Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label biomedical research. Show all posts
Showing posts with label biomedical research. Show all posts

Wednesday, February 20, 2019

Precision medicine’s rosy predictions haven’t come true. We need fewer promises and more debate

Michael Joyner and Nigel Paneth
STATnews.com
Originally published February 7, 2019

Here is an excerpt:

While we are occasionally told that we are Luddites or nihilists (generally without much debate of the merits of our position), the most frequent communications we receive have been along the lines of “I agree with you, but can’t speak up publicly for fear of losing my grants, alienating powerful people, or upsetting my dean.” This atmosphere cannot be good for the culture of science.

We are calling for an open debate, in all centers of biomedical research, about the best way forward, and about whether precision medicine is really the most promising avenue for progress. It is time for precision medicine supporters to engage in debate — to go beyond asserting the truism that all individuals are unique, and that the increase in the volume of health data and measurements combined with the decline in the cost of studying the genome constitute sufficient argument for the adoption of the precision medicine program.

Enthusiasts of precision medicine must stop evading the tough questions we raise. The two of us have learned enormously from the free and open exchange of ideas among our small band of dissenters, and we look forward to a vigorous debate engaging an ever-larger fraction of the scientific community.

The info is here.

Monday, April 24, 2017

How Flawed Science Is Undermining Good Medicine

Morning Edition
NPR.org
Originally posted April 6, 2017

Here is an excerpt:

A surprising medical finding caught the eye of NPR's veteran science correspondent Richard Harris in 2014. A scientist from the drug company Amgen had reviewed the results of 53 studies that were originally thought to be highly promising — findings likely to lead to important new drugs. But when the Amgen scientist tried to replicate those promising results, in most cases he couldn't.

"He tried to reproduce them all," Harris tells Morning Edition host David Greene. "And of those 53, he found he could only reproduce six."

That was "a real eye-opener," says Harris, whose new book Rigor Mortis: How Sloppy Science Creates Worthless Cures, Crushes Hope, and Wastes Billions explores the ways even some talented scientists go wrong — pushed by tight funding, competition and other constraints to move too quickly and sloppily to produce useful results.

"A lot of what everybody has reported about medical research in the last few years is actually wrong," Harris says. "It seemed right at the time but has not stood up to the test of time."

The impact of weak biomedical research can be especially devastating, Harris learned, as he talked to doctors and patients. And some prominent scientists he interviewed told him they agree that it's time to recognize the dysfunction in the system and fix it.

The article is here.

Saturday, July 16, 2016

Federal panel approves first test of CRISPR editing in humans

By Laurie McGinley
The Washington Post
Originally posted on June 21, 2016

A National Institutes of Health advisory panel on Tuesday approved the first human use of the gene-editing technology CRISPR, for a study designed to target three types of cancer and funded by tech billionaire Sean Parker’s new cancer institute.

The experiment, proposed by researchers at the University of Pennsylvania, would use CRISPR-Cas9 technology to modify patients’ own T cells to make them more effective in attacking melanoma, multiple myeloma and sarcoma.

The federal Recombinant DNA Advisory Committee approved the Penn proposal unanimously, with one member abstaining. The experiment still must be approved by the Food and Drug Administration, which regulates clinical trials.

The article is here.

Wednesday, March 26, 2014

The Fat Drug

By Pagan Kennedy
The New York Times
Originally published March 8, 2014

Here is an excerpt:

Nonetheless, experiments were then being conducted on humans. In the 1950s, a team of scientists fed a steady diet of antibiotics to schoolchildren in Guatemala for more than a year,while Charles H. Carter, a doctor in Florida, tried a similar regimen on mentally disabled kids. Could the children, like the farm animals, grow larger? Yes, they could.

Mr. Jukes summarized Dr. Carter’s research in a monograph on nutrition and antibiotics: “Carter carried out a prolonged investigation of a study of the effects of administering 75 mg of chlortetracycline” — the chemical name for Aureomycin — “twice daily to mentally defective children for periods of up to three years at the Florida Farm Colony. The children were mentally deficient spastic cases and were almost entirely helpless,” he wrote. “The average yearly gain in weight for the supplemented group was 6.5 lb while the control group averaged 1.9 lb in yearly weight gain.”

The entire article is here.

Thursday, November 14, 2013

How medical researchers become morally entangled

By Henry S. Richardson
Oxford University Press Blog
Originally published October 27, 2013

A huge amount of ethical angst swirls around the topic of informed consent. Can lay people who are considering signing up as subjects in a medical study really be made to understand the risks they are facing? Can information about these risks be communicated across cultural and educational gulfs? What degree of informed understanding should we expect subjects to have, anyway? 

Underlying the process of informed consent, though, is a simpler and more fundamental issue. The one-sided focus of the medical-research ethics establishment on preventing harms and abuses has obscured this core function from view. We need to remember why consent is needed for participation in medical research in the first place. It is needed because the researchers need the subjects’ permission to do things that otherwise would be wrong to do. It is wrong to examine and touch people’s naked bodies in the ways researchers need to do, to collect samples of their blood, urine, and feces, and to collect detailed information on their medical histories without getting their permission.

The entire story is here.

Tuesday, November 5, 2013

Mental illness: is chemical imbalance theory a myth?

Torstar News Service
Originally published on October 19, 2013

Here is an excerpt:

Now, neuroscience would attribute such things as depression and psychosis to “chemical imbalances” — specifically to disruptions in the neurotransmitters that allow the brain’s billions upon billions of grey matter cells to speak to one another.

And so mental illnesses became normalized and destigmatized.

And so their treatments, to a huge extent, came off of the couch, out of the asylums and onto pharmacy counters.

And so a $70-billion drug market grew to feed tens of millions worldwide with daily doses of magic bullets — pills that could bring their brain chemistry back into balance.

Trouble is, in the minds of many neuroscientists today, that chemical imbalance theory has turned out to be a myth, with little more scientific or medicinal substance than poetry or song.

The entire article is here.

Thanks to Ned Jenny for this information.

Sunday, November 3, 2013

Epigenetics: How to alter your genes

We’ve long been told our genes are our destiny. But it’s now thought they can be changed by habit, lifestyle, even finances. What does this mean for our children?

By Chris Bell
The Telegraph
Originally published on October 16, 2013

Here is an excerpt:

And yet a quiet scientific revolution is changing that thinking. For it seems you might also be what your mother ate. How much your father drank. And what your grandma smoked. Likewise your own children, too, may be shaped by whether you spend your evenings jogging, worrying about work, or sat on the sofa eating Wotsits. And that nurture, rather than our intractable nature, may determine who we are far more than was ever previously thought.

Epigenetics is a relatively new scientific field; research only began in earnest in the mid Nineties, and has only found traction in the wider scientific community in the last decade or so. And the sources of its data are eclectic, to say the least – stretching from famines in northern Sweden to the 9/11 attacks to the medical notes of Audrey Hepburn.

The entire story is here.

Wednesday, August 21, 2013

The End of Neuro-Nonsense

Is the age of mindless brain research already over?

By Daniel Engber
Slate
Originally published July 29, 2013

Brain-bashing, once an idle pastime of the science commentariat, went mainstream in June. At the beginning of the month, Slate contributor Sally Satel and Scott O. Lilienfeld published Brainwashed: The Seductive Appeal of Mindless Neuroscience, a well-informed attack on the extravagances of “neurocentrist” thought. We’re living in dangerous era, they warn in the book’s introduction. “Naïve media, slick neuroentrepreneurs, and even an occasional overzealous neuroscientist exaggerate the capacity of scans to reveal the contents of our minds, exalt brain physiology as inherently the most valuable level of explanation for understanding behavior, and rush to apply underdeveloped, if dazzling, science for commercial and forensic use.” In the United Kingdom, the neuro-gadfly Raymond Tallis—whose own attack on popular brain science, Aping Mankind, came out in 2011—added to the early-summer beat-down, complaining in the Observer that “studies that locate irreducibly social phenomena … in the function or dysfunction of bits of our brains are conceptually misconceived.”

The entire story is here.

Thanks to Tamler Sommers for this story.

Wednesday, June 26, 2013

Committee supervises ethics of human testing

By Madison Pauly
The Dartmouth
Published on Monday, February 25, 2013

From new cardiology studies to students that go overseas and want to interview people, the Committee for the Protection of Human Subjects answers ethical questions about human research at Dartmouth. The committee is an interdisciplinary group of experts and community members who analyze the risk posed to participants by Dartmouth-affiliated researchers’ studies.

As Dartmouth’s incarnation of a federally-mandated institutional review board, the committee analyzes proposals for research on human subjects from Dartmouth-Hitchcock Medical Center and the Veterans Affairs Medical Center in White River Junction, as well as the College’s graduate and undergraduate departments.

While all studies involving human participants are subject to review by the committee, those that receive funding from sources other than the government must pay a review fee to the committee office.

A division of the Provost’s Office, the committee is financed in part by federal funds allocated to Dartmouth for research. Accordingly, its review process follows federal policies to ensure “respect for persons, beneficence and justice,” according to a Department of Health and Human Services report.

Major areas of ethical concern include the research’s medical relevance, involvement of vulnerable populations, its informed consent process and use of deception, said assistant provost for research Liz Bankert, a member of the committee.

The current federal regulations were last revised in 1991 and often fail to give adequate ethical guidance on modern research questions, said Bankert, who also serves on a national research ethics advisory committee.

The entire story is here.

Thursday, April 26, 2012

A Sharp Rise in Retractions Prompts Calls for Reform

By Carl Zimmer
The New York Times
Originally published April 16, 2012

In the fall of 2010, Dr. Ferric C. Fang made an unsettling discovery. Dr. Fang, who is editor in chief of the journal Infection and Immunity, found that one of his authors had doctored several papers.

It was a new experience for him. “Prior to that time,” he said in an interview, “Infection and Immunity had only retracted nine articles over a 40-year period.”

The journal wound up retracting six of the papers from the author, Naoki Mori of the University of the Ryukyus in Japan. And it soon became clear that Infection and Immunity was hardly the only victim of Dr. Mori’s misconduct. Since then, other scientific journals have retracted two dozen of his papers, according to the watchdog blog Retraction Watch.

Wednesday, April 11, 2012

Can Most Cancer Research Be Trusted?

Addressing the problem of "academic risk" in biomedical research

By Ronald Bailey
reason.com
Originally published April 3, 2012

When a cancer study is published in a prestigious peer-reviewed journal, the implcation is the findings are robust, replicable, and point the way toward eventual treatments. Consequently, researchers scour their colleagues' work for clues about promising avenues to explore. Doctors pore over the pages, dreaming of new therapies coming down the pike. Which makes a new finding that nine out of 10 preclinical peer-reviewed cancer research studies cannot be replicated all the more shocking and discouraging.

Last week, the scientific journal Nature published a disturbing commentary claiming that in the area of preclinical research—which involves experiments done on rodents or cells in petri dishes with the goal of identifying possible targets for new treatments in people—independent researchers doing the same experiment cannot get the same result as reported in the scientific literature.

The entire commentary is here.

Thanks to Rich Ievoli for the story.  He could have been a contender.