The Transparency of Clinical Trials

by Mark Sheehan
March 7, 2008

An article in the current issue of Science examines the extent to which new policies regarding the governance of clinical trials promote transparency. It goes on to suggest further issues that remain unaddressed and require attention. The authors suggest that recent policy changes have improved the extent of public access to clinical trial data. In particular, they suggest that Section 801 of the FDA Amendments Act “should go a long way in ensuring that all patients and all data are publicly accounted for.” However, with the Editor-in-Chief of the New England Journal of Medicine, they do worry that some patients “are left on the cutting room floor to make a drug look better than it really is.”

Methuselah’s planet: the population cost of longer life

by Dominic Wilkinson
March 5, 2008

Ageing is a mysterious process. There is a good deal of ongoing research aimed at trying to understand its biological cause, though much remains unknown. Some research is aimed at trying to unlock longevity, for example a study published this week that found a particular gene mutation in a group of long-living Ashkenazi Jews. Other researchers are actively looking at rare diseases like progeria which lead to accelerated ageing. It is often expressed that such research will make it possible to extend the normal human lifespan.

But should we try to make our lives longer? In an era of increasing environmental awareness, when the costs of human overpopulation are all too clear it might be argued that the planet cannot support a significant increase in our lifespan.

Placebos as cognitive enhancers?

by Neil Levy
March 3, 2008

A recent study on the efficacy of selective serotonin reuptake inhibitors (SSRIs) – antidepressants like Prozac – has been widely reported in the media. Unfortunately it has not been reported very well. Headlines like ‘Antidepressant drugs don’t work’ (The Independent) are misleading. What the study actually found is that the efficacy of SSRIs varies with… Read More »Placebos as cognitive enhancers?

Doublethink and double effect; donation after cardiac death

by Dominic Wilkinson
February 29, 2008

In California a transplant surgeon has been charged with a felony in relation to the death in intensive care of a young disabled man (Ruben Navarro). (See also Matthew Liao’s blog from yesterday). Ruben had a severe degenerative disorder of the nervous system known as adrenoleukodystrophy, and had then suffered further brain damage after a respiratory arrest. The surgeon is accused of administering drugs to hasten Ruben’s death so that his organs could be used for transplantation. In the event Ruben’s death took some 8 hours after removal of life support, and none of the organs could be used.

What happened after Ruben Navarro’s life support was removed remains unclear. However this case highlights some of the problems of conflicting intentions when patients are allowed to die.

The Transplant Case in Real Life

by S. Matthew Liao, New York University
February 29, 2008

Philosophers have long debated about the moral permissibility of Transplant Cases such as the following one presented by Philippa Foot:

A brilliant transplant surgeon has five patients, each in need of a different organ, each of whom will die without that organ. Unfortunately, there are no organs available to perform any of these five transplant operations. A healthy young traveler, just passing through the city the doctor works in, comes in for a routine checkup. In the course of doing the checkup, the doctor discovers that his organs are compatible with all five of his dying patients. Suppose further that if the young man were to disappear, no-one would suspect the doctor.

Most people believe that it is not permissible for the doctor to murder this patient and harvest his organs, although a few consequentialists, e.g. Alastair Norcross, have argued that it might be acceptable under certain circumstances.

In a possible real-life version of the Transplant Case, the New York Times reported recently that Dr. Hootan C. Roozrokh, a transplant surgeon from Stanford, is being charged with ordering the removal of a life-supporting ventilator and prescribing excessive and improper doses of drugs, apparently in an attempt to hasten the death of a disabled and brain damaged man named Ruben Navarro in order to retrieve his organs sooner.

Changing the Building Blocks of Life: Playing God and Being gods

by Practical Ethics
February 28, 2008

All life on earth has the same simple basic structure. It is based on the genetic code contained in DNA. The differences in DNA between a toad and Albert Einstein are what determines their different properties.

The active ingredients in DNA are also simple. They are 4 bases: cytosine, guanine, adenine and thymine, or A, T, C and G. The order of these 4 bases is what determines the characteristics of life, the differences between Einstein and a toad.

Scientists in California have created two new bases in addition to A, T, C and G: dSICS and DMMO2. These new bases function like natural ones, they pair appropriately with their partner and are faithfully copied by the natural enzyme, DNA polymerase, responsible for making the billions of copies of DNA necessary to programme each cell in the body of a living organism.

At present, these new bases or building blocks do not do anything. But scientists hope they could be used

"for hundreds of purposes: for example, to build complex shapes, to build complex nanostructures, silence disease genes or even perform calculations… [and even]expand the genetic code and ‘evolvability’ of an organism."

Stairlifts, wheelchairs, and radium-powered toasters

by Rebecca Roache, Royal Holloway University of London
February 26, 2008

The BBC has
reported plans by the government to
ensure that all new homes are built to accommodate the needs of an ageing
population. Under these plans, new homes
would need to include features such as stairs wide enough to fit a stairlift,
downstairs bathrooms, and room for wheelchairs to turn. The plans are, reportedly, part of a wider
initiative to make entire neighbourhoods more old-people-friendly, through—for
example—building better pavements and kerbs, improving street lighting,
thoughtfully positioning bus stops, and ensuring access to amenities such as
toilets.

The plans
have been welcomed by organisations such as Help the Aged and Age Concern, who
believe that such measures will enable old people to live independently for as
long as possible. A spokesman for Help
the Aged is quoted as saying, ‘We live in an ageing population and our housing
must meet the needs of older people, both now and in the future’.

Come Mr Branson Mon, Tally me Biofuel

by Steve Clarke
February 25, 2008

A Virgin Atlantic flight between Heathrow airport London and Schiphol airport in the Netherlands made history yesterday, becoming the first commercial flight to be partly powered by biofuel. While three of the 747s tanks contained conventional fuel the fourth contained 20% biofuel. The biofuel was a mix of babassu oil and coconut oil. The Guardian reports that the mixture contained oil from 150,000 coconuts. Sir Richard Branson, head of Virgin Atlantic, described the flight as a ‘historic occasion’ and ‘… a biofuel breakthrough for the whole airline industry’. However environmentalists do not seem to share Branson’s enthusiasm for coconut and babassu oil based flight. According to the BBC News the flight has been branded a publicity stunt, a gimmick, and ‘high-altitude greenwash’. Critics include Friends of the Earth, Greenpeace and the World Development Movement.

Neuro-babble

by Tom Douglas
February 21, 2008

A study
published in this week’s issue of the Journal of Cognitive Neuroscience finds
that including irrelevant neuroscientific information in an explanation can
make people more likely to believe that explanation.

Three
groups of subjects – neuroscience ‘novices’, neuroscience students, and neuroscience
experts – were given descriptions of psychological phenomena followed by one of
the following types of explanation:

I. A
good explanation excluding irrelevant neuroscientific information

II. A
good explanation including irrelevant information

III. A
bad explanation excluding irrelevant neuroscientific information

IV. A
bad explanation including irrelevant information.

Novices
rated bad explanations to be more satisfying when they contained neuroscientific
information (i.e. IV > III) while students rated both good and bad
explanations more satisfying when the contained irrelevant neuroscientific
information (i.e. IV > III and II > I). No similar effect was found for
experts, who in fact rated good explanations to be less satisfying when they
included irrelevant neuroscientific information (i.e. I > II).

That neuroscientific
novices may be persuaded by neuro-babble is, of course, troubling.

The perils of cheap alcohol

by Toby Ord
February 21, 2008

Alcohol abuse in the UK has been escalating for decades, contributing to crime, unemployment, illness and death. Last month, the government reported that alcohol-related deaths in the UK have doubled over the last 15 years to almost 9,000. One prominent factor in these increases is the price of alcohol, which has remained relatively stable despite increases in income over the years, and has thus become much cheaper in real terms. The cheaper it is, the more of it people consume, and the more ill effects are felt. The British Medical Association has thus called on the government to prohibit the cheap sale of alcohol, and in a surprising turn of events, the dominant supermarket chain, Tesco, has echoed this call.