Headline News, Science Views (1991) / Chapter Skim
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Pages 179-198
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From page 181... ...
~ ~ ~ ~ _ ^~ _~t ~~—~ rev Yet choices are inescapable, as we Oregonians learned not long ago when a local boy died from leukemia. The bone marrow transplant he needed was disallowed by state Medicaid officials because the money was earmarked to provide prenatal care to the poor.
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From page 182... ...
Should money from community health programs be diverted to provide expanded medical services for AIDS patients? Are old people entitled to organ transplants?
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From page 183... ...
We need to confront these decisions squarely. November 19, 1989 Ralph Crawshaw, clinical professor of psychiatry at Oregon Health Sciences University, is on the board of directors of Oregon Health Decisions.
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From page 184... ...
Situations such as this are becoming possible as new biological tests emerge from the laboratory. Designed to uncover latent problems or predict future diseases, these diagnostic techniques offer potentially valuable clinical applications.
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From page 185... ...
The refinement of tests already is expanding the number of disease categories and the number of people judged deviant. Just as improved sensitivity in the technologies used to test food products has expanded the number of products identified as carcinogenic, so are improved diagnostics increasing the number of people defined as abnormal.
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From page 186... ...
February 4, 1990 Dorothy Nellie from New York University and Laurence Tancre~ from the University of Texas Health Science Center are the authors of Dangerous Diagnostics: The Social Power of Biological Information.
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From page 187... ...
In fact, a realistic annual estimate is that only nine hearts, two livers and no kidneys would be transplanted successfully. Thus, the number of usable organs from anencephalics would remain far short of the need, even if laws were relaxed to allow transplants to occur before the infants met the standards now used to determine death in other persons.
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From page 188... ...
Why not allow relatives to donate organs from patients in the final stages of any terminal illness or from prisoners on death row? Since anencephalics won't supply enough organs, this utilitarian argument could push society to extend the category to children with other terminal diseases to benefit babies awaiting transplants.
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From page 189... ...
Given the many problems involved, using anencephalic infants in this fashion is one "breakthrough" society should leave untouched. Parents of anencephalics should be offered the opportunity to donate their child's non-vital organs, such as corneas and heart valves, for transplantation after death, and to cooperate with postmortem investigations aimed at learning more about this tragic affliction.
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From page 190... ...
This issue was cliscussec! at a recent conference on HIV screening held by the Institute of Medicine of the National Academy of Sciences.
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From page 191... ...
Yet "informed consent" is easier said than done. Some clinicians who have little experience with HIV and are used to "presumed consent" by patients for diagnostic tests may have difficulty accepting the standard of specific consent, particularly as the epidemic expands into poor patient populations.
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From page 192... ...
The debate has become more charged over the past decade, with some radical animal-rights activists breaking into laboratories to "liberate" animals. A number of individuals have argued that progress in computer modeling and other technologies now makes it possible to test drugs, surgical techniques and other medical advances without using animals.
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From page 193... ...
In the past, animal experimentation resulted in vaccines to prevent polio, smallpox, measles and a host of other diseases. Other Americans owe their lives to kidney transplants, heart-bypass operations, the removal of brain tumors and CAT scans, all of which were tested for reliability on animals before being used with humans.
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From page 194... ...
Some opponents of animal experimentation allege that abuse and neglect of animals are widespread in research facilities, but our committee could find only limited evidence to support them. Although continual review of the matter is warranted, abuse of research animals is the exception rather than the rule.
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From page 195... ...
This carelessness includes practices such as listing one's name as a co-author of a publication without even reading it or failing to observe accepted research standards in conducting scientific experiments or interpreting findings. A researcher facing increased competition for a grant to continue a medical study, for example, may be more tempted than in the past to exaggerate the significance of preliminary findings.
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From page 196... ...
The federal government, for its part, needs to assume a more vigorous role in promoting responsible conduct in biomedical research. As the nation's primary funder of healthrelated research, the National Institutes of Health should take the lead by establishing an office with the responsibility of helping institutions develop the guidelines outlined here.
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From page 197... ...
March 2B, 1989 Arthur H Rubenstein, chairman of the Department of Medicine at the University of Chicago, chaired a committee of the Institute of Medicine that studied biomedical research misconduct.
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