Greetings from Stephen Latham, Director


Spring has sprung, classes are ending, and bioethics-y events at Yale are starting to wind down—at least until our exciting group of international students arrives for our Summer Bioethics Institute.  There are only a couple of things to mention:

Our Technology and Ethics group will wind up its unusually busy year on May 1, with a talk from transhumanist Natasha Vita-More on “Contested Culture of Radical Life Extension: Divergent Models & Design Options.” Details appear below.


Our med-school sister organization, the Program on Biomedical Ethics, and Yale’s transplant center will be co-hosting a medical ethics symposium on Transplant Surgery & Medical Marijuana Use on Tuesday, April 30, 2013, at 4:30 at the Anlyan Center. Speakers include prominent transplant specialists and well-known bioethicist Art Caplan (NYU). Dinner will be served, so please RSVP to Karen.Kolb@yale.edu if you plan to attend.

Congratulations to longtime Tech and Ethics member Joe Carvalko, whose paper, “The Implications of Interfacing In-The-Body Technologies to the Outer World in an Era of Human-Cyborgs” has been chosen for presentation at the First Annual Conference on Governance of Emerging Technologies, to be held May 20-21 at the Center for Law, Science & Innovation, Sandra Day O'Connor College of Law, Arizona State University. (The Bioethics Center is a co-sponsor of that conference.)

And congratulations to Bioethics Center member and Yale-New Haven Hospital Adult Ethics Committee co-chair Mark Siegel, MD, who has just been appointed chair of the Ethics and Conflict of Interest Committee of the American Thoracic Society.

We’ll have one more newsletter before breaking for the summer. If there’s anything you’d like to see in it, email me at Stephen.Latham@Yale.edu with the word “Frimail” in your subject line.

  BIOETHICS EVENTS
  Wednesday, May 1 at 4:15 PM
Technology & Ethics Group
Location: 77 Prospect St, rm B012
Speaker: Natasha Vita-More, University Lecturer and Producer/Host H TV
Topic: Contested Culture of Radical Life Extension: Divergent Models & Design Options

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Updates from the Summer Institute

From Associate Director Carol Pollard

*Congratulations to Emily Weisfeld who will be attending the University of Nottingham (UK) for medical school in September.

*Elise Roumeas writes: “Great news: I'll be back at Yale the 14th of August, this time as Fox International Fellow!  http://www.yale.edu/macmillan/fif/” (Congratulations Elise – and other students should be reading about this opportunity to return to Yale!)

*Kyle Oskvig writes: “Just emailing to update you on my plans for graduate study.  I'll be at the University of Cambridge next year, reading for an MPhil in Ancient Philosophy.  After Cambridge, I'll apply to doctoral programs in Ancient Philosophy, Yale being one of them -- so maybe I'll end up in New Haven after all.  We'll see.  I'll stay in touch!”

*Congratulations to Maribel Yerena on her acceptance to Strasbourg University’s Summer Program on “Interdisciplinary Ethics in a European Perspective.”

*The Center for Humans & Nature has a number of free videos that you might find useful (http://www.humansandnature.org) on such topics as “what does it mean to be human?”, “Creating a Successful Economy without Continuous Economic Growth,” and “To Build or Not to Build a Road: How do we honor the landscape?”

*Congratulations to Zohar Lederman who had another article published – this time in Haaretz, an Israeli newspaper, regarding family presence during CPR in Israel.  Zohar has been a Visiting Scholar at the Bioethics Center for the past few months and has made excellent use of his stay with us.  It seems that every week I’ve reported on a new article he’s had published.  Here is the link to this article, although it’s written in Hebrew!  http://www.haaretz.co.il/news/health/research/.premium-1.1999010.

*Kyle Fitzpatrick is now a freelance medical writer and healthcare journalist.  (Congratulations Kyle!)

*Adrien Donneaud writes “I’m back in Strasbourg pursuing the international student lifestyle.  Last year I got to live in Lisbon for 6 months, as I was an intern for the Council of Europe's European Center For Global Interdependence and Solidarity.  I learned Portuguese, and I got to travel around Portugal, a very beautiful country. I actually stayed at Tatiana's place (Tatiana dos Santos Marques) for the first two weeks.  Later during the summer, in mid-August, I went to Poland and stayed there over a month.  Needless to say, I visited both Agata (Agata Gawlik-Swatek) in Krakow and Marcin (Marcin Michalak) in Gdansk.  It was so cool to see them all again in their "natural environment" and get to know their personal everyday lives in their home-country and meet their loved ones.  As far as academics is concerned, last year I got to complete my crazy 4 Master's degrees in 3 years project (MA in Psychology, MA in Ethics, MA in Sociology, MA in Political Science).  I also published two scientific articles in the French Thanatology Society's scientific journal "Études sur la mort" (both articles can be found here, but you have to pay for them unfortunately: http://www.facebook.com/l/xAQH4EBvXAQHHnn8moAaPZczPB0cnbha1
UsguDAV7Lqrb7w/www.cairn.info/publications-de-Donneaud-Adrien--76070.htm
).  If anybody wants to read them (they're in French); I can send a copy for free over e-mail.  I decided (God knows why...) to pursue a fifth Master's degree in Geopolitics and International Relations (second MA in Political Science).  So far so good: I only have to write the thesis before August, and it's done - I'll have 5 Master's degrees. It is also very likely that next year I will get to do an Erasmus.  I'm extremely excited about that.  I will study philosophy at Tübingen University in southern Germany. Afterwards, I'm not sure what I want to do.  I will certainly carry on with a PhD at some point in the near future. This summer I will also be participating in the Strasbourg Ethics Summer School. Thérèse (Thérèse Awada) is part of the scientific committee and will be a lecturer at the school.  I'm really excited about going to Copenhagen in August as well.  Big hug from Strasbourg to everybody at the Center!” (Good Luck Adrien!)

Carol

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This Week on Campus

Saturday, April 27

Interdisciplinary Law School Forum
Time: 1:30 PM
Location: 127 Wall St, room 128
Moderator:Oona Hathaway, Gerard C. and Bernice Latrobe Smith Professor of International Law and Director of the Center for Global Legal Challenges, Yale Law School.
Panelists:
James Cavallaro, Professor and founding director of the International Human Rights and Conflict Resolution Clinic, Stanford Law School
                David Mindell, Professor of Aeronautics and Astronautics, by Yale Law School Offices of International Pro
grams and Graduate Programs and Director of Laboratory for Automation, Robotics and Society, Massachusetts Institute of Technology
                Gabor Rona, Human Rights First and adjunct at Columbia Law School

                Matthew C. Waxman, Professor of Law and Faculty Co-Chair for the Roger Hertog Program on Law and Na
tional Security, Columbia Law School
                Bruce Fein, Litchfield Associates, Washington, D.C.

Topic: Thinking about Drone Warfare

Monday, April 29

Leitner Program Seminar
Time: 12 PM
Location: 34 Hillhouse Ave, room 203
Speaker: Camilo Garcia-Jimeno (University of Pennsylvania)
Topic: The Political Economy of Moral Conflict: An Empirical Study of Learning and Law Enforcement under Prohibition

Tuesday, April 30

Biomedical Ethics/Transplant Center Lecture
Time: 4:30 PM
Location: 300 Cedar St, Anlyan Auditorium
Speakers:Dr. Arthur Caplan, the Director of Medical Ethics at NYU
               Dr. David Cronin, Professor of Transplant Surgery at Medical College of Wisconsin
               Dr. Michael Schilsky, Medical Director of the Adult Liver Transplant Service at  Yale-New Haven Hospital

Public Library Science Talk
Time: 6:30 PM
Location: New Haven Public Library, on the green
Speakers: Yale Student Science Diplomats
Topic: Actions Speak Louder than Genes: How your behavior can change your DNA

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Conferences & Off Campus Events

Animal Cruelty: Legal Challenges and Potential Solutions
The University of Connecticut School of Law and the Animal Law Section of the Connecticut Bar Association will present an afternoon multi-panel program about Animal Cruelty and how to stop it, on Friday, May 3 at 1:30 p.m. in the Law School's Starr Reading Room. The panel discussions will conclude at 4:30, followed by a reception until 5:30. The program will include panelists from varied disciplines and practice areas, including judges, legislators, state agencies, prosecutors, psychologists and animal advocates, who will discuss cruelty to animals, its link with violence against humans, and ways to effectively prevent cruelty and violence to animals and humans. Program participants will explore our current anti-cruelty statutes and how our laws can be more effectively used in criminal and other judicial proceedings. Program participants will also explore the link between violence against animals and violence against humans. The program welcomes all members of the judiciary, practicing lawyers, faculty, students, animal control officers and interested members of the public. www.law.uconn.edu/AnimalLawRSVP

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Issues and Case Studies in Clinical Trial Data Sharing: Lessons and Solutions is taking place on May 17, 2013 at Harvard Law School, co-sponsored by the Multi-Regional Clinical Trial Center at Harvard and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.  We hope you will be able to join. Get more information  or Download a PDF of the agenda here  Register Now! Let us know if you have any questions, and thank you for your attention and response.  mrct@harvard.edu

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Second Annual Conference on Medicine and Religion, May 28-30, 2013, The Westin Michigan Avenue, Chicago, IL. At the heart of medicine is care. Medical care, surgical care, nursing care, wound care, palliative care, even spiritual care—almost everything health professionals do is advanced as a form of care. But how much care is actually in health care, and how does health care fit into a faithful life, as understood in Judaism, Christianity, and Islam? The second annual Conference on Medicine and Religion will provide a forum for scholars and health care professionals to ask what it means to care and how the traditions and practices of Judaism, Christianity, and Islam inform possible answers to this pressing question. To view the schedule, please click here. For more information and to register please visit: http://pmr.uchicago.edu/2013-conference.

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Infectious Diseases World Summit 2013
Klaus Stohr, Vice President and Global Head of Influenza Franchises at Novartis, will give a keynote presentation titled "Global Trends in Pandemic Preparedness: Changes After the Last Pandemic?" at GTC's  Infectious Diseases World Summit 2013 on July 8-10, 2013 in Boston, MA. Dr. Stohr's presentation will discuss efforts to accelerate pandemic vaccine investment and their need to acknowledge that it is mainly driven from two sources: political commitment to preparedness/public health or opportunities available from seasonal influenza vaccine use/manufacturing. The Infectious Diseases World Summit 2013 will bring together experts from industry, academia, and the public sector to discuss cutting edge research and new technologies used in the pharmaceutical and biotech fields. It will also give global biotechnology and pharmaceutical companies an opportunity to network with high-level executives from top pharma and various biotech/pharmaceutical companies, explore potential collaborations, and learn about relevant infectious diseases issues and deals that will affect the industry. Registration to the Infectious Diseases World Summit 2013 gives access to the 3 concurrent tracks: 11th Vaccines Research & Development: All Things Considered,  2nd Influenza Research and Development ,  10th Anti-Infectives Partnering and Deal-making . To view the agenda, click here. To be considered for an oral presentation, please submit an abstract by June 8, 2013. Selected presentations will be based on quality of abstract and availability. Presentation slots fill up fast so please submit your abstract ASAP.

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Grants, Fellowships, & Jobs

Post-doc/Instructor Positions in Medical Ethics at NYULMC
The Division of Medical Ethics at the NYU Langone medical Center seeks to recruit two persons either as post-docs or instructors.  Core qualifications for the positions include an excellent record of quality scholarship and teaching.  Applicants must have a PhD, JD, or MD.  Successful applicants will be expected to demonstrate a strong scholarly career track in a sub-field of medical ethics/bioethics. The Division is especially interested in persons with research interests in neuroethics, reproductive technologies and ethics, public health ethics, transplantation ethics and mental health ethics.  The appointment will be for two years.  The appointment will be in the Division (http://pophealth.med.nyu.edu/divisions/medical-ethics) which is housed in the Department of Population Health at NYULMC (http://pophealth.med.nyu.edu).  The post-docs will report directly to the Director of the Division.  Successful applicants will have significant protected time to pursue research.  They will be expected to teach one class at the graduate level per year, to participate in mentoring students doing projects in medical ethics and to assist in teaching medical ethics to undergraduate medical students and residents.  Stipends will be negotiated.  Health care and other benefits will be provided. NYULMC encompasses the NYU School of Medicine, three hospitals (Tisch, Rusk, and the Hospital for Joint Diseases) and a number of affiliates including Bellevue and the Manhattan VA Medical Center.  The Division maintains close ties to the Center for Bioethics located on the Washington Square campus http://bioethics.as.nyu.edu/page/home. Send a cover letter, CV and three letters of reference electronically to Jessica Oyola at Jessica.Oyola@nyumc.org with Search Division Post-Doc in the heading.  Applications will be accepted until October 1, 2013. NYULMC is an equal employment/affirmative action employer and does not discriminate on the basis of race, color, religion, gender, gender identity or expression, sexual orientation, marital/or parental status, age, national origin, citizenship, disability, veterans status, or any other classification protected by applicable Federal, State or Municipal Law.

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2013 Summer Biomedical Ethics Internship at the Center for Biomedical Ethics and Humanities’ Program in Biomedical Ethics, School of Medicine, University of Virginia
The Program in Biomedical Ethics at the Center for Biomedical Ethics and Humanities at the University of Virginia School of Medicine invites applications for the 2013 summer Biomedical Ethics Internship Program.  Interns will have the opportunity to work closely with the Program’s multidisciplinary faculty on a wide range of topics in clinical, research, and health policy ethics. These include, but are not limited to issues in organ transplant and allocation, reproductive health, compensation for research injury, ethical issues at the end of life, policy approaches to substance abuse and chemical dependency, and the emerging use of biotechnology.  Interns will work directly with a faculty mentor on projects of mutual interest or pre-established projects. Additional opportunities, such as observation of clinical ethics consultation and participation in weekly Ethics Consult Service meetings are available. The internships are seven weeks duration, beginning June 10 and ending July 29. The Summer Internship can provide stipends of $2,800 for two students. Students who do not need financial support are also invited to apply. Housing and benefits are not provided.  Applicants should be rising 3rd or 4th year undergraduates, or recent college graduates with course work or related experience in bioethics. They should have an interest in biomedical ethics, and concrete career goals to which the study of biomedical ethics applies. Applicants should demonstrate interest in biomedical ethics through coursework, independent study, scholarship or clinical experience. Applicants must submit: an application form, a letter of intent outlining his/her interest in the field of bioethics, a writing sample such as a paper written for a course, a letter of recommendation from a former professor/mentor, and a current transcript. The deadline for applications for the 2013 summer program is May 15. Applicants will be chosen based on demonstrated interest in the field of biomedical ethics; scholarly aptitude based on course work, writing samples, and recommendations by mentors/professors; and their ability to contribute to the intellectual community of the Program in Biomedical Ethics of the Center for Biomedical Ethics and Humanities. Inquiries and completed applications/documents should be sent via email to Mary Faith Marshall at mfm@virginia.edu.

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Postdoctoral Teaching Fellowship in Bioethics
Kansas City University of Medicine and Biosciences invites applications for a 2-year postdoctoral teaching fellowship in bioethics. The fellow will hold a Ph.D. in a related field (religious studies, philosophy, or social sciences), or an M.D., D.O., or J.D. with a masters degree in bioethics. Terminal degree must be in hand by June 1, 2013. The fellow will be expected to teach four courses each year, participate in the bioethics OSCE program, conduct research related to bioethics, and participate in clinical experiences and the activities of KCUMB's bioethics program. Applicants should be able to teach courses in bioethics related to clinical ethics, medical humanities, and/or other areas of expertise in bioethics.  To apply for the fellowship, please send the following via KCUMB's career site https://jobs.kcumb.edu: Current CV and cover letter, Article-length academic writing sample, Research and teaching statements. Applications will be accepted until May 8 or until the position is filled. KCUMB offers a competitive salary and benefits package to all employees.  EOE. Tobacco-free environment.

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Articles of Interest

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In the News


Drugs & Pharmaceuticals

Grens, Kerry. Large study finds no vaccine link to nerve disorder. Chicago Tribune. 19 April 2013. 
In a review of data covering 13 years and millions of patients, researchers found no evidence of a link between being vaccinated against te   tanus, hepatitis, pneumonia or flu, and developing the nerve-degenerating disorder Guillain-Barré. "The take home message is vaccines are not causing Guillain-Barré Syndrome at a rate, if at all, that would possibly make the benefits of vaccination not worthwhile," wrote Dr. Daniel Salmon, of the Institute for Vaccine Safety at Johns Hopkins University, who was not part of the study, in an email to Reuters Health. Continue reading…

Shute, Nancy and Audrey Carlsen. FDA’s Rejection of Generic OxyContin May Have Side Effects. NPR. 18 April 2013.
Banning cheaper, generic forms of a dangerous drug sounds like a worthy idea. But the Food and Drug Administration's decision to bar generic OxyContin may also push patients towards less effective drugs without eliminating the risk of addiction, experts say. Continue reading…

Euthanasia 

Right to die: Paul Lamb takes up Tony Nicklinson fight. BBC. 18 April 2013.
In March, the Court of Appeal granted an order allowing Mr Lamb, who has waived his right to anonymity, to take over Mr Nicklinson's claims.He is seeking a court declaration that any doctor who killed him would have a defence against such a charge.The defence is known as "necessity", meaning it was necessary for the doctor to act to stop intolerable suffering. Continue reading…

Health Care

Seaman, Andrew M. Commonplace causes may lead to deadly cath lab delay. Chicago Tribune. 19 April 2013.
Delays that are outside a hospital's control often prevent doctors from unblocking a heart attack patient's arteries right away, according to a new study that also found the delayed patients are more likely to die in the hospital. So-called non-system delays occurred in about 15 percent of U.S. heart attack cases between 2009 and 2011, researchers found. Causes for the delay in using balloon angioplasty to open coronary arteries ranged from problems obtaining consent to issues involving patients' other complex medical problems. Continue reading…

Hartocollis, Anemona. Cancer CentersRacing to Map Patients’ Genes. New York Times. 21 April 2013.
Electric fans growl like airplanes taking off and banks of green lights wink in a basement at Mount Sinai’s medical school, where a new $3 million supercomputer makes quick work of huge amounts of genetic and other biological information. Major academic medical centers in New York and around the country are spending and recruiting heavily in what has become an arms race within the war on cancer. The investments are based on the belief that the medical establishment is moving toward the routine sequencing of every patient’s genome in the quest for “precision medicine,” a course for prevention and treatment based on the special, even unique characteristics of the patient’s genes. Continue reading…

Lowrey, Annie. A Health Provider Finds Success in Keeping Hospital Beds Empty. New York Times. 23 April 2013.
On a stormy evening this spring, nurses at Dr. Gary Stuck’s family practice were on the phone with patients with heart ailments, asking them not to shovel snow. The idea was to keep them out of the hospital, and that effort — combined with dozens more like it — is starting to make a difference: across the city, doctors are providing less, but not worse, health care. For most health care providers, that would be cause for alarm. But not for Advocate Health Care, based in Oak Brook, Ill., a pioneer in an approach known as “accountable care” that offers financial incentives for doctors and hospitals to cut costs rather than funnel patients through an ever-greater volume of costly medical services. Under the agreement, hospital admissions are down 6 percent. Days spent in the hospital are down nearly 9 percent. The average length of a stay has declined, and many other measures show doctors providing less care, too. Continue reading…

Law and Bioethics

Radnofsky, Loise. Bill Bars Health-Care Cost Assistance for Immigrants. Wall Street Journal. 19 April 2013.
Immigrant advocates are upset with a health-care provision of the immigration-overhaul legislation that could force certain immigrants to pay a fee for lacking insurance coverage while excluding them from financial help to buy it. The wrinkle could create the first class of Americans who would face the 2010 Affordable Care Act's penalties without having access to its main benefit. If passed into law, the immigration changes would apply to many of the 11 million immigrants living in the U.S. illegally who would have "provisional" status for a decade before becoming eligible for green cards. Continue reading…

Dayton, Leigh. In Australia, Gene Patents Also Subject of High Court Struggle. Science Magazine. 19 April 2013.
The U.S. Supreme Court isn't the only high court considering a precedent-setting case on patenting human genes. Australia's Full Federal Court this week began considering an appeal of an earlier decision that upheld the validity of breast cancer diagnostic tests developed by Myriad Genetics—the same tests that were the subject of oral argument before the U.S. high court earlier this week. Continue reading…

Medical Ethics

Zuger, Abigail. The Lies We Tell in the Exam Room. New York Times. 22 April 2013.
Doctors and patients are never supposed to lie directly to each other. (No surprise there. What is surprising is that this expectation is a fairly modern development. Even a few decades ago, honesty on the doctor’s part, at least when it came to divulging the details of a bad illness, was generally considered unnecessarily cruel. In some countries it is still good medicine to gloss over the bad parts.) Continue reading…

Public Health

Gross, Liza. Flame retardants in consumer products are linked to health and cognitive problems. Washington Post. 15 April 2013.
Synthetic chemicals added to consumer products to meet federal and state flammability standards are showing up in waterways, wildlife and even human breast milk. Studies in laboratory animals and humans have linked the most scrutinized flame retardants, called polybrominated diphenyl ethers, or PBDEs, to thyroid disruption, memory and learning problems, delayed mental and physical development, lower IQ, advanced puberty and reduced fertility. Other flame retardants have been linked to cancer. At the same time, recent studies suggest that the chemicals may not effectively reduce the flammability of treated products. Continue reading…

Park, Alice. Why Circumcision Lowers Risk of HIV.  Time. 17 April 2013.
Promising trials hinted that circumcision could lower rates of HIV infection, but until now, researchers didn’t fully understand why. Now, in a study published in the journal mBio, scientists say that changes in the population of bacteria living on and around the penis may be partly responsible. Relying on the latest technology that make sequencing the genes of organisms faster and more accessible, Lance Price of the Translational Genomics Research institute (TGen) and his colleagues conducted a detailed genetic analysis of the microbial inhabitants of the penis among a group of Ugandan men who provided samples before circumcision and again a year later. Continue reading…

Wong, Edward. Pollution is Radically Changing Childhood in China’s Cities. New York Times. 22 April 2013.
Levels of deadly pollutants up to 40 times the recommended exposure limit in Beijing and other cities have struck fear into parents and led them to take steps that are radically altering the nature of urban life for their children. Parents are confining sons and daughters to their homes, even if that means keeping them away from friends. Schools are canceling outdoor activities and field trips. Parents with means are choosing schools based on air-filtration systems, and some international schools have built gigantic, futuristic-looking domes over sports fields to ensure healthy breathing. Continue reading…

Research Ethics

Marathe, Payal. Med School Study Deemed Unethical. Yale Daily News. 20 April 2013.
A five-year study performed on premature babies has been deemed unethical by the Public Citizen Health Research Group. The Support study, funded by the National Institutes of Health (NIH), lasted from 2004 until 2009, and was led by researchers at the University of Alabama at Birmingham along with 22 other medical centers across the nation – including the Yale School of Medicine. Consent forms given to parents to sign were approved by local ethics committees, but did not include an adequate description of the risks to the premature infants, said Michael Carome, Deputy Director of the Health Research Group. Continue reading…

Technology 

Aschwanden, Christie. Gene-testing kits promise a lot. But does your DNA say much about your health? Washington Post. 22 April 2013.
What does your DNA really reveal about your health? It sounded enticing: For just $99, I could spit into a tube, mail it off to a company called 23andMe, and, six to eight weeks later, I’d receive a report explaining what my DNA reveals about my risk for 120 diseases — everything from breast cancer to gout to sudden cardiac arrest. “Knowing how your genes may impact your health can help you plan for the future and personalize your health care with your doctor,” the 23andMe Web site declares. “You’ll have access to navigational tools that enable you to explore your genome and discover a whole new world of you.” Continue reading…

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In the Journals

Benetar, Solomon R. Global Health, Vulnerable Populations, and Law. Journal of Law, Medicine, and Ethics. April 2013.
Given the fragility of individual and population wellbeing in an interdependent world threatened by many overlapping crises, the suggestion is made that new legal mechanisms have the robust potential to reduce human vulnerability locally and globally. Continue reading...

Cook, Rebecca J. Huan Rights and Maternal Health: Exploring the Effectiveness of the Alyne Decision. Journal of Law, Medicine, and Ethics. April 2013.
This article explores the effectiveness of the decision of the Committee on the Elimination of Discrimination against Women in the case ofAlyne da Silva Pimentel Teixeira (deceased) v. Brazil, concerning a poor, Afro-Brazilian woman. This is the first decision of an international human rights treaty body to hold a state accountable for its failure to prevent an avoidable death in childbirth. Assessing the future effectiveness of this decision might be undertaken concretely by determining the degree of Brazil's actual compliance with the Committee's recommendations, and how this decision influences pending domestic litigation arising from the maternal death. Alternative approaches include: determining whether, over time, the decision leads to the elimination of discrimination against women of poor, minority racial status in the health sector, and if it narrows the wide gap between rates of maternal mortality of poor, Afro-Brazilian women and the country's general female population. Determining the effectiveness of this decision will guide whether to pursue a more general strategy of judicializing maternal mortality. Continue reading...

Hoffman, Sharona. Big Bad Data: Law, Public Health, and Biomedical Databases. Journal of Law, Medicine, and Ethics. April 2013.
The accelerating adoption of electronic health record (EHR) systems will have far-reaching implications for public health research and surveillance, which in turn could lead to changes in public policy, statutes, and regulations. The public health benefits of EHR use can be significant. However, researchers and analysts who rely on EHR data must proceed with caution and understand the potential limitations of EHRs. Because of clinicians' workloads, poor user-interface design, and other factors, EHR data can be erroneous, miscoded, fragmented, and incomplete. In addition, public health findings can be tainted by the problems of selection bias, confounding bias, and measurement bias. These flaws may become all the more troubling and important in an era of electronic “big data,” in which a massive amount of information is processed automatically, without human checks. Thus, we conclude the paper by outlining several regulatory and other interventions to address data analysis difficulties that could result in invalid conclusions and unsound public health policies. Continue reading...

Mickelson, Ruth A. The Barnes Case: Taking Difficult Futility Cases Public. Journal of Law, Medicine, and Ethics. April 2013.
Futility disputes are increasing and courts are slowly abandoning their historical reluctance to engage these contentious issues, particularly when confronted with inappropriate surrogate demands for aggressive treatment. Use of the judicial system to resolve futility disputes inevitably brings media attention and requires clinicians, hospitals, and families to debate these deep moral conflicts in the public eye. A recent case in Minnesota, In re Emergency Guardianship of Albert Barnes, explores this emerging trend and the complex responsibilities of clinicians and hospital administrators seeking to replace an unfaithful surrogate demanding aggressive therapy. Use of the courts requires the coordinated commitment of significant institutional resources, management of intense media scrutiny and individual and organizational courage to enter the unpredictable world of litigation. Given the dearth of legislative guidance on medical futility, individual clinicians and institutions will continue to bear the difficult responsibility for resolution of individual futility disputes. The Barnes case illustrates how one institution successfully used the judicial system to replace an unfaithful surrogate, cease the provision of inappropriate aggressive care, and stimulate a community dialogue about appropriate care at the end of life. Continue reading...

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Opinion


Ars Technica

Timmer, John. Losing labs to Hurrican Sandy and animal rights protestors. April 24, 2013.
For better or worse, the biological research community has become heavily reliant upon an animal that most of us would try to kill if we found it in our homes: the mouse. Mice have lots of good points. There's about a century's worth of genetic research on it to draw upon, there are sophisticated tools for pursuing genetic studies, and it's relatively closely related to us. Results from mice often translate into knowledge of human disease. Continue reading…

Timmer, John. H7N9 bird flu still spreading in China. April 24, 2013.
Three weeks ago, there were only nine confirmed cases of the new H7N9 bird flu, three of which ended in the death of the infected individual. At the time, there were far more questions than answers about the risk posed by the virus. Since then, testing in China has greatly expanded, and the World Health Organization's (WHO) daily updates have seen a steady flow of new cases diagnosed—typically around five a day. As of the latest update, that flow has brought the total of confirmed cases up to 108, with 22 deaths. Continue reading…

Johnson, Scott. Exploring public concerns about geoengineering the climate. April 22, 2013.
Manage the symptoms or go after the root cause? In a way, those are the choices available to deal with climate change. If the task of weaning ourselves off fossil fuels (and reining in deforestation) is too unappealing, a potentially more palatable alternative is geoengineering—intentionally manipulating the climate system. With the large-scale removal of CO2 from the atmosphere currently beyond our grasp, shading the planet with reflective aerosols might be the most effective tool in our kit. Continue reading… 

Los Angeles Times

Editorial. Smoking and the right to dumb choices. April 24, 2013.
As thoroughly awful as everyone knows cigarettes to be — still the No. 1 cause of premature death in this country — public officials walk a blurry line when they try to reduce smoking's terrible toll. As long as they lack the will to ban tobacco altogether, they face all sorts of ethical, legal and political problems in regulating a product that is, after all, perfectly legal. Continue reading…

Editorial. LA’s million trees. April 23, 2013.
Nearly seven years ago, Los Angeles Mayor Antonio Villaraigosa launched a program to plant 1 million trees. Since then, the city has planted more than 400,000 trees — in fact, 407,000 and counting. Continue reading…

Editorial. An Rx for the doctor shortage. April 21, 2013.
New subsidies and insurance regulations in the 2010 healthcare law are expected to bring coverage to millions of uninsured Californians starting next year. The newly insured are likely to put a bigger strain on the healthcare system, particularly in their demand for primary-care doctors, of whom there are already too few in many parts of the country. That's why trained medical professionals who aren't physicians, such as nurse practitioners, want more freedom to deliver the care they're capable of giving than state rules allow. Lawmakers should give it to them. Continue reading…

New York Times

Editorial. Reaching an arctic accord. April 19, 2013.
The central Arctic Ocean has been covered in ice for eons, but under the influence of global warming, nearly half of it is now open water for part of the year. Commercial fishing has not yet begun there, but the urge to begin fishing is almost overwhelming. Continue reading…

Editorial. The loss of generic Oxycontin. April 19, 2013.
Regulatory action this week by the Food and Drug Administration regarding the painkiller OxyContin could help reduce some forms of abuse of the drug, but it will also prevent a generic version from being marketed. Continue reading…

Editorial. The constitution and blood testing. April 18, 2013.
Drunken driving kills someone every 53 minutes — 9,878 times in the United States in 2011. But the problem, however grave, should not be solved by policies that violate constitutional rights. The Supreme Court was correct when it ruled Wednesday that a Missouri policy requiring a blood test, even without a search warrant, of anyone arrested on charges of driving under the influence of alcohol violated the Constitution’s Fourth Amendment ban on unreasonable searches — unless circumstances demand immediate action and justify a warrantless test. Continue reading…

Slate

Engber, Daniel. Did concussions make him do it? April 24, 2013.
Last Friday, former amateur boxer and presumed Boston Marathon bomber Tamerlan Tsarnaev perished in a firefight with police. On Saturday, his corpse got tossed into the fight over the effects of head injuries in professional sports. Continue reading…

Plait, Phil. HPV Vaccine in Australia already appears to be working. April 20, 2013.
Some good vaccine news for a change: A vaccine against human papillomavirus (HPV) appears to be working. HPV causes genital warts, and can lead to cervical cancer in women. In Australia, which began use of the HPV vaccine in 2007, cases of genital warts in young women aged 12 - 26 dropped 59 percent, and 39 percent for men. Not only that, but cervical abnormalities dropped as well—a glimmer of hope that for these vaccinated women, their chance of getting cervical cancer is dropping as well. Continue reading…

Washington Post

Editorial. Take the local food movement global. April 18, 2013.
The United States has a proud tradition of supplying food aid to hungry people around the world, whether their plight is due to chronic poverty or sudden natural disaster. Still, food aid was never a purely altruistic exercise. In 1954, President Dwight D. Eisenhower kicked off the program that would become known as Food for Peace by saying that it would “lay the basis for a permanent expansion of our exports of agricultural products with lasting benefits to ourselves and peoples of other lands.” In the six decades since, global food aid has generated sales for U.S. farmers, business for U.S.-flagged cargo vessels and jobs for U.S. seamen. Continue reading…

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