Blogs are meant to be part of the larger, daily conversation. One of the great failures of conversation is, of course, simply waiting for your turn to speak. I’ve found myself listening recently and not quite sure what to say next. For the moment, Pop Bioethics is on pause.

For those of you who’ve [...]]]>

Blogs are meant to be part of the larger, daily conversation. One of the great failures of conversation is, of course, simply waiting for your turn to speak. I’ve found myself listening recently and not quite sure what to say next. For the moment, Pop Bioethics is on pause.

For those of you who’ve found my writing interesting or engaging I highly recommend the following:

The Institute for Ethics and Emerging Technologies Blog

io9

Big Think’s Tauriq Moosa and Orion Jones

My twitter feed @popbioethics will remain active and is the best place to continue to engage with me in conversation.

American health care costs are driving America into the ground.  These costs stand at from 2-3:1 compared with other nations (like the UK), [...]]]> Stanton Peele makes a compelling case that our obsession with being “treated” for every minor malady reflects our abject terror in the face of clinically based recommendations to cut back on testing.

American health care costs are driving America into the ground.  These costs stand at from 2-3:1 compared with other nations (like the UK), and the chasm is widening since virtually all other nations have stablized these costs, while we are only beginning to tackle the rate at which theyincrease.  But Republicans can still run on simply resuming lock, stock and barrel the same old private care system, Americans in general dislike Obamacare, and Obamacare itself is built primarily around expanding coverage without controlling costs.  This is because any effort to rein in such costs is met by accusations like “death panels” or “rationing,” which immediately kills them like glassy-eyed dead fish floating on the surface of the stagnant pond that is our care system.

It does no good to cite comparisons between America and other countries, like the study finding mature adult Americans in all social classes to have twice the rate of virtually every type of illness (from cancer, to heart disease, to diabetes) as the English, despite that the latter smoke and drink more (they are thinner), and that the British system spent (at the time of the study; the gap is greater now) roughly one-half of what Americans do per capita on health care.1  And our greatest differences in cost and health outcomes are not with the UK—in part because their health behaviors most resemble our own relative to Continental European nations.

We’re addicted. And the ACA might be the first step in a brutal intervention.

via 3QD

Jetpacks are a puerile toy that we all know would be impractical, deadly, [...]]]> Alice Park’s new book The Stem Cell Hope, convinced me it is time to retire, “Where is my jetpack!?” once and for all. After reading her new book, Park will have you screaming, “Where are my stem cells?” from every rooftop.

Jetpacks are a puerile toy that we all know would be impractical, deadly, wasteful, polluting, and that will likely never, ever be built. So why do we keep rhetorically demanding them? The saying is supposed to encapsulate the sense of ennui we all feel when we look at depictions of the future from the ’50s. And the future is still broken. It’s the complaint of our disaffected era.

Well guess what, most of the depictions of the future from the ’50s were wrong. None of them showed personal computers or cell phones (let alone smartphones) or iPads. We now rue the fact that our country is lined with interstate highways and packed with cars, which was supposed to be the proof the future was here and amazing. Sure, whole factories are packed with robots, but none of us have a robot butler (Roomba withstanding). Yes, we have a space station. That is pretty amazing.

So what the hell are we complaining about? It sure as shit isn’t technology. That stuff is incredible. Yet, we know this version of the future is broken. But how?

Medicine. Health care. Diseases and death. These were supposed to be something the future could deal with. Why can’t it?

After reading The Stem Cell Hope, you’ll have an idea of why we’re living in the medical past among a technological future. Between the covers of her great new book, Alice Park explains how the promise of stem cells came to be trapped in a Kafkaesque maze of political posturing, fundamentalist ignorance, government bans, legal quagmires, and corporate greed. The Stem Cell Hope explains why our medical future has been indefinitely delayed and gives us a new question to ask of our delinquent future.

As I’ve mentioned before, I don’t so much review media so much as I analyze it. But for those of you interested, here is a three sentence review: Alice Park’s The Stem Cell Hope (Penguin) is an interesting portrayal of the personalities behind the experiments, legislation, and discoveries that have brought stem cell from fantastic theory to ethically perplexing fact. Her humanization of scientists and exploration of How Science Gets Done is excellent and are the highlight of the book. The neutral tone means this is a good read for someone who is already a stem cell proponent who likes the stories of science, and this is a perfect gift for the anti-stem cell person in your life.

You know the person I’m talking about. The one who is probably very excited about the recent flurry of paradoxical and moronic “Personhood” legislation and laments Obama’s dissolution of Bush’s ban on federal funding of new lines of research. Or maybe they’re just cautious and don’t like the idea of “experimenting on babies” and think “life begins at conception.” Before you write this off as a something-something liberal rant, let me ask you: do you have at least one friend or family member who has a traumatic injury, Alzheimer’s, ALS, MS, diabetes, and auto-immune disorder or has/had cancer? I bet you do. I certainly do!

What I want you to realize is this: your former friend’s beliefs are actively hurting and preventing the development of and research into cures for your friends that are suffering. Your friend who is squeamish about hurting an embryo is ok with harming millions of full-grown people who are alive and suffering now.

That is the horrible lesson buried among the pages of The Stem Cell Hope. That the original ban on stem cell’s was Bush’s attempt to appeal to his fanatical base. The man who helped him write that speech announcing the ban knew the science upside-down and inside-out so that he could most accurately articulate the party line, not so he could make the right ethical and scientific decision. How do we know this? Because Park wonderfully describes how the medical and scientific community independently and autonomously set up ethical panels to discuss and debate the ethics of cloning, stem cells, and embryonic research. Self-policing was instinctual. The rest of The Stem Cell Hope is a tale of the bravery and persistence of all the researchers who have helped us get as far as we are today.

Today – in the broken future-present – where stem cells, which we’ve known about and been studying for two decades, are still a nacent, surface-barely-scratched technology.

Our future-present’s inadequacies are underlined when the parts of sci-fi that seem, well, the most science fictional, are the medical technologies. The tricorder, the hypospray, and the surgery coffin from Prometheus tell us one thing over and over and over: “Modern Medicine” is undeserving of the title. We live in an era where we treat a sinus infection by flooding the entire body with antibiotics, we treat mental illness with massive payloads of chemicals to the entire brain, and attempt to deal with most diseases (cancer, Alzheimers, ALS, auto-immune, diabetes) by just treating the symptoms. We deal with malfunctioning organs by either cutting them out, in half, or replacing them with a dead person’s leftovers and then putting your immune system in a permanent coma. We deal with traumatic injury by giving people crutches, canes, and wheelchairs, technologies from the goddamn 1800′s. We deal, we cope, we put it into remission, we treat the symptoms, but we can’t cure shit.

Our cry, our demand, our plea, prayer, and desperate invocation should be, “Where is my stem cell cure?”

I can video chat with my sister on the other side of the planet, but we can’t to a damn thing for my friends with spinal cord damage – Where is their stem cell cure?

I can watch a movie in my hand on the subway and then use the same device to take a photo, but my friends with auto-immune disorders are met with the pill equivalent of soma holidays to numb the pain – Where is their stem cell cure?

I watched grandparents deteriorate into shambling husks of anger and confusion. I’ve seen the ravages of cancer and the horrors of the “treatments” – Where were their stem cell cures?

When I say we live in a broken future, I mean it. The next time you walk into a doctor’s office, marvel at the barbarism. Paper charts, metal tools, diagnoses based on a single test or a 10 minute visit with a single person. That is, of course, if you can forget how monumentally broken the system designed to pay for it is.

Medicine is the next frontier of the future. Traditional medicine is not good. It hurts people through errors, omissions, inadequate data, and simplistic solutions every single minute of every single day.

We are all so goddamned scared we’ll make a mistake that no one is willing to look around at the medical system and say, “This, all of this, is the mistake. Time to fix it. Time to build the future.”

Until that happens, I only have one question, “Where are our stem cell cures?”

[Takanori Takebe, a stem-cell biologist at Yokohama City University in Japan,] told how his team grew the organ using induced pluripotent stem cells (iPS), created by reprogramming human skin cells to an embryo-like state. The researchers placed the cells on growth plates in a specially designed medium; after nine days, analysis showed [...]]]> From Nature:

[Takanori Takebe, a stem-cell biologist at Yokohama City University in Japan,] told how his team grew the organ using induced pluripotent stem cells (iPS), created by reprogramming human skin cells to an embryo-like state. The researchers placed the cells on growth plates in a specially designed medium; after nine days, analysis showed that they contained a biochemical marker of maturing liver cells, called hepatocytes.

At that key point, Takebe added two more types of cell known to help to recreate organ-like function in animals: endothelial cells, which line blood vessels, taken from an umbilical cord; and mesenchymal cells, which can differentiate into bone, cartilage or fat, taken from bone marrow. Two days later, the cells assembled into a 5-millimetre-long, three-dimensional tissue that the researchers labelled a liver bud — an early stage of liver development.

Japan does it again.

The tragedy to me in this whole story is that once again a medical debate is being left to the extremes. Screams of “death panels!” drowned out any fair [...]]]> A reader commenting on a home birthing thread on Andrew Sullivan’s the Dish sums up how medical regulations can fail better than I’ve heard before:

The tragedy to me in this whole story is that once again a medical debate is being left to the extremes. Screams of “death panels!” drowned out any fair discussion of end-of-life care and the wholesale suffering that has been inflicted on the dying and the old in the name of modern medicine’s “advances.” As an advocate of home birth, bolstered by the fact that 30% of Dutch babies enter the world at home, the development of home birth in America as it stands now is disheartening.

The obstetric medical establishment is in need of some serious questions about overuse of medical intervention and gadgets, which culminates in an extremely high C-section rate. For one, I think women should get better information about the numerous side effects of epidurals. But any discussion of including home birth as an legitimate option has been met with disdain, and licensed medical professionals are often legally barred from attending home birth.

The result is that lay midwives have taken up the slack. Probably many of them are smart, cautious and aware of the risks and have done a great job for women in labor and their babies. I personally know many women who birthed at home successfully and happily. But the swift growth of a home birth culture that is openly hostile to modern medicine and all its benefits is only going to lead to tragedy.

On the website you linked to, Hurt by Homebirth, it’s hard to read most of the stories. They are terrible, sickening tragedies that could have been averted if the practitioners had an inkling of what was going on, or if they weren’t actually practicing an extreme ideology more than practicing midwifery. The malpractice in these cases is absolutely appalling. But is it home birth, or the fact that lay midwifery has grown with little direct supervision from the medical industry that prefers to demonize it rather than supervise it?

In the Netherlands, home birth is something that must be approved by a doctor, and the midwife that is attending the delivery is part of, not an alternative to, the medical system. When I gave birth in 2007 and 2009 at a birth center in Cambridge MA, a doctor had to sign off before I was allowed to deliver there, and there were very clear rules about when a midwife should transfer me across the street, something that made me much surer about the safety of my babies (and me). There was an awareness that birth is a risky business, and that merely wishing for a “natural” “beautiful” birth was not a guarantee – and that the hospital across the street was there for a good reason.

Larry sees medicine as a stubborn holdout. Current efforts to reform the system—for instance, the Obama administration’s initiative to digitize all health records by 2014—are just toes in the water. Medicine has barely begun to take advantage of the million-fold increase in the amount of data [...]]]> Larry Smarr is trying to save your life:

Larry sees medicine as a stubborn holdout. Current efforts to reform the system—for instance, the Obama administration’s initiative to digitize all health records by 2014—are just toes in the water. Medicine has barely begun to take advantage of the million-fold increase in the amount of data available for the diagnosis and treatment of disease. Take the standard annual physical, with its weigh-in, blood-pressure check, and handful of numbers gleaned from select tests performed on a blood sample. To Larry, these data points give your doctor little more than a “cartoon” image of your body. Now imagine peering at the same image drawn from a galaxy of billions of data points. The cartoon becomes a high-definition, 3-D picture, with every system and organ in the body measured and mapped in real time.

So just a few days ago [and this will probably become a famous remark in the history of social networking], he wrote this: “Hello world. [...]]]> What would you do if the very means by which you said your life had no meaning suddenly gave your life meaning? Tony Nicklinson is having just that problem.

So just a few days ago [and this will probably become a famous remark in the history of social networking], he wrote this: “Hello world. I am Tony Nicklinson, I have locked-in syndrome and this is my first ever tweet.”

Among the many fascinating things about this technology is that the very nature of the euthanasia debate means that well-meaning relatives will argue with well-meaning lawyers over a person who cannot speak for him or herself.

Yet now this man can – and not just to the High court, but to the court of public opinion as well. Within five days of his first tweet he had gained 15,000 followers, many of whom were expressing openly supportive opinions of him and his right to die.

He’s got more followers than most folks desperate for followers. Which leads to the conundrum.

But here’s the potentially extraordinary thing about Mr Nicklinson and Twitter.

People have begun asking him whether he still thinks his life’s worthless if he can enjoy a conversation with anyone in the world on the internet.

Mr Nicklinson’s reply suggests an open mind: “People want to know if I will change my mind because of Twitter. Let’s hear the judgement first and maybe I’ll tell you.”

It’s not about wanting to die. It’s about wanting the freedom to choose and say, “I am done. It’s my life. It’s my death.”

Several philosophers I talked to could not understand [...]]]> Charles C. Camosy, Professor of Christian Ethics at Fordham, decided to weigh in on the “After-Birth Abortion” article that caused such a stir a few months ago. He makes the case that ideas, no matter how abhorrant they seem on face, deserve debate and rational discussion.

Several philosophers I talked to could not understand this kind of public outcry—and, indeed, some even thought that the article’s argument was not sufficiently original to be published in the first place. After all, especially as the influence of the Judeo-Christian tradition has waned in the developed West, pro-choice arguments for infanticide have become increasingly common. The thinkers who have made such arguments often point out that our culture has rejected a religious respect for the sanctity of human life given our broad acceptance of abortion; instead, we locate the right to life in having morally valuable traits like rationality and self-awareness. Since a newly born child is not rational and self-aware, so the argument goes, one should be able to commit infanticide for many of the same reasons one may now have an abortion.

This is logical, consistent reasoning.

And the pro-choice position for infanticide appears to be here to stay. In a move which will confuse those who think of this position as something new, Savulescu is planning a special issue of the Journal of Medical Ethics devoted to infanticide which will have contributions from many of its defenders over the past forty years—including himself, Peter Singer, Michael Tooley, Jeff McMahon, and more. To his credit, Savulescu is also inviting pro-lifers like myself, Robert George, and John Finnis to contribute diverse and opposing views as well.

How should pro-lifers respond to the debate over infanticide?  I have tried to convince public pro-life figures like George to resist using language like “madness” to describe the arguments of our opponents.  For if one throws out the sanctity of life ethic as one’s moral guide—as we have already done in many aspects of our culture in the developed West—it seems perfectly reasonable to be pro-choice for both abortion and infanticide.  In resisting this shift in defense of the sanctity of life, however, the correct strategy is not to insult or call names (or, God forbid, make threats of violence and murder), but instead we should respectfully engage pro-choice arguments for infanticide.