News from Bioethics.com

‘Donation after Cardiac Death’: New Heart Transplant Method Being Tested for the First Time in the U.S.

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(STAT News) – As part of the new procedure, known as “donation after cardiac death,” or DCD, transplants, organs are retrieved from those who have died because their heart stopped — either naturally or because physicians discontinued life support. That work is made possible by a machine that allows the heart to not only be perfused with warm blood after it has been removed from the donor, keeping the heart functional and “alive” enough to be transported and transplanted several hours after retrieval, but also allows surgeons to assess the heart’s functionality in a way that wasn’t previously possible.

Stealth Disease Likely to Blame for 20% of Worldwide Deaths

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(NPR) – A medical condition that often escapes public notice may be involved in 20% of deaths worldwide, according to a new study. The disease is sepsis — sometimes called blood poisoning. It arises when the body overreacts to an infection. Blood vessels throughout the body become leaky, triggering multiple-organ failure. It is surprisingly common in the United States: One prominent study estimates 1.7 million cases a year and 270,000 deaths. 

Transparency on Trial

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(Science) – For 20 years, the U.S. government has urged companies, universities, and other institutions that conduct clinical trials to record their results in a federal database, so doctors and patients can see whether new treatments are safe and effective. Few trial sponsors have consistently done so, even after a 2007 law made posting mandatory for many trials registered in the database. In 2017, the National Institutes of Health (NIH) and the Food and Drug Administration (FDA) tried again, enacting a long-awaited “final rule” to clarify the law’s expectations and penalties for failing to disclose trial results. The rule took full effect 2 years ago, on 18 January 2018, giving trial sponsors ample time to comply. But a Science investigation shows that many still ignore the requirement, while federal officials do little or nothing to enforce the law.

Embryo Research to Reduce Need for In Vitro Fertilization Raises Ethical Concerns

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(NPR) – Researchers have conducted a controversial study that involved paying dozens of young women at a hospital near Puerto Vallarta, Mexico, to get artificially inseminated so their embryos could be flushed out of their bodies and analyzed for research purposes. The study showed that embryos created that way appear to be as healthy genetically as embryos created through standard in vitro fertilization. Physically, the embryos appear to, possibly, even be healthier, the study found.

More Than 100 Billion Pain Pills Saturated the Nation Over Nine Years

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(The Washington Post) – Newly disclosed federal drug data shows that more than 100 billion doses of oxycodone and hydrocodone were shipped nationwide from 2006 through 2014 — 24 billion more doses of the highly addictive pain pills than previously known to the public. The data, which traces the path of every pain pill shipped in the United States, shows the extent to which opioids flooded the country as deaths from the epidemic continued to climb over nine years. The Washington Post and the company that owns the Charleston Gazette-Mail in West Virginia first obtained the data, collected by the Drug Enforcement Administration, from 2006 through 2012 after waging a year-long legal fight.

Chinese Health Officials Can’t Rule Out Person-to-Person Spread of New Virus

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(STAT News) – The possibility that a new virus in central China could spread between humans cannot be ruled out, though the risk of transmission at the moment appears to be low, Chinese officials said Wednesday. Forty-one people in the city of Wuhan have received a preliminary diagnosis of a novel coronavirus, a family of viruses that can cause both the common cold and more serious diseases. A 61-year-old man with severe underlying conditions died from the coronavirus on Saturday.

3D Printing and the Murky Ethics of Replicating Human Bones

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(TIME) – But the proliferation of faux bones also poses an ethical dilemma — and one that, prior to the advent of accessible 3D printing, was mostly limited to museum collections containing skeletons of dubious provenance. Laws governing how real human remains of any kind may be obtained and used for research, after all — as well as whether individuals can buy and sell such remains — are already uneven worldwide. Add to that the new ability to traffic in digital data representing these remains, and the ethical minefield becomes infinitely more fraught.

Dying in the Neurosurgical I.C.U.

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(The New York Times) – Trickier and much more common is the middle ground of a neurologically devastating injury without brain death. Here, decisions can be more difficult, and electing to continue or to withdraw treatment much more problematic. Inconsistent communication and support between medical staff members and families plays a role. A new field, neuropalliative care, seeks to focus “on outcomes important to patients and families” and “to guide and support patients and families through complex choices involving immense uncertainty and intensely important outcomes of mind and body.”

Belgian Doctors Face Trial in Country’s First Euthanasia Case

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(The New York Times) – Three Belgian doctors go on trial for murder on Tuesday for helping a woman end her life, in the country’s first criminal case concerning euthanasia. The doctors, whose names have not been made public, are accused of unlawfully poisoning 38-year-old Tine Nys on April 27, 2010. Prosecutors say Nys did not fulfill the conditions under Belgian law to be euthanised. They are the first doctors to go on trial for euthanasia in Belgium since the country legalized the practice in 2002.

Families Sending Relatives with Dementia to Thailand for Care

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(The Guardian) – British families are sending elderly relatives with dementia overseas to Thailand in a small but growing trend. Researchers visiting private care homes in Chiang Mai have found eight homes where guests from the UK are living thousands of miles away from their families, because suitable care in their home country was impossible to find or afford.

23andMe Sold the Rights to a Drug It Developed from Its Genetic Database

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(The Verge) – The genetics testing company 23andMe licensed the rights to a drug it developed in-house to a Spanish pharmaceutical company, Bloomberg reported. This is the first time that the company has directly sold a product it created using the genetic information collected from users. 23andMe has already shared genetic data with pharmaceutical companies. GlaxoSmithKline has the exclusive rights to use its data for drug development, and purchased a $300 million stake in the company in 2018. But those drug companies use the company’s data to create their own drugs. In this case, 23andMe identified a drug candidate and conducted animal studies on that drug internally before selling it. The Spanish company, Almirall, will take the product through human trials.

Medically Assisted Deaths Prove a Growing Boon to Organ Donation in Ontario

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(Ottawa Citizen) – Ontarians who opt for medically assisted deaths (MAiD) are increasingly saving or improving other people’s lives by also including organ and tissue donation as part of their final wishes. In the first 11 months of 2019, MAiD patients in the province accounted for 18 organ and 95 tissue donors, a 14 per cent increase over 2018 and a 109 per cent increase over 2017. (Figures for December 2019 are not yet available.) According to Trillium Gift of Life Network, which oversees organ and tissue donation in Ontario, the 113 MAiD-related donations in 2019 accounted for five per cent of overall donations in Ontario, a share that has also been increasing.

Artificial Intelligence Makes Bad Medicine Even Worse

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(Wired) – In other words, AI systems like the one from Google promise to combine humans and machines in order to facilitate cancer diagnosis, but they also have the potential to worsen pre-existing problems such as overtesting, overdiagnosis, and overtreatment. It’s not even clear whether the improvements in false-positive and false-negative rates reported this month would apply in real-world settings. The Google study found that AI performed better than radiologists who were not specifically trained in examining mammograms. Would it come out on top against a team of more specialized experts?

Nearly 2 Million Adults Are Estimated to Have Shown Symptoms of PTSD During Hong Kong Protests, Study Finds

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(CNN) – Almost 2 million people in Hong Kong — about a third its adult population — are estimated to have experienced symptoms of post-traumatic stress disorder (PTSD) during months of social unrest in the city, according to research published Friday in The Lancet medical journal. Researchers from the University of Hong Kong surveyed 18,000 people between 2009 and 2019 in what they said was the world’s largest and longest study of the population-wide impact of social unrest on mental health.

Hungary to Provide Free Fertility Treatment to Boost Population

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(BBC) – Hungary will provide free in-vitro fertilisation (IVF) treatment to couples at state-run clinics, Prime Minister Viktor Orban has announced. He said fertility was of “strategic importance”. Last month his government took over Hungary’s fertility clinics. Mr Orban, a right-wing nationalist, has long advocated a “procreation over immigration” approach to deal with demographic decline. The country’s population has been falling steadily for four decades.

Hospital Bankruptcies Leave Sick and Injured Nowhere to Go

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(Bloomberg) – A quiet crisis is unfolding for U.S. hospitals, with bankruptcies and closures threatening to leave some of the country’s most vulnerable citizens without care. As a gauge of distress in the health-care sector has soared, at least 30 hospitals entered bankruptcy in 2019, according to data compiled by Bloomberg. They range from Hahnemann University Hospital in downtown Philadelphia to De Queen Medical Center in rural Sevier County, Arkansas and Americore Health LLC, a company built on preserving rural hospitals. There’s more distress to come. 

Teen Girls Don’t Need Routine Pelvic Exams. Why Are Doctors Doing So Many?

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(NPR) – An estimated 1.4 million adolescent girls and young women in the U.S. might have received an unnecessary pelvic exam between 2011 and 2017, according to a new study. And an estimated 1.6 million might have received an unnecessary Pap test. The authors of the study, which was published this week in the journal JAMA Internal Medicine, say the overuse of these procedures — which can cause false-positives and anxiety — led to an estimated $123 million annually in needless expenses in 2014 alone.

A Rare Outbreak of Polio Reflects the Philippines’ Poor Health Care

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(The Economist) – FOR NINETEEN years the Philippines was free from polio. But in September the announcement came that two children living in provinces 900 miles apart had been paralysed by a vaccine-derived strain of the disease. The strain was also found in sewage and in a waterway. Foreign and domestic health authorities have since jumped into action. The next in a series of immunisation drives starts on January 20th on the southern island of Mindanao.

Second Baby in the US Born from Transplanted Uterus of Deceased Donor

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(CNN) – Now, Jennifer is the mother of the second baby in the United States to ever have been born from the transplanted uterus of a deceased donor. Gobrecht, 33, successfully gave birth via cesarean section to Benjamin Thomas Gobrecht in November as part of an ongoing trial to study uterine transplantation as a treatment option for women facing infertility, Penn Medicine in Philadelphia announced on Thursday.

DR Congo Jail: Inmates Starve to Death in Makala Prison

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(BBC) – At least 17 prisoners have died over the past week in the Democratic Republic of Congo’s biggest prison, a charity says. Aid workers say the deaths were caused by a lack of food and medicine, as well as poor hygiene. Makala Prison in the capital, Kinshasa, has received no food supplies in the last two months, state officials say.

The Sneaky Genius of Facebook’s New Preventative Health Tool

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(The Atlantic) – But for Facebook, the real value of the tool isn’t in direct monetization. It’s in becoming an integral part of yet another facet of users’ lives. Historically, this appears to be Facebook’s operating strategy: Move into a largely unregulated space, leverage the platform’s unmatched ubiquity to create a highly convenient product within that space, and then turn convenience into dependence into more time spent on the platform.

Genetic Markers Not Very Good for Predicting Disease Risk

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(Reuters) – Many people worry about inheriting health problems from their parents, but a new approach to analyzing genetic contributions to disease risk suggests that for most diseases, commercial DNA tests are not the best way to assess the odds. For the study, researchers analyzed data from almost 600 earlier studies that found associations between common variations in the DNA sequence, known as single-nucleotide polymorphisms (SNPs), and more than 200 medical conditions. Usually, genetics explained no more than 5%-10% of the risk for several common ailments including certain cancers, diabetes and Alzheimer’s.

‘Against All Odds’: The Inside Story of How Scientists Across Three Continents Produced an Ebola Vaccine

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(STAT News) – The reality was that, for years, scientists who studied Ebola, which belongs to a family of viruses called filoviruses, had poured their hearts into work to develop vaccines and drugs to combat these deadly scourges. And for years, they had seen promising work smash up against unscalable walls. There was no potential for drug makers to recoup development costs; and, with outbreaks only sporadic, there was little opportunity to subject experimental vaccines to rigorous tests.

WHO Says Mysterious Illness in China Likely Being Caused by New Virus

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(STAT News) – The World Health Organization confirmed on Wednesday that Chinese authorities believe a new coronavirus — from the family that produced SARS and MERS — may be the cause of mysterious pneumonia cases in the city of Wuhan. The Chinese government has not yet publicly stated that a coronavirus is the cause of the illness, which has infected at least 59 people. But the Wall Street Journal reported that was the case earlier Wednesday, citing unnamed sources.

The Risks Behind the Hype of Stem-Cell Treatments

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(BBC) – Some private clinics are charging UK patients thousands of pounds for unproven and unregulated treatments using the “healing powers” of stem cells, the BBC has found. And experts are warning some of these “therapies” can cause significant harm. Stem cells can become many types of cells in the body, from muscle to brain, and can repair damaged tissue. But they are approved only for treating some blood conditions, for skin grafts and the repair of damaged corneas

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