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  • Archive for the 'Bioethics' Category

    Don’t Panic: A Continuing Series

    Posted by Jay Manifold on 16th October 2014 (All posts by )

    [Readers needing background may refer to the first member of this series, Don’t Panic: Against the Spirit of the Age, posted last month. This post, unlike that one, was hastily written due to time constraints involving, perhaps ironically, international travel to a Third World country.]

    Constructive foreword: suggested case studies in disruption are the Chicago blizzard of 1/13-14/1979 (~3 million commuters immobilized) and the Milwaukee Cryptosporidiosis outbreak of 3/23-4/8/1993 (~400k residents sickened simultaneously).

    Thesis: I argue that, at least with Ebola, inept and overwrought responses pose far greater risks to American society than the disease itself. With regard to managing the risks associated with Ebola in the US, it is vital that we identify easily disrupted institutions and design our processes intelligently to avoid creating bottlenecks, mostly by resisting the urge to overreact; likely candidates include …
    Read the rest of this entry »

    Posted in Big Government, Bioethics, Civil Society, Current Events, Ebola, Health Care, Human Behavior, Organizational Analysis, Predictions, Systems Analysis, Tradeoffs, Transportation, USA | 9 Comments »

    2nd Ebola Case in Dallas Texas

    Posted by Trent Telenko on 12th October 2014 (All posts by )

    One of the health care workers (HCW) that treated Thomas Eric Duncan on in Dallas during the period of 28th thru 30th of September has tested positive for Ebola after coming down with a fever Friday night. Heath care workers at Texas Health Presbyterian Hospital intubated and placed Duncan on dialysis as a part of his palliative treatment schedule. The HCW were in personal protective equipment (PPE) level two or “droplet level” protection at the time.

    It is notable that in the laboratory environment that Ebola is treated as a full bio-hazard level four or “inhalation” threat. Especially when you see circular thinking in public by CDC .


    “I think the fact that we don’t know of a breach in protocol is concerning because clearly there was a breach in protocol. We have the ability to prevent the spread of Ebola by caring safely for patients.”

    The statement said the CDC had NO IDEA how the protocol was breached, but protocol must have been breached because there was a an infection.

    There was no mention as to why there was a two tier PPE protection level structure with widely different infection rates by routes other than Ebola virus injection accidents.

    There is a huge no confidence vote in the CDc coming. One that will take the form we are seeing in Spain — HCW no-shows for hospitals caring for Ebola outbreaks.

    Posted in Big Government, Bioethics, Current Events, Ebola, Health Care | 54 Comments »

    An Update on healthcare reform.

    Posted by Michael Kennedy on 21st July 2014 (All posts by )

    Cash medical practice or, in the phrase favored by leftists critics, “Concierge Medicine,” seems to be growing.

    Becker is shifting to a new style of practice, sometimes called concierge or retainer medicine. With the help of a company that has been helping physicians make such shifts for over 13 years, he will cease caring for a total of 2,500 patients and instead cut back to about 600. These patients will pay an annual fee of $1,650. In exchange, they will receive a two-hour annual visit with a complete physical exam, same-day appointments, 24-hour physician phone access, and personalized, web-based resources to promote wellness.

    The article suggest that all these doctors choosing to drop insurance and Medicare are primary care. Many are but I know orthopedists and even general surgeons who are dropping all insurance.

    The concierge model of practice is growing, and it is estimated that more than 4,000 U.S. physicians have adopted some variation of it. Most are general internists, with family practitioners second. It is attractive to physicians because they are relieved of much of the pressure to move patients through quickly, and they can devote more time to prevention and wellness.

    Read the rest of this entry »

    Posted in Big Government, Bioethics, Crony Capitalism, Health Care, Medicine, Politics, Science | 23 Comments »

    America’s Impending Tuberculosis Epidemic

    Posted by Trent Telenko on 10th July 2014 (All posts by )

    (NOTE — Update at the End of the Column)

    One of the things that changes you, when you become a parent, is the body of knowledge you acquire to protect your spouse and children including things like knowledge of infectious diseases in public schools. In my case that meant looking at the NY Times saying the following: “…the administration has begun to send the expected 240,000 migrants and 52,000 unaccompanied minors who have crossed the border illegally in recent months in the Rio Grande Valley to cities around the county.” And at headlines for the open border crisis like this by Todd Starnes titled “Immigration crisis: Tuberculosis spreading at camps” which caused me to immediately free associate them with a pair of “Tuberculosis in Public School”, headlines, one local to North Texas in 2011 and the other very recently in California. See this 2011 Consumer Health Daily article from Denton Texas “TB Outbreaks in Texas Schools Show Disease Still a Threat – At least 100 people have tested positive for the respiratory ailment” and this 1 July 2014 article from the Sacramento Bee “Four more students test positive for tuberculosis at Grant High.

    As a Texas parent, this idea of TB positive illegal alien children released to illegal immigrant parents scares the heck out of me from the point of view of epidemiology. In the 1920s TB was the eighth leading cause of death for children 1-to-4 years old. Since then American public health has been so effective in preventing it that the USA no longer has any “herd immunity” to TB.

    This “catch and release” illegal alien policy is horrible from the infectious disease point of view in that phlegm or aerosolized sputum that are contaminated with Mycobacterium tuberculosis are active biohazards that have long latent infection periods. This makes “exposure” very easy. The clinical definition of TB Exposure — which I found in a University of Vanderbilt student medical file PDF — is the following:

    “A person is considered to be exposed if there is shared breathing space with someone with infectious pulmonary or laryngeal tuberculosis at a time when the infectious person is not wearing a mask and the other person is not wearing an N95 respirator. Usually a person has to be in close contact with someone with infectious tuberculosis for a long period of time to become infected; however, some people do become infected after short periods, especially if the contact is in a closed or poorly ventilated space.”

    The Federal Government Hazmat protocol for dealing with suspected active TB cases is as follows:

    1. Administrative controls
    • “Develop policies and protocols to ensure the rapid identification, isolation, diagnostic evaluation and treatment of persons likely to have TB.”
     
    2. Engineering controls
    • Isolation and
    • Negative pressure room ventilation
     
    3.Personal protective equipment controls
    • N95 personal respirator protection

    Questions people and reporters need to be asking their local, state and federal elected officials regards the so-called “unattended child immigration crisis” include:

    1. How many Border Patrol Agents, health workers or other support staff at these immigration processing centers have worn N95 respirators in treating symptomatic TB sufferers?
     
    2. How many TB sufferers were also wearing masks?
     
    3. Have those Border Patrol Agents, health workers or other support staff followed a rigorous TB decontamination protocol?

    Whether people ask those questions or not, we are going to find out the answers soon, and not just in Texas. Testable anti-bodies to TB infection appear in two to 12 weeks for skin and blood tests and the incubation period for full blown active TB is six months to two(+) years.

    Read the rest of this entry »

    Posted in America 3.0, Americas, Big Government, Bioethics, Civil Liberties, Civil Society, Health Care, National Security | 76 Comments »

    Quote of the Day

    Posted by Jonathan on 5th July 2014 (All posts by )

    From an Instapundit comment thread re genetic testing of newborns to confirm/disconfirm parentage:

    Carl Pham
    Come on. Who do you think calls himself “an expert in ethics?” Would you? Would I? Of course not. Anybody with a trace of common sense and humility understands that no mere son of Adam can possible be considered competent in ethics, let alone an expert. Isn’t the next article up about Native American torture? And then there’s the one on terrorists murdering five-month olds? No sane member of the H. sapiens species would consider it plausible that any one of us could be a mini-Christ, prepared to judge right from wrong, separate the sheep from the goats.
     
    So, ipso facto, who are the “ethicists?” They are those who lack genuine empathy, humility, or any deep awareness of the challege and subtlety of moral judgment. They are the narcissists, the borderline personalities, the grandiose who imagine themselves fit to be the stewards of God. In another age, they would join the Inquisition.

    There is something to this argument.

    Posted in Bioethics, Deep Thoughts, Medicine, Morality and Philosphy | 1 Comment »

    Book Review: That Hideous Strength, by C S Lewis

    Posted by David Foster on 24th June 2014 (All posts by )

    That Hideous Strength by C. S. Lewis

    —-

    This was the first thing Mark had been asked to do which he himself, before he did it, clearly knew to be criminal. But the moment of his consent almost escaped his notice; certainly, there was no struggle, no sense of turning a corner. There may have been a time in the world’s history when such moments fully revealed their gravity, with witches prophesying on a blasted heath or visible Rubicons to be crossed. But, for him, it all slipped past in a chatter of laughter, of that intimate laughter between fellow professionals, which of all earthly powers is strongest to make men do very bad things before they are yet, individually, very bad men.

    Mark Studdock is a young on-the-make sociologist, a professor at Bracton College, in an English town called Edgestow. He is is far more interested in university politics than in his research or teaching. and as a member of the “progressive element” at the college, he strongly supports Bracton selling a tract of property to a government-sponsored entity called NICE. The NICE is the National Institute for Coordinated Experimentation,which Lewis describes as “the first fruits of that constructive fusion between the state and the laboratory on which so many thoughtful people base their hopes of a better world.”  What excites Mark most about the NICE is this:

    The real thing is that this time we’re going to get science applied to social problems and backed by the whole force of the state, just as war has been backed by the whole force of the state in the past.  One hopes, of course, that it’ll find out more than the old freelance science did, but what’s certain is that it can do more.

    Trigger Warning: There is something in this book to offend almost everybody.  It contains things that will offend technologists and believers in human progress…social scientists…feminists…academic administrators…bioscience researchers…and surely many other categories of people.  It will probably also offend some Christians, for the way in which Christian theology is mixed with non-Christian magic. By the standards now becoming current in American universities, this book, and even this book review, should be read by no one at all.  But for those who do not accept those standards…

    The Basic Story. Mark has recently married Jane, a woman with strong literary interests and with vague plans for getting an advanced degree. She has recently started having disturbing, indeed terrifying, dreams, which suggest that she has a clairvoyant ability to see distant events in real time. Afraid that she is losing her mind, Jane seeks advice, and is told that her dreams are actually visions, they are very real, will not stop, and are of utmost importance:

    “Young lady,” said Miss Ironwood, “You do not at all realize the seriousness of this matter. The things you have seen concern something compared with which the happiness, and even the life, of you and me, is of no importance.”

    Miss Ironwood warns Jane that extremely evil people will seek to use her gift, and that she would do well–both for her own interests and those of the entire human race–to join the community of which Miss Ironwood is a part, located at a place called St Anne’s. Jane responds quite negatively to the invitation, afraid that membership in the St Anne’s group will limit her autonomy. She is not interested in the dreams’ meaning; she just wants them to go away.

    Mark, on the other hand, responds enthusiastically when he is invited to take a position at the NICE, temporarily located at an old manor called Belbury.  One of the first people he meets there is the Head of the Institutional Police, a woman named Miss Hardcastle (picture Janet Napolitano), nicknamed the Fairy, who explains to Mark her theory of crime and punishment:

    “Here in the Institute, we’re backing the crusade against Red Tape.”  Mark gathered that, for the Fairy, the police side of the Institute was the really important side…In general, they had already popularized in the press the idea that the Institute should be allowed to experiment pretty largely in the hope of discovering how far humane, remedial treatment could be substituted for the old notion of “retributive” or “vindictive” punishment…The Fairy pointed out that what had hampered every English police force up to date was precisely the idea of deserved punishment. For desert was always finite; you could do so much to the criminal and no more. Remedial treatment, on the other hand, need have no fixed limit; it could go on till it had effected a cure, and those who were carrying it out would decide when that was.  And if cure were humane and desirable, how much more prevention?  Soon anyone who had ever been in the hands of the police at all would come under the control of the NICE; in the end, every citizen.

    Another person Mark meets in his first days at Belbury is the acclaimed chemist William Hingest…who has also come down to investigate the possibility of a job at Belbury, has decided against it, and strongly advises Mark to do likewise:

    “I came down here because I thought it had something to do with science. Now that I find it’s something more like a political conspiracy, I shall go home. I’m too old for that kind of thing, and if I wanted to join a conspiracy, this one wouldn’t be my choice.”

    “You mean, I suppose, that the element of social planning doesn’t appeal to you? I can quite understand that it doesn’t fit in with your work as it does with sciences like Sociology, but–”

    “There are no sciences like Sociology. And if I found chemistry beginning to fit in with a secret police run by a middle-aged virago who doesn’t wear corsets and a scheme for taking away his farm and his shop and his children from every Englishman, I’d let chemistry go to the devil and take up gardening again…I happen to believe that you can’t study men, you can only get to know them, which is quite a different thing. Because you study them, you want to make the lower orders govern the country and listen to classical music, which is balderdash. You also want to take away from them everything that makes life worth living and not only from them but from everyone except a parcel of prigs and professors.”

    Nevertheless, Mark decides to remain at Belbury, and is drawn ever-deeper into its activities–which, as only those in the innermost circles of that organization realize, are not only consistent with the goals of the 20th-century totalitarianisms, but go considerably beyond them.  The NICE seeks to establish a junction between the powers of modern science and those of ancient magic, accessing the latter by awakening the medieval wizard Merlin and using him for their purposes.  At the same time, Jane–despite her reservations–becomes increasingly involved  with the company at St Anne’s and is entranced with its leader, a Mr Fisher-King. (His name comes from the Wounded King in Arthurian legend.)  The St Anne’s group is aware of the truth about NICE and its ultimate goals, and exists for the primary purpose of opposing and, hopefully, destroying that organization.

    I will not here describe the war between the forces of Belbury and those of St Anne’s (in order to avoid spoilers), but will instead comment on the characters of some of the protagonists and some philosophically-significant events in the novel, with appropriate excerpts. Hopefully this will be enough to give a sense of the worldview that Lewis is presenting in this book.

    Mark Studdock. His character is largely defined by his strong desire to be a member of the Inner Circle, whatever that inner circle may be in a particular context.  The passage at the start of this review where Mark agrees to engage in criminal activity on Belbury’s behalf is proceeded by this:

    After a few evenings Mark ventured to walk into the library on his own; a little uncertain of his reception, yet afraid that if he did not soon assert his right to the entree this modesty might damage him. He knew that the error in either direction is equally fatal.

    It was a success. Before he had closed the door behind him all had turned with welcoming faces and Filostrato had said “Ecco ” and the Fairy, “Here’s the very man.” A glow of pleasure passed over Mark’s whole body.

    That “glow of pleasure” at being accepted by the Belbury’s Inner Circle (what Mark then thinks is Belbury’s Inner Circle) is strong enough to overcome any moral qualms on Mark’s part about the actions he is being requested to perform.  Lewis has written a great deal elsewhere about the lust for the Inner Circle, which in his view never leads to satisfaction but only to a longing for membership in another, still-more-inner circle. In That Hideous Strength, there are concentric Inner Circles at Belbury, which Mark does penetrate–and each is more sinister than the last.

    Read the rest of this entry »

    Posted in Academia, Anglosphere, Arts & Letters, Bioethics, Book Notes, Britain, Christianity, Civil Society, Conservatism, Crime and Punishment, Deep Thoughts, Human Behavior, Leftism, Morality and Philosphy, Philosophy, Political Philosophy | 12 Comments »

    A rolling catastrophe

    Posted by Michael Kennedy on 4th November 2013 (All posts by )

    Obamacare debuted on October 1. It is now November 4 and the mess is worse. I have been posting about it, here, and here, and here, and even here.

    The political left is trying very hard as can be seen here.

    keep-your-plan-flowchart

    It’s kind of complicated so I will summarize. You are screwed !

    There are accusations that insurance companies are using this to drop high risk subscribers. Maybe that is true but it is the consequence of ignorant people designing Obamacare. Did these guys ever set up a new business ? As Casey Stengel once said to the Mets , “”Can’t anybody here play this game?”

    I guess not.

    The New York Times has done what it can.

    We are also told that “in all the furor, people forget how terrible many of the soon-to-be-abandoned policies were. Some had deductibles as high as $10,000 or $25,000 and required large co-pays after that, and some didn’t cover hospital care.” Never mind that we have seen cancellations of insurance policies with deductibles much lower, and customers forced to purchase replacement policies with higher deductibles, and with premium increases of 100%, if not higher.

    Then there is this argument.

    Why can’t people opt out of mental health coverage if there is not a reasonable chance that they will need that coverage? Why can’t they get mental health coverage when it is needed? After all, pre-existing conditions can no longer be denied, so in the event that mental health coverage is needed down the line, it can be obtained and the insurance companies cannot deny people who already have pre-existing mental health conditions. The Times assures us that over-coverage–and the high premiums that come with it–is “one price of moving toward universal coverage with comprehensive benefits.” They don’t explain why having unnecessary coverage is a step towards social justice, but as we saw from the beginning of this intelligence-insulting, repulsively dishonest op-ed, the New York Times is less about explaining, and more about covering up a disastrous rollout with disastrous policy consequences for the country.

    Peggy Noonan, who has frustrated me with her obtuseness at times, gets it now.

    Politically where are we right now, at this moment?

    We have a huge piece of U.S. economic and social change that debuted a month ago as a program. The program dealt with something personal, even intimate: your health, the care of your body, the medicines you choose to take or procedures you get. It was hugely controversial from day one. It took all the political oxygen from the room. It failed to garner even one vote from the opposition when it was passed. It gave rise to a significant opposition movement, the town hall uprisings, which later produced the tea party. It caused unrest. In fact, it seemed not to answer a problem but cause it. I called ObamaCare, at the time of its passage, a catastrophic victory—one won at too great cost, with too much political bloodshed, and at the end what would you get? Barren terrain. A thing not worth fighting for.

    So the program debuts and it’s a resounding, famous, fantastical flop. The first weeks of the news coverage are about how the websites don’t work, can you believe we paid for this, do you believe they had more than three years and produced this public joke of a program, this embarrassment?

    She assumed that it wasn’t worth it if it worked !

    The problem now is not the delivery system of the program, it’s the program itself. Not the computer screen but what’s inside the program. This is something you can’t get the IT guy in to fix.

    They said if you liked your insurance you could keep your insurance—but that’s not true. It was never true! They said if you liked your doctor you could keep your doctor—but that’s not true. It was never true! They said they would cover everyone who needed it, and instead people who had coverage are losing it—millions of them! They said they would make insurance less expensive—but it’s more expensive! Premium shock, deductible shock. They said don’t worry, your health information will be secure, but instead the whole setup looks like a hacker’s holiday. Bad guys are apparently already going for your private information.

    This is the worst that could be imagined.
    Read the rest of this entry »

    Posted in Big Government, Bioethics, Civil Society, Current Events, Health Care, Leftism, Medicine, Politics | 20 Comments »

    “The taxpayer-funded PR blitz for Obamacare”

    Posted by Jonathan on 2nd December 2012 (All posts by )

    It’s already underway and will only get worse. J.E. Dyer’s analysis is worth reading:

    It’s one thing when advertisers seek to drive emotional connections with lite beer, pick-up trucks, and air fresheners. It’s something else when the government hires advertisers to drive emotional connections with government policies and institutions. This goes far beyond the old-fashioned “good government” idea of providing information to citizens. In its essence, it differs not at all from a Stalin-era poster hyping the Soviet government’s policies to a beleaguered Russian people.
     

     
    Advertising is a dangerous thing in the hands of the armed state. I am no more in favor of Republican administrations spending a lot of money on it than of Democrats doing so. With Obamacare, we have reached the fork in the road. A government with the powers conferred by Obamacare cannot, on principle, be trusted to “advertise” its policies to us. The inevitable descent into untrustworthy propaganda has already begun. Until Obamacare is repealed, it will continue to get worse.

    Posted in Advertising, Bioethics, Health Care, Media, Medicine, Obama, Politics, Rhetoric | 22 Comments »

    Another Tragedy – Another Perspective

    Posted by Ginny on 12th September 2012 (All posts by )

    Borlaug saves, Greenpeace kills.

    Posted in Bioethics, Environment | 4 Comments »

    This is What Men Do

    Posted by Ginny on 22nd July 2012 (All posts by )

    As on the Titanic, as on 9/11, and as in Aurora – this is what men do.

    Posted in Bioethics, Civil Society, History, National Security | 4 Comments »

    Why Obamacare is worse than understood by most and must be stopped.

    Posted by Michael Kennedy on 15th May 2012 (All posts by )

    The Supreme Court will rule on the constitutionality of Obamacare this year. The arguments and the issue which got the most publicity was the individual mandate. I don’t actually care much about this although it may well violate the Constitution. There are far worse things in the legislation and they should be emphatically rejected by the Supreme Court. The worst of the issues is discussed in detail here. This is a really frightening piece of legislation and I cannot imagine that the Court will let it stand. Of course, given the absence of argument, the Court will have to find this hidden provision itself.

    Perhaps nothing in the Obamacare legislation embodies the top-down, command-and-control nature of Progressive healthcare more than the Independent Payment Advisory Board (IPAB), a 15-member panel of “experts” to be appointed by the President. There are three particular features of the IPAB that illustrate this fact: The IPAB will control all healthcare spending, public and private. The IPAB has been awarded near-dictatorial power. And the IPAB is designed to be a nearly immutable entity.

    How is this accomplished ?

    Specifically, Section 10320 (in the Managers’ Amendments portion of the legislation) grants the IPAB, beginning in 2015, the authority to limit all healthcare expenditures, that is, all healthcare expenditures, and not just expenditures by Medicare or government-run programs.

    To emphasize this expanded authority, Section 10320 changes the name of the “Independent Medicare Advisory Board” to the “Independent Payment Advisory Board.” It directs the IPAB, at least every two years, to “submit to Congress and the President recommendations to slow the growth in national health expenditures” for private healthcare programs. Furthermore, it designates that these “recommendations” may be implemented by the Secretary of HHS or other Federal agencies “administratively” (that is, without any action by Congress).

    Thus the federal government can control, under penalty of criminal prosecution of doctors, private health care spending ! This goes well beyond Medicare and Medicaid. It will prevent, unless stopped, people from spending their own money on health care.

    That is not the worst of it. The IPAB cannot be changed or repealed by Congress. This is unprecedented in US law. Even the ill-advised Prohibition Amendment, promoted as another moral obligation by progressives after World War I, could be repealed by another constitutional amendment.

    A quick reading of Section 3403 might leave one with the impression that the IPAB is a sort of Mr. Rogers of healthcare – a mild-mannered, friendly, always-helpful, but ultimately undemanding agent for good. This is the impression imparted by the first few paragraphs of the Section, which paint the new entity as an “advisory” board, whose main task is to develop “proposals” and “advisory reports,” which “proposals” and “advisory reports” would solely consist of various “recommendations,” that ought to be “considered” for the purpose of cost reduction.

    Nothing could be further from the truth. This language is simply another example of supplying a new law, which is far more radical than the authors would like people to know, with a soothingly misleading introductory paragraph. The IPAB is actually designed to be as all-powerful as it’s possible to be.

    Read the rest of this entry »

    Posted in Bioethics, Civil Liberties, Health Care, Just Unbelievable, Medicine, Political Philosophy | 17 Comments »

    Graphic Novels on Health Care and other items….

    Posted by onparkstreet on 8th February 2012 (All posts by )

    -from SHOTS, NPR’s Health Care Blog:

    Health care reform is no laughing matter, but MIT economist Jonathan Gruber’s new comic book on the subject aims to communicate some pretty complicated policy details in a way that, if not exactly side-splitting, is at least engaging.
     
    In Health Care Reform: What It Is, Why It’s Necessary, How It Works, Gruber steps into the pages of a comic book to guide readers through many of the major elements of the law, including the individual mandate to buy insurance, the health insurance exchanges where people will be able to buy coverage starting in 2014 and how the law tackles controlling health care costs.

    I draw your attention to another graphic novel: The 9/11 Report: A Graphic Adaptation.

    While I was buying a copy of Persepolis from a real-life book store a few years ago, a young woman at the sales counter mentioned that there was a “great” graphic novel about North Korea that I might like. I’m not a graphic novel reader and I think Persepolis is it for me unless I decide to review the health care book, but it interested me that she seemed so enthusiastic about the topic of North Korea and graphic novels. I guess it makes sense given our “information overload” society. I don’t know. Why not look for clarity?

    PS: Linking is not endorsement and all that.

    PPS: What’s the “all that” about? Eh, I’ve been burning the candle at both ends for the past week or so and my blogging has been pretty terrible because of it. I linked the health care graphic novel because it amused me, not because I am simpatico with the message. I think you all knew that already….

    Posted in Arts & Letters, Big Government, Bioethics, Book Notes, Business, Economics & Finance, Education, Media, Medicine, Military Affairs, Miscellaneous, National Security, Politics, Science, Society | Comments Off

    Does this sound familiar ?

    Posted by Michael Kennedy on 10th September 2011 (All posts by )

    The science community is now closing in on an example of scientific fraud at Duke University. The story sounds awfully familiar.

    ANIL POTTI, Joseph Nevins and their colleagues at Duke University in Durham, North Carolina, garnered widespread attention in 2006. They reported in the New England Journal of Medicine that they could predict the course of a patient’s lung cancer using devices called expression arrays, which log the activity patterns of thousands of genes in a sample of tissue as a colourful picture. A few months later, they wrote in Nature Medicine that they had developed a similar technique which used gene expression in laboratory cultures of cancer cells, known as cell lines, to predict which chemotherapy would be most effective for an individual patient suffering from lung, breast or ovarian cancer.
     
    At the time, this work looked like a tremendous advance for personalised medicine—the idea that understanding the molecular specifics of an individual’s illness will lead to a tailored treatment.

    This would be an incredible step forward in chemotherapy. Sensitivity to anti-tumor drugs is the holy grail of chemotherapy.

    Unbeknown to most people in the field, however, within a few weeks of the publication of the Nature Medicine paper a group of biostatisticians at the MD Anderson Cancer Centre in Houston, led by Keith Baggerly and Kevin Coombes, had begun to find serious flaws in the work.
     
    Dr Baggerly and Dr Coombes had been trying to reproduce Dr Potti’s results at the request of clinical researchers at the Anderson centre who wished to use the new technique. When they first encountered problems, they followed normal procedures by asking Dr Potti, who had been in charge of the day-to-day research, and Dr Nevins, who was Dr Potti’s supervisor, for the raw data on which the published analysis was based—and also for further details about the team’s methods, so that they could try to replicate the original findings.

    The raw data is always the place that any analysis of another’s work must begin.

    Dr Potti and Dr Nevins answered the queries and publicly corrected several errors, but Dr Baggerly and Dr Coombes still found the methods’ predictions were little better than chance. Furthermore, the list of problems they uncovered continued to grow. For example, they saw that in one of their papers Dr Potti and his colleagues had mislabelled the cell lines they used to derive their chemotherapy prediction model, describing those that were sensitive as resistant, and vice versa. This meant that even if the predictive method the team at Duke were describing did work, which Dr Baggerly and Dr Coombes now seriously doubted, patients whose doctors relied on this paper would end up being given a drug they were less likely to benefit from instead of more likely.

    In other words, the raw data was a mess. The results had to be random.

    Read the rest of this entry »

    Posted in Academia, Bioethics, Environment, Health Care, Science, Statistics | 17 Comments »

    David Brooks’ Leash

    Posted by Joseph Fouche on 17th March 2011 (All posts by )

    One of the most prominent examples of experimental genetics is the infamous domesticated silver fox:

    The domesticated silver fox …is a domesticated form of the silver morph of the red fox. As a result of selective breeding, the new foxes not only became tamer, but more dog-like as well…
     
    Domesticated foxes exhibit both behavioral and physiological changes from their wild forebears. They are friendlier with humans, put their ears down (like dogs), wag their tails when happy, and vocalize, and bark like domesticated dogs. As a consequence of breeding, they also developed color patterns like domesticated dogs and lost their distinctive musky ‘fox smell’…
     
    The experiment was initiated by scientists hoping to produce easier to handle fur animals and who were interested in the topic of domestication and the process by which wolves became tame domesticated dogs. They saw some retention of juvenile traits by adult dogs, both morphological ones, such as skulls that were unusually broad for their length, and behavioral ones, such as whining, barking, and submission…
     
    [Project founder Dmitry] Belyaev believed that the key factor selected for [in the] domestication of dogs was not size or reproduction, but behavior; specifically, amenability to domestication, or tameability. He selected for low flight distance, that is, the distance one can approach the animal before it runs away. By selecting this behavior it mimics what happened through natural selection in the ancestral past of dogs. More than any other quality, Belyaev believed, tameability must have determined how well an animal would adapt to life among humans. Because behavior is rooted in biology, selecting for tameness and against aggression means selecting for physiological changes in the systems that govern the body’s hormones and neurochemicals. Belyaev decided to test his theory by domesticating foxes; in particular, the silver fox, a dark color form of the red fox. He placed a population of them in the same process of domestication, and he decided to submit this population to a strong selection pressure for inherent tameness.
     
    The result is that Russian scientists now have a number of domesticated foxes that are fundamentally different in temperament and behavior from their wild forebears. Some important changes in physiology and morphology are now visible, such as mottled or spotted colored fur. Many scientists believe that these changes related to selecting for tameness are caused by lower adrenaline production in the new breed, which causes these physiological changes in a very small number of generations, thus allowing for these new genetic offshoots not present in the original species.

    Bryant Gumbel once observed of former NFL commissioner Paul Tagliabue and his relationship with late NFL Players Union head Gene Upshaw:

    Before he cleans out his office, have Paul Tagliabue show you where he keeps Gene Upshaw’s leash. By making the docile head of the players union his personal pet, your predecessor has kept the peace without giving players the kind of guarantees other pros take for granted. Try to make sure no one competent ever replaces Upshaw on your watch.

    While watching this TEDtalk by New York Times columnist David Brooks, I thought of silver foxes, Gene Upshaw, and how David Brooks would be the ideal sire for a selective breeding program to produce a tamer right-winger. Generation after generation, you’d just have to breed for floppy ears, wagging tails, and low flight distance and you’d eventually end up with a more amenable Loyal Opposition. American politics would be a simple matter of showing your successor where you kept David Brooks’ leash.

    For the record, Brooks does take some well-aimed potshots at his TEDset/Davos-set masters. But his digs are in that long tradition of peasant humor where the serf was allowed to let off some steam while the lord of the manor reached for his knout to give the recalcitrant peasant a good whipping.

    I’m confident the next generation of TED-ready, Davos-approved conservative will offer less lip.

    And have floppier ears.

    [props Isegoria]

    Posted in Bioethics | 17 Comments »

    Slicing Spinal Cords With Scissors

    Posted by Shannon Love on 20th January 2011 (All posts by )

    [Sorry for any typos. I was a bit upset and hurried.]

    I’m mostly pro-choice but this horrific story demonstrates just how utterly extreme and insane the left in general and the Democrat party in particular have become on the matter of abortion:

    A doctor whose abortion clinic was described as a filthy, foul-smelling “house of horrors” that was overlooked by regulators for years was charged Wednesday with murder, accused of delivering seven babies alive and then using scissors to kill them.
     

     
    He “induced labor, forced the live birth of viable babies in the sixth, seventh, eighth month of pregnancy and then killed those babies by cutting into the back of the neck with scissors and severing their spinal cord,” District Attorney Seth Williams said.
     
    Gosnell referred to it as “snipping,” prosecutors said.
     
    Prosecutors estimated Gosnell ended hundreds of pregnancies by cutting the spinal cords, but they said they couldn’t prosecute more cases because he destroyed files.

    How could this go on for over 30 years?

    State regulators ignored complaints about Gosnell and the 46 lawsuits filed against him, and made just five annual inspections, most satisfactory, since the clinic opened in 1979, authorities said. The inspections stopped completely in 1993 because of what prosecutors said was the pro-abortion rights attitude that set in after Democratic Gov. Robert Casey, an abortion foe, left office.

    Again, I am pro-choice but this tragedy occurred because the left violently resisted even the least regulatory oversight of even the most extreme late term abortions. The left has made abortion the highest good that trumps every other concern, and the resulting real-world policies border on the surreal.

    Read the rest of this entry »

    Posted in Bioethics, Civil Society, Crime and Punishment, Health Care, Human Behavior, Medicine, Morality and Philosphy, Political Philosophy | 100 Comments »

    Trade-Offs

    Posted by Ginny on 9th January 2011 (All posts by )

    This began as a comment and, given my extremely limited (nonexistent) expertise, it is rambling observations and questions – and if Michael & Madhu say I’ve got it wrong, well, I probably do.

    Mental hospitals dotted the landscape in the 50′s and 60′s. That was another time: some of us got through college pulling night shifts at them. Psychiatric counseling was a rite of passage among the artsy. (Note Girl Interrupted and Emily Fox Gordon’s Mockingbird Years. ) Gordon treats that particular perspective with irony. But such approaches were not always helpful and certainly those public wards filled with the less affluent were sad and lifeless.
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    Posted in Bioethics, Human Behavior, Morality and Philosphy | 8 Comments »

    Beyond Human

    Posted by James R. Rummel on 1st January 2011 (All posts by )

    Anyone recognize this guy?

    marvel comics thor

    That is Thor, comic character from Marvel Comics. Based, of course, on the deity worshiped by the Norse.

    What can this object of ancient reverence do to warrant such regard? Like most thunder gods, he can hurl thunderbolts that destroy his enemies as long as he wields a mystical hammer called Mjolnir.

    ultimate marvel thor hammer mjolnis

    That is the main thing thunder gods do, after all, and it seemed to be something that would be extremely impressive to the Vikings.

    Anyone recognize these?

    both-9mm-carry-guns-with-spent-brass-and-loaded-magazines

    My favorite carry guns. They are smaller and lighter than that hammer thing, and yet I can still create thunder by no more effort than making a fist.

    Sure, it isn’t exactly the same thing. I can’t call the storm like Thor supposedly could, for example. But it still is a perfectly common, well known, mature technology that expands my abilities to something that is impossible for an unaided human being to duplicate.

    I’m bringing up the fantastically obvious due to this online article. (Hat tip to Glenn.) Some really strange young woman has a hobby where she cuts herself open in order to shove magnets down amongst nerve clusters. Says she can feel magnetic fields that way.
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    Posted in Bioethics, Blogging, Science, Tech | 8 Comments »

    Responses

    Posted by onparkstreet on 4th December 2010 (All posts by )

    Cromagnum, in response to my post on Chesterton, has posted a useful and informative comment here. It reads, in part (an excerpt from Eugenics and Other Evils follows):

    The Socialist system, in a more special sense than any other, is founded not on optimism but on original sin. It proposes that the State, as the conscience of the community, should possess all primary forms of property; and that obviously on the ground that men cannot be trusted to own or barter or combine or compete without injury to themselves. Just as a State might own all the guns lest people should shoot each other, so this State would own all the gold and land lest they should cheat or rackrent or exploit each other. It seems extraordinarily simple and even obvious; and so it is. It is too obvious to be true. But while it is obvious, it seems almost incredible that anybody ever thought it optimistic.

    Pundita has written a tour de force response to my post on Senator Richard Lugar: “Wikileaks plus first disbursements from 2009 US aid bill for Pakistan already under scrutiny for graft. Senator Richard Lugar please take note.”

    In a wide ranging post, she makes note of three key issues:

    1. Congressional oversight: If you’re having a hard time wrapping your mind around the concept that vital information would be withheld from key congressional defense/intelligence committees — which can’t make informed recommendations without such data — while thousands of low-level civilian government and military employees had access to the data, you should listen to the interview; it’s enough to make your blood boil if you’re an American.

    2. Allegations of corruption in the distribution of aid monies: Two months after his remarks came the news that even the first small disbursements were already in trouble due to charges of corruption. Because aid monies disbursed to the Pakistani government become the sovereign property of the government and thus immune to oversight the 2009 aid bill aimed to get around the problem by disbursing the money to NGOs. The workaround simply opened another avenue for graft:

    3. The sometimes head-scratching priorities and decision-making of American officials: Yet the revelation doesn’t fully explain why the U.S. military and executive and congressional branches have consistently made bad calls on Pakistan because this has been going on for more than a half century — ever since the U.S. first became involved with Pakistan. Yet these bad calls weren’t seen as such until NATO floundered in Afghanistan. That finally put a crimp in the style of Washington’s anti-Russia crowd but over decades the crowd and its counterpart in Europe looked the other way while Pakistan ran riot because they saw the country as a weapon first against the Soviet Union then against Russia.

    No matter who wins the presidential election in 2012, I wager that many of the structural problems that have plagued our foreign policy in recent years will remain. One of the most appealing aspects of the Tea Party movement is its “pay attention!” ethos. Complain about elites all you want, they can’t cause so many problems if we citizens are performing our own oversight functions.

    Update: Thanks for the link, Professor Reynolds!

    There are some very good comments in the comments section. I will try and respond more fully at a later date.

    Posted in Afghanistan/Pakistan, Arts & Letters, Bioethics, Book Notes, Christianity, Civil Society, Conservatism, Elections, International Affairs, Military Affairs, Morality and Philosphy, Philosophy, Society | 10 Comments »

    “Chesterton’s Warning”

    Posted by onparkstreet on 27th November 2010 (All posts by )

    It sounds like a preoccupation of the exotic fringe to most of us now, but nine decades ago eugenics was openly advocated as a mainstream Progressive idea. Indeed, the most certifiably advanced minds of the day promoted and celebrated it. In 1923, former President Charles W. Eliot of Harvard, U.S. Senator Royal Copeland of New York, former President David Starr Jordan of Indiana and Stanford Universities, President Livingston Farrand of Cornell University, and a host of other educational, medical and social-welfare luminaries making up the Eugenics Committee of the United States came forth with a program calling for “selective immigration, sterilization of defectives and control of everything having to do with the reproduction of human beings.” In 1932, Margaret Sanger, founder of the organization that would eventually become Planned Parenthood, advocated “a stern and rigid policy of sterilization and segregation to that grade of population whose progeny is already tainted or whose inheritance is such that objectionable traits may be transmitted to offspring.” Nor was support restricted to a secularist avant-garde. As Christine Rosen has shown, many American Christian and Jewish religious leaders, including even some Roman Catholics, were fully supportive of eugenic ideas and policies. It was no fringe phenomenon.1

    Wilfred M. McClay, The American Interest.

    Posted in Bioethics, Book Notes, History | 8 Comments »

    A Nexus Between Academic Medicine and Government

    Posted by Michael Kennedy on 5th July 2010 (All posts by )

    The Wall Street Journal has one more article on the effect of Obamacare on doctors. A couple of interesting statements bring up some comments on an excellent medical blog I read.

    First the WSJ points about Obamacare.

    The act will reinforce the worst features of existing third-party payment arrangements in both the private and public sectors — arrangements that already compromise the professional independence and integrity of the medical profession.

    Doctors will find themselves subject to more, not less, government regulation and oversight. Moreover, they will become increasingly dependent on unreliable government reimbursement for medical services. Medicare and Medicaid payment, including irrational government payment updates, are preserved (though shaved) and expanded to larger portions of the population.

    The Act creates even more bureaucracies with authority over the kinds of health benefits, medical treatments and procedures that Americans get through public and private health insurance. The new law provides no serious relief for tort liability. Not surprisingly, various surveys reveal deep dissatisfaction and demoralization among medical professionals.

    I’ve been posting about this for a couple of years and it is no surprise.

    Now here is where it gets interesting.

    Read the rest of this entry »

    Posted in Academia, Bioethics, Health Care | 3 Comments »

    Medicare optouts

    Posted by Michael Kennedy on 23rd June 2010 (All posts by )

    I subscribe to a physician only web site that has a lot of political items in the mix. It has over 100,000 members, well over, I believe. The subject of dropping out of Medicare, and sometimes from all insurance, is a frequent subject. I thought it might be interesting to see the comments (some of them) to one such post.

    I am opting out of Medicare

    Last week I stopped seeing new Medicare patients. Today, I decided to opt-out completely. The sign in my waiting area reads:

    Dear patients,

    As of October 1, 2010, I will no longer accept Medicare insurance due to the harassment and cuts in payments by the federal government. My fees are very reasonable – please feel free to discuss them with me personally. I would love to continue to care for my Medicare patients, just without the federal government telling me how do my job or how much to get paid.

    This is just the beginning of the healthcare reform. Please thank your elected representatives and think carefully how you vote in November.

    Yours,

    EndocrineMD

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    Posted in Bioethics, Health Care | 58 Comments »

    Personal Plug: The Victorians, Darwin & Lit Crit

    Posted by Ginny on 6th May 2010 (All posts by )

    The first review of my husband’s book, Masculinity in Four Victorian Epics is out. He’s published a lot on Matthew Arnold, Victorian autobiographies, the Czechs, but this is his first full-length critical work using Darwinian criticism. This isn’t exactly a literary blog, but Tod Williams (who, in good peer review fashion we don’t know, but appers friendly to this methodology) reminds me of the way literature used to be approached.

    My husband was attracted to this method: he argues it was growing up on a farm and reading Tennyson in the truck on the way to the feed store that made it natural. On another plane, of course, as the reviewer notes: “It should come as no surprise that an established Matthew Arnold scholar would approach literature with a concern for universal human truths or that one with such interests would turn to literary Darwinism for a methodology.” He examines that popular (but now seldom read) Victorian genre – the “long poem.” “Machann maintains in his introduction that the issue of masculinity is not only central to the four long poems he treats but to ‘our understanding of Victorian literature: its major themes, its idealism and social criticism, its perplexities and uncertainties’” (1) The Victorians restrained masculine violence in many ways, but the ideal of chivalry and “manliness” was also expressed in adventuring (both geographically and intellectually).

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    Posted in Academia, Arts & Letters, Bioethics, Book Notes | 7 Comments »

    Borlaug Remembered

    Posted by Ginny on 7th October 2009 (All posts by )

    “He regarded himself as an instrument, which he used tirelessly for the benefit of others.”

    The world honors Borlaug here and here.

    Posted in Academia, Bioethics, Obits, Science | 2 Comments »

    Norman Borlaug, 1914-2009

    Posted by Jay Manifold on 13th September 2009 (All posts by )

    Via Pejman Yousefzadeh, I hear that Norman Borlaug has passed; NYT obit.

    In the face of caviling from scarcity-mentality “environmentalists,” he saved a billion lives. Requiescat in pace.

    Posted in Bioethics, Environment, India, Latin America, Obits | 5 Comments »

    Everybody wants to go to heaven,

    Posted by Ginny on 8th August 2009 (All posts by )

    But none of us want to go now.

    A mean conservative Newt Gingrich argues: “we need a new federal resolve to truly defeat Alzheimer’s. As America’s largest generation ages, we have no time to lose.” On the empathic left Ezekial Emanuel (brother of the gentle soul, Emanual): “Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.”
    Read the rest of this entry »

    Posted in Bioethics, USA | 7 Comments »