(STAT News) – Nearly 26 million people around the world die each year with serious suffering in part because of a huge gap in pain relief: The U.S. may be awash in opioid painkillers, but they’re rare or unavailable in dozens of poor countries, says a new report. The challenge is to improve palliative care in low-income countries while avoiding mistakes that led to the U.S. addiction crisis. The report to be published Friday in The Lancet says one key is using off-patent morphine that costs pennies a dose — not profitable for drug companies that push pricier, more powerful opioids in rich countries, but critical to easing a health emergency.
(STAT News) – The de facto leader behind the leaderless collective Four Thieves Vinegar, Laufer is now on to his next project: He’s developing a desktop lab and a recipe book meant to equip patients to cook up a range of medicines, including a homemade version of the expensive hepatitis C drug Sovaldi, on their kitchen counters. Health professionals have strenuously warned against DIY pharmaceuticals, but Laufer sees his work as a moral crusade against the patent laws and market forces that let drug companies price vital remedies out of reach for many patients.
(Kaiser Health News) -An Oregon woman with Alzheimer’s disease, whose husband claimed she was kept alive with spoon-feeding against her written wishes, has died. Nora Harris, 64, died early Wednesday at the Fern Gardens senior care center in Medford, Ore. Her husband, Bill Harris, said the death marks the end of an eight-year battle with the progressive, debilitating disease, which included an unsuccessful court fight to withdraw all food and liquid.
(San Francisco Chronicle) – Swedish prosecutors have abandoned an investigation against a disgraced Italian stem cell scientist suspected of involuntary manslaughter in connection with three patients who died after windpipe transplants. Prosecutor Jennie Nordin said it can’t be proven that Dr. Paolo Macchiarini would be guilty of either causing another’s death or causing bodily harm, so he is no longer a suspect.
(Sydney Morning Herald) – If it were a train, this debate would have set off from Euthanasia Central, stopped at Voluntary Euthanasia and Assisted Suicide, moved on to Medically Assisted Death and Assisted Dying, before arriving at Voluntary Assisted Dying, the form of words that our parliamentarians have settled on (and which some would further reduce to the neutral acronym VAD). Call them dying words if you will, but the language around this issue has long been a battlefield, both here and in the handful of places worldwide where some form of euthanasia has already been legalised (Switzerland came first, in 1942).
(Nature) – Advisers to the US Food and Drug Administration (FDA) have paved the way for the agency’s first approval of a gene therapy to treat a disease caused by a genetic mutation. On 12 October, a panel of external experts unanimously voted that the benefits of the therapy, which treats a form of hereditary blindness, outweigh its risks. The FDA is not required to follow the guidance of its advisers, but it often does. A final decision on the treatment, called voretigene neparvovec (Luxturna), is expected by 12 January.
(PhysOrg) – HeLa cells are used in biomedical research around the world. HeLa was named after Henrietta Lacks, the woman whose cervical cancer cells were biopsied and used for medical research. Those cells were found to reproduce indefinitely in the lab, making them the world’s first immortalised cell line and one of the most important and commonly used cell lines in medical research to this day. HeLa cells were thrust into the public eye in recent years thanks to the book and the made-for-TV film of the same name The Immortal Life of Henrietta Lacks. Unfortunately, HeLa cells have been contaminating other cell cultures for decades.
(Aeon) – When someone is sick or needs the help of a physician, who should decide what is appropriate – what blood tests and imaging studies to order, what medicines to prescribe, what surgeries to perform? Should it be the doctor, the patient or some combination of the two? Most people nowadays (even most physicians) support what is called ‘shared decision-making’, in which the doctor and patient (and often her family or friends) discuss the situation and come up with a joint plan.
(STAT News) – The National Institutes of Health on Thursday announced a $215 million public-private partnership with 11 pharmaceutical companies in what the agency bills as a significant next step in its cancer moonshot. The Partnership for Accelerating Cancer Therapies, or PACT, is a five-year agreement to push ahead with research that seeks to “identify, develop and validate robust biomarkers — standardized biological markers of disease and treatment response — to advance new immunotherapy treatments that harness the immune system to attack cancer,” the agency said.
(Nature) – Drug regulation in Europe could temporarily freeze if the European Medicines Agency (EMA) loses staff during its post-Brexit move from London. Up to 70 per cent of its 900 staff have said they would quit if the agency relocated to some of the cities bidding to host the organisation. According to a battle plan drawn up by agency management, failure to retain enough staff would result in a shutdown of essential operations until more people could be hired. If fewer than 30% of the staff move with the agency to its new destination — to be decided next month — it would cease operation, Guido Rasi, the agency’s executive director, told Nature.
(Medscape) – The recent mass shooting in Las Vegas was the largest in modern US history, with 59 people dead (58 gunshot victims and 1 shooter suicide) and more than 500 injured. This horrific event has once again highlighted gun violence as a public health crisis in the United States. In a rare joint editorial, written by a group of editors and published in the Annals of Internal Medicine, JAMA, the New England Journal of Medicine, and PLOS Medicine, Darren B. Taichman, MD, PhD, executive deputy editor of the Annals of Internal Medicine and colleagues, share a list of ways in which healthcare professionals can use their skills and voices to address this public health threat. The editorial was published online October 10 in the Annals of Internal Medicine.
(The Conversation) – Admittedly, palliative care and MAID are both trying to treat suffering, but the methods are different: palliative care does not try to speed up (or slow down) death whereas MAID expressly speeds up death. Palliative care tries to reduce suffering by treating physical, psychosocial and spiritual distress whereas MAID stops suffering by stopping life.
(Boston Globe) – What if instead of waiting for a heart transplant, your doctor told you he or she would build you a new one from scratch? That might sound like science fiction, but it’s closer to reality than you might think. On Tuesday, several of the region’s top scientists gathered at the Harvard Club of Boston to discuss the viability of creating organs and other tissues in the laboratory, during a HUBweek presentation titled “The Organ Generation.” Their wide-ranging conversation bounced from the bioethics of organs made by human beings, to how self-driving cars — and the fewer traffic fatalities they promise — might affect the organ donor pipeline.
(New York Times) – American military officials at the Guantánamo Bay prison recently hardened their approach to hunger-striking prisoners, detainees have told their lawyers, and are allowing protesters to physically deteriorate beyond a point that previously prompted medical intervention to force-feed them. The claim comes during two significant developments for the military commissions at Guantánamo this week, including a Supreme Court decision on Tuesday not to hear an appeal in a much-watched case.
Nursing Ethics (vol. 24, no. 3, 2017) is available online by subscription only.
- “What Is Dignity in Prehospital Emergency Care?” by Anna Abelsson and Lillemor Lindwall
- “Moving It Along: A Study of Healthcare Professionals’ Experience with Ethics Consultations” by Nancy Crigger, Maria Fox, Tarris Rosell, and Wilaiporn Rojjanasrirat
- “Why the History of Nursing Ethics Matters” by Marsha D Fowler
- “Legislating for Advocacy: The Case of Whistleblowing” by Chanel L Watson and Tom O’Connor
- “IJEPA: Gray Area for Health Policy and International Nurse Migration” by Ferry Efend et al.
- “Access to Services for Young Adults with Medical Complexity” by Elizabeth Joly
- “The Relationship between Burnout and Mobbing among Hospital Managers” by Seda Karsavuran and S?d?ka Kaya
- “Clear Conscience Grounded in Relations: Expressions of Persian-Speaking Nurses in Sweden” by Monir Mazaheri et al.
- “Validation of the Policy Advocacy Engagement Scale for Frontline Healthcare Professionals” by Bruce S Jansson et al.
- “Participants’ Safety Versus Confidentiality: A Case Study of HIV Research” by Juan Manuel Leyva-Moral and Maria Feijoo-Cid
Hastings Center Report (vol. 47, no. S1, 2017) is available online by subscription only.
- “Building the Next Bioethics Commission” by Alexander M. Capron
- “International Capacity-Building Initiatives for National Bioethics Committees” by Eugenijus Gefenas and Vilma Lukaseviciene
- “Reflections on the National Bioethics Advisory Commission and Models of Public Bioethics” by James F. Childress
- “Challenges Working with Presidential Bioethics Commissions” by Ruth Macklin
- “Ethical Principles, Process, and the Work of Bioethics Commissions” by Daniel P. Sulmasy
The New Bioethics (vol. 23, no. 1, 2017) is available online by subscription only.
- “The Promise and the Hype of ‘Personalised Medicine’” by Tim Maughan
- “Personalised Medicine Approaches to Screening and Prevention” by Kezia Gaitskell
- “Personalised Medicine and the Economy of Biotechnological Promise” by Steve Sturdy
- “The Human Dimension: Putting the Person into Personalised Medicine” by Rob Horne
- “Risk and Benefit in Personalised Medicine: An End User View” by Alastair Kent
- “Self-Knowledge and Risk in Stratified Medicine” by Joshua Hordern
- “From Rosalind Franklin to Barack Obama: Data Sharing Challenges and
Solutions in Genomics and Personalised Medicine” by Mark Lawler and Tim Maughan
- “Your DNA, Your Say” by Anna Middleton
- “Data Sharing and the Idea of Ownership” by Jonathan Montgomery
- “Equity and Value in ‘Precision Medicine’” by Muir Gray, Tyra Lagerberg, and Viktor Dombrádi
- “Economics of Cancer Medicines: For Whose Benefit?” by Bishal Gyawali and Richard Sullivan
European Journal of Human Genetics (vol. 25, no. 7, 2017) is available online by subscription only.
- “Expanded Carrier Screening: What Determines Intended Participation and Can This Be Influenced by Message Framing and Narrative Information?” by Jan S Voorwinden et al.
- “Practices and Views of Neurologists Regarding the Use of Whole-Genome Sequencing in Clinical Settings: A Web-Based Survey” by Iris Jaitovich Groisman, Thierry Hurlimann, Amir Shoham, and Béatrice Godard
Human Reproduction Update (vol. 23, no. 6, 2017) is available online by subscription only.
- “Sperm Selection in Natural Conception: What Can We Learn from Mother Nature to Improve Assisted Reproduction Outcomes?” by Denny Sakkas, Mythili Ramalingam, Nicolas Garrido, and Christopher L.R. Barratt
- ” Diagnosis of Human Preimplantation Embryo Viability” by David K. Gardner, Marcos Meseguer, Carmen Rubio, and Nathan R. Treff