By Emily Stephens
Who the Heck Are You and What Did You Do With My Dentist?
The once amiable, “Good afternoon, Miss Stephens. You have no cavities. Just floss a little more, and we’ll see you in six months” has changed to:
“Ew, oh, my. Have you ever considered whitening? We do that here.” (Not covered by insurance.)
“People die from oral cancer. Would you like to save your life and take a ten-minute cancer screening test? It’s only $80…” (Also not covered by insurance.)
And…
“Has your jaw ever popped? You really need to get fitted for a $600 bite plate.” (Yup, you guessed it. Definitely not covered by insurance.)
During the last five years, I have waltzed in and out of countless dental offices dismayed by sales gimmicks. How in the world can I trust a dentist to give me responsible advice when their eyes are fixed upon my wallet and not my teeth? I’ve tolerated it, though. A good dentist is a good dentist, even if they act more like a used car salesman.
However, back in March, a neurologist at the Mayo clinic prescribed a bite guard to ease the stress endured by my TMJ, which was quite possibly triggering terrible migraines. You know, the really bad kind where you go blind, your arms and legs become numb, speaking is next to impossible, and that’s to say nothing of the pain. Unfortunately, migraines have a way of making its sufferers lose all perspective, and in desperation, sufferers will try or pay anything for a miracle cure.
A local internet search led me to Dr. Kavorkian (whose name was changed to protect his identity),a dentist specializing in TMJ disorders and migraines. His secretary scheduled a free hour-long consultation—at which point I should’ve known to run away—but after filling out a million forms and watching a 25-minute testimonial that turned Dr. Kavorkian’s occlusal treatment (bite modification) biteguards into a religious experience, I was still hopeful.
The skeptic in me was brimming with questions. How does it work? How long does it take? How much does it cost? To my surprise, it took the full hour and a few threatening staredowns to coax anything out of him. His device required weekly visits for an undetermined amount of time (for some patients it took years), and at the “meager cost” of $20,000.
Are you kidding me?
Unfortunately, I’m not. Even more regrettably, I must report that am not alone out there either:
“I have had TMJ since 1984. When I first got it, no one knew what it was. As of this date I have spent approximately $30,000 over the years having my splint adjusted.”
“I have had to stand by and watch people tell [my mother] that the pain she feels is all in her head and that it can't be that bad. I feel that I am watching her slowly give up. Now they told her she has to go through a complete joint replacement and that is going to cost at least $67,000+ and her insurance does not cover a dime if those three little letters are mentioned, ‘tmj’.”
“A dentist convinced me I needed to have all my teeth capped for $75,000 and then after that he said my teeth were perfect and I should go see a shrink and I did. She and I both couldn't figure out why if this was the problem he didn't tell me to see a shrink [during] the 3 years he was working on my teeth. Now I live my life with a bite guard on most of the time. I don't know who to trust or where to go.”
Over 10 million people suffer from poorly misunderstood TMJ diseases or disorders, characterized by severe joint and surrounding tissue pain. The temporomandibular joint (or TMJ) is the jaw joint, a highly complicated joint that allows movement up and down, side-to-side, and forward and back. TMJ is most likely not covered by medical insurance, unless the situation is so severe that the sufferer is incapable of eating, and therefore starving.
Before I left my consultation, Dr. Kavorkian added in the brief observation of how bad I looked, then finished with a story about a handicapped boy who could barely walk and who by some miracle found his way to Dr. Kavorkian’s office, received a biteguard, and is now completely healed. The dentist managed a tear.
Apparently, this life-saving, bioesthetic dentistry gadget is the newest rave in TMJ disorder treatment. Imagine fixing TMJ problems with a specially fitted bite guard that week-to-week is altered or ‘shaved down’ by the dentist until your joints fit together perfectly. Think ‘braces’, but for joints and muscles.
According to the TMJ Association:
“Bioesthetic dentistry is another name for bite modification. It is based on the idea that such diverse signs and symptoms as worn or cracked teeth, gum recession, a history of multiple root canal treatments, headache, TMJ problems, ringing in the ears, equilibrium problems, fibromyalgia, etc. are all related to a disharmony between the way the teeth meet and the correct position of the temporomandibular joint. The bioesthetic dentist has patients wear a bite appliance called a MAGO (Maxillary Anterior Guided Orthotic)…which is supposed to get the bite to match the correct jaw position. This position is then maintained by tooth grinding, bonding, crowns or braces. There is no scientific evidence to support the claims made by the bioesthetic dentists, and patients should be wary of having such irreversible changes made to their teeth and bite without such evidence. (Response by Dr. Daniel Laskin.)
The Good Ol’ FCA
False Claim Act (FCA) lawsuits are repeatedly brought against pharmaceutical companies whose marketing practices are questionable: kickbacks, artificial inflation of wholesale prices, giving doctors consultant fees, grants, and other inducements to recommend their product.
So why aren’t dentists held to the same ethical standards when it comes to marketing TMJ products? Furthermore, why aren’t TMJ disorders covered under medical insurance plans when so many suffer this debilitating problem? How do we weed through the gimmicks to determine the truth about the state of our oral health? Finally, what are the rights of TMJ disorder sufferers?
It is important to know that recklessness and deliberate ignorance are enough. Under the FCA, a business can be held liable for a false claim even if it did not actually know the claim was false. Because it is often difficult to differentiate between innocent mistakes and "recklessness," an FCA allegation is easy to make and difficult to disprove.
Also know that almost anyone can sue. The FCA authorizes whistle-blowers to file lawsuits for alleged violations of the FCA. As a reward, the whistle-blowers get a percentage of anything a business pays in settlement or as the result of a judgment. Aside from a few specific limitations, virtually anyone can accuse a business of violating the FCA, including disgruntled employees, former employees, and business competitors. Because of the large reward and the large number of potential plaintiffs, the risk of an FCA lawsuit is very high.
As a chronic tooth grinder, a miracle cure bite plate that guarantees restful nights and migraine-less days did sound appealing. I’ve gnawed through several flimsy $600 bite guards within months in the past and decided it would have been equally productive to stick rolled up $20 bills between my teeth at night. I must admit, the desperate part of me was ready to sink all my savings into the miracle bite guard, but after leaving Dr. Kavorikian’s office, reality caught up with me, as did anger. How can dentists, medical professionals bound by the hippocratic oath, ethically monopolize on the sick and afflicted by trying to convince them to go into incredible amounts of debt for something unproven?
Until next time, snap, crackle, pop—ouch.
Sunday, July 06, 2008
Friday, July 04, 2008
Are Apes People Too?
By Jenny Walters
A recent article entitled Animal-Rights Farm: Apes rights and the myth of animal equality by William Saletan discussed a “resolution headed for passage in the Spanish parliament” that will be supporting the Great Ape Project.[1]
The Great Ape Project (GAP) is an organization whose founding declaration states apes “may not be killed” or “arbitrarily deprived of their liberty.” The Spanish proposal will treat great apes “like humans of limited capacity, such as children or those who are mentally incompetent and are afforded guardians or caretakers to represent their interests.” The passage of this proposal would, “commit the (Spanish) government to ending involuntary use of apes in circuses, TV ads, and dangerous experiments.1
Peter Singer, the co-founder of GAP, states: “There is no sound moral reason why possession of basic rights should be limited to members of a particular species.” Saletan went on to state: “To borrow Martin Luther King’s rule, you should be judged by what’s inside you, not what’s on the surface.”1
Opponents of the GAP view this proposal as “egalitarian extremism.” Spanish newspapers and citizens complain that ape rights are “distracting lawmakers from human problems.”
According to one anti-animal rights reporter: “Animal rights activist believe a rat, is a pig, is a dog, is a boy.”1 In contrast, GAP believes “great apes experience an emotional and intellectual conscience similar to that of human children.” GAP demands humans, chimps, bonobos, gorillas, and orangutans are “members of the community of equals.” Singer adds: “GAP may pave the way for the extension of rights to all primates, or all mammals, or all animals.”1
The mission statement for GAP states, “great apes are entitled to rights based on their ‘morally significant characteristics.’”1 The mission reads as follows:
The idea is founded upon undeniable scientific proof that non-human great apes share more than genetically similar DNA with their human counterparts. They enjoy a rich emotional and cultural existence in which they experience emotions such as fear, anxiety and happiness. They share the intellectual capacity to create and use tools, learn and teach other languages. They remember their past and plan for their future. It is in recognition of these and other morally significant qualities that the Great Ape Project was founded.[2]
Saletan believes the GAP mission statement appeals to discrimination, not to universal equality; as most animals can’t make tool and don’t teach languages. He went on to compare the GAP mission to a “Moral Majority for vegans.”1
In a final note in the article, Saletan used a quote from George Orwell’s Animal Farm: “All animal are equal. But some animals are more equal than others.”1
This article was interesting in pointing out both sides of the argument for great ape rights. The article reports: “We are closer genetically to a chimp than a mouse is to rat.”1 The article also describes how some animal rights activists believe “a rat, is a pig, is a dog, is a boy.” Personally, I am not sold on this of being the same as a rat. However, I do feel there should be basic rights set on place for all animals and I do support the GAP proposal.
As a pet owner, I can tell each of my dogs have their own unique personalities. To me, they are just furry humans.
[1] Saletan W. Animal-rights farm: ape rights and the myth of animal equality. July 2008. Available at: http://www.slate.com/id/2194568/. Accessed on July 3, 2008.
[2] The Great Ape Project. Mission statement. Available at: http://www.greatapeproject.org/index.php. Accessed on July 4, 2008.
A recent article entitled Animal-Rights Farm: Apes rights and the myth of animal equality by William Saletan discussed a “resolution headed for passage in the Spanish parliament” that will be supporting the Great Ape Project.[1]
The Great Ape Project (GAP) is an organization whose founding declaration states apes “may not be killed” or “arbitrarily deprived of their liberty.” The Spanish proposal will treat great apes “like humans of limited capacity, such as children or those who are mentally incompetent and are afforded guardians or caretakers to represent their interests.” The passage of this proposal would, “commit the (Spanish) government to ending involuntary use of apes in circuses, TV ads, and dangerous experiments.1
Peter Singer, the co-founder of GAP, states: “There is no sound moral reason why possession of basic rights should be limited to members of a particular species.” Saletan went on to state: “To borrow Martin Luther King’s rule, you should be judged by what’s inside you, not what’s on the surface.”1
Opponents of the GAP view this proposal as “egalitarian extremism.” Spanish newspapers and citizens complain that ape rights are “distracting lawmakers from human problems.”
According to one anti-animal rights reporter: “Animal rights activist believe a rat, is a pig, is a dog, is a boy.”1 In contrast, GAP believes “great apes experience an emotional and intellectual conscience similar to that of human children.” GAP demands humans, chimps, bonobos, gorillas, and orangutans are “members of the community of equals.” Singer adds: “GAP may pave the way for the extension of rights to all primates, or all mammals, or all animals.”1
The mission statement for GAP states, “great apes are entitled to rights based on their ‘morally significant characteristics.’”1 The mission reads as follows:
The idea is founded upon undeniable scientific proof that non-human great apes share more than genetically similar DNA with their human counterparts. They enjoy a rich emotional and cultural existence in which they experience emotions such as fear, anxiety and happiness. They share the intellectual capacity to create and use tools, learn and teach other languages. They remember their past and plan for their future. It is in recognition of these and other morally significant qualities that the Great Ape Project was founded.[2]
Saletan believes the GAP mission statement appeals to discrimination, not to universal equality; as most animals can’t make tool and don’t teach languages. He went on to compare the GAP mission to a “Moral Majority for vegans.”1
In a final note in the article, Saletan used a quote from George Orwell’s Animal Farm: “All animal are equal. But some animals are more equal than others.”1
This article was interesting in pointing out both sides of the argument for great ape rights. The article reports: “We are closer genetically to a chimp than a mouse is to rat.”1 The article also describes how some animal rights activists believe “a rat, is a pig, is a dog, is a boy.” Personally, I am not sold on this of being the same as a rat. However, I do feel there should be basic rights set on place for all animals and I do support the GAP proposal.
As a pet owner, I can tell each of my dogs have their own unique personalities. To me, they are just furry humans.
[1] Saletan W. Animal-rights farm: ape rights and the myth of animal equality. July 2008. Available at: http://www.slate.com/id/2194568/. Accessed on July 3, 2008.
[2] The Great Ape Project. Mission statement. Available at: http://www.greatapeproject.org/index.php. Accessed on July 4, 2008.
Thursday, July 03, 2008
Bioethics: Finding Our Shared Moral Core
Under the direction and management of psychologist, author and founding member Valerie Tarico, Phd, the Wisdom Commons is one of the newest ethics initiatives of the Women’s Bioethics Project.
The purpose of the Wisdom Commons is to affirm, inspire, and shed light on humanity's shared moral core, meaning the convergence of our religious and secular wisdom traditions and emerging wisdom culture. Many times we define ourselves in terms of our differences. But the truth is that some of our deepest concerns and highest values transcend the boundaries of culture and tradition. Early in childhood, before we even can walk and talk, the moral emotions, empathy, shame, and guilt begin to emerge. They guide us as we take our first steps toward living in community with each other.
Around the world people recognize that the joy and pain of others are similar to their own joy and pain, and wisdom traditions express this through different forms of the golden rule. We also generally agree about what kind of qualities we seek in our friends, our leaders, and ourselves. These instincts, emotions, understandings and agreements form our moral core. This moral core in turn serves the well-being of the intricate web of life around us and, foremost, the well-being of humans within that web.
The Wisdom Commons belongs to all who use it and contribute to it. Members have the ability to create personal wisdom pages that include their favorite quotes, stories and so forth from the library. A personal wisdom page can also include content that is authored by that member. Over time, we seek to build a diverse community of stewards reflecting the various traditions of our users. These stewards will also create personal wisdom pages so that their core values are visible to our members and users.
The Wisdom Commons emerged out of two years of conversations among people who share a passion for these issues. It was catalyzed into existence by a five day event in April of 2008, Seeds of Compassion, the realization of a dream by the Venerable Tenzin Dhonden and Dan Kranzler of the Kirlin Foundation. Seeds of Compassion brought over 150,000 people together to discuss how best to nurture compassion in our children and communities. It was televised in 24 languages around the world.
It is impossible to acknowledge everyone who shaped or contributed to the project, but they include Valerie Tarico, Brian Arbogast, Jennifer Hobbs, Katherine Triandafilou, Porter Bayne, Kathryn Hinsch, Darcy Rubel, Yaffa Maritz, Lee Colleton, Clif Swiggett, Bruno Alabiso, Jonathan Mark, Kathy Washienko, Matt Lerner, Mike Mathieu, Laura Peterson, John Rae Grant, Brynn Arborico, Marley Arborico, Zuzana Nemcova, Iris Chamberlain, Jean Harrison, James Peterson, Ruth Lipscomb, and others.
The Wisdom Commons draws much inspiration and some of its structure and content from The Virtues Project International, which provides curriculum, training and inspirational materials that elevate virtues in every day life. Many thanks to Linda and Dan Popov and John Kavelin for their thoughtful, patient labor of love. The beauty and meditative feel of the Commons are the handiwork of Jody and Cynthia Baxter, who created WorldPrayers.org.
Please join us.
Who Gets Born?
The Bioethics Council of New Zealand has given its government a lot to think about.The council issued a report in mid-June recommending that parents be given the right to choose the sex of their babies in pre-implantation genetic diagnosis (PGD). New legislation would replace a 2004 law that bans gender selection except as part of treatment for rare genetic diseases.
The report, appropriately titled “Who Gets Born?,” issues a series of recommendations to the government on pre-birth testing and the challenging developments in PGD. With the hope of producing “better, longer-lasting, and wiser policy decisions,” the council used public deliberation to frame ethical issues before making its recommendations.
In its summary, the council concluded that there are “insufficient cultural, ethical, and spiritual reasons to prohibit the use of PGD for sex selection for social reasons such as family balancing.”
Critics of the recommendation include the New Zealand Catholic Bioethics Centre, which issued an immediate response to the council’s report. Taking the position of all embryos being created equal, the Catholic Bioethics Centre asks: “What stops parents from using the technology for nothing more than parental desires? [We believe] in welcoming the children we are given rather than ordering them according to specifications.”
The gender selection debate might be a fresh topic in New Zealand, but it’s nothing new in the United States. In contrast to New Zealand, Australia, and the United Kingdom, there is no ban on sex selection in America. In fact, some foreign couples—those who can afford it, anyway—avoid national bans on sex selection by traveling to the U.S. for medical procedures.
As with other medical advancements, gender selection doesn’t float through the public consciousness without sparking a healthy dose of ethical debate. Is sex selection a dangerous path that leads to discrimination against “non-selected” individuals? Are parents using the technology to fulfill their own desires as opposed to respecting life? Or is sex selection an important individual right not to be regulated by government?
This summer, it’s up to the New Zealand government to decide.
Pharma and Philanthropy
By Randy Hendrickson
How do the major pharmaceutical companies compare in providing drugs, diagnostics, and vaccines to people in lower income countries? A new index (Access to Medicine Index) rates pharmaceutical companies in terms of how well they provide aid and outreach to poor, undeveloped countries with third world diseases such as AIDS, tuberculosis, or malaria. The 2008 Outcome Index ratings are based on data in 8 areas, including management, influence, R&D, patenting, capacity, pricing, donations, and philanthropy. The index examines issues such as:
How cheaply products are sold to third world countries;
Which drugs or vaccines are sent to which countries;
Whether generic versions of patented drugs are used;
How much is actually donated; and
What research is done in the areas of third world diseases.
The Access to Medicine Foundation, based in Haarlem, The Netherlands, “aims to advance access to health care (in the widest sense of the word) in developing countries and, in particular, to encourage the pharmaceutical industry to accept a bigger role regarding access to medicine in pre-industrialized countries.” Their motto is “Engaging Industry Through Transparency”.
The top 5 industry leaders that were identified by Access to Medicine Index are:
1. GlaxoSmithKline (UK)
2. Novo Nordisk (Denmark)
3. Merck & Co. (NJ, USA)
4. Novartis (Switzerland)
5. Sanofi-Aventis (France)
The pharmaceutical companies have been permitted to verify the data in the index, and the methodology and data analysis has been reviewed by an independent panel of experts.
For a complete listing and data breakdown, see The 2008 Index Outcomes at:
http://atmindex.org/index/2008.
How do the major pharmaceutical companies compare in providing drugs, diagnostics, and vaccines to people in lower income countries? A new index (Access to Medicine Index) rates pharmaceutical companies in terms of how well they provide aid and outreach to poor, undeveloped countries with third world diseases such as AIDS, tuberculosis, or malaria. The 2008 Outcome Index ratings are based on data in 8 areas, including management, influence, R&D, patenting, capacity, pricing, donations, and philanthropy. The index examines issues such as:
How cheaply products are sold to third world countries;
Which drugs or vaccines are sent to which countries;
Whether generic versions of patented drugs are used;
How much is actually donated; and
What research is done in the areas of third world diseases.
The Access to Medicine Foundation, based in Haarlem, The Netherlands, “aims to advance access to health care (in the widest sense of the word) in developing countries and, in particular, to encourage the pharmaceutical industry to accept a bigger role regarding access to medicine in pre-industrialized countries.” Their motto is “Engaging Industry Through Transparency”.
The top 5 industry leaders that were identified by Access to Medicine Index are:
1. GlaxoSmithKline (UK)
2. Novo Nordisk (Denmark)
3. Merck & Co. (NJ, USA)
4. Novartis (Switzerland)
5. Sanofi-Aventis (France)
The pharmaceutical companies have been permitted to verify the data in the index, and the methodology and data analysis has been reviewed by an independent panel of experts.
For a complete listing and data breakdown, see The 2008 Index Outcomes at:
http://atmindex.org/index/2008.
Monday, June 30, 2008
Daycare: The Strong Will Survive
By Leane Scoz
A recent article in Newsweek suggests that children who attend daycare are healthier than kids who do not by the time they enter kindergarten.
According to columnist, Claudia Kalb, more than 7 million children are enrolled in daycare. Everyone who has ever had a child in daycare knows that they and their child will probably contract a wide variety of illnesses within the first year of their child's attendance. The illnesses run the gamut, from the common cold and earaches to more sever infections such as RSV and the flu. With all of the pain and suffering parents and children have to endure, does the light really shine at the end of the tunnel after daycare?
Researchers at the University of California, Berkeley, say yes. An analysis of their studies revealed that daycare children have a 30 percent lower risk of developing childhood leukemia due to the increased exposure to infections. University of Arizona scientists carried out research over the last 10 years and found that although kids in daycare get twice as sick as their non-daycare counterparts, they have a third fewer illnesses by the time they enter elementary school. The research also showed that daycare children are less likely to develop asthma.
However, parents of children who do not attend daycare should not be discouraged. By the time children are teenagers, researchers report that no difference exists in either group of children because their immune systems catch up with each other.
The bottom line--allow the circle of illness to continue and do not worry too much about children in daycare. Everyone equals out in the long run.
A recent article in Newsweek suggests that children who attend daycare are healthier than kids who do not by the time they enter kindergarten.
According to columnist, Claudia Kalb, more than 7 million children are enrolled in daycare. Everyone who has ever had a child in daycare knows that they and their child will probably contract a wide variety of illnesses within the first year of their child's attendance. The illnesses run the gamut, from the common cold and earaches to more sever infections such as RSV and the flu. With all of the pain and suffering parents and children have to endure, does the light really shine at the end of the tunnel after daycare?
Researchers at the University of California, Berkeley, say yes. An analysis of their studies revealed that daycare children have a 30 percent lower risk of developing childhood leukemia due to the increased exposure to infections. University of Arizona scientists carried out research over the last 10 years and found that although kids in daycare get twice as sick as their non-daycare counterparts, they have a third fewer illnesses by the time they enter elementary school. The research also showed that daycare children are less likely to develop asthma.
However, parents of children who do not attend daycare should not be discouraged. By the time children are teenagers, researchers report that no difference exists in either group of children because their immune systems catch up with each other.
The bottom line--allow the circle of illness to continue and do not worry too much about children in daycare. Everyone equals out in the long run.
Sunday, June 29, 2008
No More Monkey Business
By Randy Hendrickson
Do the advancement of science and the possibility of finding new therapeutic options for disease justify “offending the dignity” of animals?
According to Nature (June 12, 2008; 453(7197):833), the local administrative court in Zurich, Switzerland recently banned several research experiments on macaque monkeys that were being performed jointly by the University of Zurich and the Federal Institute of Technology Zurich (ETHZ). Macaques are the most widespread genus of primates and are found in northern Africa as well as parts of Asia. The brains of these monkeys are closely related to those of humans in structure, and they make an excellent research model for studying neurological function and dysfunction.
The aim of the experiments was to study how the cortex of the brain adapts to change. One experiment involved depriving the monkeys of water (or any other drinks) for long periods of time so that they would value the reward of apple juice more when they performed a task correctly. Another experiment required that the monkeys be sacrificed after the experiment in order to examine the microcircuitry of the cortex of the brain. These experiments were previously approved by the Swiss National Science Foundation; however, an external animal experimentation advisory board challenged the right to continue the research on the grounds that it would “offend the dignity” of the monkeys.
Swiss law mandates that the benefits to society must outweigh the burden to the animals. In addition, a new court interpretation of the law demands that there must be immediate benefits gained from the research. According to the court ruling, “society is unlikely to see the benefits of the research during the 3-year funding period approved, and thus the burden on the animals is not justified.”
Conversely, according to PETA, the British government automatically rubber stamps most animal research, even when the benefits are vague or intangible. The main difference between the Brits and the Swiss is that the Swiss require that the benefits be immediate, whereas the Brits only have to show that there may possibly be benefits further down the road. Unfortunately, this has led to more than 3 million animal experiments in Britain annually despite obvious scientific failings.
The Swiss researchers feel that the use of the “immediate benefit” requirement is completely unrealistic and will impede progress in preventing and treating neurologic conditions such as Parkinson’s and Alzheimer’s diseases. Both the University of Zurich and the Federal Institute of Technology Zurich are planning appeal the lower court’s decision in hopes that they can continue their research.
Do the advancement of science and the possibility of finding new therapeutic options for disease justify “offending the dignity” of animals?
According to Nature (June 12, 2008; 453(7197):833), the local administrative court in Zurich, Switzerland recently banned several research experiments on macaque monkeys that were being performed jointly by the University of Zurich and the Federal Institute of Technology Zurich (ETHZ). Macaques are the most widespread genus of primates and are found in northern Africa as well as parts of Asia. The brains of these monkeys are closely related to those of humans in structure, and they make an excellent research model for studying neurological function and dysfunction.
The aim of the experiments was to study how the cortex of the brain adapts to change. One experiment involved depriving the monkeys of water (or any other drinks) for long periods of time so that they would value the reward of apple juice more when they performed a task correctly. Another experiment required that the monkeys be sacrificed after the experiment in order to examine the microcircuitry of the cortex of the brain. These experiments were previously approved by the Swiss National Science Foundation; however, an external animal experimentation advisory board challenged the right to continue the research on the grounds that it would “offend the dignity” of the monkeys.
Swiss law mandates that the benefits to society must outweigh the burden to the animals. In addition, a new court interpretation of the law demands that there must be immediate benefits gained from the research. According to the court ruling, “society is unlikely to see the benefits of the research during the 3-year funding period approved, and thus the burden on the animals is not justified.”
Conversely, according to PETA, the British government automatically rubber stamps most animal research, even when the benefits are vague or intangible. The main difference between the Brits and the Swiss is that the Swiss require that the benefits be immediate, whereas the Brits only have to show that there may possibly be benefits further down the road. Unfortunately, this has led to more than 3 million animal experiments in Britain annually despite obvious scientific failings.
The Swiss researchers feel that the use of the “immediate benefit” requirement is completely unrealistic and will impede progress in preventing and treating neurologic conditions such as Parkinson’s and Alzheimer’s diseases. Both the University of Zurich and the Federal Institute of Technology Zurich are planning appeal the lower court’s decision in hopes that they can continue their research.
Saturday, June 28, 2008
Electrosmog, Cell Phones, and Cancer.... Oh My!
By Emily Stephens“The Earth is being engulfed in electrosmog!” Arthur Firstenberg is one of the growing number of electromagnetic hypersensitive (EHS) people who suffer physical and psychological symptoms reportedly caused by electromagnetic fields. Imagine terrible headaches, nausea, or heart arrhythmia whenever being near Wi-Fi, a computer, a cell phone, or electric lights. Firstenberg, along with a handful of others are fighting to stop a plan to install Wi-Fi in all Santa Fe public libraries and government buildings. His argument seems to be falling on deaf ears.
Santa Fe’s city attorney determined EHS is not covered by the federal Americans with Disabilities Act. Furthermore, there is no legal precedent where Wi-Fi has ever been identified as the cause of EHS. So far, the Santa Fe City Council remains undecided.
Proponents of Wi-Fi insist there is no proven, causal link between the medical symptoms and wireless technology. The World Health Organization agrees with them: although the symptoms of EHS "are certainly real" and disabling for those affected, "there is no scientific basis to link EHS symptoms to EMF (electromagnetic field) exposure." So, is the etiology of EHS simply psychosomatic?
In 1988, 60 Swedish employees of an Ericsson subsidary company developed EHS after a mobile phone base station was installed on their office building’s roof. At first, the company tried to keep quiet about the whole ordeal. After receiving a $1 million grant from the Swedish Working Life Fund, they decided to go public and change the working environment. Unfortunately, most of those who were affected are still hypersensitive.
Interesting to note, Sweden is the only country in the world that accepts electrosensitivity as a physical impairment. Over 2.4% of their population is registered as having some form of EHS. Apply that ratio to the US population, and one could extrapolate that as many as 6.5 million Americans experience wireless symptoms.
Nikola Tesla is the first person suspected of having EHS. Recognized as one of the greatest technological scientists of all time, Tesla developed a severe illness late in life that many believe was caused by repeated exposure to high levels of electromagnetic fields.
"To doctors [Tesla] appeared at death's door. One of the symptoms of the illness was an acute sensitivity of all the sense-organs. His senses had always been extremely keen, but this sensitivity was now so tremendously exaggerated that the effects were a form of torture. The ticking of a watch three rooms away sounded like the beat of hammers on an anvil. The vibration of ordinary city traffic, when transmitted through a chair or bench, pounded through his body." -The Life of Nikola Tesla by John J. O'Neill
Whether or not you believe in EHS, wireless technology has actually been proven dangerous. This last February, Dr. Seigal Sadetzki found a link between chronic cell phone usage and the development of benign and malignant tumors within the salivary gland. Those who used cell phones heavily on one side of the head were found to have an increased risk of 50% for developing main salivary gland (parotid) tumors, as compared to non-users. Sadetzki's study, which investigated nearly 500 people diagnosed with salivary gland tumors, also found those who live in rural areas have an increased risk for cancer. Rural areas typically have fewer cell phone towers and antennas, so cell phones must emit more radiation in order to work.
“While I think this technology is here to stay,” Sadetzki says, “I believe precautions should be taken in order to diminish the exposure and lower the risk for health hazards.” Her recommendations?
1. Use hands-free devices at all times.
2. When talking, hold the phone away from one’s body.
3. Call less frequently.
4. Shorten the length of your calls.
The moral of the story? Beware of electrosmog, cell phones, and cancer. Hmmm. I guess now we know. And knowing is half the battle, right?
There are Bugs in My Food
By: Jenny WaltersA recent report on National Public Radio (NPR) entitled “Getting the Goods on ‘Good Bacteria’” by Allison Aubrey and a recent article entitled “Eat Your Germs” by Sanjay Gupta, MD discussed the new trend of probiotics in yogurt.
“A probiotic is any substance containing live organisms that, when ingested, have a beneficial effect on the host by altering the body’s intestinal microflora.”[1] Probiotics are often referred to as the “good” bacteria and can be found in yogurt, kefirs, and in pill-form as dietary supplements. The “good” bacteria can include Lactobacillus reuteri, Lactobacillus rhamnosus, and Bifidus regularis.[2]
The theory behind probiotics is, “certain strains of these living organisms – or good bacteria—can displace bad bacteria in the gut.”1 One trial dealing with the popular Activia yogurt split healthy volunteers into two groups: one ate Activia and the other ate an inactive form of Activia product with no love bacteria. At the end of the study, the volunteers who ate the Activia with live bacteria experienced a 21% decrease in colon transit time (meaning food passed more quickly out of their bodies).1
According to Dr. Gary Huffnagle: “In the digestive tract the bacteria help to regulate and restore peristalsis, the rhythmic motion of he intestine that pushes digested food through…Doesn’t matter if you are constipated or the opposite…these bacteria can help make you regular.”2
In addition to aiding in regularity, the “good” bacteria can also battle numerous forms of allergies, irritable bowel, and pediatric diarrhea.1,2 In a recent study, researchers gave Lactobacillus GG, sold under the brand name Culturelle or VSL-3, to pregnant women with a history of allergies and then to their infants. The study revealed babies who received Lactobacillus GG developed a significantly lower rate of allergic eczema than the control group that did not take the product.1 However, in other studies in children with well-managed Crohn’s disease, probiotics did not reduce gastrointestinal flare-ups.1
Currently, because probiotics are categorized as dietary supplements, the Food and Drug Administration (FDA) does not approve them.1 In addition, there are some people who should not take probiotics. According to Dr. Gupta, those with weakened immune systems and those who are critically ill should not ingest foods with live bacteria.2 Furthermore, probiotics can take some time to adjust to. If one suddenly began to ingest large amounts of probiotic products, there is a possibility of developing uncomfortable bloating.2
As Dr. Huffnagle reports: “You have just started a civil war in your intestines between good bacteria and bad bacteria….Fortunately the war is usually over in one to two weeks and the good guys win.”
Dr. Gupta suggests plain yogurt remains the best product for added bacteria because it has three things the bugs absolutely love: lactose, fat, and water. However, with more than $100 million in sales in Activia’s first year in the U.S. alone, the “good” bacteria idea seems to be paying off.2 Due to successful sales of Activia, other companies are beginning to market probiotic yogurt drinks, fortified beverages, and chocolate bars.
I am not yet sold on the idea of probiotics. Personally, I prefer to stick with plain old yogurt instead of the super infused bacteria yogurt.
[1] Aubrey A. Getting the good on ‘good bacteria.’ July 2006. Available at: http://www.npr.org/templates/story/story.php?storyId=5569230. Accessed on Jun 28, 2008.
[2] Gupta S, M.D. Eat your germs. May 2008. Available at: http://www.time.com/time/specials/2007/article/0,28804,1703763_1703764_1725938,00.html. Accessed on June 28, 2008.
The lives of children in unstable nations
By: Jenny WaltersA recent article posted on CNN.com entitled Kids’ lives are nightmares in unstable nations, UNICEF reports, focused on the emerging number of child related crimes taking place in unstable nations, such as Haiti.
According to a recent United Nation’s Children’s Fund report: “More than 50 children have been abducted in Haiti since the beginning of the year, adding to a trend of kidnappings in countries affected by violence.”[1]
Children in countries, such as Central African Republic, Democratic Republic of Congo, and Iraq, which are affected by war, food shortages and poverty, have become targets for armed groups who see them as commodities. In Haiti, UNICEF and local officials report that kidnapped children are being rapped, tortured and murdered. Currently, the United Nations Stabilization Mission in Haiti is working with the national police force to try to put a stop to such crimes.
In the Dominican Republic as many as 2,000 children a year are trafficked, often with the parents’ support.1 Another 1,000 children are working as spies, messengers or soldiers for armed gangs in the Haitian capital of Port-au-Prince.
In Iraq, children have been recruited by militia and insurgent groups. “Girls are increasingly subject to murder, kidnapping and rape, or are being abducted and trafficked within or outside Iraq for sexual exploitation.”1
In the Central African Republic, armed gangs terrorize farms and communities, kidnapping children and holding them ransom.1 Souleimane Garga, in Paoua, told UNICEF, “Bandits broke into his home nearly two years ago and kidnapped his wife, newborn, baby, and two other children, after killing older family members including an uncle and a grandfather.” For two-years, two of his children were held in bush camps, as he was “financially broken” after paying to free his wife and newborn and could not pay the ransom for his other two children. Souleimane’s children are home now, but wake with nightmares and cries remembering what they endured in the bush camps.1
Earlier this month, following the murder of a 16-year-old hostage and the rapping and lynching of other hostages, including infants, a demonstration was held in Haiti’s capital. UNICEF’s Haiti representative stated: “There is no acceptable motive or rationale for these crimes, as there is no acceptable excuse that they should be allowed to continue with flagrant impunity.”1
In July 2006, UNICEF’s report on child soldiers in the nation, reported “as many as 30,000 children may be associated with armed forces or groups as fighters.”1 Of those children, “30 to 40 percent of children associated with armed forces are girls.”
After reading this report, I was almost in tears. The thought that children and families are put through such unimaginable acts, is both disturbing and unsettling. Yet, this type of cruelty takes place in all parts of the world on a daily basis. I look in my daughter’s eyes everyday and could not imagine my world without her.
According to a recent United Nation’s Children’s Fund report: “More than 50 children have been abducted in Haiti since the beginning of the year, adding to a trend of kidnappings in countries affected by violence.”[1]
Children in countries, such as Central African Republic, Democratic Republic of Congo, and Iraq, which are affected by war, food shortages and poverty, have become targets for armed groups who see them as commodities. In Haiti, UNICEF and local officials report that kidnapped children are being rapped, tortured and murdered. Currently, the United Nations Stabilization Mission in Haiti is working with the national police force to try to put a stop to such crimes.
In the Dominican Republic as many as 2,000 children a year are trafficked, often with the parents’ support.1 Another 1,000 children are working as spies, messengers or soldiers for armed gangs in the Haitian capital of Port-au-Prince.
In Iraq, children have been recruited by militia and insurgent groups. “Girls are increasingly subject to murder, kidnapping and rape, or are being abducted and trafficked within or outside Iraq for sexual exploitation.”1
In the Central African Republic, armed gangs terrorize farms and communities, kidnapping children and holding them ransom.1 Souleimane Garga, in Paoua, told UNICEF, “Bandits broke into his home nearly two years ago and kidnapped his wife, newborn, baby, and two other children, after killing older family members including an uncle and a grandfather.” For two-years, two of his children were held in bush camps, as he was “financially broken” after paying to free his wife and newborn and could not pay the ransom for his other two children. Souleimane’s children are home now, but wake with nightmares and cries remembering what they endured in the bush camps.1
Earlier this month, following the murder of a 16-year-old hostage and the rapping and lynching of other hostages, including infants, a demonstration was held in Haiti’s capital. UNICEF’s Haiti representative stated: “There is no acceptable motive or rationale for these crimes, as there is no acceptable excuse that they should be allowed to continue with flagrant impunity.”1
In July 2006, UNICEF’s report on child soldiers in the nation, reported “as many as 30,000 children may be associated with armed forces or groups as fighters.”1 Of those children, “30 to 40 percent of children associated with armed forces are girls.”
After reading this report, I was almost in tears. The thought that children and families are put through such unimaginable acts, is both disturbing and unsettling. Yet, this type of cruelty takes place in all parts of the world on a daily basis. I look in my daughter’s eyes everyday and could not imagine my world without her.
[1] CNN.com. Kids’ lives are nightmares in unstable nations, UNICEF reports. Available at: http://edition.cnn.com/2008/WORLD/africa/06/21/unicef/index.html. Accessed on June 21, 2008.
Friday, June 27, 2008
If i were a rich man, could I buy a pancreas?
Our friend and colleague, Art Caplan, explains in his latest column why cash for kidneys is a scheme that won't work:
Need extra livers hearts or kidneys to transplant because the demand is greater than the supply? The answer, say proponents, is simple. Put a price on kidneys and livers and people will be falling all over one another to sell them. Set the price high enough and hordes will amble into hospitals, sign binding agreements to let themselves be sawed into transplantable bits for cash upon their demise, the thinking goes.
In fact, the American Medical Association recently called for pilot studies on financial incentives for organ sales.
Sounds good, right? Not so fast. Despite the AMA’s enthusiasm for testing a cash-for-parts scheme, it will never work in America.
The market of supply and demand has its place. When it comes to things like cars and paperclips, what we pay for them goes, in part, to helping make more. But when it’s impossible or difficult to create more of the item that’s in high demand, markets simply hike prices to ration access to whatever resource exists. If you don’t believe me, visit a gas station or a ticket scalper.
The supply of transplantable organs is very limited. Despite the AMA’s hopes, we are not going to get a lot more simply by putting a price tag on them.
Not so easy
Becoming an organ donor when you die is actually a very difficult thing to do. About 2.5 million people died in the U.S. last year. But only about 25,000 transplants were done using cadaver organs. While it may seem like there’s plenty of potential to get more organs if the price is right, which is what the AMA apparently is thinking, getting a big boost in the supply from cadavers would be very hard.
You can only be an organ donor if you die in a hospital on life-support. Very few of us do. And you need to be in fairly good shape except for a traumatic injury to your brain. Add to that the fact that donors cannot have any serious communicable diseases and the number of possible donors in that 2.5 million pool shrinks to a fraction.
Many of those who haven’t already signed up to be a potential donor probably have little interest in doing so. The prospect of legally auctioning off their useful remains to the highest bidder when their number is up is not likely to change their minds.
Money and body parts don’t mix
Whether for religious or cultural reasons, some Americans don’t like mixing money and body parts. Some just don’t trust the health care system and fear being rushed off to their maker prematurely if they indicate a willingness to be a donor — a fear not likely to be assuaged if paying for organs makes people worth more dead than alive. Others think markets in body parts smacks of treating bodies as property in a way akin to slavery — something this nation fought a horrendous war to eliminate. And still others know their religion does not permit treating the body as property — what is a gift from God cannot be sold but only stewarded.
If this country were to allow financial incentives for organs, the money would presumably go to the family or the deceased’s designee. But if these people have their hand on the life-support plug and know they stand to make good money as soon as the owner of the valuable body parts is dead, how hard are they going to try to keep that owner alive? While offering money for organs might persuade a few more to donate, it is more likely to turn off those now willing to consider giving out of fear or knowing there’s a reward for their death. Net result: A loss in the overall number of organs available.
The same story applies to using money to encourage living donations. Unless things take a really unethical turn, we are only talking about kidneys and parts of liver or pancreas. But having surgery to remove those organs, and living without them, carries real medical risks. Are there really lots of Americans who are going to line up to sell their parts knowing that potentially nasty complications and even a slight risk of death will follow? I doubt it. And even if some are willing, it won’t be long before prices start to inch up, opening a bidding war for scarce organs and leaving all but the richest with no shot at a transplant. Add in the incentive for potential sellers to lie about their health status as prices begin to climb and you have created a mess, not a solution.
A better way
Perhaps the best argument against markets is that there is another option that has yet to be tried in the U.S. In Spain, Italy and Belgium, laws creating presumed consent or what I prefer to call “default to donation” have been enacted. In those countries, people who don’t want to be organ donors upon their deaths have to register on a computer, carry a card or tell their loved ones they don’t want to donate. Otherwise, the presumption is that you want to be a donor.
No, this is not a socialist plot to give the state control over your body. Under “default to donation” no one’s rights are taken away. You don’t want to donate? Just say so. Default donation is basically the same system we have now except that instead of opting in using a card or drivers license you have to opt out using a card or a driver’s license.
Based on the European experience, we’d likely see a significant jump in the number of organs available to dying Americans. Spain has donor rates two times higher than in many parts of the United States. The default plan could bring a boost in organs for transplant without creating the headaches, fears and misdistribution of a financial market. Doesn’t it make more sense to try a low cost plan that has a chance of working then a high priced market that won’t?
Url Link: http://www.msnbc.msn.com/id/25370851/
Need extra livers hearts or kidneys to transplant because the demand is greater than the supply? The answer, say proponents, is simple. Put a price on kidneys and livers and people will be falling all over one another to sell them. Set the price high enough and hordes will amble into hospitals, sign binding agreements to let themselves be sawed into transplantable bits for cash upon their demise, the thinking goes.
In fact, the American Medical Association recently called for pilot studies on financial incentives for organ sales.
Sounds good, right? Not so fast. Despite the AMA’s enthusiasm for testing a cash-for-parts scheme, it will never work in America.
The market of supply and demand has its place. When it comes to things like cars and paperclips, what we pay for them goes, in part, to helping make more. But when it’s impossible or difficult to create more of the item that’s in high demand, markets simply hike prices to ration access to whatever resource exists. If you don’t believe me, visit a gas station or a ticket scalper.
The supply of transplantable organs is very limited. Despite the AMA’s hopes, we are not going to get a lot more simply by putting a price tag on them.
Not so easy
Becoming an organ donor when you die is actually a very difficult thing to do. About 2.5 million people died in the U.S. last year. But only about 25,000 transplants were done using cadaver organs. While it may seem like there’s plenty of potential to get more organs if the price is right, which is what the AMA apparently is thinking, getting a big boost in the supply from cadavers would be very hard.
You can only be an organ donor if you die in a hospital on life-support. Very few of us do. And you need to be in fairly good shape except for a traumatic injury to your brain. Add to that the fact that donors cannot have any serious communicable diseases and the number of possible donors in that 2.5 million pool shrinks to a fraction.
Many of those who haven’t already signed up to be a potential donor probably have little interest in doing so. The prospect of legally auctioning off their useful remains to the highest bidder when their number is up is not likely to change their minds.
Money and body parts don’t mix
Whether for religious or cultural reasons, some Americans don’t like mixing money and body parts. Some just don’t trust the health care system and fear being rushed off to their maker prematurely if they indicate a willingness to be a donor — a fear not likely to be assuaged if paying for organs makes people worth more dead than alive. Others think markets in body parts smacks of treating bodies as property in a way akin to slavery — something this nation fought a horrendous war to eliminate. And still others know their religion does not permit treating the body as property — what is a gift from God cannot be sold but only stewarded.
If this country were to allow financial incentives for organs, the money would presumably go to the family or the deceased’s designee. But if these people have their hand on the life-support plug and know they stand to make good money as soon as the owner of the valuable body parts is dead, how hard are they going to try to keep that owner alive? While offering money for organs might persuade a few more to donate, it is more likely to turn off those now willing to consider giving out of fear or knowing there’s a reward for their death. Net result: A loss in the overall number of organs available.
The same story applies to using money to encourage living donations. Unless things take a really unethical turn, we are only talking about kidneys and parts of liver or pancreas. But having surgery to remove those organs, and living without them, carries real medical risks. Are there really lots of Americans who are going to line up to sell their parts knowing that potentially nasty complications and even a slight risk of death will follow? I doubt it. And even if some are willing, it won’t be long before prices start to inch up, opening a bidding war for scarce organs and leaving all but the richest with no shot at a transplant. Add in the incentive for potential sellers to lie about their health status as prices begin to climb and you have created a mess, not a solution.
A better way
Perhaps the best argument against markets is that there is another option that has yet to be tried in the U.S. In Spain, Italy and Belgium, laws creating presumed consent or what I prefer to call “default to donation” have been enacted. In those countries, people who don’t want to be organ donors upon their deaths have to register on a computer, carry a card or tell their loved ones they don’t want to donate. Otherwise, the presumption is that you want to be a donor.
No, this is not a socialist plot to give the state control over your body. Under “default to donation” no one’s rights are taken away. You don’t want to donate? Just say so. Default donation is basically the same system we have now except that instead of opting in using a card or drivers license you have to opt out using a card or a driver’s license.
Based on the European experience, we’d likely see a significant jump in the number of organs available to dying Americans. Spain has donor rates two times higher than in many parts of the United States. The default plan could bring a boost in organs for transplant without creating the headaches, fears and misdistribution of a financial market. Doesn’t it make more sense to try a low cost plan that has a chance of working then a high priced market that won’t?
Url Link: http://www.msnbc.msn.com/id/25370851/
Wednesday, June 25, 2008
Do You Tip Your Doc for Botox®?
In the last few years, an increasing number of General Practitioners, Family Practitioners and OB-GYNs in the United States, Canada, and Australia have added revenue-enhancing cosmetic procedures to their core practice. Because 91 percent of cosmetic procedures are performed on women, OB-GYNs have a ready-made client base—but is the integrity of the physician-patient relationship, the practice of medicine, and ultimately the care of patients compromised when physicians offer cosmetic procedures and products that don’t increase the health and welfare of their patients?“We are physicians who limit our practice to women,” writes David Levine, MD in the Journal of Minimally Invasive Gynecology, an OB-GYN and outspoken proponent of the practice, “and these same women are responsible for the bulk of the $6 billion per year spent on cosmetic treatments, it seems natural for us to consider offering these treatments.”
Levine’s argument seems logical on the surface, but in medicine, what makes sense financially is not always what makes sense ethically. We must face the fact that there are deep ethical implications of the rapidly increasing trend of General Practitioners (GPs) Family Practitioners (FPs) and OB-GYNs adding revenue-enhancing cosmetic procedures and products such as skin rejuvenation, Botox®, Radiesse®, liposuction, breast augmentation, and mesotherapy to their core practice.
As GPs, FPs and OB-GYNs continue to add cosmetic product lines and menus of cosmetic procedures to the general fare of PAP smears and annual checkups, they risk demeaning their profession by creating a public image that physicians are mainly businesspeople working to increase their income. This trend makes it easy for patients to wonder whether their health and safety is the priority or whether the physician’s income is the priority.
Daniel Frank, MD, an internist in Seattle, established his primary care practice in 2002. At the time other primary care practices were starting to offer cosmetic procedures, but he rejected the idea, “When setting up the practice, we were called upon by a number of sales people who wanted us to offer cosmetic procedures. I believe if there is too much of a financial incentive to offer a procedure or service, then my objectivity could be comprised, and even the best and most diligent and objective among us can’t help but be swayed by the economic factors, particularly in primary care. We did not want to detract from our primary mission, which is the care of our patients, so we declined.”
Until the medical community does something about this trend, we as consumers of healthcare need to raise awareness in our GPs, FPs and OB-GYNs. We need to let them know of the potential moral harms of adding cosmetic procedures to their practice, and we need to lobby for reform. Trust is central to the patient-physician relationship and little is more destructive to patient care than a widespread degradation of the public trust in the medical profession.
The integrity of the physician-patient relationship, the practice of medicine, and ultimately the care of patients is compromised when physicians offer cosmetic procedures and products that don’t increase the health and welfare of their patients. Let’s work to make this trend-line spike down.
Read the full Women's Bioethics Project white paper here.
*Question on Yahoo! Answers forum: Do you tip the doctor who does your Botox? How much? Answer: Docs are not supposed to get tipped as it conflicts with their Code of Ethics.
Tuesday, June 24, 2008
On a Lighter Note...
On a lighter note…
By Michael Leshinski
Not kidding, the seemingly progressive Japanese government has begun the early stages of weight control for its population. The New York Times recently reported that a law requiring all individuals age 40 through 74 must have their waistlines measured during an annual doctor visit. Government officials hope that the recently instituted laws will help accomplish their goal of reducing the number of overweight citizens.
I wonder if the famous Sumo wrestlers are subject to waistline measurement. If so, I wouldn’t want to be the guy who had to enforce those rules. Those with a waist size being greater than the national law will be recommended to undergo weight education in order to drop a few pounds. Violators have 3 months to lose weight or be forced to receive dieting guidance, and then even more education will be imposed after another failed “weigh-in”. The national average for American man’s waistline is 39 inches, almost 6 full inches above the new Japanese standard. I seriously doubt that these standards would fly in the
- http://www.nytimes.com/2008/06/13/world/asia/13fat.html?_r=2&pagewanted=1&oref=slogin
- win.niddk.nih.gov/publications/PDFs/hlthrisks1104.pdf - 04-15-2008
Sunday, June 22, 2008
Heaven on Earth for Researchers
by Leane Scoz
Most people have heard of the largest charity in the United States, the Bill and Melinda Gates Foundation, but few are probably familiar with the second largest, the Howard Hughes Medical Institute (HHMI). A recent news segment on the CBS show, 60 Minutes, profiled the charity. Located in Chevy Chase, Maryland, the non-profit medical research institute invests about $450 million per year in biomedical research.
Howard Hughes is remembered as an aviator, engineer, film producer/director, playboy, and bazaar billionaire who suffered from obsessive-compulsive disorder. However, few think of him as a founder of one of the nation's largest private medical research organization. The institute was founded in 1953 by Hughes for the purpose of basic medical research "to probe the genesis of life itself."
Initially, the institute was thought to be the refuge for Hughes' fortune since non-profit organizations are tax exempt. However, after Hughes' death in 1976 and several years of court proceedings to determine the fate of his fortune, the institute experienced incredible growth. Today, it employs more than 2,600 people throughout the country and has an endowment of $18.7 billion.
What makes this organization more appealing to medical researchers than government agencies, such as the NIH? According to the HHMI, the institute is guided by the principle of "people, not projects." It supports researchers who take risks, think about big problems, and explore things that they would not otherwise be able to do if they were federally funded. Researchers are not responsible for huge amounts of paperwork to defend their need for funding. Instead, they are encouraged to spend more time in the laboratory and follow their ideas through to fruition no matter how long it takes.
The institute spends about $1 million per year per investigator and currently funds over 300 investigators. Because the HHMI is a private institute, researchers are permitted to work on controversial topics such as stem cell research from human embryos, which federal grant holders are not permitted to do. Scientists can change the course of their study if they so choose, such as leading stem cell and diabetes researcher, Douglas A. Melton, Ph.D., who switched from frog development research to juvenile diabetes research after his two children were diagnosed with the disease.
At the time of conception, Hughes probably never imagined his organization to be funding research on society's biggest health concerns. Today, the HHMI supports research on subjects ranging from AIDS, diabetes, and cancer to climate effects on cholera and malaria. The research possibilities and funding seem endless.
Most people have heard of the largest charity in the United States, the Bill and Melinda Gates Foundation, but few are probably familiar with the second largest, the Howard Hughes Medical Institute (HHMI). A recent news segment on the CBS show, 60 Minutes, profiled the charity. Located in Chevy Chase, Maryland, the non-profit medical research institute invests about $450 million per year in biomedical research.
Howard Hughes is remembered as an aviator, engineer, film producer/director, playboy, and bazaar billionaire who suffered from obsessive-compulsive disorder. However, few think of him as a founder of one of the nation's largest private medical research organization. The institute was founded in 1953 by Hughes for the purpose of basic medical research "to probe the genesis of life itself."
Initially, the institute was thought to be the refuge for Hughes' fortune since non-profit organizations are tax exempt. However, after Hughes' death in 1976 and several years of court proceedings to determine the fate of his fortune, the institute experienced incredible growth. Today, it employs more than 2,600 people throughout the country and has an endowment of $18.7 billion.
What makes this organization more appealing to medical researchers than government agencies, such as the NIH? According to the HHMI, the institute is guided by the principle of "people, not projects." It supports researchers who take risks, think about big problems, and explore things that they would not otherwise be able to do if they were federally funded. Researchers are not responsible for huge amounts of paperwork to defend their need for funding. Instead, they are encouraged to spend more time in the laboratory and follow their ideas through to fruition no matter how long it takes.
The institute spends about $1 million per year per investigator and currently funds over 300 investigators. Because the HHMI is a private institute, researchers are permitted to work on controversial topics such as stem cell research from human embryos, which federal grant holders are not permitted to do. Scientists can change the course of their study if they so choose, such as leading stem cell and diabetes researcher, Douglas A. Melton, Ph.D., who switched from frog development research to juvenile diabetes research after his two children were diagnosed with the disease.
At the time of conception, Hughes probably never imagined his organization to be funding research on society's biggest health concerns. Today, the HHMI supports research on subjects ranging from AIDS, diabetes, and cancer to climate effects on cholera and malaria. The research possibilities and funding seem endless.
"Don't Ask, Don't Smell"
by Emily StephensLove Potion 69? Weapon of Ass Destruction? Have you heard of the “gay bomb”? It’s a weapon—or rather the theory of a potential nonlethal weapon—that has gay activist groups and anyone with half a brain up in arms. News of an United States Air Force “Gay Bomb” began circulating way back in 1994, when the Sunshine Project (a now-disbanded Berkeley watchdog group who tracked government spending) obtained a 3-page proposal written by the Air Force Wright Laboratory in Ohio for future non-lethal chemical weapons.
According to the proposal, “One distasteful but completely non-lethal example would be strong aphrodisiacs, especially if the chemical also caused homosexual behavior.” Wright Laboratory asked for $7.5 million to fund research and development of the project. It also proposed other non-lethal weapon ideas such as a sweating bomb, a flatulence bomb, and spraying the enemy with bee pheromones and releasing beehives into the combat area. The gay bomb certainly takes the cake, however. “The notion was that...by virtue of either breathing or having their skin exposed to this chemical...soldiers would become gay,” explained Edward Hammond of the Sunshine Project.
The Department of Defense claims to have dismissed the idea at a very early stage, but Hammond doesn't believe them. “The truth of the matter is, it would have never come to my attention if it was dismissed at the time it was proposed. In fact, the Pentagon has used it repeatedly and subsequently in an effort to promote non-lethal weapons, and they submitted it to the highest scientific review body in the country for them to consider.” Nonetheless, government officials insisted again in June 2007 that no funding was awarded to the project.
It’s hard not to be fascinated by non-lethal weapons. Imagine fighting a war where nobody dies. But a gay bomb? Really? There are so many inherent problems and assumptions within this formula, it is actually terrifying to think something like this might be possible. After all, it would mean human beings, like mindless drones, are incapable of controlling their actions. And, personal agency, or free will, is totally out the window. It also assumes that gays make ineffective soldiers at best. “Throughout history we have had so many brave men and women who are gay and lesbian serving the military with distinction,” said Geoff Kors of Equality California. “So, it’s just offensive that they think by turning people gay that the other military would be incapable of doing their job.”
Is there any medical truth behind the “gay bomb”?
Two compounds long suspected of being pheramones were tested: a testosterone derivative produced in men's sweat and an estrogen-like compound in women's urine. The estrogen-like compound activated smell-related regions in women and the hypothalamus in men. Basically, the hypothalamus governs sexual behavior and the pituitary gland’s release of hormones. Conversely, the male sweat compound activated the hypothalamus in women and the smell-related regions in men. However, when the study was repeated with homosexual men, it was discovered that gay men responded the same way as women—as if the hypothalamus’s response was determined by sexual orientation. A similar study was performed with lesbian women where they partly shared activation of the anterior hypothalamus with heterosexual men.
Scent can influence how our brain fires, but can it control how we act? Perfumes and body spray advertisers would like us to think so. Many aphrodisiac substances contain human sexual pheromones in order to stimulate the opposite sex. “Copulins” were patented in the 1970s as
products that release human pheromones following questionable research on rhesus monkeys. However, no data has ever supported that pheromones cause “rapid behavioral changes, such as attraction and/or copulation.” [1,2]
How Wright Laboratory planned on overcoming the small hurdle of forcing a rapid behavioral change is unclear. Their efforts were not ignored, however. The lab won the 2007 Ig Nobel Peace Prize for the “gay bomb.” Ig Nobel Prizes, a parody of the Nobel Prizes, are given away at Harvard University around the time the recipients of the genuine Nobel Prizes are announced. Ten achievements are awarded each year that "first make people laugh, and then make them think." Needless to say, the gay bomb made for a perfect nominee. By the way, no one from the DoD bothered to attend the ceremony or accept the Ig Nobel prize.
What's this mean for our military's future? I guess I should start working on my proposal for pillow fights, whoopie cushions, and water balloon grenades: Operation You Gotta Be Kidding. Do you think the DoD will give me $7.5 million?
1. Wyatt, Tristram D. (2003). Pheromones and Animal Behaviour: Communication by Smell and Taste. Cambridge: Cambridge University Press. p. 298 Quoting Preti & Weski (1999) "No peer reviewed data supporting the presences of...human...pheromones that cause rapid behavioral changes, such as attraction and/or copulation have been documented."
2. Bear, Mark F.; Barry W. Connors, Michael A. Paradiso (2006). Neuroscience: Exploring the Brain. p. 264 ...there has not yet been any hard evidence for human pheromones that might [change] sexual attraction (for members of either sex) [naturally].
According to the proposal, “One distasteful but completely non-lethal example would be strong aphrodisiacs, especially if the chemical also caused homosexual behavior.” Wright Laboratory asked for $7.5 million to fund research and development of the project. It also proposed other non-lethal weapon ideas such as a sweating bomb, a flatulence bomb, and spraying the enemy with bee pheromones and releasing beehives into the combat area. The gay bomb certainly takes the cake, however. “The notion was that...by virtue of either breathing or having their skin exposed to this chemical...soldiers would become gay,” explained Edward Hammond of the Sunshine Project.
The Department of Defense claims to have dismissed the idea at a very early stage, but Hammond doesn't believe them. “The truth of the matter is, it would have never come to my attention if it was dismissed at the time it was proposed. In fact, the Pentagon has used it repeatedly and subsequently in an effort to promote non-lethal weapons, and they submitted it to the highest scientific review body in the country for them to consider.” Nonetheless, government officials insisted again in June 2007 that no funding was awarded to the project.
It’s hard not to be fascinated by non-lethal weapons. Imagine fighting a war where nobody dies. But a gay bomb? Really? There are so many inherent problems and assumptions within this formula, it is actually terrifying to think something like this might be possible. After all, it would mean human beings, like mindless drones, are incapable of controlling their actions. And, personal agency, or free will, is totally out the window. It also assumes that gays make ineffective soldiers at best. “Throughout history we have had so many brave men and women who are gay and lesbian serving the military with distinction,” said Geoff Kors of Equality California. “So, it’s just offensive that they think by turning people gay that the other military would be incapable of doing their job.”
Is there any medical truth behind the “gay bomb”?
Two compounds long suspected of being pheramones were tested: a testosterone derivative produced in men's sweat and an estrogen-like compound in women's urine. The estrogen-like compound activated smell-related regions in women and the hypothalamus in men. Basically, the hypothalamus governs sexual behavior and the pituitary gland’s release of hormones. Conversely, the male sweat compound activated the hypothalamus in women and the smell-related regions in men. However, when the study was repeated with homosexual men, it was discovered that gay men responded the same way as women—as if the hypothalamus’s response was determined by sexual orientation. A similar study was performed with lesbian women where they partly shared activation of the anterior hypothalamus with heterosexual men.
Scent can influence how our brain fires, but can it control how we act? Perfumes and body spray advertisers would like us to think so. Many aphrodisiac substances contain human sexual pheromones in order to stimulate the opposite sex. “Copulins” were patented in the 1970s as
products that release human pheromones following questionable research on rhesus monkeys. However, no data has ever supported that pheromones cause “rapid behavioral changes, such as attraction and/or copulation.” [1,2]
How Wright Laboratory planned on overcoming the small hurdle of forcing a rapid behavioral change is unclear. Their efforts were not ignored, however. The lab won the 2007 Ig Nobel Peace Prize for the “gay bomb.” Ig Nobel Prizes, a parody of the Nobel Prizes, are given away at Harvard University around the time the recipients of the genuine Nobel Prizes are announced. Ten achievements are awarded each year that "first make people laugh, and then make them think." Needless to say, the gay bomb made for a perfect nominee. By the way, no one from the DoD bothered to attend the ceremony or accept the Ig Nobel prize.
What's this mean for our military's future? I guess I should start working on my proposal for pillow fights, whoopie cushions, and water balloon grenades: Operation You Gotta Be Kidding. Do you think the DoD will give me $7.5 million?
1. Wyatt, Tristram D. (2003). Pheromones and Animal Behaviour: Communication by Smell and Taste. Cambridge: Cambridge University Press. p. 298 Quoting Preti & Weski (1999) "No peer reviewed data supporting the presences of...human...pheromones that cause rapid behavioral changes, such as attraction and/or copulation have been documented."
2. Bear, Mark F.; Barry W. Connors, Michael A. Paradiso (2006). Neuroscience: Exploring the Brain. p. 264 ...there has not yet been any hard evidence for human pheromones that might [change] sexual attraction (for members of either sex) [naturally].
Saturday, June 21, 2008
Pro-Life Drugstores: A Trend for the Future?
By Randy Hendrickson
According to the Washington Post ( “Pro-Life Drugstores Market Beliefs” June 16, 2008), no methods of birth control will be sold in DMC Pharmacy, based in Chantilly, Virginia. This faith-based pharmacy will open in August, however, no birth control pills, morning after pills, condoms, or any other forms of contraception will be available, even with a prescription. This may be the beginning of a new trend in pharmacies that are refusing to 
sell products that the health care providers (pharmacists in this case) find morally objectionable. “[S]uch methods can cause what amounts to an abortion, and contraceptives promote promiscuity, divorce, the spread of sexually transmitted diseases and other societal woes…. This allows a pharmacist who does not wish to be involved in stopping a human life in any way to practice in a way that feels comfortable.” Some pro-life pharmacies do not sell contraception products only, whereas others also refuse to sell tobacco, pornography, rolling papers, or other commodities that are deemed morally questionable. The patient has the option of going elsewhere to another pharmacy if she does not share this philosophy.
In traditional pharmacy practice, the legal and moral obligations have always involved ensuring that the proper medication ordered by the prescriber is properly delivered to the patient. Physicians, not pharmacists, hold the ultimate responsibility in making sure that the final treatment outcome is achieved. However, according to the American Association of Colleges of Pharmacy’s Commission to Implement Change in Pharmaceutical Care, the definition of ‘pharmaceutical care’ now focuses on “the pharmacists’ attitudes, behaviors, commitments, concerns, ethics, functions, knowledge, responsibilities, and skills on the provision of drug therapy with the goal of achieving definite outcomes towards the improvement of the quality of life for the patient.” How does provision of contraceptive products fit into this view of pharmaceutical care?
Bioethicists have mixed feelings about this issue. Some hold that the needs of the patients should come before the beliefs of the health care professional.
Nancy Berlinger of the Hastings Center for Bioethics Research, claims that “if you are a health care professional, you are bound by professional obligations,” and you can’t refuse to do what is required by the profession.
R. Alto Charo, a University of Wisconsin bioethicist, also fears that pro-life pharmacies may proliferate in the future, especially in rural areas, “creating a separate universe of pharmacies that puts women at a disadvantage.”
Others have differing views:
Loren E. Lomasky, a bioethicist at University of Virginia, states that finding a niche market based on ethical beliefs and “product differentiation expressive of differing values is a very good thing for a free, pluralistic society."
Similarly, Pharmacists for Life International, which is dedicated to the pro-life philosophy, supports the pharmacist’s right to refuse to fill prescriptions for birth control products.
Several other issues are also at stake. Many pro-life pharmacies do not have signs indicating that they will not dispense contraceptives. As a result, women who need the morning after pill may be wasting valuable time finding a pharmacy that will fill her prescription. This would also be a major concern for rape victims. There have also been reports of pharmacists who not only refuse to fill the prescription, but also refuse to return the prescription to the patient so that she could have it filled at another pharmacy. This, however, is extreme, but it has been reported.
A few states, including New Jersey, California, Illinois, and Washington, have laws that require pharmacies to fill all prescriptions for contraception products OR help women find other means to fill their prescriptions, such as recommending other available pharmacies. The state of Virginia, however, has no such restrictions and no intentions to adopt any such prohibitions.
Because of the societal issues that are constantly evolving, the ethics of pharmacy (and medicine in general) has changed tremendously over the past few years, and these changes make the need for an ethical framework more vital today than it has been in the past. Health care providers need to be cognizant of both the expanding ethical responsibilities as practitioners, but also the traditional moral obligations to patients. Hopefully a balance can be achieved that will benefit all involved.
sell products that the health care providers (pharmacists in this case) find morally objectionable. “[S]uch methods can cause what amounts to an abortion, and contraceptives promote promiscuity, divorce, the spread of sexually transmitted diseases and other societal woes…. This allows a pharmacist who does not wish to be involved in stopping a human life in any way to practice in a way that feels comfortable.” Some pro-life pharmacies do not sell contraception products only, whereas others also refuse to sell tobacco, pornography, rolling papers, or other commodities that are deemed morally questionable. The patient has the option of going elsewhere to another pharmacy if she does not share this philosophy.In traditional pharmacy practice, the legal and moral obligations have always involved ensuring that the proper medication ordered by the prescriber is properly delivered to the patient. Physicians, not pharmacists, hold the ultimate responsibility in making sure that the final treatment outcome is achieved. However, according to the American Association of Colleges of Pharmacy’s Commission to Implement Change in Pharmaceutical Care, the definition of ‘pharmaceutical care’ now focuses on “the pharmacists’ attitudes, behaviors, commitments, concerns, ethics, functions, knowledge, responsibilities, and skills on the provision of drug therapy with the goal of achieving definite outcomes towards the improvement of the quality of life for the patient.” How does provision of contraceptive products fit into this view of pharmaceutical care?
Bioethicists have mixed feelings about this issue. Some hold that the needs of the patients should come before the beliefs of the health care professional.
Nancy Berlinger of the Hastings Center for Bioethics Research, claims that “if you are a health care professional, you are bound by professional obligations,” and you can’t refuse to do what is required by the profession.
R. Alto Charo, a University of Wisconsin bioethicist, also fears that pro-life pharmacies may proliferate in the future, especially in rural areas, “creating a separate universe of pharmacies that puts women at a disadvantage.”
Others have differing views:
Loren E. Lomasky, a bioethicist at University of Virginia, states that finding a niche market based on ethical beliefs and “product differentiation expressive of differing values is a very good thing for a free, pluralistic society."
Similarly, Pharmacists for Life International, which is dedicated to the pro-life philosophy, supports the pharmacist’s right to refuse to fill prescriptions for birth control products.
Several other issues are also at stake. Many pro-life pharmacies do not have signs indicating that they will not dispense contraceptives. As a result, women who need the morning after pill may be wasting valuable time finding a pharmacy that will fill her prescription. This would also be a major concern for rape victims. There have also been reports of pharmacists who not only refuse to fill the prescription, but also refuse to return the prescription to the patient so that she could have it filled at another pharmacy. This, however, is extreme, but it has been reported.
A few states, including New Jersey, California, Illinois, and Washington, have laws that require pharmacies to fill all prescriptions for contraception products OR help women find other means to fill their prescriptions, such as recommending other available pharmacies. The state of Virginia, however, has no such restrictions and no intentions to adopt any such prohibitions.
Because of the societal issues that are constantly evolving, the ethics of pharmacy (and medicine in general) has changed tremendously over the past few years, and these changes make the need for an ethical framework more vital today than it has been in the past. Health care providers need to be cognizant of both the expanding ethical responsibilities as practitioners, but also the traditional moral obligations to patients. Hopefully a balance can be achieved that will benefit all involved.
"These Are Early Days"
Stem cells, bioethics, and…vacations to Thailand?
Those were some of the hot topics last week at the Pennsylvania Convention Center, where the International Society for Stem Cell Research held its sixth annual meeting. The ISSCR kicked off the week with a public workshop and symposium highlighted by some of the world’s leading stem cell experts.
The workshop provided an overview of stem cell biology, which was particularly useful to me because I don’t have a background in science (there were many moments, however, when the discussion passed over my head at a much higher altitude).
Dr. Jonathan Epstein, co-director of the Institute for Regenerative Medicine at the University of Pennsylvania, provided a fascinating look at the potential of stem cells to help regenerate heart tissue. Our bodies can regenerate some organs, such as the liver—so why not hearts? Epstein presented a video showing functional heart tissue generated with stem cell technology. The new cells could be seen beating under the microscope, then continuing to beat in unison as they developed into a larger piece of tissue.
Below is a clip showing beating heart cells derived from human embryonic stem cells similar to the one Epstein presented:
For me, Epstein’s presentation magnified the potential of stem cell research. It was only one example of the latest research happening in the labs of researchers around the world. As Epstein was quick to point out, “these are early days.”
Some researchers can’t wait to tap into the potential. As a result, stem cell tourism has popped up in Thailand, China, India, and elsewhere around the globe. The ISSCR unveiled a set of guidelines to halt what its president, Dr. George Daley, calls “the snake oil we’ve seen in medical fraud for centuries.”
But what lies ahead? Dr. Jonathan Moreno, medical ethicist at the University of Pennsylvania, discussed the ethical issues surrounding stem cell research. The moral and metaphysical debate about the status of the human embryo has permeated the political arena over the last decade, and it is likely to continue with the election of a new American president in November. Moreno noted that both Barack Obama and John McCain support stem cell research but have yet to articulate the details and conditions of their policies.
Having made 140 trips to Capitol Hill to educate elected officials about stem cell research, Dr. John Gearhart often finds himself in the center of the political storm. Gearhart remembers his first trip to Congress vividly: “the first person I met asked what it felt like to kill the smallest Americans.” Amy Comstock Rick, president of the Coalition for the Advancement of Medical Research, is also no stranger to members of Congress. CAMR wants to reverse President Bush’s policy on stem cell research, and “will not stop until we get new legislation,” according to Rick.
Whether new legislation is imminent or not, the stem cell debate will no doubt remain heated at the nexus of politics and science.
Those were some of the hot topics last week at the Pennsylvania Convention Center, where the International Society for Stem Cell Research held its sixth annual meeting. The ISSCR kicked off the week with a public workshop and symposium highlighted by some of the world’s leading stem cell experts.
The workshop provided an overview of stem cell biology, which was particularly useful to me because I don’t have a background in science (there were many moments, however, when the discussion passed over my head at a much higher altitude).
Dr. Jonathan Epstein, co-director of the Institute for Regenerative Medicine at the University of Pennsylvania, provided a fascinating look at the potential of stem cells to help regenerate heart tissue. Our bodies can regenerate some organs, such as the liver—so why not hearts? Epstein presented a video showing functional heart tissue generated with stem cell technology. The new cells could be seen beating under the microscope, then continuing to beat in unison as they developed into a larger piece of tissue.
Below is a clip showing beating heart cells derived from human embryonic stem cells similar to the one Epstein presented:
For me, Epstein’s presentation magnified the potential of stem cell research. It was only one example of the latest research happening in the labs of researchers around the world. As Epstein was quick to point out, “these are early days.”
Some researchers can’t wait to tap into the potential. As a result, stem cell tourism has popped up in Thailand, China, India, and elsewhere around the globe. The ISSCR unveiled a set of guidelines to halt what its president, Dr. George Daley, calls “the snake oil we’ve seen in medical fraud for centuries.”
But what lies ahead? Dr. Jonathan Moreno, medical ethicist at the University of Pennsylvania, discussed the ethical issues surrounding stem cell research. The moral and metaphysical debate about the status of the human embryo has permeated the political arena over the last decade, and it is likely to continue with the election of a new American president in November. Moreno noted that both Barack Obama and John McCain support stem cell research but have yet to articulate the details and conditions of their policies.
Having made 140 trips to Capitol Hill to educate elected officials about stem cell research, Dr. John Gearhart often finds himself in the center of the political storm. Gearhart remembers his first trip to Congress vividly: “the first person I met asked what it felt like to kill the smallest Americans.” Amy Comstock Rick, president of the Coalition for the Advancement of Medical Research, is also no stranger to members of Congress. CAMR wants to reverse President Bush’s policy on stem cell research, and “will not stop until we get new legislation,” according to Rick.
Whether new legislation is imminent or not, the stem cell debate will no doubt remain heated at the nexus of politics and science.