Lott Blog

You, too, are a universal blood donor

Advance online publication from Nature Biotechnology is reporting the successful use of glycosidases for efficient, RBC-friendly removal of group A and B antigens, thereby providing a potential mechanism for converting all blood to type O.

Now that is a development worthy of attention. As the authors mention, not only does this mean increasing the supply of compatible blood, it means making existing blood supplies safer, hopefully by avoiding the sorts of clerical errors and mistakes that account for the most likely adverse consequences of obtaining a blood transfusion.

Stem Cell Debate 2007

New year, same old debate.

Round 1: As Art Caplan notes, the White House draws first blood with its "Advancing Stem Cell Science Without Destroying Human Life" report.

Round 2: The new House of Representatives passes the same old stem cell bill they passed years prior (which Bush vetoed)

(*Blast from the stem cell past: remember what we were talking about before 9-11?)

Round 3: Inevitable delay and stalling in the Senate while a new debate boils and bubbles over pluripotent amniotic fluid cells

Prediction: More political brouhaha as American society struggles with its own metaphysical values in an age dominated by the promises and purported perils of biotechnology.

Birth Control Pills Again Affordable

Amanda Schaffer at Slate covers Ortho-McNeil's abrupt, unexpected move to increase oral contraceptive prices 1,800-fold as well as their equally abrupt move to bring prices back into reality-range.

HPV-Who? Many U.S. Adults Unaware of Cervical Cancer-Causing Virus

The heralding of the new cervical cancer vaccine may fall on deaf ears. This in today from the Wall Street Journal Online's Health Industry Edition:

A new Wall Street Journal Online/Harris Interactive Health-Care Poll found that while a large minority (42%) of the population has not heard of human papillomavirus (HPV), a large majority (70%) of the population supports, or reacts favorably to the widespread use of a new vaccine to prevent it.  The Harris Interactive online survey of 2,604 U.S. adults, conducted between July 27 and 31, 2006 for The Wall Street Journal Online's Health Industry Edition (http://www.wsj.com/health) also found that almost three in five (58%)adults have heard of HPV, and about half (48%) have heard or seen that there is a vaccine that can prevent this virus in teenage girls and women. While women are much more likely than men to have heard of HPV (70% vs. 47%) and of the HPV vaccine (57% vs. 38%), attitudes toward its use are not very different. Three quarters (75%) of women and 64 percent of men agree strongly or somewhat that encouraging girls and young women to get the HPV vaccine is a good way to prevent the future spread of cervical cancer. A majority (61%) of parents of girls under 18 years of age would want their daughters to get the vaccine, and only a few (6%) definitely would not, with many (32%) undecided. Additionally, 72 percent of these parents say that information about the HPV vaccine should be included in health education classes in school. However, the study found that a "substantial minority" of the public has reservations about use of the HPV vaccine. About one quarter of adults and parents (27% each) feels that the HPV vaccine may encourage young girls to become sexually active. A third of adults (34%) and 42 percent of parents do not believe that teenage girls should be allowed to get the vaccine without their parents' permission [emphasis added]; and fully 44 percent (of both adults and parents) think that abstinence programs are a better way of preventing HPV than medical treatment[emphasis added].

Frankly, the "perverse incentives" argument is getting old. Anytime a new technology comes along that has the potential to make sex safer, hoards of naysayers gather to preach about the coming sexual Armageddon that will inevitably follow. Atop commanding moral heights they remind us that abstinence is the only way to absolutely prevent the transmission of STDs. No disagreement there, but in the meantime loads of people are having sex, and shouldn't we be at all concerned for their safety?

And here's a quick and dirty solution to by-pass perverse incentives altogether--vaccinate girls (and boys, if they eventually get the indication) while they are still infants or toddlers--i.e. when the opposite sex is still thought to be plagued with cooties.

Decline in Rape Related to Increase in Pornography?

Anthony D' Amato, Leighton Professor of Law at Northwestern University, seems to think so.

See his full paper, D'Amato, Anthony, "Porn Up, Rape Down" (June 23, 2006). Northwestern Public Law Research Paper No. 913013 Available at SSRN: http://ssrn.com/abstract=913013

His abstract summarizes the correlation:

The incidence of rape in the United States has declined 85% in the past 25 years while access to pornography has become freely available to teenagers and adults. The Nixon and Reagan Commissions tried to show that exposure to pornographic materials produced social violence. The reverse may be true: that pornography has reduced social violence.

Suggestions of causality comes later in the paper, most convincingly in Table 3:

TABLE 3. COMBINED PER CAPITA PERCENTAGE CHANGE IN INCIDENCE OF RAPE.

                                                           Aggregate per capita increase or decline in rape.

Four states with lowest internet access              Increase in rape of 53%

Four states with highest internet access             Decrease in rape of 27%

"Embryo-friendly" Embryonic Stem Cell Research

Several news agencies are reporting a newly announced technique (announced in Nature) to harvest human embryonic stem cells that would leave the embryo unharmed. Researchers at Advanced Cell Technology claim to be able to pluck a single cell from an early embryo without destroying it.

Could this be a reasonable solution to the ongoing, fiery-and-fiesty stem cell debate in the U.S.? Much of the answer probably depends upon whether the plucked cell itself is totipotent and could potentially develop into a full-fledged human being.

If so, then we're no further from where we started (research on the plucked cell would be morally equivalent, by detractors' standards, to research on the embryo from which it was plucked).

If not, then perhaps the moral status of the embryo is indeed more than just the sum of its parts and we've in fact made some headway after all.

Personally, I'm not too optimistic.

Tainted Tissues--Body Parts Recalled

It seems another body parts scandal is brewing again, this time in North Carolina. CNN reports that

Federal authorities kept the North Carolina episode quiet until late last Friday, when the FDA shut down Donor Referral Services of Raleigh, North Carolina...

...The FDA said the company, run by Philip Guyett, had "serious deficiencies" in its processing, donor screening and record-keeping. The government accused him of altering records to overlook such problems as cancer or drug use by the deceased donor.

Apparently the body broker also engaged in unsterile harvesting techniques when procuring tissues.

This is the lastest scandal pointing toward the need for a tighter regulation of this industry, whose participants have every incentive to cut corners in the pursuit of maximizing profits. Patients are hurt, and the medical profession loses another inch of its integrity and pride.

I would submit, however, that the solution is not to establish a regulatory framework mimicking the United Network for Organ Sharing (UNOS) model, a private organization that continues to exert monopolistic, unwaivering control over organ procurement and distribution in the U.S., and which has been fairly criticized in the past for stifling debate suggesting other ways of solving the organ distribution problem.

Establishing a tissue procurement and distribution program under the direct auspices of the federal government (say, within the Department of Health and Human Services), rather than the FDA farming out the job to a private group (as happened with UNOS) might deliver the safety and reliability that one would otherwise expect from the tissue brokering community.

UPDATE: MSNBC.com has a great review of the scandal.

New Book--Ethics and Infectious Disease

Blackwell Publishers has just released a new bioethics book examining the intersection between bioethics and infectious disease--a topic largely ignored by contemporary bioethics literature (until very recently). The title is Ethics and Infectious Disease, and it is definitely worth checking out.

(Disclaimer--I have a paper in the book (co-authored with Professor Julian Savulescu) analyzing the intersection of public health policy and hepatitis C. If you have the chance, take a look!)

Sporty Genes--Genetic Testing for Athletic Prowess

An Australian biotechnology firm has reached Olympian heights.

For about $150.00, Genetic Technologies, Ltd. will swab your cheek and test for the R577X variant of the ACTN3 gene, which encodes for the protein -actinin-3 that is involved in the production of fast-twitch muscle fibers. Since R577X produces less of this protein, individuals with no copies of the variant would be expected to perform better, on average, in fast-paced, high-intensity sports, such as sprinting. Conversely, individuals homozygous for the gene would be expected to excel at endurance-oriented activities, where a preponderance of slow-twitch muscle fibers matters most.

Of course nothing is for certain, and great athletes are more than just the sum of their nucleotides. Arguably most sporting challenges are won in the mind well before they are played out on the field, which means that your R577X homozygous-null, blue-eyed baby boy may well grow up to be a couch potato instead of a quarterback.

Still, knowledge that your offspring could potentially excel at certain sports might be potentially useful for parents who would like to encourage their children to consider sports. Of course the problem--and the controversy--arises when "encourage" turns to "coercion." As Drs. Julian Savulescu and Bennett Foddy write in the British Journal of Sports Medicine,

There are parents who will put their child under tremendous pressure to be an elite sprinter because they show the appropriate genetic aptitude. When advances in technology let us predict if our fetus will be an overall athletic success, we will no doubt be tempted to place talented children in training during their infancy. 

However, they correctly note that the technology per se is not where the problem lies:

These choices would make us bad coaches, and bad parents, for putting sporting performance ahead of a child’s wellbeing. But the technology will not make bad parents out of good parents. Good parents understand that these kinds of pressures can make for a harrowed, unhappy childhood...

People often voice concerns about how genetic technologies may lead parents to treat their children. It is up to parents to be kind to their children, and to support their autonomy and personal growth. A parent who wants to oppress their child, to live through them or to make their life miserable in some way can already do this with great efficiency without using genetic technology. Therefore such a test poses no additional risks to a child.

Agreed. Moreover, just because some adults do not know how to behave like good parents does not mean that all parents should be treated with kid gloves. Genetic testing for athletic prowess is just another tool parents can use (or misuse) to better (or worsen) the lives of their children.

Welcome to LottBlog!

Dear Readers,

LottBlog has a found a new home here at Biowizard.com!

All new postings, discussion, and debate will take place--unabated--in this new forum. A number of selected articles previously published on LottBlog have also been published on this site.

Thanks again, and welcome!

Sincerely,

Jason P. Lott