Why “Provider” is a Four-letter Word
D. Joy Riley, M.D., M.A. Executive Director
Family and friends of Dr. Robert D. Orr recently gathered in Vermont to mark his passing. Due to previous COVID restrictions, this celebration of his life took place almost a year after his passing. Dr. Orr, a nationally-recognized physician and medical ethicist, was a mentor to many, many physicians and medical students, including this writer. He is sorely missed.
It is fair to say that Dr. Orr despised the term “provider” as an appellation of a physician. He once surprised a colleague of mine who had submitted a paper to him. He told my colleague that ...read more
Who is He and what has he done to our children?
Joyce A. Shelton, Ph.D. Professor of Biology Emerita Trinity International University
Remember He Jiankui? He is the Chinese scientist who used CRISPR technology to edit the CCR5 gene for the HIV receptor in the genomes of human embryos. His goal was to make them HIV resistant. He reported at an international conference in 2018 that two of the edited embryos had resulted in the live births of non-identical twins, Nana and Lulu. There were also reports of a third child born in 2019. His revelations in a public forum provoked moral outrage from the scientific community. Global pressure caused Chinese authorities to suspend ...read more
Life and Choice
Janet Liljestrand, M.D., M.A.
In 1862 Louis Pasteur performed the definitive experiment that proved even the smallest organisms, those only seen under the microscope, derived from other like organisms. (1) Life came from life. Fast forward to 1973, and Justice Blackmun, writing for the majority decision in Roe v. Wade stated “We need not resolve the difficult decision of when life begins”. (2) What was the Justice’s definition of life? The human zygote contains all it needs for cellular division–and thus growth–at the union of a living sperm and living egg. How then has its human life not begun? Yes, in ...read more
Human Dignity — A First Principle
C. Ben Mitchell, Ph.D. Distinguished Fellow The Tennessee Center for Bioethics & Culture
After the horrific human rights abuses of Nazi Germany were revealed at the end of World War II, an international tribunal was held in Nuremberg to try those who were responsible for the Holocaust. Hard on the heels of those Nuremberg Trials (1945-46) followed the United Nations Declaration of Human Rights (1948) which enshrined the notion of human dignity, declaring that “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of ...read more
If Monkeys Could Talk
Joyce A. Shelton, Ph.D. Professor of Biology, Trinity International University Guest Column
Recent news announcements proclaimed, with both excitement and alarm, that Tan and colleagues, scientists from China and the US, had successfully produced human-monkey hybrid embryos. (1, 2) The hybrids (also termed chimeras) were made by injecting human pluripotent stem cells from an induced pluripotent stem cell line into 132 early- stage monkey embryos. Human pluripotent stem cells have the capacity to develop into a range of tissues and cell types which ultimately form all the structures of the human body including the brain and reproductive cells (sperm and egg). (3) In ...read more
Tennessee Legislative Update: Commercial Surrogacy and a Pot of Gold
By D. Joy Riley, M.D., M.A. Executive Director
References to pots of gold usually occur in the month of March, and involve leprechauns and rainbows. This year, pots of gold figure in at least one set of companion bills (House Bill No. 1379 and Senate Bill No. 425) the Tennessee Legislature is transforming into law. Instead of leprechauns and rainbows, though, it is the fertility physicians/clinics and “third-party reproductive care for the benefit of the enrollee(s).” The pots of gold are to be provided by “insurance companies,” which means, of course, “the insured,” which would include all of us who pay insurance ...read more
A Tale of Two Data Scientists
Neil Ferguson, Ph.D. Infamous Graph Youyang Gu
D. Joy Riley, M.D., M.A. Executive Director
It was a long year ago (March 2020) that a dire prediction was issued by a group at Imperial College London (UK) regarding the possible effects of the novel coronavirus, SARS-CoV-2. The model predicted more than 500,000 UK deaths, and >2.2 million deaths in the U.S. by summer if no action were taken. One of the data scientists issuing that proclamation was Neil Ferguson, Ph.D. He and his group advised the government that “in the UK and US context, suppression will minimally require a combination of social distancing of the entire ...read more
When Breath Is (Not Enough) Air: Let’s Talk about Ventilators
There has been much public discussion about ventilators amidst the COVID-19 pandemic. It is humbling to consider that we, or someone we love, might require one. Most people know something about the benefit of a ventilator when needed; but how well do we really understand the functions and risks of mechanical ventilation? The pandemic presents an opportune time to learn about this. So I posed a series of questions about these machines and the processes involved in using them to a physician, who is a specialist in using ventilators to treat very ill patients. Those questions, and her answers, follow.
1) ...read moreWhen the Foundations Are Wobbling, Part II
Death Certificates and COVID-19
D. Joy Riley, M.D., M.A. Executive Director
One of the tasks assigned to physicians is the completion of death certificates—at least, the portion of death certificates that list cause of death (COD). I learned the importance of accuracy of death certificate completion as a pathology student fellow, an extra year of pathology training in the middle of my medical school career. We were instructed never to use the mechanism of death, such as cardiac or respiratory arrest, as a cause of death. Additionally, the use of terms like “probable” or “suspected” were not allowed. After all, the goal of ...read more
When the Foundations Are Wobbling, Part I
The Denominator of Death Rates
D. Joy Riley, M.D., M.A. Executive Director
How many people in the U.S. have died of SARS-CoV-2 infection, or COVID-19? That is difficult to say, and not for lack of numbers on the website of the Centers for Disease Control and Prevention (CDC). The case fatality rate for a particular disease is, basically, the number of persons dying of a disease, divided by the number of persons who have the disease, and multiplied by 100, to give an answer in terms of percentage:
# persons dying of COVID-19 disease X 100 # persons infected with SARS-CoV-2
How is this complicated? ...read more
