On Bioethics

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Archive for medical

Prepare for the worst

The American Medical Association has launched a new journal for a new discipline: disaster medicine, to be called Disaster Medicine and Public Health Preparedness. The inaugural issue features Hurricane Katrina, the Oklahoma City bombing, and “lifeboat ethics”. ~ WSJ health blog, Jun 21



A recent scandal has brought to light the fact that most Indian doctors are not taught medical ethics. A doctor in Tamil Nadu allowed his 15-year-old son to perform a Caesarean section, outraging his colleagues. With cases like this emerging, private and government medical schools believe that a structured medical ethics curriculum may be needed. However, a proposal from the Medical Council of India to do this has been gathering dust health ministry for three years. It advises that entering students should spend their first three months learning medical ethics, computers and communicative English. ~ Times of India, Jun 22  


“Manimals” are around the corner, according to the bioethics writer for the Washington Post and Slate, William Saletan. In an update on scientists’ progress towards creating animals with varying degrees of human characteristics, he points out that “the more you humanise animals, the better they serve their purpose as lab models of humanity. That’s what scary about species mixing. It’s not some crazy Frankenstein project. It’s the future of medicine.”Saletan points out that at Stanford, where human brain stem cells have already been inserted into foetal mice, even more ambitious projects are afoot. Ethicists there have tentatively endorsed the notion of humanised mouse brains. Even endowing mice with “some aspects of human consciousness or some human cognitive abilities” might prove useful. The UK’s Academy of Medical Sciences and the US National Academy of Sciences have refused to permanently restrict the humanisation of animals. ~ Washington Post, Jun 24   



International medical tourism has become a US$60 billion industry which is growing at the galloping pace of 20% a year. Patients in Europe and North America seeking bargains or speedier treatment are travelling to countries like India, Brazil and Thailand for medicine which is as good or better than what they could afford at home. India will treat half a million overseas patients this year, for instance.

The trend has increased since the Asian currency crisis between 1997 and 2001, and 9/11, because Asians and Arabs were effectively unable to travel to the US for treatment. Savvy medical administrators sensed an opportunity and stepped into the gap. In some instances, the quality of medicine is outstanding.

According to Ruben Toral, a marketing manager for a Bangkok-based hospital, the typical medical tourist is someone over 50 who wants elective surgery or a medical procedure on a budget. His hospital pays its doctors lower wages and runs a strictly cash business.

At a seminar on international medical tourism in Las Vegas earlier this month, however, some concerns about the trend emerged. In many of these countries medical liability is not well developed. Although there is little hard information, some procedures have required reparative surgery back home. A recent survey of 68 Australian plastic surgeons uncovered 100 instances of botched procedures after women took “cosmetic surgery holidays” in Thailand and Malaysia.

What does the future hold? Perhaps the globalisation of medicine, as baby boomers go abroad for their operations. The Lancet cites an expert who predicts that insurance companies will develop products specifically for the medical tourism market and developing countries will build hospitals to capitalise on their relatively low labour costs. ~ Lancet, Jun 2


Pressure is growing on the British government to permit the creation of human-animal hybrid embryos for stem cell research. After a recent public consultation, it appears that the government is preparing to ban it, but there have been noisy protests from scientists and MPs. The Association of Medical Charities has sent a letter to Prime Minister Tony Blair signed by 223 medical foundations and patient groups.

Whatever the public might feel, suggests the letter, the views of scientists should prevail: “They highlight the need for this work because of the shortage of human eggs for medical research and because they see it as a vital avenue of inquiry which could greatly increase our understanding of serious medical conditions and ultimately lead to new treatments.”  

Within Parliament, members of a science and technology select committee are giving hybrid embryos vigorous support. “Ministers have never provided a rational basis for their ban and their only supporters are pro-life groups and anti-science campaigners who oppose all embryo research,” says MP Evan Harris.

However, Josephine Quintavalle, director of Comment on Reproductive Ethics, said: “Despite the enthusiasm of this small committee, worldwide there is more opposition than support for the creation of such entities, and within the United Kingdom as well. The public should now demand an extensive and objective consultation at the highest democratic level, and by this we mean Parliament itself.” ~ BBC, Apr 5; AMC website