News from Bioethics.com

How Doctors Are Getting Rich on Urine Tests for Opioid Patients

3 months 2 weeks

(Bloomberg) – The high-tech testing lab’s raw material has become liquid gold for the doctors who own Comprehensive Pain Specialists. This testing process, driven by the nation’s epidemic of painkiller addiction, generates profits across the doctor-owned network of 54 clinics, the largest pain-treatment practice in the Southeast. Medicare paid the company at least $11 million for urine and related tests in 2014, when five of its professionals stood among the nation’s top billers.

Should Children Form Emotional Bonds with Robots?

3 months 2 weeks

(The Atlantic) – Stefania Druga and Randi Williams, the researchers behind the study, want to know how children perceive smart robots, and, eventually, to study how those bots affect kids’ cognitive development. So far, they’ve discovered that little children (ages 3 and 4) aren’t sure whether the robots are smarter than they are, but that slightly older children (ages 6 to 10) believe the robots to have superior intelligence. Druga and Williams were inspired by the research of the legendary Sherry Turkle, who wrote a highly influential 1984 book called The Second Self.

Over-the-Counter Painkillers Treated Painful Injuries Just as Well as Opioids in New Study

3 months 2 weeks

(Los Angeles Times) – In an opioid epidemic that currently claims an average of 91 lives per day, there have been many paths to addiction. For some, it started with a fall or a sports injury, a trip to a nearby emergency room and a prescription for a narcotic pain reliever that seemed to work well in the ER. New research underscores how tragically risky — and unnecessary — such prescribing choices have been. In a new study of patients who showed up to an emergency department with acute pain in their shoulders, arms, hips or legs, researchers found that a cocktail of two non-addictive, over-the-counter drugs relieved pain just as well as — and maybe just a little better than — a trio of opioid pain medications widely prescribed under such circumstances.

For Patients with Heart Failure, Little Guidance as Death Nears

3 months 2 weeks

(New York Times) – Yet there are no widely accepted guidelines for dealing with these patients as they near death. Cancer specialists regularly move their patients to hospice at the end of life, for instance, but few cardiologists even think of it. Heart patients account for just 15 percent of hospice deaths, while cancer patients make up half, according to a recent study. That paper, published in the Journal of the American College of Cardiology, reviewed a number of ways in which heart patients are let down at the end of life. Implanted defibrillators often remain activated until the very end, for example, even for those in hospice.

‘You Could Do It Tomorrow’: How Soon Is ‘Soon’ for Trans Women Wanting to Give Birth?

3 months 2 weeks

(Sacramento Bee) – Medical treatments for transgender people have gone “mainstream,” according to Richard Paulson, an obstetrician-gynecologist in Los Angeles and the president of the American Society for Reproductive Medicine. With that comes the prospect for a medical development that could shatter some of the most strongly-held beliefs for centuries about biological sex and the ability to conceive a child. In short, some scientists believe that transgender women — those who were assigned male at birth — could soon give birth.

The Public’s Distrust of Biotech Is Deepening. Commercialization May Be to Blame.

3 months 2 weeks

(Undark) – Harvard medical geneticist Robert C. Green, reflective, cautious, and as decent as a scientist can sound, took to television last month to make people aware of an open trial at the Brigham and Women’s Hospital, which uses genomic sequencing to screen for variants that can predict 1,800 genetic conditions in newborns. The cutting-edge study foreshadows what genetic science might bestow to human health, but the more interesting takeaway is that the failure of the study to connect with the public — very few are enrolling — may signify a deepening distrust of biotech.

Should Patients with Dementia Be Able to Decline Spoon-Feeding?

3 months 2 weeks

(NPR) – People who abhor the thought of being kept alive with feeding tubes or other types of artificial nutrition and hydration have, for years, had a way out: They could officially document their wishes to halt such interventions using advance directives. Even patients diagnosed with progressive dementia who are able to record crucial end-of-life decisions before the disease robs them of their mental capacity could write advance directives. But caregivers and courts have rarely honored patients’ wishes to refuse food and fluids offered by hand.

Why Plague Caught Madagascar Unaware

3 months 2 weeks

(BBC) – Madagascar is facing the worst outbreak of plague in 50 years. There have been more than 1,800 cases and 127 deaths since the start of August, according to new figures. The island off the south-east coast of Africa is used to seeing about 400 cases of mostly bubonic plague in the same rural areas every year.  But this year it has developed into the deadlier pneumonic version and spread to much more populated areas, including the capital.

Heart Disease Death Rate Plummets, But Overdose Death Rate Rises, CDC Says

3 months 2 weeks

(CNN) – Three new reports from the US Centers for Disease Control and Prevention bring both good and bad news about Americans’ health. Death rates for heart disease, cancer and HIV are all down in the United States in the year ending mid-2017 compared to the same period last year, according to one report published Friday by the CDC’s National Center for Health Statistics. Despite these “wins,” the overall mortality rate has increased from the same time last year, the report also indicated. This overall uptick includes the death rate for drug overdoses.

MDMA’s Journey from Molly to Medicine

3 months 2 weeks

(Scientific American) – The speed and effectiveness of the psychedelic experience Casey describes has caught the attention of the Food and Drug Administration, despite the Drug Enforcement Administration’s 1985 classification of MDMA as a Schedule I substance—the murderer’s row of illicit drugs that include heroin and are deemed to have no medical value. This past August the FDA granted MDMA “breakthrough therapy” status in the treatment of PTSD, meaning it may provide a substantial improvement over existing therapies. The agency will work closely with MAPS—a privately funded research institute founded 31 years ago in Santa Cruz, California—to design and conduct phase III trials starting next spring. This marks the first time psychedelic-assisted psychotherapy will be monitored in phase III trials for possible prescription use.

West Virginia Cities Sue Accrediting Group over Painkillers

3 months 2 weeks

(STAT News) – Several West Virginia municipalities are suing The Joint Commission, claiming the Chicago-based health care accreditation group downplayed the dangers of prescription painkillers and helped fuel addictions. The Charleston Gazette-Mail reports that the cities of Charleston, Huntington and Kenova and the town of Ceredo filed the class-action lawsuit Thursday in Charleston.

Baby Gene Therapy Study Offers Hope for Fatal Muscle Disease

3 months 2 weeks

(ABC News) – A first attempt at gene therapy for a disease that leaves babies unable to move, swallow and, eventually, breathe has extended the tots’ lives, and some began to roll over, sit and stand on their own, researchers reported Wednesday. Only 15 babies with spinal muscular atrophy received the experimental gene therapy, but researchers in Ohio credited the preliminary and promising results to replacing the infants’ defective gene early — in the first few months of life, before the neuromuscular disease destroyed too many key nerve cells.

EpiPen Failures Cited in Seven Deaths this Year, FDA Files Show

3 months 2 weeks

(Bloomberg) – EpiPens, which contain the hormone epinephrine (also known as adrenaline), are used to stave off allergic reactions that can in some cases kill. Failure of EpiPens to deploy correctly have been cited in seven deaths this year through mid-September, according to reports by patients and physicians made to the U.S. Food and Drug Administration and obtained by Bloomberg News. The FDA received a total of 228 reports of EpiPen or EpiPen Jr. failures during the same time period, according to documents made available as a result of a Freedom of Information Act request. In addition to the deaths, 35 people were hospitalized, according to the reports.

Bogus Breast Cancer Tests Are Putting Women’s Lives in Danger

3 months 2 weeks

(Quartz) – Last week, the US Food and Drug Administration issued a warning about advertisements for thermograms falsely claiming the technology could be as good or better than mammograms. In 1982, the FDA approved thermograms for breast-cancer screening—but only in conjunction with regular mammograms. Although thermography is not harmful in and of itself, there’s no scientific evidence that actually can detect breast cancer on its own. Since 2016, the FDA has issued two warnings to companies advertising preventative breast cancer screenings.

Workers Displaced by Automation Should Try a New Job: Caregiver

3 months 2 weeks

(Wired) – So what can help? There is a category of jobs today that is critical to our society. Many of us will employ the services of these workers, but these positions are all-too-often held in low esteem with poor pay and minimal career advancement prospects. Some are designing so-called social robots to take these jobs. Yet, these are jobs we categorically do not want machines doing for us, though machines could potentially assist humans. I am speaking of caregiving.

Infusions of Young Blood Tested in Patients with Dementia

3 months 2 weeks

(Nature) – The first controlled, but controversial and small, clinical trial of giving young blood to people with dementia has reported that the procedure appears safe. It has also hinted that it may even produce modest improvements in the daily lives of people who have Alzheimer’s disease. Researchers who conducted the trial and others caution that the results are based on just 18 people and therefore are only a first step in exploring this type of treatment. “This is a really very small trial and the results should not be over-interpreted,” says Tony Wyss-Coray, a neurologist at Stanford University in California who led the study. The trial was conducted by his start-up company Alkahest, which is based in San Carlos, California.

Eugenics 2.0: We’re at the Dawn of Choosing Embryos by Health, Height, and More

3 months 2 weeks

(MIT Technology Review) – IVF clinics already test the DNA of embryos to spot rare diseases, like cystic fibrosis, caused by defects in a single gene. But these “preimplantation” tests are poised for a dramatic leap forward as it becomes possible to peer more deeply at an embryo’s genome and create broad statistical forecasts about the person it would become. The advance is occurring, say scientists, thanks to a growing flood of genetic data collected from large population studies.

Bitter CRISPR Patent War Intensifies

3 months 2 weeks

(Nature) – The long-running battle over US patents for CRISPR–Cas9 gene editing continues. On 25 October, the Broad Institute of Cambridge, Massachusetts, filed a fresh set of arguments with the US government to defend a key patent. That action helps to set the stage for a second round of oral arguments in the unusually vitriolic case, which observers expect to take place in early 2018. A decision is anticipated to follow shortly thereafter. In the filing, lawyers for the Broad and its collaborators argued that its opponent, a team that includes the University of California, Berkeley, has failed to provide new evidence that would undermine the legitimacy of the Broad’s patent. The lawyers also used the University of California’s own press releases as a sign that the case should be thrown out.

U.S. Oversight of Risky Pathogen Research Has Flaws, Report Finds

3 months 2 weeks

(Science) – The program that keeps watch over the management of dangerous pathogens at research laboratories still isn’t up to snuff, according to a new report from the U.S. Government Accountability Office (GAO). The Federal Select Agent Program, run jointly by the Centers for Disease Control and Prevention (CDC) and the Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS), regulates how government, academic, and industry labs store, use, and transfer 66 potentially harmful organisms and toxins, including anthrax and plague. It has faced new scrutiny from Congress and GAO in recent years after a string of safety incidents involving select agents at laboratories run by the federal government.

Better Palliative Care Essential as Canada Considers Medically Assisted Death for Youth, Pediatricians Say

3 months 3 weeks

(CBC) – The Canadian Paediatric Society is urging improved palliative care for children and youth as a key part of preparing for the possibility of legalizing medical assistance in dying for certain patients under age 18. “Medical assistance in dying is something that has been legislated [for adults] and stated [as] needing to be accessible … but there isn’t the same ‘oomph’ for saying that all Canadians need good access to palliative care,” said Dr. Dawn Davies, chair of the society’s bioethics committee and a pediatric palliative care physician in Edmonton, in an interview with CBC News.

No Surgery for Smokers or the Obese: Policy in UK Stirs Debate

3 months 3 weeks

(CNN) – Two issues are the cause of a plethora of diseases and health conditions affecting people worldwide: smoking and obesity. And one local health committee in the UK has announced a controversial policy “to support patients whose health is at risk from smoking or being very overweight.” For an indefinite amount of time, it plans to ban access to routine, or non-urgent, surgery under the National Health Service until patients “improve their health,” the policy states, claiming that “exceptional clinical circumstances (will) be taken into account on a case-by-case basis.”

MSF Says Closing Most Cholera Centers in Yemen as Epidemic Wanes

3 months 3 weeks

(Reuters) – The medical charity Medecins Sans Frontieres (Doctors Without Borders) is closing most of its 37 cholera treatment centers in Yemen, saying the epidemic appears to have peaked. Some 884,368 suspected cholera cases have been recorded in the war-torn country in the past six months, including 2,184 deaths, according to the latest figures from the World Health Organization (WHO). The case fatality rate is now 0.25 percent.

U.S. States to Expand Generic Drug Price-Fixing Suit–Sources

3 months 3 weeks

(Reuters) – Forty-six U.S. state attorneys general will seek to expand a lawsuit alleging price fixing of generic drugs to 18 companies and 15 medicines on Tuesday, including Novartis AG’s generic unit Sandoz and India-based Sun Pharmaceutical Industries Ltd, people familiar with the matter said.  The original complaint, being litigated in federal court in Pennsylvania, describes an industry-wide conspiracy in which companies divide up the market as a way to push up prices.

Pretending to Give a Robot Citizenship Helps No One

3 months 3 weeks

(The Verge) – If this sounds like a PR stunt to you, well, you’re right: the Saudi kingdom was using this eye-grabbing headline to promote a tech summit, part of its nationwide policy to transform an oil-based economy into something more forward-thinking. But it’s not just headline fluff. Some experts say this sort of approach to robot rights is actively damaging, both to public understanding of technology and to civil society itself.

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