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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Medicine’s Schizophrenic Approach to Suicide

Blog, Medicine & Health, Resource Room / /

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

On 10 May 2018, Medscape Medical News published an article about the recent suicides — five days apart — of an NYU psychiatry resident and a medical student. Marcia Frellick, reporting for Medscape, wrote

The university confirmed the deaths to Medscape Medical News in a statement: “We were saddened to learn of the recent deaths of one of our medical students and one of our psychiatry residents, both by suicide. Counseling and support services are being offered to students, faculty, and staff. On behalf of the institution, we extend our deepest condolences to their families, friends, ...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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What’s Happening with Physician-Assisted Suicide?

Blog, End of Life, Other Voices, United States / /

Mrs. Jane Patton is a Vanderbilt University graduate, a nurse, and worked most recently in clinical research. Her interest in bioethics began in college with thinking through Roe v. Wade and the inherent value of human life. She has done further work in bioethics, and now volunteers with The Tennessee CBC. Below, Jane Patton addresses recent developments in physician-assisted suicide.

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Here we are in 2017, loaded with the benefits of technological innovation. In healthcare the movement is at warp speed such that we can be like frogs in the proverbial frying pan, not taking to heart the implications of such rapid and ...read more

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CRISPR — Who’s in Charge? (Part IV)

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

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

This is part IV of our report. View part I, part II, or part III.

The ability to edit genes using CRISPR (clustered regularly interspaced short palindromic repeats) has been in the news for more than a year. A committee has been appointed to advise our government regarding the editing of genes, particularly editing the genes of the human embryo.

Who are the members of that committee? What are their views? The Tennessee Center for Bioethics & Culture has been working to gather information for you, our readers.

Here is a brief look at some of the writings and organizational ...read more

CRISPR — Who’s in Charge? (Part IV) Read More »

CRISPR — Who’s in Charge? (Part III)

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

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

This is part III of our report. View part I, part II, or part IV.

The ability to edit genes using CRISPR (clustered regularly interspaced short palindromic repeats) has been in the news for more than a year. A committee has been appointed to advise our government regarding the editing of genes, particularly editing the genes of the human embryo.

Who are the members of that committee? What are their views? The Tennessee Center for Bioethics & Culture has been working to gather information for you, our readers.

Here is a brief look at some of the writings and organizational ...read more

CRISPR — Who’s in Charge? (Part III) Read More »