(Nature) – It might take years or even decades until BCI and other neurotechnologies are part of our daily lives. But technological developments mean that we are on a path to a world in which it will be possible to decode people’s mental processes and directly manipulate the brain mechanisms underlying their intentions, emotions and decisions; where individuals could communicate with others simply by thinking; and where powerful computational systems linked directly to people’s brains aid their interactions with the world such that their mental and physical abilities are greatly enhanced. Such advances could revolutionize the treatment of many conditions, from brain injury and paralysis to epilepsy and schizophrenia, and transform human experience for the better. But the technology could also exacerbate social inequalities and offer corporations, hackers, governments or anyone else new ways to exploit and manipulate people. And it could profoundly alter some core human characteristics: private mental life, individual agency and an understanding of individuals as entities bound by their bodies.
(Nature) – Somewhere in Germany’s Ruhr valley, a nine-year-old boy is doing what children do: playing football, joking around with friends and going to school. Two years ago, he was confined to a hospital bed, dying of a rare and cruel genetic skin disease. In a landmark paper online in Nature this week, scientists and clinicians present the details of his astonishing recovery. The boy had junctional epidermolysis bullosa, or JEB. He, like other people with the disease, carried a mutation in a gene that controls the integrity of the skin. Doctors could only try to ease his suffering as some 80% of his skin simply fell away.
(STAT News) – At an NHL hockey game, it’s not uncommon to see some blood. The other day, it turned out to be some of my own. The good news is that it was all in the name of science. The Boston-based consumer genetics company Orig3n had announced that it was planning to set up booths at a Boston Bruins game I was going to attend. Along with other fans, I could get a free DNA test and learn about my own genes. These kinds of tests are increasingly common — and many of them are marketed toward fitness junkies and sports fans like myself. The idea is that you can discover all kinds of things you never knew about your health.
(ABC News) – The city of Delhi, India, is surrounded by a thickening blanket of smog that covers the city, making the sky less visible and the air less breathable. The Indian Medical Association (IMA) declared a public health emergency in the city on Tuesday — the city’s air quality rating is above the highest levels on the index. People have been advised to avoid any outdoors activity and to keep children indoors to avoid the risks of the “severely harmful” air quality.
(GEN) – Stem cells have been a boon to biological research, allowing researchers to visualize and develop potential therapies for diseases where intervention has hit a wall. However, not all stem cell therapies are as simple as adding undifferentiated cells to damaged areas, allowing natural biological processes to take hold. For instance, inner ear stem cells can be converted to auditory neurons that could reverse deafness, but the process can also make those cells divide too quickly, posing a cancer risk—this according to recent findings from a study led by investigators at Rutgers University-New Brunswick.
Bioethics (vol. 31, no. 7, 2017) is available online by subscription only.
- “Wrongness, Responsibility, and Conscientious Refusals in Health Care” by Alida Liberman
- ‘You Are Inferior!’ Revisiting the Expressivist Argument” by Bjørn Hofmann
- A Pragmatic Analysis of Vulnerability in Clinical Research” by David Wendler
- Euthanasia and Cryothanasia” by Francesca Minerva and Anders Sandberg
- Human Organisms Begin to Exist at Fertilization” by Calum Miller and Alexander Pruss
- Tying Oneself to the Mast: One Necessary Cost to Morally Enhancing Oneself Biomedically” by Benedict Rumbold
- First, Do No Harm: Generalized Procreative Non-Maleficence” by Ben Saunders
- Defending the Social Value of Knowledge as a Safeguard for Public Trust” by Felicitas S. Holzer
JAMA Internal Medicine (vol. 177, no. 8, 2017) is available online by subscription only.
- “Cosmetics, Regulations, and the Public Health: Understanding the Safety of Medical and Other Products” by Robert M. Califf, Jonathan McCall, and Daniel B. Mark
Genetics in Medicine (vol. 19, no. 5, 2017) is available online by subscription only.
- “Diagnostic Cytogenetic Testing Following Positive Noninvasive Prenatal Screening Results: A Clinical Practice Resource of the American College of Medical Genetics and Genomics (ACMG)” by Athena M. Cherry et al.
- “Carnitine Palmitoyltransferase 1A P479L and Infant Death: Policy Implications of Emerging Data” by Alison E. Fohner, Nanibaa’ A. Garrison, Melissa A. Austin, and Wylie Burke
- “The Current State of Implementation Science in Genomic Medicine: Opportunities for Improvement” by Megan C. Roberts, Amy E. Kennedy, David A. Chambers, and Muin J. Khoury
- “Conflicts of Interest in Genetic Counseling: Acknowledging and Accepting” by Katie A. Stoll, Amanda Mackison, Megan A. Allyse, and Marsha Michie
Nursing Ethics (vol. 24, no. 3, 2017) is available online by subscription only.
- “Nurse Ethical Awareness: Understanding the Nature of Everyday Practice” by Aimee Milliken and Pamela Grace
- “The Development of Ethical Guidelines for Nurses’ Collegiality Using the Delphi Method” by Mari Kangasniemi et al.
- “From Painful Busyness to Emotional Immunization: Nurses’ Experiences of Ethical Challenges” by Anne Storaker, Dagfinn Nåden, and Berit Sæteren
- “Evaluating Care from a Care Ethical Perspective:: A Pilot Study” by Esther E Kuis and Anne Goossensen
- “Nurses’ and Patients’ Perceptions of Privacy Protection Behaviours and Information Provision” by Kyunghee Kim, Yonghee Han, and Ji-su Kim
JAMA (vol. 318, no. 6, 2017) is available online by subscription only.
- “Can Patients Make Recordings of Medical Encounters? What Does the Law Say?” by Glyn Elwyn, Paul James Barr, and Mary Castaldo
- “Challenges in International Comparison of Health Care Systems” by Irene Papanicolas and Ashish K. Jha
- “Unintended Consequences of Machine Learning in Medicine” by Federico Cabitza, Raffaele Rasoini, and Gian Franco Gensini
- “Health and Spirituality” by Tyler J. VanderWeele, Tracy A. Balboni, and Howard K. Koh
- “Organ Donation After Euthanasia” by Rahul M. Jindal
(Bloomberg) – The high-tech testing lab’s raw material has become liquid gold for the doctors who own Comprehensive Pain Specialists. This testing process, driven by the nation’s epidemic of painkiller addiction, generates profits across the doctor-owned network of 54 clinics, the largest pain-treatment practice in the Southeast. Medicare paid the company at least $11 million for urine and related tests in 2014, when five of its professionals stood among the nation’s top billers.
(Gizmodo) – The newly proposed regulations will allow genetic health tests to make it to market without prior review. Companies seeking to sell such tests would have to come to the FDA for a one-time review. But after getting that initial FDA stamp of approval, any subsequent genetic health test the company develops will not face further regulatory hurdles. “Our goal is to streamline the regulatory pathway to get innovative medical products to people more efficiently, while providing the FDA assurances that consumers seek,” said Gottlieb.
(The Atlantic) – Stefania Druga and Randi Williams, the researchers behind the study, want to know how children perceive smart robots, and, eventually, to study how those bots affect kids’ cognitive development. So far, they’ve discovered that little children (ages 3 and 4) aren’t sure whether the robots are smarter than they are, but that slightly older children (ages 6 to 10) believe the robots to have superior intelligence. Druga and Williams were inspired by the research of the legendary Sherry Turkle, who wrote a highly influential 1984 book called The Second Self.
(Science Daily) – Researchers have found that patients with different types of attention-deficit/hyperactivity disorder (ADHD) have impairments in unique brain systems, indicating that there may not be a one-size-fits-all explanation for the cause of the disorder. Based on performance on behavioral tests, adolescents with ADHD fit into one of three subgroups, where each group demonstrated distinct impairments in the brain with no common abnormalities between them.
(Los Angeles Times) – In an opioid epidemic that currently claims an average of 91 lives per day, there have been many paths to addiction. For some, it started with a fall or a sports injury, a trip to a nearby emergency room and a prescription for a narcotic pain reliever that seemed to work well in the ER. New research underscores how tragically risky — and unnecessary — such prescribing choices have been. In a new study of patients who showed up to an emergency department with acute pain in their shoulders, arms, hips or legs, researchers found that a cocktail of two non-addictive, over-the-counter drugs relieved pain just as well as — and maybe just a little better than — a trio of opioid pain medications widely prescribed under such circumstances.
(New York Times) – Yet there are no widely accepted guidelines for dealing with these patients as they near death. Cancer specialists regularly move their patients to hospice at the end of life, for instance, but few cardiologists even think of it. Heart patients account for just 15 percent of hospice deaths, while cancer patients make up half, according to a recent study. That paper, published in the Journal of the American College of Cardiology, reviewed a number of ways in which heart patients are let down at the end of life. Implanted defibrillators often remain activated until the very end, for example, even for those in hospice.
Tokyo: Artificial Intelligence ‘Boy’ Shibuya Mirai Becomes World’s First AI Bot To Be Granted Residency
(Newsweek) – A chatbot programmed to be a seven-year-old boy has become the first AI bot to be granted official residence in Tokyo, Japan. Shibuya Mirai is the latest resident of Shibuya, a Tokyo ward with a population of around 224,000 people, despite only existing as a chatbot on the Line messaging app. The ward’s decision to make Mirai—meaning ‘future’ in Japanese—an official resident is part of a project aimed at making the local government more familiar and accessible to locals. The chatty seven-year-old is designed to listen to the opinions of Shibuya residents.
(Politico) – Patrick Soon-Shiong, the medical entrepreneur who has expanded his influence in Washington by cultivating close ties to both parties, has struggled to meet analysts’ expectations for sales of his GPS genetic test, the key to his plan to transform cancer treatment by matching patients with tailored drug treatments. At the same time, sales of the GPS test are being boosted by purchases from hospitals and clinics associated with doctors who have financial ties to his network of for-profit and non-profit companies.
(BMJ) – Of 33 DCNM, [due care not met], cases identified (occurring 2012–2016), 32 cases (97%) were published online and included in the analysis. 22 cases (69%) violated only procedural criteria, relating to improper medication administration or inadequate physician consultation. 10 cases (31%) failed to meet substantive criteria, with the most common violation involving the no reasonable alternative (to EAS [euthanasia and physician-assisted suicide]) criterion (seven cases). Most substantive cases involved controversial elements, such as EAS for psychiatric disorders or ‘tired of life’, in incapacitated patients or by physicians from advocacy organisations. Even in substantive criteria cases, the RTE’s focus was procedural.
(Sacramento Bee) – Medical treatments for transgender people have gone “mainstream,” according to Richard Paulson, an obstetrician-gynecologist in Los Angeles and the president of the American Society for Reproductive Medicine. With that comes the prospect for a medical development that could shatter some of the most strongly-held beliefs for centuries about biological sex and the ability to conceive a child. In short, some scientists believe that transgender women — those who were assigned male at birth — could soon give birth.