular instructions. The pace of work has been accelerating, thanks in part to recent advances in microfluidic technologies, which allow scientists to coordinate the movements of minuscule cellular components.

(The Guardian) – Jane Ballantyne

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(The Guardian) – Jane Ballantyne was, at one time, a true believer. The British-born doctor, who trained as an anaesthetist on the NHS before her appointment to head the pain department at Harvard and its associated hospital, drank up the promise of opioid painkillers – drugs such as morphine and methadone – in the late 1990s. Ballantyne listened to the evangelists among her colleagues who painted the drugs as magic bullets against the scourge of chronic pain blighting millions of American lives. Doctors such as Russell Portenoy at the Memorial Sloan Kettering Cancer Center in New York saw how effective morphine was in easing the pain of dying cancer patients thanks to the hospice movement that came out of the UK in the 1970s.

Canadian Doctors Grapple with How to Approach Assisted Dying for Young Patients

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(CBC) – Three years after Canada’s top court decriminalized doctor-assisted suicide, the federal government is about to wade into an emerging controversy: How to respond to requests from children for medical assistance in dying, or MAID. Canada’s largest children’s hospital has already gotten a taste of this thorny issue.

F.D.A. Approves Powerful New Opioid Despite Warnings of Likely Abuse

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(New York Times) – The Food and Drug Administration on Friday approved a new form of an extremely potent opioid to manage acute pain in adults, weeks after the chairman of the advisory committee that reviewed it asked the agency to reject it on grounds that it would likely be abused. The drug, Dsuvia, is a tablet form of sufentanil, a synthetic opioid that has been used intravenously and in epidurals since the 1980s. It is 10 times stronger than fentanyl, a parent drug that is often used in hospitals but is also produced illegally in forms that have caused tens of thousands of overdose deaths in recent years.

Biosimilar Drugs Promise to Slash Health-Care Costs in Rich Countries

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(The Economist) – “IT’S THE prices, stupid.” That simple assessment of America’s wildly expensive health-care system was made 15 years ago by Uwe Reinhardt, a health economist who died last year. Health costs as a proportion of America’s economic output have soared since, from 14.5% in 2003 to over 17% in 2017, with drug-price inflation a big culprit. Less than 2% of Americans are treated with specialty biotech drugs, but these account for as much as 35% of total drug spending. The good news is that cheaper biotech drugs are coming.

Cardiac Devices Can Cost Six Times More in U.S. Than in Europe

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(Reuters) – Implanted heart devices like pacemakers and stents can cost two to six times more in the U.S. than in Germany, where costs are among the lowest in Europe, a recent study suggests. Medical devices account for about 6 percent of health expenditures in the U.S. and 7 percent in the European Union. But far less is known about pricing for devices than is known about drug costs, researchers note in Health Affairs. For the current study, they examined data on device prices at hospitals in the U.S., France, Germany, Italy and the UK from 2006 to 2014.

What If the Placebo Effect Isn’t a Trick?

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(New York Times) – But as ubiquitous as the phenomenon is, and as plentiful the studies that demonstrate it, the placebo effect has yet to become part of the doctor’s standard armamentarium — and not only because it has a reputation as “fake medicine” doled out by the unscrupulous to the credulous. It also has, so far, resisted a full understanding, its mechanisms shrouded in mystery. Without a clear knowledge of how it works, doctors can’t know when to deploy it, or how.

Peru ‘Baby Trafficking Ring’: Ex-Police Chief Held

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(BBC) – Police in Peru say they have busted a suspected baby trafficking ring in the southern city of Arequipa.  Among the 14 people arrested in early morning raids is the former head of Peru’s national police force, Gen Raúl Becerra. He has not yet commented. Police suspect his partner of being the ringleader of the gang which convinced poor women to hand over their babies and then sold them.

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