What Say You?

Blog, United States / /

Update: See the bottom of this post for the National Institutes of Health’s response to our letter. 

An Open Letter to Dr. Francis S. Collins, Director of the National Institutes of Health

D. Joy Riley, M.D., M.A. Executive Director

Francis S. Collins, M.D., Ph.D. Director National Institutes of Health 9000 Rockville Pike Bethesda, Maryland 20892 [email protected]

17 December 2018

Dear Dr. Collins:

The Tennessee Center for Bioethics & Culture lauds the position of the National Institutes of Health (NIH) as evidenced by your concluding statement of 28 November 2018: “NIH does not support the use of gene-editing technologies in human embryos.” As embryonic humans represent the most vulnerable amongst our species, the ...read more

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Crossing a Bright Red Line: Human Embryo Editing

Blog, China / /

D. Joy Riley, M.D., M.A. Executive Director

On Monday of this week, He Jiankui of Southern University of Science and Technology in Shenzhen, China, shocked the scientific world prior to the beginning of a conference on gene editing. Dr. He announced a first: that he had edited the genes of embryos for seven couples undergoing fertility treatments, and that one pregnancy has resulted to date. It should be noted that there is no corroboration of this claim currently: it is an announcement; no scientific paper has been published about it.

Some of the specific claims, published in The Guardian, are as follows:

All of ...read more

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What if we call it “Medical Aid in Dying”?

Blog, United States / /

 

A Lesson from History

In the aftermath of WWII, Leo Alexander penned the following as part of an article published in the New England Journal of Medicine:

The Example of Successful Resistance by the Physicians of the Netherlands There is no doubt that in Germany itself the first and most effective step of propaganda within the medical profession was the propaganda barrage against the useless, incurably sick described above. Similar, even more subtle efforts were made in some of the occupied countries. It is to the everlasting honor of the medical profession of Holland that they recognized the earliest and most subtle ...read more

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How Do We Promote Human Dignity?

Blog, United States / /

D. Joy Riley, M.D., M.A. Executive Director

A week ago, I was privileged to tour portions of a few of the buildings in a complex that had previously been used as a state “Hospital for the Insane” in Michigan. Although a number of the buildings have been repurposed into condos, restaurants, and shops, the two-hour tour was of several spaces that have yet to be restored. The architect of the original hospital and treatment regimen was a psychiatrist named Thomas Kirkbride. I was impressed by his understanding of human dignity, as represented by his work. The story is fascinating . . .

Thomas ...read more

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The Rubicon

Blog, End of Life, Medicine & Health, Resource Room, United States / /

D. Joy Riley, M.D., M.A. Executive Director

The law in the Roman Republic in 49 B.C. was very clear about an army crossing a small stream outside Rome: it was considered an act of war. Julius Caesar knew this, and led his 13th Legion across that stream, declaring, in the historian Suetonius’ words, “The die is cast!” Caesar and his army did not turn back, but continued on to war, and ultimately defeated Pompey the Great. This turning point in history is referenced whenever we talk about approaching a point of no return and utter the phrase, “crossing the Rubicon.”

“The Rubicon” sculpture ...read more

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The ACP Releases a Position Paper on Physician-Assisted Suicide

Blog, End of Life, United States / /

D. Joy Riley, M.D., M.A. Executive Director

On 19 September 2017, the Ethics, Professionalism and Human Rights Committee of the American College of Physicians released their position paper on physician-assisted suicide (P-AS). A brief synopsis of it follows…

Re: Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper

The statement released last week builds on previous work:

1997 report by the Institute of Medicine (IOM), Approaching Death: Improving Care at the End of Life, which cited “inadequate end-of-life care” in the U.S. 2001 statement by the American College of Physicians, in which the ACP did not support the legalization of P-AS. ...read more

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First Human Embryos Edited in U.S.: A Bright Red Line Is Crossed

Blog, Emerging Technologies, Genomic & Genetics Issues, Medicine & Health, uncategorized, United States / /

D. Joy Riley, M.D., M.A. Executive Director

“Sooner than we expected”: A friend – a scientist steeped in the bioethics realm – wrote to me of her surprise at the announcement of the first embryonic humans edited in the United States. Steve Connor, writing in the MIT Technology Review, reported the work on 26 July 2017.  Doubtless, the publication of the work in a scientific journal will follow.

The article, “First human embryos edited in U.S.” by Steve Connor, describes the process thusly: “A person familiar with the research says ‘many tens’ of human IVF embryos were created for the experiment using the ...read more

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Helping Patients Live vs. Helping Them Die

Blog, End of Life, Hot Topics, Medicine & Health, United States / /

D. Joy Riley, M.D., M.A. Executive Director

Cultural Suicide On Sunday, 28 May 2017, The Tennessean published a full page set of articles on the problem of suicide amongst the armed forces in our nation. The year 2012 saw a peak of 22 U.S. veterans killing themselves per day (Jake Lowary, “‘I can’t do barbecues:’ Veteran says“). The Department of Veterans Affairs plans a 7.5 percent budget increase to $186.1 million in 2018 — all to address suicide prevention, the department’s “highest clinical priority” (Jake Lowary, “Suicide rising in the military, but some programs give veterans hope“).

In light of these sobering statistics, it ...read more

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What Is a SHEEF, and Why Should We Care?

Blog, Emerging Technologies, Stem Cell Research, United States / /

D. Joy Riley, M.D., M.A. Executive Director

Human embryo research has long been guided by what is known as the “14-day rule.” That is, various nations have allowed research on embryos up to 14 days post fertilization. The 14-day rule was put in place ostensibly in order to avoid causing pain for the developing embryo. The primitive streak — the first visible evidence of gastrulation and the formation of differentiated tissues in the embryo — appears at about day 15 after fertilization. (See video at the bottom of this post for more information.)

When the 14-day rule was put in place, laboratories were ...read more

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It Has Arrived: Gene Editing Recommendations Published

Blog, Emerging Technologies, Engineering Humans, Genomic & Genetics Issues, United States / /

D. Joy Riley, M.D., M.A. Executive Director

The committee appointed to advise our government regarding the editing of genes, including editing the genes of the human embryo, has published a draft report (see the title page screen shot above). We at The Tennessee Center for Bioethics & Culture are studying the document’s 261 pages, and have a few caveats to share with our readers. Germline gene editing was given cautious approval by the committee:

Heritable germline genome editing trials must be approached with caution, but caution does not mean they must be prohibited. (p. 102)

and

If the technical challenges are ...read more

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