Diane Coleman, Fierce Foe of the Right-to-Die Movement, (1953-2024)

 A courageous, long-lived disability-rights activist who made an eloquent case against medical aid in dying has died.

Diane Coleman, Fierce Foe of the Right-to-Die Movement, Dies at 71
Her fight for disability rights included founding a group called Not Dead Yet, which protested the work of Dr. Jack Kevorkian and others.   By Clay Risen

"At the core of her critique was the argument that the idea of a “right to die” was evidence of how little society valued people like her and a warning that the health care system was broken.

“It is already possible in some states for impoverished disabled, elderly and chronically ill people to get assistance to die,” she told the House Judiciary Committee in 1996, “but impossible for them to get shoes, eyeglasses and tooth repair.”

"Not Dead Yet showed up at Princeton University in 1999 after the university announced the hiring of Peter Singer, an Australian philosopher who had argued for voluntary euthanasia for people with disabilities.

...

“It’s the ultimate form of discrimination to offer people with disabilities help to die,” she told The New York Times in 2011, “without having offered real options to live.”

The right to contraception is open to question again in the U.S.

 Here's a paper in the J. of Women's health that brings us up to date on contraception law in the U.S.

The Right to Contraception Act: A Present-Day Imperative, by Eli Y. Adashi, Daniel P. O’Mahony, and I. Glenn Cohen, Journal of Women's Health, published online Dec 2024

"For nearly 60 years, the right to contraception was deemed a constitutional right secure by dint of the landmark 1965 U.S. Supreme Court decision in Griswold v. Connecticut.1 The court found unconstitutional a Connecticut law declaring that “[a]ny person who uses any drug, medicinal article or instrument for the purpose of preventing conception shall be fined not less than fifty dollars or imprisoned not less than sixty days nor more than one year or be both fined and imprisoned,” as well as aiding and abetting that act, as applied to a physician and professor who “gave information, instruction, and medical advice to married persons as to the means of preventing conception.”1 In so doing, the U.S. Supreme Court affirmed the protection afforded by the U.S. Constitution to the “right to marital privacy” and thus to the liberty of married couples to deploy contraceptives absent governmental restriction.1 Seven years later, in Eisenstadt v. Baird, the U.S. Supreme Court extended the constitutional protections of Griswold v. Connecticut to unmarried couples.2
 

"More recently, however, in 2022, doubts have arisen as to the durability of the Griswold v. Connecticut precedent. Specifically, in his concurring opinion in Dobbs v. Jackson Women’s Health Organization, Justice Clarence Thomas urged that “in future cases, we should reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence, and Obergefell.”3 It is with an eye to protecting against potential reversal of the right to use contraceptives, especially those viewed by some antiabortion advocates as abortifacients, that congressional Democrats saw to the introduction of the Right to Contraception Act.4,5

...

"All indications are that the Right to Contraception Act is unlikely to advance in the current divided Congress. While some states saw to the establishment of legal or constitutional measures with an eye toward protecting the right to contraception, the trend was hardly uniform. A relevant health care bill in Missouri remains unenacted.7 Uniform Republican opposition to the right to contraception has been underway for some time in Arizona as well.7 Comparable legislation proposed in the Democratic-controlled Virginia legislature by Sen. Ghazala Hashmi (D-Richmond) and Del. Cia Price (D-Newport News) was vetoed by Governor Glenn A. Youngkin.7 A house divided has yet to reunite in the spirit of Griswold v. Connecticut."

The year in passings

 More reminders of mortality.

Friday, March 8, 2024 Dr. Guy Alexandre (1934-2024), gave birth to brain death in deceased organ transplantation

 

Wednesday, March 27, 2024 Danny Kahneman (1934-2024)

          Tuesday, July 30, 2024 Danny Kahneman, remembered by Stanford's Center for Advanced Study in the Behavioral Sciences

 

Saturday, May 11, 2024 Jim Simons (1938-2024)

        Sunday, August 4, 2024 Remembering Jim Simons

 

 Sunday, May 12, 2024 Richard Slayman: first recipient of pig kidney transplant dies after two months. (RIP)

 

Tuesday, June 11, 2024 Frans de Waal (1948-2024)

 

Thursday, July 4, 2024 YingHua He 何 英华 has died.

 

Sunday, November 24, 2024 A medically aided death in New Jersey: Pat Koch Thaler

 

and a reminder of Ken Arrow's passing in 2017, Saturday, December 21, 2024 KENNETH ARROW’S LAST THEOREM by Paul Milgrom

Should big Tobacco fund (and program) continuing medical education?

 Should physicians learn about tobacco from the source?

The Tobacco Industry Has No Business Funding Continuing Medical Education, by Robert K. Jackler, MD1,2; Pamela M. Ling, MD, MPH3,4, JAMA. 2024; doi:10.1001/jama.2024.9241 

"Recently, the for-profit medical media company Medscape promoted a series of continuing medical education (CME) courses (see the Supplement) funded by a grant from tobacco company Philip Morris International (PMI).1 These activities were certified (see the Supplement) by the Accreditation Council for Continuing Medical Education (ACCME) along with other health care professional education organizations (American Nurses Credentialing Center, Interprofessional Continuing Education, Accreditation Council for Pharmacy Education, American Board of Internal Medicine). As cigarette sales decline, PMI is promoting “harm reduction” nicotine products. This superficially appealing slogan thinly disguises PMI’s campaign to promote company brands designed to sustain nicotine addiction among people who smoke and entice youth who do not smoke to adopt new nicotine products.

...

"The tobacco industry has a long history of undermining science to promote its products, the leading cause of preventable disease and premature death in the US, indicating inherently unresolvable conflicts incompatible with education of clinicians or sponsorship of certified CME. PMI’s hypocrisy in promoting a harm reduction agenda is highlighted by its aggressive marketing of Marlboro, the world’s leading cigarette brand, including campaigns manifestly targeting youth."

...

"Rhino horns are a renewable resource." Would a legal market help save endangered rhinoceroses?

 Right now it is illegal to buy or cell rhino horn, to protect endangered rhinoceroses from poachers who kill them.  But could a legal, tightly regulated market work better? It's controversial...

From Science:

Protect white rhinos by legalizing horn trade  by Martin Wikelsk  Science
10 Oct 2024, Vol 386, Issue 6718, p. 157, DOI: 10.1126/science.adq5925

 "Rhino horn is a renewable resource that grows like fingernails. To protect white rhino populations effectively, the international trade of rhino horn should be legalized and carefully monitored, including the tracking of each sample sold. Legal trade—the preferred option of horn consumers (3)—will derail international trafficking syndicates and enable essential private rhino guardianship. Legalized trade provides the best chance for the future of white rhino populations ."

 

 

And here's a companion story from the Guardian:

‘We have to change our attitude’: wildlife expert says rhino horn trade must be legalised
Call for illicit market to be taken out of hands of criminals as numbers continue to fall drastically due to poaching  by Robin McKie 

"International trade in rhino horns should be legalised, a leading wildlife expert has urged.

...

“A few years ago, I was very much against this idea but now looking at the grim situation we are in I believe we have to change our attitude to the issue of trade in rhino horn,” said Wikelski, of the Max Planck Institute of Animal Behaviour in Germany.

“International crime syndicates have overcome every countermeasure that conservationists have mounted to defend rhinos from poachers. The result has been a drastic drop in numbers of animals. By legalising trade in rhino horn we can take back control of the market and halt the loss.” 

"Wikelski’s idea would be to remove the horn and allow a new one to grow while selling the horn to make money. This could be used to fund protection for the rhino. At present, removed horn is stored in secure vaults.

"However, the proposal to use stocks to create a legitimate trade in rhino horn has triggered worried responses from many conservationists, who reject the idea that such a scheme would save the rhino from the attention of poachers. 

...

“In addition, a legal rhino horn market could increase demand, provide opportunities for money laundering, and complicate law enforcement’s ability to distinguish legal sources from illegal sources,” Rascha Nuijten, director of Future For Nature Foundation, wrote in a response to Wikelski’s arguments that was also published in Science."

Pardon me: JAMA Network Statement on Potentially Offensive Content

 JAMA asks your pardon. (I don't know when they started including this statement, but I just noticed it...)

JAMA Network Statement on Potentially Offensive Content
This journal's previously published content may include language, information, or terms that are offensive, insensitive, or unethical and may reflect attitudes, biases, or conventions that were deemed acceptable at the original time of publication. The JAMA Network regrets any offense or harm caused by any previous publication with potentially offensive content or language, which do not reflect the current core values of the JAMA Network journals. The JAMA Network stands against all forms of racism and discrimination. In support of this commitment, the journals are actively addressing these and related concerns of diversity, equity, and inclusion.

Sports gambling presents problems for gamblers, athletes, and sports

 Sports betting has some potentially dire implications both for betters and for athletes and sports. Gamblers can find in-app gambling while the game is going on addictive."Prop" bets on the performance of particular athletes during the game, can also subject athletes to pressures that may be at odds with their incentives arising simply from the rules of the game. And this may open up sports to gambling and point-shaving scandals that have been vigorously suppressed in the past.

Here's a variety of headlines (in sufficient number that I won't summarize the accompanying stories, but you can click through to see them).

The Guardian:

‘A serious disease’: Congress weighs federal gambling crackdown amid growing concerns
With sports betting now legal in 38 states, experts worry that gambling addiction is on the rise  by Callum Jones 

NPR:

The president of the NCAA calls for a ban on 'prop bets' in college sports,  by Becky Sullivan
Becky Sullivan

The Atlantic:

Legalizing Sports Gambling Was a Huge Mistake. The evidence is convincing: The betting industry is ruining lives.  By Charles Fain Lehman

Paul Krugman's substack:

America the Addicted. Gambling — on sports, stocks and crypto — is the new opioids.  by Paul Krugman

Regulating emerging technologies

 Here's a recent RAND report, on the current diverse attempts to regulate emerging biotechnologies, focusing on organoids,* embryos, genes, and neurotechnology:

State-of-play and future trends on the development of oversight frameworks for emerging technologies
Part 2: Technology oversight report, by Sana Zakaria, Ioli Howard, Eva Coringrato, Anna Louise Todsen, Imogen Wade, Devika Kapoor, Alec Ross, Katarina Pisani, Chryssa Politi, Martin Szomszor, Salil Gunashekar, Dec 16, 2024 

"This RAND Europe study commissioned by Wellcome explores the current and future oversight frameworks for emerging technologies, focusing on organoids, human embryology, engineering biology and neurotechnology. 

...

"Key Findings:

Lack of specific frameworks for organoids

• There is an absence of specific regulatory frameworks for organoids, with current oversight relying on broader stem cell and biomedical regulations. Emerging mechanisms, such as Japan's consent-to-govern approach, are gaining traction to address ethical challenges, particularly around donor consent and privacy concerns.

Challenges in human embryology oversight

• Existing frameworks, like the UK's Human Fertilisation and Embryology Act, are outdated and not designed for new technologies such as AI in embryo selection. Disparate national regulations complicate international collaboration, and there is a need for frameworks to adapt to scientific advancements and public interest.

Fragmented oversight in engineering biology

• The global landscape features disparate oversight mechanisms, creating obstacles for international collaboration. There is a need for alignment across diverse applications and jurisdictions, with potential solutions including cross-sector collaboration and international biosecurity measures.

Neurotechnology oversight gaps

• Current regulations do not address the unique challenges posed by neurotechnologies, such as data privacy and dual-use concerns. Ethical guidelines, like Chile's neurorights, offer proactive models, but there is a need for stronger post-market surveillance and international guidelines to prevent misuse.

Priority considerations for future oversight

• The report outlines eight priority considerations, including developing interconnected oversight networks, ensuring equity, harmonizing international governance, fostering public involvement, and integrating adaptive and anticipatory strategies into oversight frameworks."
  

#########

* "Organoids are three-dimensional structures that are derived from stem cells and are capable of self-organising into structures that mimic the key functional, structural and biological complexity of an organ."

Kidney exchange chain at Ohio State--a gift transforms 20 lives

 Here's a recent big kidney exchange chain, begun by a nondirected donor, involving patient-donor pairs all at OSU's medical center

The Columbus Dispatch has the story. (If I had written the headline, it would have said "transforming 20 lives," since many of the donors I've met have also been transformed.)

Ohio State Wexner sets record-breaking kidney 'donation chain,' transforming 10 lives   by Samantha Hendrickson

"On Dec. 13, Samantha Fledderjohann donated one of her kidneys to a stranger in need, and in the process, transformed 10 lives.

The 46-year-old was the first of a record-breaking "chain" of 20 surgeries over a two-day period at the Ohio State University Wexner Medical Center Comprehensive Transplant Center, both to remove and transplant kidneys from 10 living donors to 10 recipients. That means 10 people now have another chance to live more of their lives better and longer with a healthy kidney.

...

"The transplant swap begins with an "altruistic non-directed" donor like Fledderjohann, who saw a need for more kidney donors, and felt an internal pull to donate even without someone in mind

...

"The "chain reaction" continued, thanks to individuals like Carnahan staying on OSU's donor list despite not being a match for a loved one, instead extending that offer to a stranger in need.

...

"According to the Organ Procurement and Transplantation Network, there are 104,840 people on the transplant waitlist and 90,506 need a kidney in the United States, and 2,079 of them live in Ohio. Ohio State’s transplant center has performed more than 8,500 kidney transplants since 1967."