February 26, 2007

In Retrospect: What the Media Did Wrong in Covering Ashley X

She is the 9 year-old who will "never grow up," and Art Caplan does an excellent job for the Poynter Institute in pointing out what the media can do to cover stories like this better - and what went wrong in this social debate that the media could have fixed. It's a great interview with lots of links - definitive if you are searcing for the comprehensive source of coverage of Ashley X's case.

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January 04, 2005

Prison Blocks Inmate from Donating Organ

New Orleans Times-Picayune reports that Stephen Stage, 53, convicted of aggravated battery, wants to give his kidney to a woman whose plight he read about in the paper. The Orleans Parish Criminal Sheriff's Office, which runs the prison, says no.
Even though Medicaid, Wiltz's insurer, would cover all medical fees, including a blood test to determine whether she could receive Stage's kidney, Inglese said transferring deputy sheriffs to a hospital to guard Stage around the clock would be a drain on the department's already tight budget and leave the prison vulnerable.

That money "is the taxpayers' money," he said. "The Orleans Parish Criminal Sheriff's Office doesn't have the right to donate that money so someone can have a kidney transplant. . . . We need the money for people in the jail to receive health care, not people in the community."

- Arthur Caplan

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January 01, 2005

End of the Year Take One

We'll keep updating this post as the stuff pours in, so scroll down during the next week or so if you are interested in year-end review stuff:

Art Caplan has closed out the year in bioethics on MSNBC, the last web news Op Ed column (CNN and ABC have both closed up shop in bioethics).

Betterhumans, the transhumanist blog, identifies this as its top story as the year, a review of the potential for a drug called rimonabant to prevent cravings for cigarettes and food.

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December 29, 2004

Wesley Smith has Lots of Nerve

Wesley Smith has made a serious bid for the 2004 chutzpah award. in a new column he complains that proponents of embryonic stem cell research using cloned embryos are playing word games in how they describe cloned embryos. This coming in the context of a year's worth of conniving on the part of proponents of a ban on cloning for research to say they are not opposed to 'stem' cell research when what they mean is adult stem cell research and intentionally confusing reproductive cloning with cloning for research. Wesley--stones, glass houses, c'mon now! - Art Caplan

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December 28, 2004

The Transplant Idea that Will not Die

Are pigs the future of transplants? Byron Spice of Pittsburgh Post-Gazette is impressed. - Art Caplan

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Perfect People: the Grudge Match

PLoS Pic Perfect people: is it a good aim? Art Caplan and Carl Elliott debate in Public Library of Science. It is fun to read but the argument is pretty much what you expect. Caplan discharges the debate as somewhat silly:
Beating up on the pursuit of perfection is silly. As Salvadore Dali famously pointed out, “Have no fear of perfection—you'll never reach it.” Critics of those who allegedly seek to perfect human beings know this. While often couching their critiques in language that assails the pursuit of perfection, what they really are attacking is the far more oft-expressed—albeit far less lofty—desire to improve or enhance a particular behavior or trait by the application of emerging biomedical knowledge in genetics, neuroscience, pharmacology, and physiology.
And Elliott responds that it isn't a conservative defense of human nature that motivates him, rather he is concerned about misplaced energies devoted to enhancement instead of more important aims; in particular Elliott is as always primarily fighting against big pharma's promotion of enhancement:
Caplan does not defend medical enhancement so much as attack its critics. Or rather, he attacks a small group of conservative critics who want to preserve “human nature.” He dispatches those critics with admirable precision, but I am not sure why he believes that group of critics includes me. My worry about enhancement technologies has little to do with human nature. My worry is that we will ignore important human needs at the expense of frivolous human desires; that dominant social norms will crowd out those of the minority; that the self-improvement agenda will be set not by individuals, but by powerful corporate interests; and that in the pursuit of betterment, we will actually make ourselves worse off.
Still, it is a fun read. And maybe it will get a few more copies of Better than Well and The Perfect Baby into circulation. Come to think of it, maybe we could stage a series of these wrestling matches ... yeah ... that's the ticket ...

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December 19, 2004

"A Number" - A Preview

We blogged the NY premier of this great new play about cloning. Now Religion and News Weekly reports on it, including an interview with Caplan and others who had a chance to see the press-night preview. [Link]

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November 29, 2004

Arf Arf Arf

From Christian Science Monitor:
Is it necessarily the right choice to apply advanced medical technology to animals? Is it really the best option for the animal involved? And is it always the right choice for the pet owner, who might in some cases accrue staggering veterinary bills?
[thanks Art Caplan]

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November 26, 2004

Bioethics Abandons the Creationism Debate

Texbook disclaimer stickers are here. Bioethicists remain oddly silent on the issue of teaching evolution in schools. Given the renewed efforts of creationists to both discredit evolution and to have creationism taught as science rather than as religion this paucity of comment is inexcusable. This website nicely captures the dangers that await high school kids when those in bioethics fail to comment on one of the core ethical challenges facing biomedicine--that its foundational theory ought not be taught in American schools as science! - Art Caplan UPDATE: polls confirm that most Americans adhere to at least some creationist views.

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November 19, 2004

A More Dramatic Case Than Schiavo - Major Story

From Art Caplan:
HOSPITAL, WIFE BATTLE OVER PATIENT'S LIFE A HEARING IN ORANGE WILL CONSIDER THE FATE OF A CLERMONT MAN WHO HAS A LIVING WILL. BY ANTHONY COLAROSSI | SENTINEL STAFF WRITER POSTED NOVEMBER 18, 2004

Hanford Pinette made his wishes clear in a living will: He never wanted to be kept alive by a machine.

Today Pinette, 73, lies in an Orlando hospital, where machines run his lungs and kidneys. Doctors see an unresponsive patient with no hope of recovery. Alice Pinette sees her husband of 53 years clinging to life.

Now the Clermont man's fate will be fought out in a courtroom in an unusual battle waged by Orlando Regional Healthcare System officials, who want to let him die, against Alice Pinette, who wants to keep him alive.

"They're just trying to pull the plugs," Alice Pinette, 73, said Wednesday, standing in the doorway of her home. "He still communicates with me, and I won't let them do it."

A hearing in the case is scheduled for Tuesday before Orange Circuit Court Judge Lawrence Kirkwood. The outcome could have broad implications on the enforcement of living wills, which are supposed to remove uncertainty about a patient's wishes in the event of a terminal illness and incapacity.

Paul Malley, president of the Tallahassee-based Aging With Dignity, a national organization that advises people about the benefits of living wills, said he could not recall a Florida hospital going to court to enforce a written living will over the wishes of a patient's family.

"It's definitely highly unusual for a hospital to bring up a case like this," Malley said. "Where this case is, is a real challenge. There may not be an easy answer here."

The argument doesn't center on Pinette's wishes, but whether he's sick enough to carry them out.

"He's all right," Alice Pinette said. "He's getting better, a little each day." David L. Evans, Orlando Regional Healthcare's lawyer, said the hospital maintains Pinette will not get better and is trying to abide by the patient's wishes.

"All we can do is come in and describe his medical condition and his competency," Evans said last week. "We're just doing what we feel we're legally obligated to do."

The Pinette matter is almost a reversal of the Terri Schiavo case.

Schiavo collapsed 14 years ago and is now in a Clearwater nursing home in what doctors call a progressive vegetative state. She is kept alive by a feeding tube and left no written directive of her wishes.

Schiavo's husband, Michael, contends his wife told him she would not want to be kept alive. Her parents, Bob and Mary Schindler, have battled Schiavo in court, arguing their daughter is aware of her surroundings.

The case sparked a national controversy when Gov. Jeb Bush and the Florida Legislature intervened to block a court order removing Terri Schiavo's feeding tube. The courts ruled in Michael Schiavo's favor and the case remains on appeal in Florida's courts.

The case has been cited as an example of why people need to write living wills.

Pinette, a Korean War veteran and government engineer who moved to Clermont in 1994 from Maryland to retire, wrote a living will in 1998 and assigned his wife to carry out his wishes, designating her as his "surrogate."

In the event of a terminal condition with no probability of recovery, Pinette stated: "I direct that life-prolonging procedures be withheld or withdrawn when the application of such procedures would serve only to prolong the process of dying."

Pinette stated in the will that he wanted "to die naturally" and receive medication only to "alleviate pain."

But Alice Pinette produced a durable power of attorney signed by her husband on the same date in 1998.

The power of attorney states her husband assigned her "to decide for me [Hanford Pinette] any matters regarding my health care, including, but not limited to, consenting to withhold or withdraw life-prolonging procedures."

Earlier this year, Pinette suffered congestive heart failure, his wife said. He has been hospitalized since February, according to the petition filed by Orlando Regional Healthcare, and is currently at Lucerne Hospital.

Despite Alice Pinette's assertions that her husband is not terminally ill, the hospital argues in court documents that Pinette's "renal system, respiratory system and cardiovascular system are all being supported by artificial means alone."

The petition also says Pinette is not competent to make his own decisions and is not likely to recover his mental capacity. The hospital's bioethics committee which reviews cases such as this also agreed to withdraw life support.

And two doctors -- Sanjay Muttreja and Juan Herran -- submitted affidavits that Pinette is terminally ill and has no "medical probability" of recovering.

"It is my opinion as Mr. Pinette's treating physician that Mr. Pinette meets the requirements of his living will," Muttreja said in his affidavit.

But Alice Pinette, who goes to the hospital daily, said her husband "still communicates with me."

She said Pinette squeezes her hand, shakes his head and has indicated that "he wants to go home."

That is proof enough to her that he's not terminally ill.

"There's a lot of people they say that about, and it's not true," she said. "They've been after me since July to put him down."

Robert Wilkins, a Maitland attorney whose practice includes living wills, said Alice Pinette is fighting an uphill battle.

"You should be able to control your own destiny and a surrogate shouldn't be able to override that," Wilkins said. "It really isn't her prerogative, it seems to me, to disregard that."

Wilkins said Alice Pinette's best hope is if her attorney can successfully argue that the living will is invalid.

Alice Pinette's attorney, William E. Ruffier, could not be reached for comment Wednesday.

Malley, the Aging With Dignity president, said the case may help others avoid this situation by talking about living wills and the responsibilities of the surrogate before it's too late.

The best person to be someone's surrogate, for instance, might not be his or her spouse, Malley said.

"It's a difficult situation," Malley said. "But it can be avoided with other families."

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November 16, 2004

Dying to Live

Major new series on organ tranplant issues. Not to be missed. - Art Caplan

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Illinois is Coming for the Stem Cell Pot, Too

While the national press continues to speculate on what President Bush will do if anything with respect to modifying his 'ban' on Federal funds for embryonic stem cell research the reality is that the battle is for all intents and purposes over. The only issue remaining is which states will follow California and either permit or fund stem cell research. Illinois looks like it is very close to being the next state to work around the Federal ban. - Art Caplan

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November 02, 2004

The Kindness Deficit

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Embryonic Stem Cell Research Legal Now in Spain

Incredibly, even Spain is allowing some forms of ESR. This shows just how hollow and illogical the ban that the President has imposed on federal funding and the anti-ESR arguments of the President's Council truly are. - Art Caplan

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November 01, 2004

The Ever-Increasing Misuse of Science UPDATED

Chris Mooney's great piece on the role of pseudoscience ideology in the discussion of scientific problems is just out in Columbia Journalism Review. Mooney highlights several particularly eggregious cases in which "moral seriousness" (the new Bush/Kass pseudonym for "neocon-friendliness") trumps rigorous science, e.g. the abortion/breast cancer link. Simultaneously, Art Caplan saw this piece in New York Review of Books on the same book that Mooney is discussing. NYRB also discussed the Union of Concerned Scientists' own manuscript on the same phenomenon.

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October 26, 2004

A Venter and Collins...PLAY

NPR did a story yesterday on a new play about Venter and Collins: "The Sequence." Seems kind of interesting; they made a specific note that the playwright really incorporates technical science into the play rather than glossing over the actual specifics. Evidently, the actor playing Venter actually explains the shotgun sequencing technique. The play is in LA (in readings). - Art Caplan

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October 25, 2004

organs.eBay.com (UPDATED AGAIN)

St. Luke's (Denver) ethics committee tried to stop the transplant of a kidney from one man, who paid $290 to post his profile on the Internet at a new website called MatchingDonors.com, to another. In a "compassionate exception" the hospital decided that this was an appropriate thing to do just this once, before they debate things. Precedent doesn't seem to be an issue for them. And the CEO of the hospital took great pains to say that it is not endorsing the website. Mr. Smitty, the donor, was to be paid $5,000 for his kidney ... I mean ... for his travel expenses. UPDATE: After innumerable stories reported on the phenomenon, hospital officials decided to cancel the transplant. Interestingly, George Annas uses the case as a (brilliant) opportunity to demonstrate that we would not have problems like this if organ procurement were both a higher priority and better executed. UPDATE2: Rocky Mountain News' piece is just out and interesting. Art Caplan is interviewed on it at Medscape. UPDATE3: A shakedown for life? UPDATE4: USA Today begins the spinning of the implications of the matchingdonors saga.

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October 21, 2004

Caplan & NYT on Flu Shot "Public Health Disaster"

From the MSNBC column. Chris Mooney posts the New York Times review of the facts about the whole flu vaccine problem, which is also must-reading.

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October 07, 2004

Pew Poll Out Today on Stem Cell Opinion

Pretty sophisticated polling data about changes in public opinion about politics and stem cells was released from Pew - this will figure in the next Presidential debate for sure. This from A.Caplan.

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October 06, 2004

MSNBC - Stem-cell research a pawn in election politics

Art Caplan's MSNBC.com editorial on stem cell research is easily the clearest defense of hES research during the election cycle, and has already caused a huge stir among Bush supporters and campaign staff.

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