News from Bioethics.com

Physician-Assisted Suicide an Issue for Nominee Gorsuch

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(CNN) – Supreme Court nominee Neil Gorsuch has frustrated legislators on both sides of the aisle with his refusal to talk specifics on several major issues he could rule on if he’s confirmed. But one matter on which his past writings offer a detailed picture of his views is medical aid in dying, sometimes referred to as physician-assisted suicide. In 2006, Gorsuch wrote “The Future of Assisted Suicide and Euthanasia,” a 311-page book in which he “builds a nuanced, novel, and powerful moral and legal argument against legalization,” the book proclaims on its back cover. Gorsuch also addressed questions on the polarizing issue during his Senate Judiciary Committee confirmation hearings.

Study Finds Large Data Breaches at U.S. Hospital

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(UPI) – Researchers at Michigan State University have found the personal data of patients may be at risk of data breaches in U.S. hospitals. The study found nearly 1,800 incidences of large data breaches in patient information over a seven-year period from October 2009 to December 2016. Researchers analyzed data from the U.S. Department of Health and Human Services on data breaches at hospitals and healthcare providers.

Addicts Who Can’t Get Opioids Are Overdosing on a Diarrhea Drug

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(The Atlantic) – Opioid painkillers have an inconvenient, lesser-known side effect: terrible constipation. Perhaps then it’s no surprise that people addicted to opioids have considered the inverse. If a drug that gets you high causes constipation, could a drug that causes constipation get you high? Yes, and that drug is another opioid called loperamide, better known by its brand name Imodium as an over-the-counter treatment for diarrhea. At extremely high doses—dozens or even hundreds of pills a day—it can produce a high or ease withdrawal symptoms. And in the middle of a national opioid epidemic, overdoses of loperamide are rising, too.

How to Understand the Resurgence of Eugenics

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(JSTOR) – At the same time, we are seeing an advance in methods of manipulating human DNA that, though they present many benefits, could also be used to advance eugenic goals. This combination of a dubious political agenda and the tools to implement it could take us in uncharted directions. We can find guidance in two classic works about the dangers of modifying people and labeling them as “superior” or “inferior”—the novel Brave New World (1932) and the film Gattaca (1997). Their publication anniversaries in 2017 are sharp reminders of the costs of embracing any kind of twenty-first-century eugenics.

Machine Learning Predicts the Look of Stem Cells

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(Nature) – No two stem cells are identical, even if they are genetic clones. This stunning diversity is revealed today in an enormous publicly available online catalogue of 3D stem cell images. The visuals were produced using deep learning analyses and cell lines altered with the gene-editing tool CRISPR. And soon the portal will allow researchers to predict variations in cell layouts that may foreshadow cancer and other diseases. The Allen Cell Explorer, produced by the Allen Institute for Cell Science in Seattle, Washington, includes a growing library of more than 6,000 pictures of induced pluripotent stem cells (iPS) — key components of which glow thanks to fluorescent markers that highlight specific genes.

Stem-Cell Therapy Is Poised to Disrupt the Tommy John Epidemic in Baseball

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(Quartz) – For about half a decade, it’s been something of an open secret in baseball that players—pitchers especially—regularly undergo stem-cell therapy to stave off surgeries and lost playing time. It’s a cutting-edge medical procedure, done by everyone from high-school standouts to major-league all-stars. It’s rarely discussed by players, or by their coaches, parents, doctors, or employers.

Stem Cells Offer Hope for Autism

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(CNN) – Gracie was one of 25 children who took part in the first-of-its-kind study at Duke University in Durham, North Carolina. The goal: to see whether a transfusion of their own umbilical cord blood containing rare stem cells could help treat their autism. The results were impressive: More than two-thirds of the children showed reported improvements. A larger second trial is underway, one its researchers hope will lead to long-term treatment for children with autism.

States Find Other Execution Methods after Difficulties with Lethal Injection

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(NPR) – Death penalty laws are on the books in 31 states, but only five carried out executions last year. Now Arkansas is rushing to execute death row inmates at an unprecedented pace this month, before the state’s supply of lethal drugs expires. Nationwide the number of executions are down, as states struggle to obtain execution drugs that pass constitutional muster. Pharmacies are refusing to provide the deadly combinations of paralytics and fast-acting sedatives needed to put prisoners to death.

The Moral Failure of Crowdfunding Health Care

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(Medium) – The study, published in the journal Social Science & Medicine, finds that crowdfunding sites give an advantage to those already skilled in self-marketing and generating attention on social media. The digital platforms can present problems for older people?—?those most likely to have costly chronic conditions?—?as well as non-English speakers. Very few campaigns go viral beyond one’s personal network, which penalizes those who don’t have wealthy connections. It’s easier to fundraise for a single need, rather than a tangle of medical costs, housing payments, utility bills, and car repairs?—?exactly the kinds of needs that pile up for those living in poverty. In short, the rise of medical crowdfunding reflects?—?and potentially worsens?—?the inequities already at play in the United States.

Study Reverses Thinking on Genetic Links to Stress, Depression

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(Science Daily) – For years, scientists have been trying to determine what effect a gene linked to the brain chemical serotonin may have on depression in people exposed to stress. But now, analyzing information from more than 40,000 people who have been studied over more than a decade, researchers have found no evidence that the gene alters the impact stress has on depression.

Zika Appears to Cause Birth Defects in One in 10 Pregnancies

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(Scientific American) – About one in 10 pregnant women with confirmed Zika infections had a fetus or baby with birth defects, offering the clearest picture yet of the risk of Zika infection during pregnancy, U.S. researchers said on Tuesday. The report from the Centers for Disease Control and Prevention is the first to analyze a group of U.S. women with clear, confirmed test results of Zika infection during pregnancy.

Genetic Details of Controversial ‘Three-Parent Baby’ Revealed

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(Nature) – When a US fertility clinic revealed last year that it had created a baby boy using a controversial technique that mixes DNA from three people, scientists were quick to raise the alarm. Some objected on ethical grounds, and others questioned the scientific claims made by the clinic’s leader, physician John Zhang. Now, after months of intense debate and speculation, Zhang’s team has provided more details about the child’s conception, in a paper published on 3 April in Reproductive Biomedicine Online. But major questions remain about the long-term health of the boy, and whether the experiment will ultimately advance reproductive medicine.

Technology to Screen Embryos Before Implantation Falls Short

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(Eurekalert) – The healthy development of an embryo created through in vitro fertilization (IVF) depends on whether most, if not all, of the cells have the proper number of chromosomes. With pre-implantation genetic screening (PGS) technology, doctors can, in principle, spot-check chromosome count before choosing which embryo to implant in the mother. In a new article, however, scholars at Brown University and the University of Washington report that PGS has serious limitations that can only be overcome with more human embryo research, even as they acknowledge the controversy surrounding that research.

Europe Says University of California Deserves Broad Patent for CRISPR

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(Science) – The European Patent Office (EPO) announced on 23 March its “intention to grant a patent” to the University of California (UC) for its broad-based claims about the genome-editing tool popularly known as CRISPR. UC, on behalf of several parties, has been in a pitched battle with the Broad Institute of Cambridge, Massachusetts, over CRISPR patents, and the new decision marks a sharp departure from the position of the U.S. Patent and Trademark Office (USPTO).

Why the Newly Proposed Sepsis Treatment Needs More Study

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(NPR) – Dr. Paul Marik, a well-regarded intensive care physician at the Eastern Virginia Medical School in Norfolk, Va., is the doctor with the extraordinary claim. As we reported last week, he says he has treated about 150 patients with sepsis and that only one died of that often fatal condition (though some died of other causes). The question is how to find out whether he is right — and, ideally, how to do that quickly. Marik’s treatment involves a mix of intravenous corticosteroids, vitamin C and vitamin B, along with careful management of fluids. And his experience, so far, falls far short of the “extraordinary evidence” that a claim like his requires.

The Trauma of Facing Deportation

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(The New Yorker) – The next day, a doctor inserted a feeding tube through Georgi’s nostril. “He showed no resistance,” Soslan said. “Nothing.” Georgi was given a diagnosis of uppgivenhetssyndrom, or resignation syndrome, an illness that is said to exist only in Sweden, and only among refugees. The patients have no underlying physical or neurological disease, but they seem to have lost the will to live. The Swedish refer to them as de apatiska, the apathetic. “I think it is a form of protection, this coma they are in,” Hultcrantz said. “They are like Snow White. They just fall away from the world.”

Pioneering Cell Transplant Shows Vision and Promise

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(Nature) – On 28 March, the same team carried out a procedure that sounds similar, but with an important twist. This time, the retinal repair cells were made using iPS cells from an anonymous donor. There are many things to say about this achievement. The first is congratulations. Takahashi, an ophthalmologist at the RIKEN Center for Developmental Biology in Kobe, and Kurimoto, a surgeon at the Kobe City Medical Center General Hospital, have moved iPS-cell technology towards the clinic in the way it should be done — slowly and cautiously — and have thereby set a great precedent. They had non-human primate data, they rigorously tested cells before using them, and when they found a genetic abnormality in the first study — even though it was one that they didn’t think would cause cancer — they called off the procedure and were open about the abnormality.

Refugee Children Are Self-Harming After Seeing Adults in Detention Attempt Suicide

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(Quartz) – On the five Greek islands where more than 13,000 migrants and refugees have remained trapped since March 2016, a mental-health crisis is raging. The confinement and conditions in detention camps have a particularly devastating effect on the 5,000-plus children held in this limbo. Recently, aid workers noticed an increase in suicide attempts and self-harm incidents in children as young as nine. The humanitarian group Doctors Without Borders says suicide attempts have been rising in recent months on the islands of Lesbos and Samos.

India Decriminalizes Attempted Suicide

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(The Economist) – Attempted suicide, as well as “any act towards the commission” of suicide, has for years been a crime in India. But on March 27th the Lok Sabha, India’s lower house, passed a package of mental-health reforms, among them one that decriminalises attempted suicide. The bill declares access to psychiatric care to be a right for all Indians, and promises a huge boost in funding to help provide it. Policymakers in India have long argued that people driven to attempt suicide need rehabilitation. But under the previous law, they instead faced punishment: a fine and up to a year in prison.

Why Were There Fewer Microcephaly Cases from Zika Last Year?

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(STAT News) – Of the many mysteries that remain about the Zika virus and its attack on the Americas, perhaps the most puzzling one relates to the bizarre distribution of babies born with Zika-induced microcephaly. After so many such births were recorded in Northeastern Brazil in the last quarter of 2015, the country — and other places where the virus fanned out to from Brazil — braced themselves for a similar tsunami in 2016. But it didn’t materialize — at least not to the same degree.

Famine Menaces 20m People in Africa and Yemen

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(The Economist) – South Sudan is not alone. According to the Famine Early Warning Systems Network (FEWS Net), run by the American government, 70m people around the world will need food assistance this year, a level it says is “unprecedented in recent decades”. Three other countries, Nigeria, Somalia and Yemen, have what it calls a “credible risk of famine”. Between the four, 20m people risk starvation. Like extreme poverty, famine has been driven from most of the world. But in those countries it is burrowing in.

Managing Supplies of Vaccines Is a Huge Problem

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(The Economist) – KEEP a tomato cool in a refrigerator and it will stay fresh far longer than it would at room temperature. Accidentally freeze it, though, and you will reduce it to a disgusting mush. A similar problem plagues the storage of vaccines. About six in ten of those procured by UNICEF, the UN’s children’s fund, must be stored at a temperature between 2°C and 8°C. Generally, the focus of efforts to do this is on the top end of the range, with the establishment of “cold chains”, the links of which are refrigerators on the journey from factory to clinic, to stop vaccines overheating. Less effort is put into making sure a vaccine never gets too cold. But a vial of vaccine that has been accidentally frozen, and then thawed, may lose its potency as surely as one that has been warmed up.

A New Kind of Male Birth Control Is Coming

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(Bloomberg) – Doctors are on the cusp of launching the first new male contraceptive in more than a century. But rather than a Big Pharma lab, the breakthrough is emerging from a university startup in the heart of rural India. Years of human trials on the injectable, sperm-zapping product are coming to an end, and researchers are preparing to submit it for regulatory approval. Results so far show it’s safe, effective and easy to use—but gaining little traction with drugmakers. That’s frustrating its inventor, who says his technique could play a crucial role in condom-averse populations.

Scientists Want Relaxation of Laws to Allow Gene Editing of Human Embryos

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(Sydney Morning Herald) – NSW Stem Cell Network director Bernie Tuch said Australia risked being left behind if it did not allow scientists to press forward on research involving human embryos, which were now allowed in the UK, Sweden and North America. “We could adopt the approach of saying, ‘Thank you very much, we will wait for the rest of the world to explore this new area and then we will come on board’,” Professor Tuch said. “I guess that’s the conservative approach. We would argue that Australia is up there with the rest of the world and we should be seriously considering this possibility.”

Measles Outbreak Across Europe

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(BBC) – Measles is spreading across Europe wherever immunisation coverage has dropped, the World Health Organization is warning. The largest outbreaks are being seen in Italy and Romania. In the first month of this year, Italy reported more than 200 cases. Romania has reported more than 3,400 cases and 17 deaths since January 2016. Measles is highly contagious. Travel patterns mean no person or country is beyond its reach, says the WHO.

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