sábado, 29 de abril de 2017

BioEdge: Belgian Catholic psychiatric hospitals ‘adjust’ their view of euthanasia

BioEdge: Belgian Catholic psychiatric hospitals ‘adjust’ their view of euthanasia

Saturday, April 29, 2017



Belgian Catholic psychiatric hospitals ‘adjust’ their view of euthanasia
     


One of the last substantial barriers to increasing the number of euthanasia cases for non-terminally-ill psychiatric patients in Belgium seems to have crumbled.

A religious order in the Catholic Church, the Brothers of Charity, is responsible for a large proportion of beds for psychiatric patients in Belgium – about 5,000 of them. The international head of the order, Brother René Stockman, is a Belgian who has been one of the leading opponents of euthanasia in recent years.

Nonetheless, in a surprise move this week, the board controlling the institutions of the Brothers of Charity announced that from now on, it will allow euthanasia to take place in their psychiatric hospitals.

In a statement posted on their website the Brothers of Charity explain the policy shift. “We take seriously unbearable and hopeless suffering and patients’ request for euthanasia. On the other hand, we do want to protect lives and ensure that euthanasia is performed only if there is no more possibility to provide a reasonable perspective to treat the patient.”

Euthanasia for psychiatric patients has already happened dozens of times in Belgium. But from now on it will probably be easier for people suffering from schizophrenia, personality
disorders, depression, autism, or loneliness to access it. In fact, it will be hard to find an institution in Belgium where euthanasia is not being offered as an option.

Brother Stockman was stunned. “We deplore this new vision,” he told the media.

Nursing homes and hospitals opposing euthanasia have been under even more pressure after a court fined a Catholic nursing home a total of €6,000 last year for blocking a resident from accessing euthanasia.

However, Stockman felt that this was not an open and shut case. “I am confident that we have the right to refuse euthanasia,” Stockman told De Morgen. “We want to take seriously the needs of the patients, but the inviolability of life is for us an absolute. We cannot accept that euthanasia is carried out within the walls of our institutions. “

The leading figure in Belgian euthanasia, Dr Wim Distelmans, was delighted. Fifteen years after legalisation, he wrote in a newspaper op-ed, the Brothers of Charity have finally admitted that they had excluded the democratically approved policy of euthanasia from their institutions and forbidden doctors to follow their conscience and professional judgement.

Rubbing it in further, a member of the Belgian Parliament, Jean-Jacques De Gucht, summed up the situation: “the last relics of the paternalism of the shepherd have been replaced by individual self-determination”.

The chairman of the board, Raf De Rycke, an economist who has worked with the Brothers of Charity for years, denied that the ethos of their hospitals had changed “We have not made a 180 degree turn,” he told De Morgen newspaper. “It is not that we used to be against euthanasia and now suddenly are for it. This is consistent with our existing criteria. We are making both possible routes for our patients: both a pro-life perspective and euthanasia.”

Although this seems odd for a Catholic group, especially when the Pope has been outspoken in denouncing euthanasia, De Rycke believes that the inspiration of the Belgian Brothers of Charity fundamentally remains the same. “We start from the same basic values: the inviolability of life is an important foundation, but for us it is not absolute. This is where we are on a different wavelength from Rome.”


Bioedge

Saturday, April 29, 2017

The Belgian media was abuzz this week with the news that the Catholic hospitals which provide a substantial portion of psychiatric beds will permit euthanasia for non-terminally-ill patients. It is an unprecedented reversal of their stand on end-of-life care.
Supporters of euthanasia, of course, were delighted. “The last relics of the paternalism of the shepherd have been replaced by individual self-determination," said one politician. Opponents, however, were puzzled and alarmed. Fifteen years after Belgium legalised euthanasia, it has become hard to find a hospital where is it not being practised. Read about it below. 


Michael Cook
Editor
BioEdge

NEWS THIS WEEK
 
by Michael Cook | Apr 29, 2017
From now on it will be difficult to find a psychiatric hospital where euthanasia is not offered
 
by Michael Cook | Apr 29, 2017
US researchers are close to an artificial womb for extremely premature babies
 
by Michael Cook | Apr 29, 2017
Life expectancy has risen steeply
 
by Michael Cook | Apr 29, 2017
Why should they settle for anything less than heterosexual couples?
 
by Michael Cook | Apr 29, 2017
There was no lack of ethical training in the Nazi era
 
by Paul Russell | Apr 27, 2017
Ezekiel Emanuel says that pain is not the the reason people ask doctors to end their lives
 
by Michael Cook | Apr 26, 2017
Ellinor Grimmark has had to move to Norway to find work
BioEdge
Suite 12A, Level 2 | 5 George St | North Strathfield NSW 2137 | Australia
Phone: +61 2 8005 8605
Mobile: 0422-691-615
New Media Foundation | Level 2, 5 George St | North Strathfield NSW 2137 | AUSTRALIA | +61 2 8005 8605 

BioEdge: Recreating the womb for preemies

BioEdge: Recreating the womb for preemies

Saturday, April 29, 2017



Recreating the womb for preemies
     


Researchers have moved a step closer to ectogenesis – brewing babies in an artificial womb. A team at the Center for Fetal Research in Philadelphia have developed a womb-like environment in which premature lambs have already lived at least four weeks before being delivered.

A similar system for babies is at least two years off, but if it is successful, it would give the tiniest newborns a precious few weeks to develop their lungs and other organs.

The fetal lambs grow in a temperature-controlled, near-sterile environment, breathing amniotic fluid as they normally do in the womb, their hearts pumping blood through their umbilical cord into a gas exchange machine outside the bag.

Of the one in ten US births that are premature (younger than 37 weeks gestational age), about 30,000 per year are critically preterm -- younger than 26 weeks. Extreme prematurity is the nation's leading cause of infant mortality and morbidity, accounting for one-third of all infant deaths and one-half of all cases of cerebral palsy attributed to prematurity.

Neonatal care practices have improved overall survival of premature infants and have pushed the limits of viability to 22 to 23 weeks of gestation. At that age an infant weighs below 600 grams -- little more than a pound -- and has a 30 to 50% chance of survival. But this survival comes at a high price in quality of life, with a 90% risk of morbidity, from chronic lung disease or other complications of organ immaturity. Survivors face lifelong disability.

Previous researchers have investigated versions of an artificial placenta in animal models, but pumpless systems have achieved a maximum duration of 60 hours, and the animals have sustained brain damage. The new system, in contrast, has operated up to 670 hours (28 days) with some animals, which remained healthy. The lambs showed normal breathing and swallowing, opened their eyes, grew wool, became more active, and had normal growth, neurological function and organ maturation.

The team does not aim to extend viability to an earlier period than the current mark of 23 weeks. Before that point, limitations of physical size and physiologic functioning would impose unacceptably high risks.

The development of an artificial womb will inevitably be linked to the abortion debate. Reasoning that babies could survive after 20 weeks, some legislators might try to ban abortions after 20 weeks of gestation. And if it became a viable alternative, the meaning of abortion changes. As Peter Singer wrote with Deane Wells in 1985 in The Reproductive Revolution, “Freedom to choose what is to happen to one’s body is one thing; freedom to insist on the death of a being that is capable of living outside of one’s body is another.”


Bioedge

Saturday, April 29, 2017

The Belgian media was abuzz this week with the news that the Catholic hospitals which provide a substantial portion of psychiatric beds will permit euthanasia for non-terminally-ill patients. It is an unprecedented reversal of their stand on end-of-life care.
Supporters of euthanasia, of course, were delighted. “The last relics of the paternalism of the shepherd have been replaced by individual self-determination," said one politician. Opponents, however, were puzzled and alarmed. Fifteen years after Belgium legalised euthanasia, it has become hard to find a hospital where is it not being practised. Read about it below. 


Michael Cook

Editor

BioEdge

NEWS THIS WEEK
by Michael Cook | Apr 29, 2017
From now on it will be difficult to find a psychiatric hospital where euthanasia is not offered

by Michael Cook | Apr 29, 2017
US researchers are close to an artificial womb for extremely premature babies

by Michael Cook | Apr 29, 2017
Life expectancy has risen steeply

by Michael Cook | Apr 29, 2017
Why should they settle for anything less than heterosexual couples?

by Michael Cook | Apr 29, 2017
There was no lack of ethical training in the Nazi era

by Paul Russell | Apr 27, 2017
Ezekiel Emanuel says that pain is not the the reason people ask doctors to end their lives

by Michael Cook | Apr 26, 2017
Ellinor Grimmark has had to move to Norway to find work
BioEdge
Suite 12A, Level 2 | 5 George St | North Strathfield NSW 2137 | Australia
Phone: +61 2 8005 8605
Mobile: 0422-691-615
New Media Foundation | Level 2, 5 George St | North Strathfield NSW 2137 | AUSTRALIA | +61 2 8005 8605 

BioEdge: Recreating the womb for preemies

BioEdge: Counting Down syndrome Americans

BioEdge: Counting Down syndrome Americans

Saturday, April 29, 2017



Counting Down syndrome Americans
     


Down syndrome is the leading cause of intellectual disability in the United States. But how many Americans have Down syndrome? There is no clear answer to that question, as the US does not record this information systematically.

Brian Skotko, of Harvard Medical School, and colleagues have done a statistical analysis of Down syndrome Americans in the journal Genetics in Medicine and come up with some very interesting statistics.

The number has quadrupled in the last 60 years because people with DS have a much higher life expectancy.

“We estimate that the number of people with DS living in the United States has grown from 49,923 in 1950 to 206,366 in 2010, which includes 138,019 non-Hispanic whites, 27,141 non-Hispanic blacks, 32,933 Hispanics, 6,747 Asians/Pacific Islanders, and 1,527 American Indians/American Natives. Population prevalence of DS in the United States, as of 2010, was estimated at 6.7 per 10,000 inhabitants (or 1 in 1,499).”
The impact of abortion is substantial:

“In the absence of elective terminations, these predicted numbers would have been 245,981, including 167,992 NHW, 31,836 NHB, 33,620 HIS, 10,716 AS/PI, and 1,817 AI/AN. This corresponds with reductions in population prevalence related to elective terminations, which are estimated to be 19% for all people with DS, 19% for NHW, 16% for NHB, 13% for HIS, 47% for AS/PI, and 16% for AI/AN.”
The impact of abortion is even higher in the UK:

“In the United States, in 1995, there were an estimated 8% fewer people with DS than there would have been without elective terminations, and this value increased to approximately 19% in 2010. In the United Kingdom, the corresponding estimated values were 10 and 26%, respectively.”
Down syndrome people are living much longer. In the US, Down syndrome is no longer a childhood disability:

“According to our model, the mean and median age of death also increased, and even more rapidly, from an estimated 3 and 0 years, respectively, in 1950 to 12 and 2 years in 1970 to 35 and 38 years in 1990 to 48 and 54 years in 2010.”


Bioedge

Saturday, April 29, 2017

The Belgian media was abuzz this week with the news that the Catholic hospitals which provide a substantial portion of psychiatric beds will permit euthanasia for non-terminally-ill patients. It is an unprecedented reversal of their stand on end-of-life care.
Supporters of euthanasia, of course, were delighted. “The last relics of the paternalism of the shepherd have been replaced by individual self-determination," said one politician. Opponents, however, were puzzled and alarmed. Fifteen years after Belgium legalised euthanasia, it has become hard to find a hospital where is it not being practised. Read about it below. 


Michael Cook
Editor
BioEdge

NEWS THIS WEEK
 
by Michael Cook | Apr 29, 2017
From now on it will be difficult to find a psychiatric hospital where euthanasia is not offered
 
by Michael Cook | Apr 29, 2017
US researchers are close to an artificial womb for extremely premature babies
 
by Michael Cook | Apr 29, 2017
Life expectancy has risen steeply
 
by Michael Cook | Apr 29, 2017
Why should they settle for anything less than heterosexual couples?
 
by Michael Cook | Apr 29, 2017
There was no lack of ethical training in the Nazi era
 
by Paul Russell | Apr 27, 2017
Ezekiel Emanuel says that pain is not the the reason people ask doctors to end their lives
 
by Michael Cook | Apr 26, 2017
Ellinor Grimmark has had to move to Norway to find work
BioEdge
Suite 12A, Level 2 | 5 George St | North Strathfield NSW 2137 | Australia
Phone: +61 2 8005 8605
Mobile: 0422-691-615
New Media Foundation | Level 2, 5 George St | North Strathfield NSW 2137 | AUSTRALIA | +61 2 8005 8605 

BioEdge: Do LGBT parents have a right to a full genetic relationship?

BioEdge: Do LGBT parents have a right to a full genetic relationship?

Saturday, April 29, 2017



Do LGBT parents have a right to a full genetic relationship?
     


The possibility of creating synthetic gametes (eggs from male stem cells, sperm from female stem cells) raises some interesting ethical issues. LGBT couples currently depend upon a third party to contribute opposite-sex gametes. This means that their children will never be fully genetically related and that their relationship depends on outside intervention.

But even for LGBT couples, a genetic relationship with a child is the “cultural gold standard” for reproduction, Timothy Murphy points out in the Journal of Medical Ethics. If this is the case, then LBGT couples should be able to have it as well.

After all, if that kind of relatedness is socioculturally and psychologically important enough to override searching questions about the ethics of fertility medicine in general, then it would seem to be important enough to theorise in relation to same-sex couples' inability to secure it for their families.
Settling for less than the gold standard is inequitable, Murphy argues. In the near future, LGBT couples won’t have to. They will no longer be “inherently infertile”. Rather, they will only be “situationally infertile” in relation to each other – something which can be solved with the help of reproductive technology.

Perhaps LGBT couples, he argues, should even be prioritised in research to help infertile couples conceive and have children:

 it's unclear why—as a matter of moral theory—same-sex couples should have to ‘settle for’ anything less than the same shared genetics in their children as is available to opposite-sex couples. It's plausible in some ways that opposite-sex couples are owed research priority towards securing shared genetics in their children simply as a matter of access and equity and also—more searchingly—as a matter of compensatory justice, for past road blocks imposed against having children. As it often does, biology might stand in the way of human hopes, but then again we won't know for sure unless we test it against our moral ambitions.


Bioedge

Saturday, April 29, 2017

The Belgian media was abuzz this week with the news that the Catholic hospitals which provide a substantial portion of psychiatric beds will permit euthanasia for non-terminally-ill patients. It is an unprecedented reversal of their stand on end-of-life care.
Supporters of euthanasia, of course, were delighted. “The last relics of the paternalism of the shepherd have been replaced by individual self-determination," said one politician. Opponents, however, were puzzled and alarmed. Fifteen years after Belgium legalised euthanasia, it has become hard to find a hospital where is it not being practised. Read about it below. 


Michael Cook
Editor
BioEdge

NEWS THIS WEEK
 
by Michael Cook | Apr 29, 2017
From now on it will be difficult to find a psychiatric hospital where euthanasia is not offered
 
by Michael Cook | Apr 29, 2017
US researchers are close to an artificial womb for extremely premature babies
 
by Michael Cook | Apr 29, 2017
Life expectancy has risen steeply
 
by Michael Cook | Apr 29, 2017
Why should they settle for anything less than heterosexual couples?
 
by Michael Cook | Apr 29, 2017
There was no lack of ethical training in the Nazi era
 
by Paul Russell | Apr 27, 2017
Ezekiel Emanuel says that pain is not the the reason people ask doctors to end their lives
 
by Michael Cook | Apr 26, 2017
Ellinor Grimmark has had to move to Norway to find work
BioEdge
Suite 12A, Level 2 | 5 George St | North Strathfield NSW 2137 | Australia
Phone: +61 2 8005 8605
Mobile: 0422-691-615
New Media Foundation | Level 2, 5 George St | North Strathfield NSW 2137 | AUSTRALIA | +61 2 8005 8605 

BioEdge: Where did Nazi doctors learn their ethics? From a textbook

BioEdge: Where did Nazi doctors learn their ethics? From a textbook

Saturday, April 29, 2017



Where did Nazi doctors learn their ethics? From a textbook
     
Karl Brandt, one of the defendants in the "doctors' trial"   
German medicine under Hitler resulted in so many horrors – eugenics, human experimentation, forced sterilization, involuntary euthanasia, mass murder – that there is a temptation to say that “Nazi doctors had no ethics”.

However, according to an article in the Annals of Internal Medicine by Florian Bruns and Tessa Chelouche (from Germany and Israel respectively), this was not the case at all. In fact, medical ethics was an important part of the medical curriculum between 1939 and 1945. Nazi officials established lectureships in every medical school in Germany for a subject called “Medical Law and Professional Studies” (MLPS).

There was no lack of ethics. It was just the wrong kind of ethics.

The focus of their study is a Rudolf Ramm, a German general practitioner who became the pre-eminent purveyor of Nazi medical ethics. He was editor-in-chief of the journal of the German Medical Association, Deutsches Ärzteblatt, and published a textbook, Ärztliche Rechts- Standeskunde (Medical Law and Health). The textbook sold out within a year. Ramm did not survive to be a defendant in the famous “doctors trial” in 1947. He was tried and shot by the Soviets in August 1945. His book was banned a few months later.

What did medical students learn during the Nazi era? According to Bruns and Chelouche, it was “the unequal worth of human beings, the moral imperative of preserving a pure Aryan people, the authoritarian role of the physician, the individual's obligation to stay healthy, and the priority of public health over individual-patient care”.

Ramm taught his students that:

Nazism brought the “reinstatement of a high level of professional ethics.” He welcomed the fact that “the profession had been extensively cleansed of politically unreliable elements foreign to our race” (that is, German-Jewish physicians).

Ramm saw 3 distinct dangers facing the German people: “racial miscegenation,” a declining birthrate, and the “growth of inferior elements” in the German population. He traced the origins of these perceived dangers to a “disregard for the laws of nature,” caused by church dogma and socialist ideologies. Ramm denounced any form of health care for “hereditarily inferior” people and asserted that every person in Nazi Germany had a moral duty to stay healthy.

After this brief survey, Bruns and Chelouche argue that today’s doctors must resist the temptation to believe that they are much more ethical than “the bad old days”. A commitment to ethics can wax and wane. In fact, in the Weimar Republic, the ethical standards for human experimentation were “remarkably advanced”. The Nazis did not even bother to repeal them, but simply redefined the subject of experimentation to exclude concentration camp inmates. They conclude by warning that:

It is important to realize that ethical reasoning can be corrupted and that teaching ethics is, in itself, no guarantee of the moral integrity of physicians. The history of bioethics reveals that the professional ethos of physicians is more fragile than we might believe because it depends on the moral zeitgeist and politico-social circumstances, both of which are subject to change ...


Bioedge

Saturday, April 29, 2017

The Belgian media was abuzz this week with the news that the Catholic hospitals which provide a substantial portion of psychiatric beds will permit euthanasia for non-terminally-ill patients. It is an unprecedented reversal of their stand on end-of-life care.
Supporters of euthanasia, of course, were delighted. “The last relics of the paternalism of the shepherd have been replaced by individual self-determination," said one politician. Opponents, however, were puzzled and alarmed. Fifteen years after Belgium legalised euthanasia, it has become hard to find a hospital where is it not being practised. Read about it below. 


Michael Cook
Editor
BioEdge

NEWS THIS WEEK
 
by Michael Cook | Apr 29, 2017
From now on it will be difficult to find a psychiatric hospital where euthanasia is not offered
 
by Michael Cook | Apr 29, 2017
US researchers are close to an artificial womb for extremely premature babies
 
by Michael Cook | Apr 29, 2017
Life expectancy has risen steeply
 
by Michael Cook | Apr 29, 2017
Why should they settle for anything less than heterosexual couples?
 
by Michael Cook | Apr 29, 2017
There was no lack of ethical training in the Nazi era
 
by Paul Russell | Apr 27, 2017
Ezekiel Emanuel says that pain is not the the reason people ask doctors to end their lives
 
by Michael Cook | Apr 26, 2017
Ellinor Grimmark has had to move to Norway to find work
BioEdge
Suite 12A, Level 2 | 5 George St | North Strathfield NSW 2137 | Australia
Phone: +61 2 8005 8605
Mobile: 0422-691-615
New Media Foundation | Level 2, 5 George St | North Strathfield NSW 2137 | AUSTRALIA | +61 2 8005 8605