I would like to be an abolitionist also, and I think I have some pretty good reasons for wanting to do so, to think that way, to consider myself an abolitionist.
Moral status is for many ethicists independent of the claimant’s social position in the ‘hierarchy’ (phylogenic scale, in this case) or their role in socially constructing ethical theory. In other words, moral status is not a private social product; it’s public to the extent that it is widely accorded the belief that it’s morally true (in some meaningful sense).
In other words, to claim that nonhumans ought not to be brutalized is somehow believed to be a morally true statement, and the place and status of the ‘ought’ will be thought to be correct. Is ‘ought’ indicative of a duty that is ‘owed’ to the claimants (in this case, those for whom the claim is made)? Yes.
To claims that animals ought NOT to be brutalized is further qualified by ‘in science’ or ‘in the name of science’.
There are at times qualifiers which modify the ‘ought’ (as in ‘just war’ theories), and I do NOT believe that science qualifies as a ‘just war’ modification of our obligation to not harm vulnerable sentient beings. Lab animals are not individually out to harm us deliberately; if rodents were to consume our grain or other crops, we with capacity to construct our social relations with the ecological ‘others’ could be expected to do so in order to protect OUR interests without negating ours.
We have many moral illustrations of the long history of attempting to benignly address the needs of others without harming ourselves – some more gracious, some more loving, some more brilliant than others. Consider one which many of us know: the Hebrew proscription (as in the narrative about Ruth, Naomi, and Boaz) to leave the corners of the field ungleaned so that the poor scavengers could find enough to get by with some reasonable effort. They didn’t have a free food pantry as such, but they were given (by conscious forethought) enough to take by a modest amount of effort on their parts – and it was 100% plant-based food, too, unlike many of the free food pantries you and are asked to support, which conflicts with many of OUR deeply-held moral values about not trading off the interests of some – the animals – in order to address the interests of others – the class of persons benefitting from our exploitation and abuse and murder).
But this illustration shows how those without ready access to meeting their needs are seen as morally significant persons with interests that we ought to consider. Short of socializing all effort and recruiting these persons (perhaps they were antisocial or uncooperative, but the narrative doesn’t paint them that way, nor even suggest as much), the social ‘solution’ seems to have been widely affirmed – at least b y those who subscribed to the moral teachings of ‘leaving the corners of the fields’ (of grain) for the outsiders to glean after the ‘main’ gleaning had been finished.
Was this a potential ‘waste’ of edible grain? Perhaps. Is there a risk of inefficiency? Perhaps. But the system was widely known.
In thinking about nonhumans in the context of our (socially constructed) ‘duties’ to care for our fellow human beings AND to provide extra for them (as a safety net when they are injured or get ill, whether because they have been personally careless or inept, or because they were vulnerable to the malice of others), one claim (the appeal to do science on behalf of future victims and potential victims) runs afoul of the prior moral claims of nonhumans to not be harmed by direct intentions, by direct interventions.
Given that there are these claims to provide a medical safety net, even those who favor those socially-constructed claims can understand that killing or harming unwilling animals because of their vulnerability is morally objectionable. In other words, it can REASONABLY be considered objectionable based on the physical characteristics of these sentient nonhumans.
Given the ‘moral difficulty’ of solving these problem, compromise solutions are often presented, as the ‘public option’ is offered in the USA as a compromise between single-payer and what single-payer’s opponents call ‘market-driven’ solutions. SP friends are unhappy with the compromise; free-market advocates are unhappy; whether the compromise works for the greater benefit and satisfaction of the vast majority is not yet known (and can only be reasonably predicted).
In the vegetarian (and vegan) world, we have the 10% solution, which is offered to meateaters to consider life with meatless meals. One meatless day per week would be about 1/7 (or 14.2857%), which they TERM ‘the 10% solution) in that (THEORETICALLY) it could free about 10% of agricultural land (and presumably return it to a ‘wild’ state (though it’s likely to be exploited by real estate developers). The term 10% is widely-known in monotheistic religious contexts when talking about ‘tithing’ (giving 10% ‘off the top’).
But I’ve long suggested the 30% solution as follows:
The overwhelming proportion of researchers in the life sciences (whether they use animals or not) are researchers only, not fund raisers. They depend upon funding (for laboratories, salaries, supplies, and animals). They seek funding from corporations, government grants, private foundations, individual benefactors, and some other sources. Grant money typically has an overhead percentage that goes to the hosting institution(s).
I propose that a ‘first 30%’ be given to fund aggressive research INTO nonanimal research methods – methodological research into developing and validating nonanimal research methods.
This suggestion itself is likely to make me (in the aggregate) far MORE enemies in the vegan world than I’ve already made in my 30-35 years of veganism, but let it be discussed.
It’s not abolitionism; it’s likely to be termed ‘welfarism!
However, short of addressing the CLAIM that is widely-accepted that some things NEED to be researched and understood and that, to date, nonanimal research methods (for doing WHAT WE THINK WE NEED TO DO/RESEARCH) are not yet available with a confidence level sufficient to warrant their use instead of animal methods (not in conjunction with animal research methods), we have no quick response EXCEPT the moral argument that animals are not ours to eat, wear OR EXPERIMENT UPON.
(I accept fully that NO person is ours to eat, wear, or experiment upon, and I wish folks like Bill Maher and the ‘social deconstructionists’ we accept into our camp would understand that some interpersonal social behaviors that are widely accepted by the morally casual’ either are or lend themselves more to experimenting upon sentient beings (and as such, should be frowned upon and denounced. But I digress.)
But let’s do a little analysis here of my suggested “30% solution” that would fund the development and validation of nonanimal research methods in the same way that tobacco taxes and penalties on tobacco companies fund aggressive health education about the risks and harmful effects of tobacco use. In a libertarian political context (and more and more dietary vegans are TERMING themselves libertarians; I’ll see HUNDREDS of such ‘libertarian vegans’ at the upcoming Boston Vegetarian Food Festival), what else can we do? Yes, it’s a political and moral compromise, and we’re not coming back to the animals OR ‘the district’ with the solutions we had wanted. But in the same spirit that we send elected representatives to our democratic legislative bodies and expect them to bring SOMETHING back that is better than no representation at all, is the 30% solution a totally contemptible half-way ‘solution ‘ in light of the historical hope that we WILL – with the intelligence, ingenuity, collaboration, funding, and moral will to do so – be able to develop somehow the social consensus that replacing animal models in ALL basic science (as in toxicology and other research, including military wound research) is both desirable AND feasible, and we offer a provisional means to help our societies get to that point of total abolition of animal research?
Here’s the current downside of NOT replacing animal models:
Not only are animals sacrificed in research facilities, but the credibility of the moral claim that NO animals are ours to eat, wear OR EXPERIMENT UPON is diminished BECAUSE we’ve already consented to let them be experimented upon BECAUSE of the moral gravity of the moral claim that our fellow humans need a medical ‘safety net’ that is perpetually improved.
Yes, we are being asked to trade off our abolitionism for two things: (a) funding (finite) and (b) widespread public support for the belief – consensus – that research on animals is something that is morally objectionable, needs to be replaced, and MUST be replaced within the foreseeable future. The ‘win’ here is that we work for the public agreement on the 3 Rs agenda, which they don’t FORMALLY approve or support AT THIS TIME.
This suggestion MAY be all wrong, but I’d like to see us incubate a discussion.
I further suggest that CLAIMS by researchers to love their animals because we can see that they love their dog(s) and/or cat(s) cannot be trusted BECAUSE they are not signing on to the replacement agenda in the 3Rs: reduce, refine, and replace.
For nearly 3 decades of street outreach, particularly at Harvard, when I see that I can make NO headway with researchers (some really DO want to see some possible consensus, perhaps because they tend to like me – as a bright person, accepted collegially), I suggest that the ACID TEST of whether or not they ARE talking in good faith is their public and wholehearted acceptance of the 3 Rs standard and THEIR willingness to fund and support replacement research. Short of that WHOLEHEARTED acceptance of the 3 Rs to the point of sharing funding, I call their ‘moral pleas’ (of innocence and good will in a morally difficult context) ‘mere huff’ (and something to be publicly protested).
Of course, if NO experiments on nonhumans have ANY applicability to human beings [http://www.safermedicines.org/faqs/faq16.shtml], then the 3Rs is moot and we should reject all medical experiments on animals (for human interventions) as unscientific . However, the 3 Rs seems to suggest that (a) some experiments on nonhumans are less than optimal and should be replaced; (b) some experiments on nonhumans are less than optimal and should be refined, and (c) some experiments on animals are morally objectionable but AT THIS TIME are scientifically necessary to get WHAT WE THINK we need to know (and we may find that there are other ways to reach the goal of health populations without pharmaceutical or surgical interventions.
That’s not how the 3 RS is always read, but closer study of the 3 Rs does seem to suggest that as a valid reading.
At the Longwood Medical Area’s annual lab equipment 2-day exhibition, a number of research facilities DO offer nonanimal research methods, but in that context there’s a certain anxiety about billing themselves as nonanimal research method developers. But here are some of the non-ethical ‘drivers’ or forces moving less-than-concerned animal researchers towards replacement of animal models wherever possible:
(a) Cost – experimental animals are VERY expensive to (i) purchase, (ii) house, and (iii) maintain, and (iv) hygienically and safely dispose of
(b) Contagion – working with experimental animals poses some health risk to human researchers AND to those (i) associated with those human researchers [cleaning cages, cleaning labs, in the department, traveling with them on public transportation, family members and friends, other colleagues] AND (b) those who deal in animals [hopefully HIPAA-compliance in the USA reduces some of this concern, but it’s still there].
(c) Ethical discord among researchers and their communities
(d) Risk of violence developing among researchers who work with animals (a recent study, I believe at Cornell, showed that interpersonal violence among researchers who deal with animals is potentially volatile).
(e) Potentially better results from nonanimal research methods
(f) Repeatability of experiments is easier and cheaper, and science is nothing if not repeatable.
(g) Training (surgical training specifically) needs to be done FAR more times than is affordable using animal-based models for surgical training; healthcare is plagued with medical errors, and systems- research, including work offered by Dr. Donald Berwick of Cambridge-based IHI – the Institute for Healthcare Improvement, suggests that we need to require much higher levels of surgical practice and that is not affordable without shifting to simulation modules, as offered by SimuLab and a few other providers (in the USA).
So let’s think NOW about the 30% solution and, as we near the tipping point for shifts in research paradigms, perhaps th entire house of cards (or most of it) will fall IN OUR LIFETIMES.
Vigorous debate is encouraged!
Showing posts with label medical. Show all posts
Showing posts with label medical. Show all posts
Sunday, October 25, 2009
Saturday, October 10, 2009
30 Scientists Accuse Tufts Researchers of Ethical Violations-- Nuremberg Code
30 Scientists Accuse Tufts Researchers of Ethical Violations-- Nuremberg Code
ALLIANCE FOR HUMAN RESEARCH PROTECTION
A Catalyst for Public Debate: Promoting Openness, Full Disclosure, and Accountability
http://www.ahrp.org
FYI
A report in the business forum, Zikkir, "Out of Sight" was prompted by the publicity surrounding the $79 million settlement of Pfizer's unethical Trovan experiment conducted on Nigerian infants.
http://www.ahrp.org/cms/content/view/571/72/.
The Zikkir article touches on the problems related to the US pharmaceutical industry's increased outsourcing of clinical trials to off-shore locations, mostly in underdeveloped countries including Eastern Europe and Russia which do not conform to ethical restraints mandated by the Nuremberg Code or the Declaration of Helsinki. http://zikkir.com/business/6259?wscr=1024x768.
An in-depth report by the Institute of Science in Society, "The Golden Rice
Scandal Unfolds," demonstrates that academics who are shielded by the US
government seal of approval, have been conducting medical experiments that
are clearly prohibited by the Nuremberg Code. The article focuses on a
series of recent unethical Phase II trials conducted by Tufts University
researchers, who tested genetically modified "Golden Rice' (GR2) on children
in the U.S. exposing them to "an unapproved experimental genetically
modified rice enhanced in pro-Vitamin A that has the potential to cause
birth defects and developmental abnormalities."
The questionable experiments-which ISIS described as "an exercise in how not to do science"--are:
1. Project NCT 00680355.(10) Bioavailability of Golden Rice Carotenoids in Humans.
http://clinicaltrials.gov/ct2/show/record/NCT00680355?term=golden
2. Project NCT 00082420. Retinol Equivalence of Plant Carotenoids in Children.
http://clinicaltrials.gov/archive/NCT00082420
The experiment compared the vitamin A value of b-carotene in oil capsule, spinach and Golden Rice - recruited 72 children 7 to 9 years of age. The starting date of the experiment was September 2004, it ended November 2005.
3. Project NCT 00680212. Vitamin A Equivalence of Plant Carotenoids in Children.
http://clinicaltrials.gov/ct2/show/record/NCT00680212?term=golden
In this experiment, researchers recruited 72 children 6 to 8 years of age and registered start and finish dates July 2008 and January 2009.
The ISIS report (submitted to the FDA in March, 2009) states:
"The Golden Rice Project website [6] (accessed 17 March 2009), stated that "Golden Rice has gone through many tests since it was first obtained" Nine items are listed; but no feeding trial on animals among them." See: http://www.i-sis.org.uk/goldenRiceScandal.php
"Golden Rice" has been touted as a humanitarian effort to resolve vitamin A deficiency. However, it has met with significant opposition from environmental and anti-globalization activists who view it as a commercial threat.
For example, Dr. Vandana Shiva called it "a hoax:"
"Unfortunately, Vitamin A rice is a hoax, and will bring further dispute to plant genetic engineering where public relations exercises seem to have replaced science in promotion of untested, unproven and unnecessary technology."
"The problem is that vitamin A rice will not remove vitamin A deficiency (VAD). It will seriously aggravate it. It is a technology that fails in its promise.
Since the daily average requirement of vitamin A is 750 micrograms of vitamin A and 1 serving contains 30g of rice according to dry weight basis, vitamin A rice would only provide 9.9 micrograms which is 1.32% of the required allowance. Even taking the 100g figure of daily consumption of rice used in the technology transfer paper would only provide 4.4% of the RDA."
"In order to meet the full needs of 750 micrograms of vitamin A from rice, an adult would have to consume 2 kg 272g of rice per day. This implies that one family member would consume the entire family ration of 10 kg. from the PDS in 4 days to meet vitaminA needs through "Golden rice".
"This is a recipe for creating hunger and malnutrition, not solving it."
"Even the World Bank has admitted that rediscovering and use of local plants and conservation of vitamin A rich green leafy vegetables and fruits have dramatically reduced VAD threatened children over the past 20 years in very cheap and efficient ways."
See: THE "GOLDEN RICE" HOAX -When Public Relations replaces Science
http://online.sfsu.edu/~rone/GEessays/goldenricehoax.html
The ISIS report calls the Tufts experiments "morally inexcusable:"
"The phase II clinical trials of uncharacterized, unapproved, experimental GR2 events on children, some of whom may indeed be suffering from vitamin A deficiency, is morally inexcusable. GR2 has not been assessed for safety, and there are reasons to suspect it is unsafe."
See: http://www.i-sis.org.uk/goldenRiceScandal.php
In February, 2009, an open letter addressed to Professor Robert Russell, Professor Emeritus, Friedman School of Nutrition Science and Policy, Tufts University School of Medicine (Email: rob.russell@tufts.edu) was signed by 30 senior scientists who protested the unethical testing of a possibly hazardous substance--"Golden Rice" (GR2) in children.
The letter states that the trials
"appear to be an experimental collection of transgenic events still in the laboratory, uncharacterized in terms of basic molecular genetics or biological and biochemical properties, not tested pre-clinically on animals, or subjected to any other safety assessment."
"The variety of Golden Rice used in these experiments (GR2) is inadequately described in terms of biological and biochemical characterization. anywhere else in the publicly available literature, and has woefully inadequate pre-clinical evaluation."
" It is a genetically modified product which has not been shown to be distinctive, uniform and stable over time. It has never been through a regulatory /approvals process anywhere in the world. There is now a large body of evidence that shows that GM crop/food production is highly prone to inadvertent and unpredictable pleiotropic effects, which can result in health damaging effects when GM food products are fed to animals (for reviews see Pusztai and Bardocz , 2006; Schubert, 2008; Dona and
Arvanitoyannis, 2009)."
"More specifically, our greatest concern is that this rice, which is engineered to overproduce beta carotene, has never been tested in animals, and there is an extensive medical literature showing that retinoids that can be derived from beta carotene are both toxic and cause birth defects."
No results have been made available for either of the pediatric studies (as of 17 March 2009).
The scientists noted that the three Tufts Projects breached the Nuremberg Code / medical ethics code "on a number of counts, and we urge you to call them to a halt immediately."
"They should not be resumed unless and until the researchers can demonstrate that a full range of laboratory and animal feeding trials have been completed and published for the Golden Rice strain being used, and unless and until appropriate regulatory bodies have had an opportunity to come to a view on the health and safety issues about which we are very concerned."
"We can assure you that such trials would not have been approved within the European Union in the absence of safety information, which highlights yet again the flaw of the USDA and FDA regulatory system in considering GM crops/foods as hypothetically "generally recognised as safe - GRAS" in the
absence of hard experimental data."
Further underscoring the U.S. academics' and government agency disregard for medical ethics, the ISIS report notes that an Indian newspaper reported that a clinical trial was cut short in China in July 2008, when the government found that 24 children 6-8 years of age at a primary school in Henyan, Hunan, were to be used as guinea pigs for a trial with Golden Rice."
That trial was also sponsored by Tufts University and approved by the US National Institute of Health--though not from the Chinese government, which was alerted by Greenpeace. Greenpeace has also warned the governments of Bangladesh, India, Indonesia, Philippines and Vietnam against the risky trials.
It would appear that the Chinese government conforms to higher medical ethics standards than the US National Institute of Health.
So, why has the media failed to pay any attention to these morally deplorable human experiments on American children ?
Contact: Vera Hassner Sharav
veracare@ahrp.org
212-595-8974
http://www.i-sis.org.uk/goldenRiceScandal.php
ISIS Report 18/03/09
The Golden Rice Scandal Unfolds
Phase II clinical trials on children have been conducted with unapproved experimental GM rice enhanced in pro-Vitamin A that has the potential to cause birth defects and developmental abnormalities Dr. Mae-Wan Ho and Prof. Joe Cummins
This report has been sent to the United States Food and Drug Administration on behalf of ISIS
Clinical trials of unapproved, uncharacterized GM rice on children
EXCERPT:
According to a recent report [9], a sample of the Golden Rice grains was sent to Germany in 2001 for a feeding trial with mice. But when the grains were tested for carotenoid content, the scientists were "surprised to find it contained less than one percent of the amount expected." After the rice was cooked, this was reduced by another 50 percent, so the trial was abandoned.
In 2005, Syngenta made GR2 [10] using the maize version of the enzyme phytoene synthase that was transferred from daffodil. GR2 produced up to 23 times the amount of carotenoids in the original Golden Rice, GR1.
But GR2 was not a transgenic variety based on a single transformation event. On the contrary, it was explicitly stated that [10]: "The reported transgenic rice events [emphasis added] are experimental." There is no telling whether all the children or adults taking part in any of the trials
were given Golden Rice from the same GR2 event. The results of the trials, as yet unreleased, could well be utterly worthless.
Syngenta was donating these GR2 events, via the Humanitarian Project for Golden Rice, for further research and development (to institutes across China, India, Philippines, Indonesia, Bangladesh and Vietnam) "through license under certain conditions", which include "being governed by the
strategic direction of the Golden Rice Humanitarian Board" Requests were to be directed to Adrian Dubock, a previous employee of Syngenta.
Dubock helped Potrykus and Beyer work out a deal in which Syngenta could develop Golden Rice commercially, but farmers in developing countries who make less than US$10 000 a year could get it for free [5]. Dubock retired from Syngenta in 2007, but remains a member of the Golden Rice Humanitarian Board, chaired by Potykus.
Golden Rice, an exercise in how not to do science
Golden Rice, genetically modified to make pro-vitamin A in the endosperm (the grain remaining after polishing), was announced with great fanfare in 2000 as a cure for widespread vitamin A deficiency in developing countries.
The project had already cost US$100 million, funded by the Rockefeller Foundation, the Swiss Federal Institute of Technology, the European Community Biotech Programme and the Swiss Federal Office for Education and Science, and could cost as much again to develop. It was tied up in at least 70 patent claims on genes, DNA sequences and constructs, a problem only partly solved in the "ground-breaking deal" worked out by Dubock (see above)..
Condemnation was swift and widespread, not least because it was absurd to offer Golden Rice as the cure for vitamin A deficiency when there are plenty of alternative, infinitely cheaper sources of vitamin A or pro-Vitamin A, such as green vegetables and unpolished coloured rice (especially black and purple varieties [11], which would be rich in other essential vitamins and minerals, and hence much more nutritious. The UN Food and Agricultural Organization (FAO) started a project in 1985 to deal with vitamin A deficiency using a combination of food fortification, food supplements and general improvements in diets by encouraging people to grow and eat a variety of green leafy vegetables. One main discovery from the project was that the absorption of pro-vitamin A depends on the overall nutritional status, which in turn depends on the diversity of the food consumed [12].
The main cause of hunger and malnutrition in the Third World is the industrial monocultures of the Green Revolution, which obliterated agricultural biodiversity and soil fertility, resulting in ever-worsening mineral and micronutrient deficiencies in our food. Golden Rice, like other GM crops, is industrial monoculture only worse, and will exacerbate this trend, as well as the destruction of agricultural land, and the impoverishment of family farmers that also accompanied the Green Revolution [13] (see Beware the New "Doubly Green Revolution", SiS 37).
GR1 was made with the standard 'first generation' genetic modification techniques, using GM constructs that cause uncontrollable mutations and other collateral damage to the host plant genome, with many unintended, uncharacterized effects [14]. In addition, the viral and bacterial sequences, including antibiotic resistance marker genes, in the construct and in the vectors created for gene transfer enhance horizontal gene transfer and recombination, the main route to creating new pathogens and spreading antibiotic resistance.
GR2 represents an improvement in so far as antibiotic resistance markers were no longer used, but still includes a medley combination of sequences\ from plant pathogens Agrobacterium (used in a binary vector system) and Erwinia uredovor, and from E. coli, inhabitant of the human gut, which also contains pathogenic strains. We have highlighted the special hazards of the Agrobacterium vector system since 2003 [15] (Agrobacterium & Morgellons Disease, A GM Connection?, SiS 38) (see below). The main reason for Golden Rice was revealed in the unusually long news feature article [16] accompanying the scientific publication [8] which stated: "One can only hope that this application of plant genetic engineering to ameliorate human misery without regard to short-term profit will restore this technology to political acceptability."
A detailed audit on the project [14] (The 'Golden Rice', An Exercise in How Not to Do Science, ISIS Report) uncovered "fundamental deficiencies" from the scientific and social rationale to the science and technology involved. It was being promoted "to salvage a morally as well as financially bankrupt agricultural biotech industry." The situation has changed little since.
The phase II clinical trials of uncharacterized, unapproved, experimental GR2 events on children, some of whom may indeed be suffering from vitamin A deficiency, is morally inexcusable. GR2 has not been assessed for safety, and there are reasons to suspect it is unsafe. GMO safety in question
The biotech industry has consistently found genetically modified food and feed 'as safe as their conventional counterparts', and regulators in the United States and European Union have accepted this assertion overwhelmingly based on studies carried out and interpreted by the industry [17] (GM Food Nightmare Unfolding in the Regulatory Sham, ISIS scientific publication).
There is now a string of evidence that exposure of many species of animals to a variety of genetically modified crops, and food and feed derived from them, can cause illnesses and death, raising the distinct possibility that genetic modification is inherently dangerous [18] (GM is Dangerous and Futile, SiS 40). This is reinforced in results obtained in the most recent studies.
....
Golden Rice particularly dangerous
In addition, the unbalanced enhancement of single nutrients in GM crops may do more harm than good [27] (GM Crops and Microbes for Health or Public Health Hazards? SiS 32). As David Schubert at the Salk Institute for Biological Sciences La Jolla, California, in the United States points out [28], plants possess the ability to synthesize between 90,000 and 200,000 nonessential small molecules, with up to 500 in one species. The enormous repertoire is due in part to enzymes with very low substrate specificity, which are unpredictably altered by mutations and pleiotropic effects associated with GM technology. Furthermore, overdose of many single nutrients are known to be toxic, vitamin A being a case in point. Schubert highlights the toxic effects of retinoic acid and other metabolites of b-carotene, only a few of them can be identified and measured in the current state of technology.
Golden Rice is enhanced in b-carotene, which on ingestion, is cleaved in half to generate retinal for use in the visual cycle. Retinal is also reduced to retinol, or oxidized to retinoic acid (RA), which interacts with highly specific nuclear receptors. Essentially all of the biological activity of retinoids, apart from vision, involves RA. While high concentrations of retinol are toxic, RA is biologically active at concentrations several orders of magnitude lower than retinol. Hence, Schubert states [28]: "excess RA or RA derivatives are exceedingly dangerous, particularly to infants and during pregnancy." RA is required for the development of the nervous system, both by directly controlling nerve differentiation and by generating concentration gradients that direct cell migration, embryonic segmentation, and development. Therefore, RA and synthetic derivative of RA are teratogenic (able to cause birth defects). They can accumulate in fat and plasma, becoming a risk factor for pregnancy for up to 2 years following ingestion, and multiple low doses of retinoids have greater toxicity than a single high dose.
Because of the type of biological functions controlled by low levels of RA, any perturbation of its signalling pathways by plant-derived RA receptor agonists or antagonists will have clinical consequences. "Could the GM modifications used to enhance b-carotene synthesis create such compounds?"
(This question remains unanswered to this day.) Six hundred naturally occurring compounds exist in the carotene family, and at least 60 can be precursors to retinoids. "Therefore, plants have the potential to make many potentially harmful retinoid-like compounds when there are increased levels of synthetic intermediates to b-carotene as in golden rice."
While all retinoids and derivatives are likely to be teratogenic, good assays and information regarding the behaviour and teralogic activity are available for only three: retinol, RA, and retinal. Therefore, at the very least, "extensive safety testing should be required before the introduction of golden rice as a food."
See complete ISIS report with copious references at:
http://www.i-sis.org.uk/goldenRiceScandal.php
FAIR USE NOTICE: This may contain copyrighted (C ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit.
ALLIANCE FOR HUMAN RESEARCH PROTECTION
A Catalyst for Public Debate: Promoting Openness, Full Disclosure, and Accountability
http://www.ahrp.org
FYI
A report in the business forum, Zikkir, "Out of Sight" was prompted by the publicity surrounding the $79 million settlement of Pfizer's unethical Trovan experiment conducted on Nigerian infants.
http://www.ahrp.org/cms/content/view/571/72/.
The Zikkir article touches on the problems related to the US pharmaceutical industry's increased outsourcing of clinical trials to off-shore locations, mostly in underdeveloped countries including Eastern Europe and Russia which do not conform to ethical restraints mandated by the Nuremberg Code or the Declaration of Helsinki. http://zikkir.com/business/6259?wscr=1024x768.
An in-depth report by the Institute of Science in Society, "The Golden Rice
Scandal Unfolds," demonstrates that academics who are shielded by the US
government seal of approval, have been conducting medical experiments that
are clearly prohibited by the Nuremberg Code. The article focuses on a
series of recent unethical Phase II trials conducted by Tufts University
researchers, who tested genetically modified "Golden Rice' (GR2) on children
in the U.S. exposing them to "an unapproved experimental genetically
modified rice enhanced in pro-Vitamin A that has the potential to cause
birth defects and developmental abnormalities."
The questionable experiments-which ISIS described as "an exercise in how not to do science"--are:
1. Project NCT 00680355.(10) Bioavailability of Golden Rice Carotenoids in Humans.
http://clinicaltrials.gov/ct2/show/record/NCT00680355?term=golden
2. Project NCT 00082420. Retinol Equivalence of Plant Carotenoids in Children.
http://clinicaltrials.gov/archive/NCT00082420
The experiment compared the vitamin A value of b-carotene in oil capsule, spinach and Golden Rice - recruited 72 children 7 to 9 years of age. The starting date of the experiment was September 2004, it ended November 2005.
3. Project NCT 00680212. Vitamin A Equivalence of Plant Carotenoids in Children.
http://clinicaltrials.gov/ct2/show/record/NCT00680212?term=golden
In this experiment, researchers recruited 72 children 6 to 8 years of age and registered start and finish dates July 2008 and January 2009.
The ISIS report (submitted to the FDA in March, 2009) states:
"The Golden Rice Project website [6] (accessed 17 March 2009), stated that "Golden Rice has gone through many tests since it was first obtained" Nine items are listed; but no feeding trial on animals among them." See: http://www.i-sis.org.uk/goldenRiceScandal.php
"Golden Rice" has been touted as a humanitarian effort to resolve vitamin A deficiency. However, it has met with significant opposition from environmental and anti-globalization activists who view it as a commercial threat.
For example, Dr. Vandana Shiva called it "a hoax:"
"Unfortunately, Vitamin A rice is a hoax, and will bring further dispute to plant genetic engineering where public relations exercises seem to have replaced science in promotion of untested, unproven and unnecessary technology."
"The problem is that vitamin A rice will not remove vitamin A deficiency (VAD). It will seriously aggravate it. It is a technology that fails in its promise.
Since the daily average requirement of vitamin A is 750 micrograms of vitamin A and 1 serving contains 30g of rice according to dry weight basis, vitamin A rice would only provide 9.9 micrograms which is 1.32% of the required allowance. Even taking the 100g figure of daily consumption of rice used in the technology transfer paper would only provide 4.4% of the RDA."
"In order to meet the full needs of 750 micrograms of vitamin A from rice, an adult would have to consume 2 kg 272g of rice per day. This implies that one family member would consume the entire family ration of 10 kg. from the PDS in 4 days to meet vitaminA needs through "Golden rice".
"This is a recipe for creating hunger and malnutrition, not solving it."
"Even the World Bank has admitted that rediscovering and use of local plants and conservation of vitamin A rich green leafy vegetables and fruits have dramatically reduced VAD threatened children over the past 20 years in very cheap and efficient ways."
See: THE "GOLDEN RICE" HOAX -When Public Relations replaces Science
http://online.sfsu.edu/~rone/GEessays/goldenricehoax.html
The ISIS report calls the Tufts experiments "morally inexcusable:"
"The phase II clinical trials of uncharacterized, unapproved, experimental GR2 events on children, some of whom may indeed be suffering from vitamin A deficiency, is morally inexcusable. GR2 has not been assessed for safety, and there are reasons to suspect it is unsafe."
See: http://www.i-sis.org.uk/goldenRiceScandal.php
In February, 2009, an open letter addressed to Professor Robert Russell, Professor Emeritus, Friedman School of Nutrition Science and Policy, Tufts University School of Medicine (Email: rob.russell@tufts.edu) was signed by 30 senior scientists who protested the unethical testing of a possibly hazardous substance--"Golden Rice" (GR2) in children.
The letter states that the trials
"appear to be an experimental collection of transgenic events still in the laboratory, uncharacterized in terms of basic molecular genetics or biological and biochemical properties, not tested pre-clinically on animals, or subjected to any other safety assessment."
"The variety of Golden Rice used in these experiments (GR2) is inadequately described in terms of biological and biochemical characterization. anywhere else in the publicly available literature, and has woefully inadequate pre-clinical evaluation."
" It is a genetically modified product which has not been shown to be distinctive, uniform and stable over time. It has never been through a regulatory /approvals process anywhere in the world. There is now a large body of evidence that shows that GM crop/food production is highly prone to inadvertent and unpredictable pleiotropic effects, which can result in health damaging effects when GM food products are fed to animals (for reviews see Pusztai and Bardocz , 2006; Schubert, 2008; Dona and
Arvanitoyannis, 2009)."
"More specifically, our greatest concern is that this rice, which is engineered to overproduce beta carotene, has never been tested in animals, and there is an extensive medical literature showing that retinoids that can be derived from beta carotene are both toxic and cause birth defects."
No results have been made available for either of the pediatric studies (as of 17 March 2009).
The scientists noted that the three Tufts Projects breached the Nuremberg Code / medical ethics code "on a number of counts, and we urge you to call them to a halt immediately."
"They should not be resumed unless and until the researchers can demonstrate that a full range of laboratory and animal feeding trials have been completed and published for the Golden Rice strain being used, and unless and until appropriate regulatory bodies have had an opportunity to come to a view on the health and safety issues about which we are very concerned."
"We can assure you that such trials would not have been approved within the European Union in the absence of safety information, which highlights yet again the flaw of the USDA and FDA regulatory system in considering GM crops/foods as hypothetically "generally recognised as safe - GRAS" in the
absence of hard experimental data."
Further underscoring the U.S. academics' and government agency disregard for medical ethics, the ISIS report notes that an Indian newspaper reported that a clinical trial was cut short in China in July 2008, when the government found that 24 children 6-8 years of age at a primary school in Henyan, Hunan, were to be used as guinea pigs for a trial with Golden Rice."
That trial was also sponsored by Tufts University and approved by the US National Institute of Health--though not from the Chinese government, which was alerted by Greenpeace. Greenpeace has also warned the governments of Bangladesh, India, Indonesia, Philippines and Vietnam against the risky trials.
It would appear that the Chinese government conforms to higher medical ethics standards than the US National Institute of Health.
So, why has the media failed to pay any attention to these morally deplorable human experiments on American children ?
Contact: Vera Hassner Sharav
veracare@ahrp.org
212-595-8974
http://www.i-sis.org.uk/goldenRiceScandal.php
ISIS Report 18/03/09
The Golden Rice Scandal Unfolds
Phase II clinical trials on children have been conducted with unapproved experimental GM rice enhanced in pro-Vitamin A that has the potential to cause birth defects and developmental abnormalities Dr. Mae-Wan Ho and Prof. Joe Cummins
This report has been sent to the United States Food and Drug Administration on behalf of ISIS
Clinical trials of unapproved, uncharacterized GM rice on children
EXCERPT:
According to a recent report [9], a sample of the Golden Rice grains was sent to Germany in 2001 for a feeding trial with mice. But when the grains were tested for carotenoid content, the scientists were "surprised to find it contained less than one percent of the amount expected." After the rice was cooked, this was reduced by another 50 percent, so the trial was abandoned.
In 2005, Syngenta made GR2 [10] using the maize version of the enzyme phytoene synthase that was transferred from daffodil. GR2 produced up to 23 times the amount of carotenoids in the original Golden Rice, GR1.
But GR2 was not a transgenic variety based on a single transformation event. On the contrary, it was explicitly stated that [10]: "The reported transgenic rice events [emphasis added] are experimental." There is no telling whether all the children or adults taking part in any of the trials
were given Golden Rice from the same GR2 event. The results of the trials, as yet unreleased, could well be utterly worthless.
Syngenta was donating these GR2 events, via the Humanitarian Project for Golden Rice, for further research and development (to institutes across China, India, Philippines, Indonesia, Bangladesh and Vietnam) "through license under certain conditions", which include "being governed by the
strategic direction of the Golden Rice Humanitarian Board" Requests were to be directed to Adrian Dubock, a previous employee of Syngenta.
Dubock helped Potrykus and Beyer work out a deal in which Syngenta could develop Golden Rice commercially, but farmers in developing countries who make less than US$10 000 a year could get it for free [5]. Dubock retired from Syngenta in 2007, but remains a member of the Golden Rice Humanitarian Board, chaired by Potykus.
Golden Rice, an exercise in how not to do science
Golden Rice, genetically modified to make pro-vitamin A in the endosperm (the grain remaining after polishing), was announced with great fanfare in 2000 as a cure for widespread vitamin A deficiency in developing countries.
The project had already cost US$100 million, funded by the Rockefeller Foundation, the Swiss Federal Institute of Technology, the European Community Biotech Programme and the Swiss Federal Office for Education and Science, and could cost as much again to develop. It was tied up in at least 70 patent claims on genes, DNA sequences and constructs, a problem only partly solved in the "ground-breaking deal" worked out by Dubock (see above)..
Condemnation was swift and widespread, not least because it was absurd to offer Golden Rice as the cure for vitamin A deficiency when there are plenty of alternative, infinitely cheaper sources of vitamin A or pro-Vitamin A, such as green vegetables and unpolished coloured rice (especially black and purple varieties [11], which would be rich in other essential vitamins and minerals, and hence much more nutritious. The UN Food and Agricultural Organization (FAO) started a project in 1985 to deal with vitamin A deficiency using a combination of food fortification, food supplements and general improvements in diets by encouraging people to grow and eat a variety of green leafy vegetables. One main discovery from the project was that the absorption of pro-vitamin A depends on the overall nutritional status, which in turn depends on the diversity of the food consumed [12].
The main cause of hunger and malnutrition in the Third World is the industrial monocultures of the Green Revolution, which obliterated agricultural biodiversity and soil fertility, resulting in ever-worsening mineral and micronutrient deficiencies in our food. Golden Rice, like other GM crops, is industrial monoculture only worse, and will exacerbate this trend, as well as the destruction of agricultural land, and the impoverishment of family farmers that also accompanied the Green Revolution [13] (see Beware the New "Doubly Green Revolution", SiS 37).
GR1 was made with the standard 'first generation' genetic modification techniques, using GM constructs that cause uncontrollable mutations and other collateral damage to the host plant genome, with many unintended, uncharacterized effects [14]. In addition, the viral and bacterial sequences, including antibiotic resistance marker genes, in the construct and in the vectors created for gene transfer enhance horizontal gene transfer and recombination, the main route to creating new pathogens and spreading antibiotic resistance.
GR2 represents an improvement in so far as antibiotic resistance markers were no longer used, but still includes a medley combination of sequences\ from plant pathogens Agrobacterium (used in a binary vector system) and Erwinia uredovor, and from E. coli, inhabitant of the human gut, which also contains pathogenic strains. We have highlighted the special hazards of the Agrobacterium vector system since 2003 [15] (Agrobacterium & Morgellons Disease, A GM Connection?, SiS 38) (see below). The main reason for Golden Rice was revealed in the unusually long news feature article [16] accompanying the scientific publication [8] which stated: "One can only hope that this application of plant genetic engineering to ameliorate human misery without regard to short-term profit will restore this technology to political acceptability."
A detailed audit on the project [14] (The 'Golden Rice', An Exercise in How Not to Do Science, ISIS Report) uncovered "fundamental deficiencies" from the scientific and social rationale to the science and technology involved. It was being promoted "to salvage a morally as well as financially bankrupt agricultural biotech industry." The situation has changed little since.
The phase II clinical trials of uncharacterized, unapproved, experimental GR2 events on children, some of whom may indeed be suffering from vitamin A deficiency, is morally inexcusable. GR2 has not been assessed for safety, and there are reasons to suspect it is unsafe. GMO safety in question
The biotech industry has consistently found genetically modified food and feed 'as safe as their conventional counterparts', and regulators in the United States and European Union have accepted this assertion overwhelmingly based on studies carried out and interpreted by the industry [17] (GM Food Nightmare Unfolding in the Regulatory Sham, ISIS scientific publication).
There is now a string of evidence that exposure of many species of animals to a variety of genetically modified crops, and food and feed derived from them, can cause illnesses and death, raising the distinct possibility that genetic modification is inherently dangerous [18] (GM is Dangerous and Futile, SiS 40). This is reinforced in results obtained in the most recent studies.
....
Golden Rice particularly dangerous
In addition, the unbalanced enhancement of single nutrients in GM crops may do more harm than good [27] (GM Crops and Microbes for Health or Public Health Hazards? SiS 32). As David Schubert at the Salk Institute for Biological Sciences La Jolla, California, in the United States points out [28], plants possess the ability to synthesize between 90,000 and 200,000 nonessential small molecules, with up to 500 in one species. The enormous repertoire is due in part to enzymes with very low substrate specificity, which are unpredictably altered by mutations and pleiotropic effects associated with GM technology. Furthermore, overdose of many single nutrients are known to be toxic, vitamin A being a case in point. Schubert highlights the toxic effects of retinoic acid and other metabolites of b-carotene, only a few of them can be identified and measured in the current state of technology.
Golden Rice is enhanced in b-carotene, which on ingestion, is cleaved in half to generate retinal for use in the visual cycle. Retinal is also reduced to retinol, or oxidized to retinoic acid (RA), which interacts with highly specific nuclear receptors. Essentially all of the biological activity of retinoids, apart from vision, involves RA. While high concentrations of retinol are toxic, RA is biologically active at concentrations several orders of magnitude lower than retinol. Hence, Schubert states [28]: "excess RA or RA derivatives are exceedingly dangerous, particularly to infants and during pregnancy." RA is required for the development of the nervous system, both by directly controlling nerve differentiation and by generating concentration gradients that direct cell migration, embryonic segmentation, and development. Therefore, RA and synthetic derivative of RA are teratogenic (able to cause birth defects). They can accumulate in fat and plasma, becoming a risk factor for pregnancy for up to 2 years following ingestion, and multiple low doses of retinoids have greater toxicity than a single high dose.
Because of the type of biological functions controlled by low levels of RA, any perturbation of its signalling pathways by plant-derived RA receptor agonists or antagonists will have clinical consequences. "Could the GM modifications used to enhance b-carotene synthesis create such compounds?"
(This question remains unanswered to this day.) Six hundred naturally occurring compounds exist in the carotene family, and at least 60 can be precursors to retinoids. "Therefore, plants have the potential to make many potentially harmful retinoid-like compounds when there are increased levels of synthetic intermediates to b-carotene as in golden rice."
While all retinoids and derivatives are likely to be teratogenic, good assays and information regarding the behaviour and teralogic activity are available for only three: retinol, RA, and retinal. Therefore, at the very least, "extensive safety testing should be required before the introduction of golden rice as a food."
See complete ISIS report with copious references at:
http://www.i-sis.org.uk/goldenRiceScandal.php
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Tuesday, September 01, 2009
Cells don’t like to be alone
Detached Early Cancer Cells May Die from Lack of Nourishment
Antioxidants Could Rescue Starving Tumors-to-be
http://focus.hms.harvard.edu/2009/082809/antioxidants.shtml
Antioxidants Could Rescue Starving Tumors-to-be
http://focus.hms.harvard.edu/2009/082809/antioxidants.shtml
 |
Detached Early Cancer Cells May Die from Lack of NourishmentAntioxidants Could Rescue Starving Tumors-to-beCells don’t like to be alone. In the early stages of tumor formation, a cell might be pushed out of its normal environment due to excessive growth. But a cell usually responds to this homeless state by dismantling its nucleus, packing up its DNA, and offering itself to be eaten by immune cells. Simply put, the homeless cell kills itself. This process, known as apoptosis, typically stops potential cancer cells before they have a chance to proliferate.  Photo by Liza Green, HMS Media Services Joan Brugge and collaborators have identified metabolic defects with a lethal effect on cells that stray too far from their home environment. The defects might be a way for the body to stop potential tumor cells from proliferating. Now, researchers from the lab of Joan Brugge, the Louise Foote Pfeiffer professor of cell biology and chair of that department, have discovered another mechanism that these precancerous, homeless cells use to commit suicide. By studying two different types of human breast epithelial cells, the researchers found that when separated from their natural environment, these cells lose their ability to harvest energy from their surroundings. Eventually, they starve. “We originally thought that in order for cells to survive outside their normal environment, they would simply need to suppress apoptosis,” said Brugge, senior author on the paper, which appeared online Aug. 19 in Nature. “But our studies indicate that this activity is not sufficient to prevent the demise of homeless cells. Even if they escape apoptosis, these cells can’t transport enough glucose to sustain an energy supply.” Surprisingly, metabolic function is restored if antioxidant activity is increased inside the cells, allowing them to use energy pathways that do not rely on glucose. “It raises the interesting idea that antioxidants, which are typically thought to be protective because they prevent genomic damage, might be allowing these potentially dangerous cells to survive,” said first author Zachary Schafer, assistant professor at the University of Notre Dame and a former postdoc in Brugge’s lab.
“We think that genes with antioxidant activity play a much bigger role than antioxidant compounds administered from outside the body,” said Brugge. Beyond Cell Suicide The team had previously reported that when cells were endowed with a cancer-causing gene that prevents them from committing suicide, they still died when cut off from their extracellular environment. This puzzled the researchers since they had long thought that apoptosis was the only way the cells could die. In the recent study, Schafer and colleagues took a closer look, measuring the levels of proteins and molecules associated with metabolic activity in the displaced, but apoptosis-resistant, cells. They found that the cells had become incapable of taking up glucose, their primary energy source. Under the microscope, the cells also displayed telltale signs of oxidative stress, a harmful accumulation of oxygen-derived molecules called reactive oxygen species (ROS). The result was a halt in the production of ATP, the molecular lifeblood that transports energy in the cells. The unmoored cells were literally starving to death. “The idea that a lack of extracellular matrix can prevent cells from accessing nutrients hasn’t been shown conclusively before,” said Schafer. “Loss of glucose transport, decreased ATP production, increased oxidative stress—all those things turn out to be interrelated.” Tumor Metabolism To figure out what was wrong, the researchers took a direct approach: they tried to fix it. Schafer engineered the homeless cells to express high levels of a gene, HER2, known to be hyperactive in many breast tumors. He also treated the cells with antioxidants in an attempt to relieve oxidative stress and help the cells survive. Both strategies worked. The cells with the breast cancer gene regained glucose transport, preventing ROS accumulation, and recovered their ATP levels. The antioxidant-treated cells also survived, but by using fatty acids instead of glucose as an energy source.
The researchers are currently planning to test the effects of antioxidant genes, some of which are abnormally regulated in human tumors, and a wider range of antioxidants in animal models. They also plan on characterizing the metabolic consequences of matrix detachment in more detail. “Ultimately,” Brugge said, “we want to understand enough about the metabolism of tumor cells so that new types of drugs can be designed to target them.” Students may contact Joan Brugge at joan_brugge@hms.harvard.edu for more information. Conflict Disclosure: The authors declare no conflict of interest. Funding Sources: The National Cancer Institute and the National Institutes of Health; the authors are solely responsible for the content of this work. top | |||||
Sunday, August 30, 2009
Animal byproducts in common medicines and over-the-counter preparations
Why doctors should inform their patients where the medicines comes from
My many readers will know - from my many blogs (one Yahoo! 360 blog, recently closed by Yahoo! - had 1.3 million readers) that (a) I am NOT A FAN OF NOMINAL RELIGIOUS IDENTIFICATION - (b) nor am I supportive of arbitrary defections of any kind to lower moral standards.
An infrequently recurring question on vegetarian medical discussion lists in including those on topical medical concerns, where some clinicians and medical trained professionals are signed up, is animal ingredients in common medications. Some great servants of the vegetarians community like the Michaels - Dr. Michael Greger and Dr. Michael Klaper, have tried to help us steer clear of common over-the-counter preparations with animal ingredients, as have some pro-animal organizations (not only PETA, but others, too). You'll noted that, to the discredit of both vegetarians and presumptive vegetarians who are clinicians who ought to know the products AND our ethical and moral scruples about animal byproducts, many clinicians - including nominal Hindus, nominal Jains, nominal Adventists, and others - have failed to engage in pro-active HELP and service to the vegetarian communities, though they MAY be uniquely qualified to do so. Is it laziness or a misshapen sense that their NEW 'higher calling' is professional loyalty, a a jingoistic chauvinism to their professional colleagues, even when the profession is doing the wrong thing.
Let's get one thing clear: NO product of ANY kind should have ANY kind of animal ingredient or byproduct in it.
Therefore, no MEDICAL product of ANY kind should have ANY kind of animal ingredient or byproduct in it.
There's wide-ranging ignorance of this moral truth, but medical and health professionals who are NOT ignorant have even less to say in their defense when they err than have those whose moral laziness merely REFLECTS the social backgrounds from which they come.
In a column in the New York Times this week, Randy Cohen fields a question from an anaesthetist.
Should the doctor ask a devoutly religious patient whether he minds that his anticoagulant (heparin) is derived from pigs?
In his reply, Randy Cohen suggests that the doctrine of informed consent requires the doctor to consider the non-medical preferences of the patient and to make sure Muslims, Jews, and vegetarians (like us) know where medicine to be used in their treatment is coming from.
That's a second best (or third best, or not good) standard at best, but that's what Randy Cohen offers. It's a standard that's been around, has been widely accepted by medical ethicists and others in our culture, and seems to work with little additional thought. After all, clinicians should have a laboratory 'sense of things' that would include routinely understanding the chemical nature of stuffs, stuffs used in clinical treatment.
Are you with us so far? Good!
So Randy Cohen, in his New York Times article a week or so ago, suggests that the doctor's role includes a duty to provide whatever information patients need in order to make decisions about, decide, and effectively manage or control their care. But some doubt that it is a doctor's responsibilityto take into account what they call "preferences" (because they don't clearly understand the moral status of animals d they dismissive discount or deny their personhood.
These deniers claim that the doctors' role is too greatly extended.
:
"Imagine a vegan who takes particular exception to drugs that have been tested in higher order primates. Is the doctor expected to ask about all possible preferences and provide corresponding advice about treatments that conform to these? If so, this seems to be unreasonably demanding."
Briton Wikinson goes on to distinguish what he terms "the normative force of different claims about information-giving" (in other words, different nuances have different moral claims and intellectual legitimacy):
"There is a difference between
1. what would be good for the doctor to do, and
2. what we should expect the doctor to do, and
3. what we should sanction the doctor if they don't do?
If your doctor knows that you are a devout religious adherent, and that you may have an objection to a medical product that they know contains animal products, the doctor should inform you that the drug she is about to prescribe is derived from pigs. It would be good for them do so (level 1 above)."
So far, so good.
"And if you ask your doctor - does this drug contain animal products then the doctor should (stronger - probably level 2, maybe 3) find out about the drug and let you know."
Here's where we can take issue:
"Whether we should expect them (2) if you haven't asked or sanction them (3) if they didn't tell you is less clear to me.
We might also note that there is another side to responsibility when it comes to personal preferences for different treatments. If your preference is idiosyncratic or unusual you, the patient, probably have a responsibility to find out which potential treatments may contain animal products, as well as to let your doctor know that you really don't want animal products (or blood products etc). On the other hand if the preference is very common within the population perhaps the onus should be on the doctor."
Finally, Wilkinson quibbles further:"As for the relevance of all of this for orthodox judaism, Randy Cohen notes that since Heparin is administered subcutaneously rather than orally it is apparently not proscribed."
Thinking here of being carried away kicking and screaming while refusing ill-intentioned treatment, I rephrase German Lutheran Pastor Martin Niemoller just a little:
First they came for the Muslims, but I wasn't a Muslim...
Then they came for the Orthodox Jews, but I wasn't an Orthodox Jew...
Then they can for the ethical vegans, and I wasn't an ethical vegan...
Then they came for me, kicking and screaming (and what did they want to do surreptitiously to MY body, about which I would object?)...
Let's put it this way:
Ethicists, particularly bioethicists should be thankful (or, if they don't believe in thankfulness, count themselves fortunate) to HAVE observant Muslims, Orthodox Jews, careful SDAs, self-caring body-owning feminists, and us ethical vegans BECAUSE we help to clarify the case that humans DO object to anyone's surreptitiously sneaking objectionable methods into their treatment and materials and substances into our bodies - in the same way we object to the USDA's approval of GMOs, irradiation, chemicalized agriculture, and more.
We should be THANKFUL that the woman's movement in the West and around the world has joined this chorus of these serious moral objections, and we should WELCOME American Republicanswho are yelling at the top of their lungs:
"Just one moment! What's going to be IN this treatment? What's going to be IN this health care program?"
We psychophysical unities of every stripe, brand, variety, background, persuasion, and pattern of human dignity demand no less than a transparent and open discussion of all these issues, even if it means that some well-intentioned measures can't be ramrodding into law quite so quickly.
Those who KNOW there is objection should be especially eager to fund research into NON-objectionable methods of caring for and preserving human health and for restoring it when illness and disease emerge (and for reducing and eliminating pain and providing proper care and treatment when that's the limit of suitable medical intervention).
We all know that the status quo in healthcare is not good enough, but it's more than access to currently-available treatments and their funding that's a mess. What is also all messed up is the WAY our society thinks about health and healthcare. I can give Ted Kennedy credit for noting that we ought to be paying doctors for keeping patients well, but I only puzzle whether or not we have trained these physicians to KEEP people well (when so much emphasis is placed on listening to complaints and treating post-diagnosisconditions.
Why not listyen to us? Of coruse, they ARE listening to us, and if it flies and flies far, they can claim it as their own.
And who should we be to com,plain if they DO develop treatment modalities that are agree of animal exploitation and abuse, focus first on primary prevention, emphasize a strong role for individual responsibility for health andsocial support for enabling that personal responsibility (safe and suitable exercise facilities in all workplace regions and residential areas, designing urban and suburban areas for exercise, and eliminating all subsidies for animal agriculture and making fresh produce afforcable and safe; shifting emphasis from high tech medicine to wards the low-hanging fruit of primary prevention, etc.). After all, what does it mean sociologically to be a servant of the greater public good, the good of all society? It means to serve wisely and effectively; it does NOT mean taking the credit. In the long run, the HEALTH of the people is FAR MORE IMPORTANT than the healthcare delivery of the people UNLESS that healthcare delivery PREVENTS the problems in the first place.
It is BETTER to have NOT suffered at all than to have suffered ravaging illness and disease, then, after costly treatment funded socially, to have recuperated (at least temporarily). Treatment costs money directly AND in lost productivity AND in lost happiness AND in suffering AND in grief for significant others and workplace colleagues. Being HEALTHY IS a savings. That's "IN THE NATURE OF THINGS" for all of us.
If you're looking for healthcare delivery savings, it's in keeping people well; that's why we're shifting to the IDEA of paying healthcare providers differently: paying healthcare systems (not just the doctors) for keeping people well.
In the search for cost savings, Peter Orszag should be exploring primary prevention. Shouldn't we all?
But don't put those animal ingredients in MY treatment protocols (and if we're well, we're less at risk for the medical violation of our bodies).
And the lowest common denominator, and thus the cheapest path for pharmaceutical companies, is to make ALL medicaments FREE of all animal ingredients and byproducts.
The ethicist (note point 3 above) told us that those who object the most should object the loudest because they're the ones who are hardest for the dulled mainstream to hear. We need to make OUR cases that we want an ethical and above-board system of providing health services to our species that don't violate the inherent rights of persons - nonhuman AND human.
And it's better to proactively make the case early than to resort to attorneys 'post-diagnosis' (after our bodies - and bodily rights - have been violated).
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