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Now Proven: Zika Virus Causes Microcephaly

Friday, April 15th, 2016

SAMap

When I first heard about a newer mosquito-borne infection in South America, similar to Dengue fever, but with the possibility of causing birth defects, I was not too worried. I thought the news reports were overblown, and that the actual danger here in the U.S. was minimal. I was wrong. Now even the normally conservative Center for Disease Control and Prevention claims that Zika is “scarier than we initially thought.”

The Zika virus is transmitted by the Aedes aegypti mosquito, endemic in Brazil and other parts of South American, but also common in the southern United States. It should be noted that sexual interaction can also spread the virus.So far, the disease has only appeared in those patients who have visited affected areas:

With global infection rates of the Zika virus increasing rapidly, physicians should be prepared to handle possible cases of the virus and answer patients’ questions. No locally acquired vector-borne Zika virus cases have been reported in the continental United States, but cases have been confirmed in returning travelers.

 

A recent CDC report has confirmed that Zika can definitely cause microcephaly. This leads to abnormally small brains in babies born of women infected with Zika during the first trimester of pregnancy. It is not yet known what percentage of infected women’s babies actually have this problem, or what other abnormalities may appear. It is entirely possible that other problems may arise with Zika infection, or that it may even lead to miscarriages.

This is all the more worrisome because symptoms of Zika infection are often mild, and many infected subjects are asymptomatic. The CDC and World Health Organization have both issued recommendations that women in affected areas should use birth control or avoid sexual intimacy at this time.

In predominantly-Catholic South American countries, such as Peru, Brazil, Colombia, and Venezuela, abortion is illegal. But fear of Zika-infected women having babies with birth defects has led many to demand termination of their pregnancies. The Zika crisis may be used as a wedge to loosen abortion restrictions in the near future.

AMA Resource Website on Zika Virus

USA Today report on CDC advisory

Religious Liberty: Making Our Case

Tuesday, March 15th, 2016

rings

The current climate of secular society has declared, aided and abetted by the U.S. Supreme Court, that traditional views of marriage are unacceptable. For those who protest, the cry of “religious liberty” has become a synonym for bigotry.

Individuals and groups that wish to uphold the view that marriage is between one man and one woman have turned to the First Amendment for help: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” Yuval Levin, in the February issue of First Things. points out that efforts to defend religious liberty could go two ways: based on the establishment clause, or based on the free exercise clause, and that efforts in the courts have depended on the latter.

Free exercise arguments work like this: religious believers should be free to act out their convictions, even when public opinion is against them. In other words, the state should carve out exemptions for such individuals. But the argument does not work very well when the individuals in question are part of larger groups, which the judiciary is loathe to exempt. And yet it is membership in such groups that should give strength to the dissenters, because the groups have a positive message to convey.

“Free exercise” arguments assert a right to not be constrained by secular public opinion. But perhaps it’s time that we made an “establishment” argument, to be free from the civil religion called progressive liberalism. And the argument should be positive rather than negative, a right to advocate for a certain view of human flourishing, rather than just to be free from constraint. Yuval Levin puts it this way:

This means we need to see that we are defending more than religious liberty: We are defending the very idea that our government exists to protect the space in which various institutions of civil society do the work that enables Americans to thrive, and we are defending the proposition that this work involves moral formation and not just liberation from constraint. That is an entire conception of the meaning of a free society that goes well beyond toleration and freedom of religion. It is ultimately about the proper shape and structure of American life.

 

There is a reason that we hold the views we do: we believe, with good cause, that heterosexual marriage as a civil institution should be preserved, and that this is the best course for our republic. Even if we are called bigots, we have a message designed to make this world a better place.

First Things article

American Doctor Claims Research in India was Unethical

Wednesday, February 17th, 2016

caduce

An American doctor has claimed that a major study of cervical cancer in India was unethical, leading to at least 254 “pointless deaths.” American pathologist Dr Eric Suba has criticized three major long-term studies of cervical cancer, conducted in India between 1997 and 2012. In a lecture given in Mubai last February, Dr. Suba has claimed:

“In my opinion, these studies are the worst betrayals of science and ethics anywhere in the world in the 21st century.”

 

Dr. Suba may have a point. The three clinical trials in question compared an “experimental” group of low-income women screened with pelvic exams and Pap smears with a “control” group of women who had no such screening. The results were predictable: the experimental groups fared better in terms of cancer rates and survival than the controls. Dr. Suba claims, therefore, that the study was “scientifically pointless,” since it was “contemplating a question that has already been answered.”

There is an important ethical question here. The whole idea of a control and an experimental group in a statistical study depends on a principle of experimental medicine known as clinical equipoise, where we don’t really know which group will fare better. Otherwise, who would agree to take part in a randomized study? We’ve known for years that the Pap smear, invented in the 1920s, clearly detects early cervical cancer and saves lives.

The U.S Office of Human Research Protections has already found violations of informed consent in the India study, and a full investigation continues.

Suba Report Details

BMJ Discussion of Clinical Equipoise

 

New Challenges to Brain Death

Wednesday, February 10th, 2016

heart-beat

Since 1969, the Harvard Criteria on Brain Death have provided guidelines for declaring a patient dead, even if the heart is still beating. This has allowed for a significant expansion of organ transplants. Donation occurs while the organ is still viable, resulting in better outcomes for recipients. As a legal, ethical determinant of the end of life, brain death is enshrined as firm doctrine in all 50 states.

Two recent cases in the news, however, have called brain death into question. In Oakland, California, 13 year-old Jahi McMath suffered a catastrophic complication of an operation to treat her sleep apnea. In Forth Worth, Texas, Marlese Munoz, 14 weeks pregnant, suffered a massive pulmonary embolism. In both cases, the patient was declared brain dead. In the case of Jahi, her parents insisted that life support be maintained, in the vain hope that she might improve and survive. With Marlese, her parents wanted to have life support discontinued, but the state intervened to keep her on the ventilator because of the pregnancy.

There are separate ethical issues in the Munoz case, but one thing should be clear: neither parents nor the state should have the power to determine when a patient has died. That is a clinical determination, and brain death is well established in ethics and law. Now, it is certainly reasonable for doctors to permit families to “say goodbye” to a loved one before turning off life support, but that does not change the facts. It is not a matter for debate: both California and Texas law permit doctors to end treatments under such circumstances, even over family objections, and protect physicians against liability for doing so.

Please note: Brain death is not an assault on the sanctity of human life. Religious voices that object to brain death often assert a sort of “Christian vitalism,” that claims physical life should trump everything, perhaps even God’s sovereignty. Modern medical ethics is complicated enough without adding this confusion.

Understanding Brain Death
Controversies about Brain Death
Arthur Caplan on Brain Death

Debate over Long Hours for Surgeons in Training

Monday, January 11th, 2016

cartoon-doctor

(by guest blogger Kathryn Sill)

Most of us know that surgical trainees (residents) within hospitals can work some long shifts; 100 hour work weeks are not unusual. Recent standards by the Accreditation Council for Graduate Medical Education have attempted to reduce the number of hours to a maximum of 80 per week, in the belief that tired doctors make mistakes. But is this true?

To address the question of short versus long shifts, the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial will assess residents within 117 different training programs. This study is the first of its kind to try to uncover whether the length of shifts is detrimental to the well-being of both residents and patients. Some believe that long shifts dangerously lead to fatigue among trainees. However, those opposed to shorter shifts claim that they interfere with continuity of care and hinder communication between the residents, leading to even more errors.

The results for the study will be released in February.

Sources:
Article on surgeon training study

FIRST trial information

Gene Editing in Animals May Become Controversial

Tuesday, December 1st, 2015

salmon

(by guest blogger Kathryn Sill)
Your tall glass of milk may come from an unexpected source, thanks to DNA modification in animals. Also known as gene editing, this process uses enzymes to alter an animal’s DNA in specific advantageous ways. This may change an animal’s appearance or increase muscle mass. Such methods may be used to create better food products, to fight diseases, or even to design a household pet.

There are some major ethical concerns with all of this. Animal rights activists claim it is abusive to animals, while those concerned with food safety worry about the effects of modified DNA in the food chain. Finally, many fear that gene editing in animals will eventually lead to gene editing of human embryos.

These concerns are not far-fetched. The FDA has just approved the first genetically modified salmon for widespread consumption, soon to be available in American supermarkets. Stay tuned for a complex and perhaps divisive public debate.

Sources:
* Animal Gene Editing
* Genetically Engineered Salmon

Health Care Conscience Bill Before Congress

Monday, November 23rd, 2015

health-care-md

The freedom of conscience in health care is now under attack more than ever. Nurses, doctors, and pharmacists are speaking up. From Catherina Cenzon-DeCarlo, an operating room nurse:

On May 24, 2009, the hospital where I work coerced me to assist in a 22-week abortion. My duties as a nurse included being present for the bloody dismemberment and accounting for body parts afterwards.

 

The employer threatened to fire the nurse if she did not go along with all this, despite her deeply-held religious beliefs (her beliefs had been previously identified to the hospital administration).

The modern environment in health care, based on a radical view of patient autonomy, wants to remove conscience and professionalism from medicine. If these efforts succeed, people of faith will not become healthcare providers, and the compassionate practice of medicine will erode.

S. 50, the Abortion Non-Discrimination Act, is currently before congress. It would protect any healthcare professional (doctor, nurse, physician assistant, pharmacist) or clinical entity (hospital, clinic, medical practice) from retribution or negative consequences from exercising the right to abide by their personal conscience.

Be in prayer – support your lawmakers.

Cathy’s Story (YouTube)

Freedom 2 Care Website

 

Digging Deeper: Latest PP Video Does Further Damage

Friday, October 30th, 2015

baby_in_womb

Compounding the damage of earlier revelations, an 11th video has been released by the Center for Medical Progress. The covert interview features Dr. Amna Dermish, yet another abortionist working for Planned Parenthood, this time in Texas. I recently provided comments to the online news site The Blaze. Here’s an excerpt:

The problem with the 11th video from the Center for Medical Progress, according to Sullivan, is that the dialogue presented seems to show that doctors want to provide researchers with intact calvariums, or brains. To do this, he said they would not be able to use the aforementioned method, as it would destroy the tissue that they are looking to procure.

 

“So how do they insure that the fetus dies before delivery? In the video, Dr. Dermish clearly states that she does not use digitalis to stop the heart unless the fetus is 20 weeks or older,” Sullivan said. “So I’m left with the unavoidable conclusion that some of these fetuses are born alive, then killed after birth. If true, this is a clear violation of federal law.”

 

He continued, “Nonetheless, Dr. Dermish does not explicitly admit this.”

 

Now CMP does a bit of heavy-handed editing, going back and forth with an earlier interview to make the latest revelations seem even more disturbing. Nonetheless, we should not let the Planned Parenthood doctors off the hook for their unethical behavior. And we should not use our tax dollars fund this deeply flawed organization.

Read the full article in The Blaze here.

Fighting Over Frozen Lives

Monday, September 28th, 2015

8-cell_stage_embryo

The latest chapter in the embryo wars is in California, where a couple is engaged in a bitter custody dispute over the woman’s children, currently in the form of unimplanted frozen embryos. Dr. Mimi Lee and Steven Findley underwent in vitro fertilization when Dr. Lee was diagnosed with breast cancer, making pregnancy risky. She had planned to have a genetically-related child with the help of a surrogate mother. After three years, the couple divorced. Dr. Lee, now 46, would like to have her children. Her ex-husband disagrees.

The similar 1992 Davis v. Davis embryo case in Tennessee granted embryos “special status,” but nevertheless had them destroyed. Since that time, courts have tended to consider embryos as property rather than persons. But recent rulings in Pennsylvania, Maryland, and Illinois have shown more sympathy towards women with cancer, who will not be able to have children biologically themselves. Dr. Mark Sauer, a reproductive endocrinologist, provides some clarity on the issue:

It is compelling and dramatic how these issues play out. These are embryos that will potentially live lives. It is not like you are bartering over the furniture in your house.

 

A decision in the case is likely within the next few weeks, and may set a new precedent.

News Article (LA Times)

New Journal Launch!

Tuesday, September 8th, 2015

Journal Logo framed

The Center for Bioethics is pleased to announce the launch of a new, peer-reviewed academic journal: Bioethics in Faith and Practice.

The focus of the new journal is Health Care Ethics, but it also may include articles of a more theoretical nature. Though it will emphasize Judeo-Christian values, we will be open to a large variety of voices, including secular ones. The first issue is now available online, at: http://digitalcommons.cedarville.edu/bioethics_in_faith_and_practice/.

Both academic and clinical scholars should consider submitting to the new journal. Submissions may include case study analysis or longer commentaries and reviews. Appropriate clinical ethics topics may also include reproductive ethics, end-of-life matters, stem cell research, abortion, genetic ethics, research ethics, and conscience rights for health professionals. We are open to more theoretical matters as well, such as nuances of ethical theory, meta-ethics, and metaphysics as it relates to human nature. The perspective may be from medicine, nursing, biology, pharmaceutical sciences, psychology, social work, chaplaincy, and biblical scholarship.

Articles submitted for consideration should be of interest to the educated professional, but not restricted to the specialist. An author need not be a full-time academic of a member of a college or university faculty. Submitted papers will be reviewed by the Editorial Advisory Board, made up of ten Cedarville University faculty, plus six from outside the institution.