Bills to legalize physician-assisted suicide have been introduced in Connecticut by Senator Edward Meyer, Representative Gary Holder-Winfield, and the Public Health Committee. Read more here.
The latest report from the Presidential Commission for the Study of Bioethical Issues provides that an anthrax vaccine may be tested on children. However, the report does not provide unconditional approval for such testing, as it explicitly recognizes that researchers must deal with significant barriers prior to beginning a clinical trial involving children. Furthermore, the report acknowledges that the children involved in an anthrax vaccine trial would not benefit directly from the study and “would face more than minimal risk.” Critics suggest these circumstances dictate against permitting a pediatric study. Read more here.
Dan Markingson was enrolled in an anti-psychotic drug trial at the University of Minnesota. He committed suicide almost ten years ago, during the course of the drug trial. When Dan was initially enrolled in the study, a doctor at the University of Minnesota determined that Dan “’lack[ed] the capacity to make decisions regarding [his] treatment.’” Consequently, Dan probably could not have provided informed consent to participate in the study. As the study progressed, Dan’s mental state deteriorated and his mother asked to have him removed from the study. However, despite his mother’s request, the University of Minnesota refused to end Dan’s participation. Subsequently, Dan committed suicide.
In recent years, it has been reported that the study’s design may have been flawed and that the trial investigators may have been influenced by financial conflicts of interest – the study was funded by he pharmaceutical industry. However, the University of Minnesota has not only refused to open a new investigation into the issue, but also “appeared to threaten the leading bioethicist dissent, Dr. Carl Elliot.” Subsequently, as previously reported on this blog, Dr. Elliot claimed that the consent documents for two separate patients enrolled in the trial were exactly the same, indicating ethical misconduct. Furthermore, Dr. Elliot has obtained additional documents that bring the study’s administration into question. Despite this potential new evidence of misconduct, the University of Minnesota has refused to investigate the matter. As a result, Dr. Elliot has created an online petition in the hopes of initiating “an outside investigation.” Read more here.
The Yale Journal of Health Policy, Law and Ethics recently published an article by Eric Cohen, Director of the Bioethics and American Democracy Project, addressing the foundations of bioethics and potential problems in the future. Cohen writes that, although bioethics must “keep pace with our changing technological condition,” it is helpful to rediscover primary bioethical concerns and the questions the discipline attempts to resolve. Read the article here.
A pregnancy surrogate in Connecticut refused to terminate her surrogate pregnancy after tests confirmed that the baby would have “a cleft lip and palate, a cyst in the brain, and a complex heart abnormality.” The baby’s aspiring parents believed that the medical procedures necessary to manage the baby’s health problems would be too much for an infant and that it would be “more humane” to terminate the pregnancy. The parents previously had thee premature births, requiring two of their children to be hospitalized and suffer ongoing medical conditions. However, the pregnancy surrogate disagreed with the parents’ decision, believing that “all efforts should be made to ‘give the baby a chance.’” As the aspiring parents prepared to exercise their legal rights to custody under the laws of Connecticut, the pregnant surrogate travelled to Michigan where she would be recognized as the baby’s mother. Then, matters were further complicated when it came to light that the egg was from an anonymous egg donor. The baby was subsequently adopted by a couple in Michigan and the Connecticut couple will stay in touch with the baby’s adoptive family. Read more here.
Irom Sharmila was recently charged with attempted suicide in India, arising “from a 2006 protest she attended in New Delhi.” Ms. Sharmila has been on a hunger strike for the last 12 years, in protest of an Indian law that allows troops to shoot and kill suspected rebels and authorizes warrantless arrests of suspected militants in conflict areas. Ms. Sharmila has not voluntarily eaten since November of 2000, however she has been subjected to mandatory nasogastric feeding since three days after beginning her hunger strike. If convicted of attempted suicide, she could serve up to one year in prison. Read more here.
Last Tuesday, March 5, 2013, Juan Mendez called for an international debate on health care abuse that is akin to “torture or cruel, inhuman, or degrading treatment or punishment.” Mr. Mendez, a Special Rapporteur to the United Nations, believes such a debate is necessary in light of his report to the Human Rights Council, which was released in February. The report highlights certain abuses, including: “compulsory detention for drug users, street children, homeless individuals, and others in rehabilitation centers run by military or police; violation of reproductive rights such as involuntary sterilization, female genital mutilation, and denial of abortion or post-abortion care; denial of pain treatment; solitary confinement and prolonged restraint of persons with psychosocial disabilities; and denial of treatment to HIV/AIDS patients and lesbian, gay, bisexual, transgender and intersex persons.” Read more here and here.
Adam Mohammed Muthna was convicted of armed robbery in Sudan. He was subsequently sentenced to having his right hand and left foot amputated. Although the punishment had not been used in Sudan for 30 years, the amputation was carried out this February. Consequently, medical organizations and human rights groups are concerned about the involvement of Sudanese doctors in the procedure. Read more here.
Professor Carl Elliot claims that the consent documents for two schizophrenic patients enrolled in a drug study at the University of Minnesota are exactly the same. If Professor Elliot’s allegation is true, consent may not have been properly obtained for the patients’ involvement in the drug study. The consent questionnaire involves several open-ended questions, which the two patients answered in exactly the same way. Professor Elliot points out that such an occurrence is “improbable” and raises concerns about the university’s examination of the patients as it relates to their ability to consent to involvement in the drug study. Mark Rotenburg, an attorney for the university, disputes the allegations. However, the university’s methods for recruiting patients were previously questioned in 2004, following the suicide of Dan Markingson. Read more here.
In other news, ethical concerns related to another study conducted at the University of Minnesota, involving AstraZeneca’s Seroquel, are also gaining attention on the internet. Read more here.
Antipsychotic drugs, such as Seroquel and Haldol, are often used in nursing homes as “chemical restraints.” A recent investigation found that the seemingly underregulated practice is prevalent within New York City nursing homes, even though the use of such drugs “can lead to falls, strokes, and even death.” Analysis of data from the Centers for Medicare and Medicaid Services shows that approximately 25% of nursing home residents in New York City received antipsychotic drugs in 2011. Furthermore, at a number of facilities, the high rate of antipsychotic drug usage was “associated with fewer nursing hours per patient, and higher rates of bedsores and depression.” However, within the last three years, not one of the ten New York City nursing homes with the highest rates of antipsychotic drug usage was cited for using the medications inappropriately.
Read more about the investigation, the history of “chemical straight jackets,” and the lack of effective oversight here.