News from Bioethics.com

At a Dangerous Point in the Ebola Outbreak, Residents Increase Cooperation with Containment Efforts

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(STAT News) – The Ebola outbreak in the Democratic Republic of the Congo has reached a dangerous phase, with the response operation acknowledging it hasn’t got a full picture of where the virus is spreading in a large urban center. That concerning development is tempered slightly by signs that people living in Beni, the current hot spot of transmission, are beginning to comprehend more fully the danger the virus poses, said a senior World Health Organization official. That understanding is translating into better cooperation — a welcome development in an outbreak response that has had more than its share of bad luck.

The Main Suspect Behind an Ominous Spike in a Polio-Like Illness

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(The Atlantic) – AFM is a new term, but not a new syndrome. Its package of symptoms can be caused by a wide range of factors including, as the Centers for Disease Control and Prevention notes, poliovirus, West Nile virus, environmental toxins, and genetic disorders. The question isn’t what causes AFM per se, but what is specifically behind the biennial spikes that have appeared since 2014. (There was a small peak in 2012, too, before the condition came to national attention.) That has proven to be a tough problem to crack. In this era, it seems that scientists could easily grab tissue samples, sequence the genes of everything in them, and pinpoint some consistent microbial culprit. But that hasn’t happened—so far, no single germ has shown up in every case.

A Scientist’s Fraudulent Studies Put Patients at Risk

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(Science) – In biomedical science, most papers that lead to retractions don’t threaten anyone’s life. But medical studies published by a once-prominent anesthesiologist offer a troubling exception, a story of how flawed and fraudulent papers can put patients in danger. By 2010, Joachim Boldt was a research leader at Klinikum Ludwigshafen, an academic teaching hospital in Germany. That year, a sharp-eyed reader noticed a suspicious figure in one of Boldt’s 2009 publications, in the journal Anesthesia & Analgesia. A later investigation revealed that Boldt had likely fabricated data, ignored ethics rules, and committed other kinds of misconduct in 98 articles he published with co-authors.

The Largest-Ever Database of Retracted Articles Suggests the Burgeoning Numbers Reflect Better Oversight, Not a Crisis in Science.

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(Science) – Still, the surge in retractions led many observers to call on publishers, editors, and other gatekeepers to make greater efforts to stamp out bad science. The attention also helped catalyze an effort by two longtime health journalists—Ivan Oransky and Adam Marcus, who founded the blog Retraction Watch, based in New York City—to get more insight into just how many scientific papers were being withdrawn, and why. They began to assemble a list of retractions. That list, formally released to the public this week as a searchable database, is now the largest and most comprehensive of its kind.

Abortion Pills Now Available by Mail in US–But FDA Is Investigating

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(CNN) – Signaling a new chapter in the battle over abortion access in the United States, a European organization has stepped into the fray, providing Americans a way to get doctor-prescribed pills by mail to medically induce abortions at home. Called Aid Access, the organization says it uses telemedicine, including online consultations, to facilitate services for healthy women who are less than nine weeks pregnant. If a woman completes the consultation and is deemed eligible for a medical abortion, the organization’s founder writes a prescription for the two pills used to terminate the pregnancy, misoprostol and mifepristone.

Gene Therapy Shows Early Signs of Parkinson’s Improvement

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(Medscape) – An investigative adenovirus-delivered gene therapy yielded encouraging improvement in symptoms of Parkinson’s disease for patients whose condition was refractory to standard treatment. The therapy was well tolerated, and the effects were maintained through 36 months, preliminary results indicate. “So far, we are seeing safety with this treatment and signals of a possible clinical benefit,” said first author Chadwick W. Christine, MD, PhD, University of California, San Francisco, in presenting the findings here at ANA 2018: 143rd Annual Meeting of the American Neurological Association.

It’s Too Soon to Celebrate the End of the Opioid Epidemic

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(The Atlantic) – Preliminary figures reported by the Centers for Disease Control and Prevention this week show that compared with the 12 months ending September 2017, opioid deaths are down 2.8 percent in the 12 months that ended March 2018, reflecting about 2,000 fewer people who have died of a drug overdose. But, as the Associated Press points out, the final numbers for this year won’t be available until the end of next year, so we don’t know if this downward trend has continued.

What Can the Trolley Problem Teach Self-Driving Car Engineers?

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(Wired) – Two years on, those researchers have collected a heck of lot of data about people’s killing preferences: some 39.6 million judgement calls in 10 languages from millions of people in 233 different countries and territories, according to a paper published in Nature today. Encoded inside are different cultures’ various answers to the ethical knots of the trolley problem.

Self-Driving Car Dilemmas Reveal That Moral Choices Are Not Universal

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(Nature) – When a driver slams on the brakes to avoid hitting a pedestrian crossing the road illegally, she is making a moral decision that shifts risk from the pedestrian to the people in the car. Self-driving cars might soon have to make such ethical judgments on their own — but settling on a universal moral code for the vehicles could be a thorny task, suggests a survey of 2.3 million people from around the world. The largest ever survey of machine ethics1, published today in Nature, finds that many of the moral principles that guide a driver’s decisions vary by country.

A New Study Offers a Glimpse into the Genetics of Same-Sex Attraction

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(STAT News) – A massive genetic study aims to unravel these basic biological questions. It also touches on the question of whether it’s worthwhile, or even ethical, to study the genetics of sexual attraction in the first place. Surveying the genes of nearly 500,000 men and women, researchers found four variants that were linked to people who had self-reported same-sex encounters. When those variants showed up in heterosexual men, those men tended to have a larger number of lifetime sexual partners and — and, though researchers didn’t say who did the judging — to be more physically attractive.

Sociogenomics Is Opening a New Door to Eugenics

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(MIT Technology Review) – Advocates of sociogenomics envision a prospect that not everyone will find entirely benevolent: health “report cards,” based on your genome and handed out at birth, that predict your risk of various diseases and propensity for different behaviors. In the new social sciences, sociologists will examine the genetic component of educational attainment and wealth, while economists will envision genetic “risk scores” for spending, saving, and investment behavior.

FDA Approves a Fast-Acting Flu Drug That Is Taken in a Single Dose

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(STAT News) – Xofluza was approved for use in people 12 and older who have been experiencing flu symptoms for no more than 48 hours. It is the first drug in a new class called endonuclease inhibitors. They work by interrupting viral replication — the process by which invading viruses take over the inner workings of cells to make hordes of copies of themselves to further spread the infection.

Saving Mila: How a Tailor-Made Therapy, Developed in a Flash, May Have Halted a Young Girl’s Rare Disease

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(STAT News) – Drug development typically takes several years before a new therapy can even make it into clinical trials. Mila, however, made it from diagnosis to bespoke therapy in just over a year. Her case serves as a proof-of-concept in efforts to rapidly develop and deliver precision medicine — as tailored to a single patient. The drug was designed specifically for Mila’s unique mutation, and it’s not clear whether many more children carry it as well, or will benefit from the therapy.

Antipsychotics Drugs Don’t Ease ICU Delirium

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(NPR) – Ely and colleagues at 16 U.S. medical centers decided to put antipsychotic drugs to a rigorous test. They divided nearly 600 patients who were suffering from delirium into three groups. One group got the powerful antipsychotic haloperidol. A second group got ziprasidone, which is a related medication from a class of drugs called “atypical antipsychotics.” A third group got a placebo. “The three groups did exactly the same,” Ely says. There was no change in the duration of delirium, or the number of coma-free days. “They stayed in the ICU the same amount of time. They stayed on the mechanical ventilator the same amount of time. They didn’t get out of the hospital any sooner.”

Crowdfunding Raises Millions for Risky Medical Treatments, Study Says

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(CNN) – Certain medical fundraising efforts could do more harm than good for some patients. That’s according to a new research letter published in the medical journal JAMA on Tuesday. The paper found that more than 1,000 online medical crowdfunding campaigns have raised nearly $6.8 million intended for several treatments that are either potentially dangerous or yet to be scientifically supported as effective. The paper specifically tracked funding for five treatments: homeopathy or naturopathy for cancer; hyperbaric oxygen therapy, known as HBOT, for brain injury; stem cell therapy for brain injury and spinal cord injury; and long-term antibiotic therapy for chronic Lyme disease.

Number of Unvaccinated Children Increasing in US Despite Overall High Coverage

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(ABC News) – Despite increased efforts by federal health officials to vaccinate children early in life, the number of unvaccinated children in the U.S. continues to rise, according to a new report. The percentage of children who were unvaccinated increased from 0.3 percent in 2001 to 1.3 percent in 2017, according to the the Centers for Disease Control and Prevention. Children by the age of 3 should have already gotten several vaccines, including some follow-up shots and boosters. The CDC points to two reasons why vaccination rates have fallen: lack of health insurance and access to doctors in rural parts of the country.

Designer Babies Aren’t Futuristic. They’re Already Here.

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(MIT Technology Review) – All embryo testing does fit the “designer” label in one important way, however: it is not available to everybody.  Matthew and Olivia opted in to what is a quiet but significant trend. Although the number of couples using this technology remains small, it is growing rapidly. According to the Society for Assisted Reproductive Technology, the number of US IVF attempts with single-gene testing rose from 1,941 in 2014 to 3,271 in 2016, an increase of almost 70%.

155 Cases of Polio-Like Illness Now Under Investigation, CDC Says

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(CNN) – The US Centers for Disease Control and Prevention reported Monday that there are 155 patients under investigation this year for acute flaccid myelitis, a condition that that can cause paralysis and mostly affects children. Of these, 62 have been confirmed by the CDC in 22 states, and the remainder continue to be investigated.  Acute flaccid myelitis, also called AFM, is a rare but serious condition that affects the nervous system — specifically, the area of the spinal cord called gray matter. It affects fewer than one in a million people each year across the country, the CDC estimates.

Egypt-Holiday-Death Dad David Humphries ‘Missing Heart and Kidneys’

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(BBC) – A father of four who died on a family holiday in Egypt was returned to the UK without his heart and kidneys, a legal firm for the family has said. David Humphries, 62, collapsed and died while in Makadi, a beachside resort near Hurghada, on 18 September. Lawyers Irwin Mitchell said a post-mortem examination was carried out in Egypt and again in the UK, when it was discovered his organs were missing.

Texas Hospital Must Keep Girl on Life Support, Appeals Court Says

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(Fort Worth Star Telegram) – An appeals court ruled Friday that a girl suffering from cancer can be maintained on life support in accordance with her parent’s wishes, according to the court clerk’s office for the Second Court of Appeals in Fort Worth. Attorneys for Cook Children’s Medical Center, where Payton Summons is being kept on a ventilation machine, had appealed a judge’s decision extending an order to maintain the girl on life support until Monday.

Researchers Call for a Halt of $63M Cardiac Stem Cell Trial

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(Cardiovascular Business) – Cardiologists and researchers alike are calling for the early halt of a national heart stem cell trial after Harvard Medical School and Brigham and Women’s Hospital expressed concern earlier this week that some of the work the study is based on might be falsified.

An Ebola Outbreak Presents a New Mystery Involving Children

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(STAT News) – Epidemiologists working on the world’s latest Ebola outbreak are racing to try to solve a mystery. Why have so many children — some still infants — been infected with the virus? The disproportionate number of recent infections among children in the Democratic Republic of Congo — specifically in Beni, the outbreak’s current hot spot — has come as a surprise; typically young children don’t make up a big proportion of cases during an Ebola outbreak.

EU Drug Agency Urges Approval for Dengue Vaccine

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(ABC News) – Europe’s drug regulator has recommended approving the first vaccine for dengue despite concerns about the vaccine’s wide use and a lawsuit in the Philippines alleging that it was linked to three deaths. The European Medicines Agency said Friday it had adopted a “positive opinion” of French pharmaceutical company Sanofi’s Dengvaxia. The vaccine is the world’s first against dengue, which sickens about 96 million people annually.

Women in the U.S. Can Now Get Safe Abortions by Mail

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(The Atlantic) – For years, an organization called Women on Web has given women a way to perform their own medication-induced abortions at home. The organization would remotely do online consultations, fill prescriptions, and ship pills that trigger miscarriages to women who live in countries where abortion is illegal. Several studies have shown that the service is safe. For American women who’ve wanted pills, though, there’s been one major problem: Women on Web wouldn’t ship to the United States.

Feds Crack Down on Stem Cell Clinics That Touted Autism Treatments, Blindness Cures

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(STAT News) – For the first time, the Federal Trade Commission has cracked down on stem cell clinics for overzealous marketing claims, filing a complaint against two California clinics that promoted their treatments for everything from autism to Parkinson’s despite a lack of evidence. As part of a proposed settlement announced Thursday, the FTC is requiring the clinics — Regenerative Medical Group and Telehealth Medical Group — and their owner, Dr. Bryn Jarald Henderson, to stop making such claims and to inform past and current patients about the settlement.

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