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Center Challenges AAP Radical Pro-Abortion Stance

Monday, February 6th, 2017 by Dr. Dennis Sullivan

Ohio Right to Life recently asked us if we would join them in a letter critical of the American Academy of Pediatrics, a move we were happy to make. We signed the letter, along with other medical groups, to  urge the American Academy of Pediatrics to wind back its position that even teenagers have a clear right to abortion. The Academy’s position further contends that this is an unfettered right with no restrictions, no even  parental involvement. Ohio Right to Life president Mike Gonidakis said this:

In a sad twist, the Academy in fact harms children twice: First, the teen seeking the abortion; and second, the child who is the target of abortion. The statement appears to be first and foremost that of a political agenda. . .  [T]he modern-day American medical profession was founded with the intent of stamping out harmful practices like abortion—practices that contradict the physician’s duty to ‘First, do no harm.’ If the American Academy of Pediatrics is to honor that legacy and truly dedicate themselves to the health of all children, they will rescind this horrific polemic in favor of sound medical science.

 

What a distortion of parental duties — implying that we protect our adolescent children by allowing them to commit such an immoral act. We stand with Ohio Right to Life and other professional organizations that expose this as a lie.

Ohio Right to Life Press Release

New ‘Incentives’ to Choose Death

Wednesday, February 1st, 2017 by Dr. Dennis Sullivan

As we have commented in this blog recently, the American Medical Association (AMA) is thinking of reversing its opposition to physician-assisted suicide (PAS). Canada and five U.S. states have made this practice legal, and “aid in dying” is now a part of everyday medical discussions. Here are a few more reasons to worry about all this:

In January, the Canadian Medical Association Journal published a “Cost Analysis of Medical Assistance in Dying in Canada.” Their conclusion: patients that choose PAS could save the national healthcare system millions of dollars over more expensive palliative care. My colleague Phillip Thompson discusses this issue in his blog here.

 

More grease for this slippery slope comes from the prestigious Journal of Medical Ethics. The December issue features an article entitled, “Organ Donation after Medical Assistance in Dying” (link). PAS may become more attractive for some terminally-ill patients if they could donate their organs. So add the subtle social coercion of doing a “noble” act as another reason to choose PAS. John Holmlund reacts to the trend here.

 

Those who endorse these ideas are acting compassionately, to be sure, but with individual radical autonomy as the underlying principle, rather than an absolute commitment to the sanctity of human life. May God have mercy on all of us as we struggle to find our way in the modern context of managed health care.

Bioethics in Faith & Practice: Latest Issue

Tuesday, January 24th, 2017 by Dr. Dennis Sullivan

Bioethics in Faith and Practice has just published its latest issue. As we close out 2016, the New Year brings many ethical challenges. This edition of the journal features dilemmas at the beginning of life, the end of life, and in the laboratory. Features in this issue:

The first editorial discusses the new trend to facilitate assisted suicide, now legal by statute in five states. This is a dangerous trend, with serious negative implications for modern medicine. Dr. Kuruvilla, our Managing Editor, then discusses the new CRISPR technology, a novel new gene-editing technology that may allow for some truly breathtaking possibilities, especially in the fight against cancer. But there are many hidden ethical dangers.

The first of our full-length articles in this issue is by attorney Gregory Smith, and deals with the thorny issue of the persistent vegetative state (PVS). Using a perspective from Catholic moral philosophy, he asks if artificial nutrition and hydration are always obligatory in such cases.

Finally, pastor and hospital chaplain Mark Lones discusses the issue of reproductive surrogacy. His analysis gives us multiple reasons to consider surrogacy highly problematic from an ethical perspective.

All of these articles, along with the Senior Editor’s preview, are available in the Cedarville University Digital Commons, at this link.

 

Bioethics Challenges for the New Year

Monday, January 9th, 2017 by Dr. Dennis Sullivan

A colleague of mine has referred to this modern era as the “Biotech Century.” More than ever before, biological research and medical science have improved our lives, but have created new ethical dilemmas as well. Here are some of the major trends to watch for in the coming year.

Issues at the Beginning of Life

  1. Abortion. Forty-four years after the Roe v. Wade Supreme Court decision, Americans are more conflicted about the issue of abortion than ever before. 18 states have banned the procedure at 20 weeks of gestation. Such “pain-capable” abortion bans are based on the idea that the 20 week-old fetus has enough neurological development to feel pain, making abortion a form of torture. With a Republican administration in Washington, watch for renewed attempts to appoint conservatives to the bench and to overturn Roe.
  2. Reproductive technologies. Choices, choices: so many ways to have a baby. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). have pushed the envelope, making a genetically-related baby more and more possible for childless couples. The downside? Thousands of human embryos frozen for future use, discarded, or experimented on. A fundamental question remains: Are our children the God-ordained offspring of a loving marital union, or are they merely the products of an assembly line?

Issues at the End of Life

  1. When does death occur? New protocols are making it easier to withdraw care from acutely-injured patients, in order to provide more organs for transplants. Slippery-slope concerns should cause all of us to worry about the details.
  2. Assisted suicide. The American Medical Association is re-thinking its traditional opposition to medically-assisted death. As a part of this trend, five states have passed laws allowing doctors to help terminally-ill patients to end their lives at a time of their choosing. So who owns the life that we live, we ourselves or the Creator Who made us?

From the Laboratory

  1. Animal-human chimeras. Here’s an interesting idea: genetically modify a species of pig, making it incapable of growing a pancreas. Incubate the pig embryo with human pancreas cells, so that the resulting piglet has a human-derived pancreas, which can be used as a donor organ for transplant. Such a procedure might be a cure for diabetes, and may be ready for human trials soon. How about the ethics of all this? The devil is in the details.
  2. Gene editing. The completion of the Human Genome Project in 2003 produced the genetic blueprint of the human species, leading to a plethora of new research ideas. One revolutionary new insight takes advantage of a bacterial defense mechanism to recognize foreign DNA. A new procedure modifies this into a molecular “machine” that can actually edit any genome, including those of human beings. So-called CRISPR technology may make some very nifty things possible: think of engineered mosquitoes incapable of transmitting the Zika virus. But this new technique opens up some very disturbing ideas about modifying human nature itself.

Stay tuned – We’ll be talking about these and other trends in 2017.

In the meantime, have a blessed and productive New Year!

Links Related to Topics Discussed:
Pain-Capable Abortion Bans
Reproductive Technologies

Brain Death

Assisted Suicide

Animal-Human Chimeras
More about Gene Editing

The New Push for Assisted Suicide

Tuesday, December 6th, 2016 by Dr. Dennis Sullivan

Mortar 

There is a growing movement within the American Medical Association (AMA) to legalize “aid in dying,” otherwise known as physician-assisted suicide. The current ethics statement of the AMA, with roots going back thousands of years, states the following:

It is the policy of the AMA that:
1.Physician assisted suicide is fundamentally inconsistent with the physician’s professional role.
2.It is critical that the medical profession redouble its efforts to ensure that dying patients are provided optimal treatment for their pain and other discomfort.
3.Physicians must resist the natural tendency to withdraw physically and emotionally from their terminally ill patients.
4.Requests for physician assisted suicide should be a signal to the physician that the patient’s needs are unmet . . .

 

Now this commonsense, compassionate standard is giving way to something more radical. At its meeting last June, the AMA’s Council for Ethical and Judicial Affairs approved the study of “aid in dying,” prior to its next annual meeting in 2017. The stated goal is to consider going “neutral” on assisted suicide. This would be an historical departure for the AMA.

There are many reasons this is a bad idea. It impairs the trust relationship between a doctor and her patients. It would detract from modern efforts to improve  palliative care and hospice. And given our utilitarian society that so devalues the sanctity of life, a “right to die” could easily morph into a “duty to die.”

All of this is bad medicine, and we should oppose it.

Current AMA Ethics Statement

Still Pushing the Limits with Abortion

Tuesday, August 23rd, 2016 by Dr. Dennis Sullivan

Month 7

(by guest blogger Dr. Mark Pinkerton)

It has been over a year since the shocking release of undercover videos showing Planned Parenthood executives haggling over the price of fetal body parts. Despite those disclosures, the abortion industry continues some very questionable practices. According to a recent news report, a congressional committee sent a letter to the New Mexico attorney general. The letter detailed how the University of New Mexico provided whole aborted fetuses from an abortion clinic as dissection specimens for a high school summer camp. The news article went on to state, “the students dissected the babies and had no feelings for the babies.”

As a physician, I understand the importance of anatomical dissection. If this were a camp for teens aspiring to be physicians, dissecting would be very educational. Is a human fetus the best choice for this purpose? Prior to medical school, I dissected a piglet and a cat. Once I got to med school, we employed adult human specimens, but only with that person’s prior consent to donate. Our dissection lab started with a moment of silence to respect the life and personhood this body once contained. But the casual use of late-term fetuses for a high school camp seems callous.

Is this what happens after years of society teaching us that our life is a merely the product of natural evolution? Is this how life is treated if viewed without a soul? It is time for our society to return to treating one another, including the recently deceased, with respect. No matter your religion or politics, human dignity demands it.

Life News Article
Daily Wire Article

 

 

 

 

Pharmacist Conscience Rights Denied

Wednesday, July 6th, 2016 by Dr. Dennis Sullivan

Mortar

Disappointing news from the United States Supreme Court: Pharmacists in the state of Washington have no conscience protections in regard to contraceptive drugs, even those that may induce abortion. In the case of Stormans v. Wiesman, the owners of Ralph’s Thriftway Pharmacy declined to stock certain contraceptives, such as Plan B, that may cause an early abortion. Dispensing such a drug conflicts with the sincere pro-life views of Kevin Stormans and his family.

In the past, when abortifacient drugs were requested, the Stormans would simply and graciously refer the client to one of “more than 30 other pharmacies within five miles of Ralph’s.” This type of arrangement is a time-honored move that has been legal and ethical in all 50 states – until now. Recently enacted State Board of Pharmacy rules now require dispensing all contraceptive agents, regardless of their mechanism of action, and regardless of any ethical views held by pharmacists. The Stormans family sued to retain their right of conscience.

An unfavorable Ninth Circuit Court ruling led to an appeal to the U.S. Supreme Court, which on June 28th denied certiorari, that is, they refused to hear the case. In his written dissent, Justice Samuel Alito described the clearly anti-religious bias of the high court:

This case is an ominous sign. At issue are Washington State regulations that are likely to make a pharmacist unemployable if he or she objects on religious grounds to dispensing certain prescription medications. There are strong reasons to doubt whether the regulations were adopted for — or that they actually serve — any legitimate purpose. And there is much evidence that the impetus for the adoption of the regulations was hostility to pharmacists whose religious beliefs regarding abortion and contraception are out of step with prevailing opinion in the State.

 

The impact of this ruling will be widespread, and directly affects healthcare professionals throughout the Ninth Circuit Court’s jurisdiction, which includes nine western states. A similar law is currently pending in California (part of the Ninth Circuit).

Make no mistake: conscience rights are under attack. Healthcare professionals of faith may be driven from their vocation by these draconian regulations. Christians must take a stand, and we must pray.

National Review

Alliance Defending Freedom

 

 

Animal – Human Chimeras May Solve Transplant Organ Shortage

Thursday, June 9th, 2016 by Dr. Dennis Sullivan

pig

In a move guaranteed to raise ethical questions around the world, scientists in California are using gene-editing techniques to remove parts of a pig’s DNA, then replace it with human DNA that codes for the human pancreas. It is their hope that this will provide a source to grow human organs, toi deal with the desperate shortage of transplantable organs currently available:

Researchers at the University of California, Davis combined human stem cells and pig DNA and allowed the embryos to mature for 28 days, before terminating the experiment and analyzing the tissue. They believe the animals, if they had been carried to term, would have developed a human internal organ, but would have looked and behaved like any other pig. The goal is that in the future, similar animals could potentially act as a ready source of organs for life-saving transplants.

 

Of course, the key ethics question is: how much human DNA can be added to a pig before the pig becomes “too human?” Getting the balance right will be the goal of future research, which nonetheless promises an exciting new advance in transplantation medicine.

News Article from the Guardian

Profiteering from the Poor

Tuesday, May 24th, 2016 by Dr. Dennis Sullivan

euthan

Many of you will recall the highly publicized case last fall, of Martin Shkreli, CEO of Turing Pharmaceuticals, smirking and invoking his Fifth Amendment rights before a televised House Oversight Committee hearing. He had led his company to acquire a generic drug that had been available inexpensively for decades. The company immediately jacked up the price. As reported in Fortune Magazine:

Daraprim, a treatment for malaria and toxoplasmosis, is now 5,455% more expensive than it was only two months ago. The drug’s price jumped from $13.50 to $750 a pill, bringing the annual cost of treatment into the hundreds of thousands for some patients—and possibly out of reach for many.

 

Such unapologetic and unethical behavior by a major drug company has become common. Prices have skyrocketed on older drugs whose patents have expired, some of them on the World Health Organization’s essential medicine lists. Another good example is the antiparasitic drug albendazole, whose daily cost has jumped from about $5.92 in 2010 to $201.27 last year. One of my colleagues, who makes regular mission trips to Honduras, worries that the price increases will make the drug unavailable to the poor population he serves.

In fact, these price-gouging practices disproportionately hurt the poor.  A recent report in the New England Journal of Medicine (NEJM) put it this way:

What makes this business model particularly disturbing is that vulnerable patients — such as immigrants, refugees, and people of low socioeconomic status — are often disproportionately affected, since many of the medications are for tropical or opportunistic infections. These patients often have limited or no access to insurance, or have access only through public programs, so already stark health disparities are compounded.

 

Now I know you’ve heard the explanation for high prices usually offered by drug manufacturers: research and development (R&D) costs are high and risky. Yet here is the reality (from NEJM again):

Though some companies that have purchased and increased the price of niche medicines cite R&D as an explanation for high prices, it’s hard to find credible evidence of their involvement in substantial drug-development projects. Turing and Amedra state on their websites that they’re engaged in research, yet neither company lists substantial R&D activities or publications.

 

Let’s be clear: none of this is illegal, though it is highly unethical. The JAMA article concludes with this comment: “Timely market solutions that promote competition are needed when high prices result from monopolies.” In other words, drug companies will not do the right thing unless it aligns with their corporate self-interest. They will need a nudge from those who care about the poor.

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Fortune Magazine Article

WHO Essential Medicine Lists

NEJM Article (pdf)

Much Ado About MOLST

Tuesday, May 17th, 2016 by Dr. Dennis Sullivan

molst_form

Most healthcare professionals agree that patients rarely document their wishes about end-of-life care before a crisis occurs. This often makes decision-making difficult for both clinicians and families. I have long advocated that everyone should have an advance directive in place. This may take two forms. The first is a living will, which specifies the kind of medical treatments you want if you have a life-threatening illness and cannot make decisions for yourself. Better yet is a durable power of attorney for health care (DPAHC), which legally designates a surrogate decision-maker, typically a spouse or child, who can make decisions for you, knowing your values and acting in your best interests.

For the very sick, especially those unlikely to live more than a year, a newer document has arisen in over 20 states, called MOLST (Medical Orders for Life-Sustaining Treatment) or POLST (Physician Orders for Life-Sustaining Treatment). Unlike a ‘do-not-resuscitate’ (DNR) order, MOLST documents address more than just CPR. They may also involve the use of a ventilator, a feeding tube, dialysis, antibiotics, or simple I.V. fluids. The purpose is to carry out the specifics of the patient’s advance directives in the form of a persistent medical order. In theory, this should be a better guarantee that a patient’s final wishes are carried out.

Advantages of MOLST:

  • Can help protect dying patients from unwanted, intrusive, or disproportionate treatments (e.g., ventilators or CPR).
  • May relieve the burden of decision-making for family members and other surrogates.
  • Transferable as part of the medical record to various institutions.

Some Concerns about MOLST:

  • It is a medical document, not a legal one. It is therefore more difficult to modify or revoke it.
  • Advance directives (living wills and DPAHC) are enacted only when a patient loses decision-making capacity; a MOLST document is effective immediately. regardless of a patient’s capacity.
  • On the form, the default is to limit treatments, which may imply a utilitarian agenda that devalues life for the elderly and infirm.
  • Many pro-life groups oppose MOLST legislation, fearing that it paves the way for legalizing assisted suicide, and ultimately, euthanasia.

I have some reservations about MOLST, though the goal is to protect patients’ rights. Specifically, Ohio Right to Life is neutral on the proposed Ohio law, while other Ohio RTL groups oppose it.

ORTL Statement

Greater Cinci RTL (click on ‘Life Issues’)