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Can you get paid for donating an organ?
In practice, you can. All over the world, people are being paid for their kidneys. But what about the United States? Under U.S. law, can you demand compensation for such a gift?
Richard Batista of Long Island, New York, thinks he can. He's suing his ex-wife for $1.5 million, citing, among other things, the kidney he gave her eight years ago. He says she rewarded his life-saving generosity by having an affair, divorcing him, and keeping their children away from him.
Newsday implies the case will go nowhere:
Medical ethicists agreed that the case is a nonstarter. Arthur Caplan of the University of Pennsylvania's Center for Bioethics said the likelihood of Batista getting either his kidney or cash was "somewhere between impossible and completely impossible." Robert Veatch, a medical ethicist at Georgetown University's Kennedy Institute of Ethics, noted that "it's illegal for an organ to be exchanged for anything of value."
I'm not so sure. Batista can't take his kidney back, but that's not what he's after. He wants his ex-wife to let him visit their kids, on pain of compensating him for what he gave her. And what he gave her, according to his attorney, wasn't just an organ, but a livelihood. According to Newsday, the attorney says the $1.5 million demand "reflects damages, including how much money she made as a result of being able to continue working and not having to go on dialysis." So the dollar figure isn't based on the price of an organ (which would be considerably cheaper, based on the going rate of kidneys abroad); it's based on the income one spouse accrued thanks to the other's sacrifice. And sacrifices between spouses are treated differently, under the law, from sacrifices between strangers or friends. There's a tradition and expectation of common benefit. You and your spouse become one flesh—in this case, literally.
I'm sure some of you clever lawyers can figure out how to position this claim as an extension of those divorce cases where the wife gets compensated for devoting herself to her husband's executive career. "It's not the organ itself we're asking you to value. It's the financial benefit the defendant gained thanks to the risk, the pain, and the extensive, invasive medical procedures this good man, this loving husband, endured. Yes, it was a gift of love—but no less a gift of love than the other sacrifices so many spouses make for each other's careers. Let it be acknowledged in the same way."
I'm tearing up already. Will it work? I wouldn't be a kidney on it. But it's worth a try.
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What is it with the Catholic Church and female anatomy?
The total opposition to abortion I can understand. The men in Rome believe that personhood begins at conception.
The opposition to artificial contraception strikes me as completely wrongheaded but not necessarily a guy thing. They believe that sex must be open to life and that life must arise through sex.
The misunderstanding of morning-after pills in their latest instruction to Catholics? Well, that's a bit ignorant. But even the average woman isn't familiar with the research on LH surges, luteal dysfunction, and endometrial damage.
On all these issues, I'm willing to give the men in Rome the benefit of the doubt. But then I read this report from the Vatican newspaper, via Agence France Presse:
The contraceptive pill is polluting the environment and is in part responsible for male infertility, a report in the Vatican newspaper L'Osservatore Romano said Saturday. The pill "has for some years had devastating effects on the environment by releasing tonnes of hormones into nature" through female urine, said Pedro Jose Maria Simon Castellvi, president of the International Federation of Catholic Medical Associations. ... "We have sufficient evidence to state that a non-negligible cause of male infertility in the West is the environmental pollution caused by the pill," he said, without elaborating further.
That's right: The new cause of male infertility is female urine. Specifically, the urine of women who are committing the sin of contraception.
Scientifically, the theory looks a bit wet. AFP continues:
The article was promptly dismissed by several organisations. "Once metabolised, the hormones contained in oral contraceptives no longer have any of the characteristic effects of feminine hormones," said Gianbenedetto Melis, vice-president of a contraceptive research association, quoted by the ANSA news agency. The hormones contained in the pill such as oestrogen "are present everywhere ... in plastic, in disinfectants, in meat that we eat," added Flavia Franconi, of the Society of Italian Pharmacology.
Perhaps it's a sign of the modern age that moralists feel obliged to associate their principles with health effects. Abortion isn't just murder; it causes breast cancer and psychological damage to women. Contraception isn't just a violation of God's will; it's an environmental toxin. But none of these health claims has turned out to be valid. And in this case, the claim is so perfectly consistent with the history of misogyny—blaming men's fertility problems on women's sins and fluids—that it risks not just scientific but moral discredit.
On the other hand, if it turns out to be true, I'll be really pissed.
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For ages, we've been telling children that ghosts aren't real. But the Department of Defense has just put out a request for proposals to create what are, in effect, virtual ghosts. Another truism of parenting is about to become untrue.
More here.
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I'm just back from vacation and trying to catch up on the war in Gaza. More on that later. But first, something I didn't have a chance to get to before the break: the Vatican's latest pronouncement on fertility technology. Apparently the men in Rome are having trouble understanding some nuances of the female reproductive system.
The pronouncement comes in the form of Dignitas Personae, an instruction from the Congregation for the Doctrine of the Faith, which articulates official Catholic positions. This document covers several interesting topics, which I hope to get to in the days ahead. But the one that calls for rebuttal right away is the section on "[n]ew forms of interception and contragestation." It says:
Alongside methods of preventing pregnancy which are, properly speaking, contraceptive, that is, which prevent conception following from a sexual act, there are other technical means which act after fertilization, when the embryo is already constituted, either before or after implantation in the uterine wall. Such methods are interceptive if they interfere with the embryo before implantation and contragestative if they cause the elimination of the embryo once implanted.
This is an astute and useful set of distinctions. Unfortunately, the CDF immediately proceeds to violate them. Here's its next paragraph:
In order to promote wider use of interceptive methods [a footnote here specifies "morning-after pills"], it is sometimes stated that the way in which they function is not sufficiently understood. It is true that there is not always complete knowledge of the way that different pharmaceuticals operate, but scientific studies indicate that the effect of inhibiting implantation is certainly present, even if this does not mean that such interceptives cause an abortion every time they are used. ...
Really? Is the effect of inhibiting implantation "certainly present"? Let's review the mechanics of morning-after pills, specifically levonorgestrel, marketed as Plan B. The problem with the CDF's statement is that this "interceptive" is chemically identical to the best-known contraceptive: the pill. And the risk that this drug
will prevent implantation of an embryo is purely theoretical. There is no documented case of such a tragedy, since we have no way to verify conception inside a woman's body prior to implantation without causing the embryo's death. Even theoretically, the risk is vanishingly small, since the primary effect of oral contraception is to prevent ovulation, and the secondary effect is to prevent fertilization. To classify oral contraception as abortifacient, one would have to posit a scenario in which the drug fails to block ovulation, then fails to block fertilization, and yet somehow, having proved impotent at every other task, manages to prevent implantation.
So, the assertion of an anti-implantation effect is theoretically unsound. But what do the data show? Two years ago, the world's leading expert on levonorgestrel, James Trussell, co-authored an analysis of the available research in the Journal of the American Medical Association. The analysis confirmed that that anti-ovulation effects wipe out any data suggesting a possible anti-implantation effect. It concluded:
Published evidence clearly indicates that Plan B can interfere with sperm migration by altering the cervical and uterine environment, and that preovulatory use of Plan B usually suppresses the LH surge either completely or partially, which in turn either prevents ovulation or leads to the release of ova that are resistant to fertilization. Epidemiological evidence rules strongly against interruption of fallopian tube function by Plan B. Evidence that would support direct involvement of endometrial damage or luteal dysfunction in Plan B's contraceptive mechanism is either weak or lacking altogether. Both epidemiologic and clinical studies of Plan B's efficacy in relation to the timing of ovulation are inconsistent with the hypothesis that Plan B acts to prevent implantation.
In fact:
Progestational drugs, including levonorgestrel, are used therapeutically in assisted reproduction because they increase the rate of successful implantation and pregnancy. That observation a priori reduces the likelihood that Plan B interferes with implantation; it even raises the counterintuitive but undocumented possibility that Plan B used after ovulation might actually prevent the loss of at least some of the 40% of fertilized ova that ordinarily fail spontaneously to implant or to survive after implantation.
So, in summary:
[T]he ability of Plan B to interfere with implantation remains speculative, since virtually no evidence supports that mechanism and some evidence contradicts it. ... [T]he best available evidence indicates that Plan B's ability to prevent pregnancy can be fully accounted for by mechanisms that do not involve interference with postfertilization events.
So much for the question of effect. But what about the other part of the moral equation: intent? The Vatican document, still referring to morning-after pills, says that "anyone who seeks to prevent the implantation of an embryo which may possibly have been conceived and who therefore either requests or prescribes such a pharmaceutical, generally intends abortion."
But a woman who requests a morning-after pill doesn't necessarily seek to prevent an embryo's implantation. In fact, as we just showed, it would be irrational of her to seek that effect, since no evidence supports it. In fact, given the evidence, it would make just as much sense for her to request the pill in order to prevent embryonic loss. And anyone who has ever taken a morning-after pill knows that at that moment, your actual intent is to avert pregnancy at the earliest possible stage of the process, which happens to be ovulation.
Bottom line: The perceptive analytical framework established by Dignitas Personae, combined with the best scientific evidence and analysis, clearly implies that morning-after pills are contraceptives, not interceptives. Therefore, from the standpoint of respecting embryonic life, you may take them in good conscience.
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Human Nature is on vacation and won't be back till after New Year's. In the spirit of the holidays, I'd like to thank each of you for staying in touch as a reader and, I hope, as a correspondent. In fact, I'd like to ask one favor of you: Tell me how you'd like me to do my job differently.
The mission of this column is to explore the ways in which science and technology are changing how we live, what we think, and who we are. It's a huge and growing part of modern life. Traditional media have covered it poorly, I think, because they're too accustomed to the old system of beats. There's the science beat, where you cover the latest studies. There's the health beat, where you cover the human body. And then there are political and cultural beats, which address how we live and govern ourselves.
The problem with the old system is that technology is moving so fast, and transforming society so extensively, that we can no longer adequately cover politics and culture without accounting for science and technology. Nor can we cover science and technology without examining how they're affecting culture and politics. Hence this column.
With that framework in mind, which topics should I be covering more? Which developments am I missing? Which questions am I neglecting to ask? And while you're at it: Which formats do you prefer to read? How often do you want to be updated? Do you prefer the longer pieces of previous years? The quick headline links of last spring? The daily, medium-length blog items of the last month or so? Something else?
Who are your favorite writers on science and technology? Your favorite news sources? Your favorite blogs? Last spring I drew up a list of blogs and news outlets. I'll probably adapt it to run in the right-hand column of this page. Should I add to it? If I narrow it, which links should I keep? Got any good books to recommend?
One thing I've come to admire about science, as opposed to politics, is its humility. Today's proudest theories are always at the mercy of tomorrow's inconvenient data, and today's seemingly straightforward data are always open to being reshuffled by tomorrow's perspective-shifting theories. We have a lot to learn from each other.
So give me your best advice. I can't learn without you. And I'll be back to return the favor in 2009.
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We have a verdict in the premature-organ-harvesting case.
Let's go to the Los Angeles Times for a summary of the case. Two years ago, the patient, Ruben Navarro, lay close to death after a heart attack.
His mother had given permission for organ donation, and a team that included [Dr. Hootan] Roozrokh flew in from San Francisco on behalf of a regional transplant network. Roozrokh ... was to supervise a donation after cardiac death ... In most transplants, the removal of organs occurs only after a patient is declared brain-dead. In donations after cardiac death, a patient's brain is irreversibly damaged but still functioning minimally. With a family's consent, the patient is removed from life support and, once the heart has stopped, the patient is declared dead, and organs may be removed minutes later. Many experts say, however, that organs are usable only if they can be retrieved within 30 minutes after the machines are turned off.
According to prosecutors, Roozrokh ordered up excessive doses of the painkiller morphine and Ativan, an anti-anxiety drug, so that Navarro would die within that crucial half-hour. As it turned out, he died eight hours later and Roozrokh did not remove any organs.
So the basic problem was that Navarro's medical care was being directed by a guy sent to the hospital to get his organs—and that the doctor's actions may have helped the organs but not the patient. The doctor was looking at a felony charge, dependent adult abuse, with a possible sentence of four years.
Verdict: Not guilty. But the jury also issued this statement (handwritten PDF here):
Ruben's case has identified that Donation by Cardiac Death (DCD) is in desperate need for further identification of prescribed policy in order to continue successfully as a viable option for organ donation in this country. Refining the nationwide protocol of DCD organ procurements will be an important part of Ruben's legacy...
In other words, Roozrokh may have crossed the line, but the jury blames the system, or lack thereof, for failing to draw the line clearly in the first place. I think the jury did the right thing. Most of us are selectively pious. We like to single out villains when bad things are done. It's harder to admit that the bad things are extensions of good ideas and that the people behind those ideas include us. What happened to Navarro wasn't a bad doctor. It was a system that has increasingly pushed boundaries to get organs that save lives. As Art Caplan puts it in the Times story:
There's a growing waiting list; there are more centers competing for donors; and it's a very lucrative procedure for hospitals. It's against that backdrop that the story of a doctor being sent out to come back with organs unfolds.
The pressure has reached the point where doctors at one hospital, as noted here,
removed hearts from infants 75 seconds after their hearts stopped. The infants were declared dead of heart failure even as their hearts, in new bodies, resume ticking.
It's a discomfiting new trend of treating people as bags of organs. But the driving force behind this trend isn't Hootan Roozrokh. It's all of us.
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I went to see President Bush's farewell chat with the American Enterprise Institute yesterday. It was an unusually frank conversation: He actually admitted mistakes. In fact, he wandered so far off-message that when he was asked about defense spending, he started talking about specific weapons systems, and pretty soon he said this:
Our soldiers are carrying unbelievably new technologies, using Predators to use over-the-wall intelligence to be able to have better battlefield awareness.
Over-the-wall intelligence? I've searched DefenseLink, and I don't see that term or anything like it. I do, however, see "through-the-wall surveillance," associated with the Air Force Research Laboratory. And the last time I checked, walls tended to be associated with roofs. So one way or another, the Predators have to see through something.
Is Bush possibly blabbing about the technology cryptically described by Bob Woodward and others? The ability of U.S. unmanned aerial vehicles to identify and track human targets "even when they are inside buildings"? If so, the convergence sketched here two months ago—unmanned vehicles that can see through walls—is indeed upon us.
By the way, as of this week's hit in North Waziristan, the number of U.S. drone missile strikes in Pakistan this year is approaching 30, and the body count is over 200.
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From yesterday's piece:
Don't look now, but a woman in Ohio has a new face. And the world has a new kind of medicine: socially necessary surgery.
The operation, announced yesterday at the Cleveland Clinic, was a face transplant from a corpse. ... Doctors replaced 77 square inches of the patient's face, from her eyelids to her chin.
More here.
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Hey, Detroit! We have a new job for you.
Just in time to bail out the auto parts suppliers, Madeline Drexler heralds the latest cool new (or is it old?) idea: car-parts incubators. Here's her description of them in yesterday's Science Times:
The heat source is a pair of headlights. A car door alarm signals emergencies. An auto air filter and fan provide climate control. ... Unlike the notoriously high-maintenance incubators found in neonatal intensive care units in the United States, it is easily repaired, because all of its operational parts come from cars. And while incubators can cost $40,000 or more, this one can be built for less than $1,000. The creators of the car parts incubator ... say it could prevent millions of newborn deaths in the developing world.
We're so used to incubators these days that we've forgotten how radical they are. Their function, Drexler notes, is "providing a warm, clean, womblike environment in which a baby can mature." In short, they're artificial wombs. They don't replicate every function, of course. But for millions of babies who would otherwise die, they replicate enough.
They also destabilize our notions of abortion and infanticide. U.S. abortion laws are organized around viability, the idea that a fetus is entitled to protection when it can survive outside the womb. That's a technical question, and incubators, by creating a kind of womb outside the womb, influence the answer. The earlier they can sustain preemies, the further the line of viability advances.
But that's the fancy far edge of incubator technology. Drexler is talking about something simpler and more immediate: making basic incubation available and functional around the world. Who cares about the latest million-dollar American baby born at 21 weeks when you live in a country where preemies die at 35 weeks? You can't spend that kind of money. You can't even find somebody local to fix a $20,000 incubator. You need an affordable machine that works for most preemies and can be reliably maintained. That's what the car-parts incubator is designed for: babies born at 32 weeks or later.
In the transition from George W. Bush to Barack Obama, we're going to see a big shift in the politics of biotechnology. The conservative preoccupation with technological frontiers will be replaced, for the time being, by a progressive preoccupation with distributive justice. That means less debate about things like future artificial wombs and more attention to things like car-parts incubators. In some ways, it'll be more boring. But tell that to the woman in Indonesia who gets to keep her baby.
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I'm now going to depict an adult and a minor having sex. The adult is represented by the character on the left. The minor is represented by the character on the right. Here is my depiction:
&i
Have I just committed a crime punishable by 10 years in jail?
Under a ruling issued last week in Australia, it's quite possible that I have. The ruling, issued by the Supreme Court of New South Wales, affirms that a cartoon can be prosecuted as child pornography. Here's the background of the case:
[T]he plaintiff was convicted ... of possessing child pornography contrary to s 91H(3) of the Crimes Act 1900 (the Act) and using his computer to access child pornography material contrary to s 474.19(1)(a)(i) of the Criminal Code Act 1995 (the Code). The alleged pornography comprised a series of cartoons depicting figures modelled on members of the television animated series "The Simpsons". Sexual acts are depicted as being performed, in particular, by the "children" of the family. The male figures have genitalia which is evidently human, as do the mother and the girl.
The Australian laws in question define child pornography as depictions of a "person" or depictions of "a representation of a person." A related memorandum says such definitions "are intended to cover all visual images, both still and motion, including representations of children, such as cartoons or animation." But even without the memorandum, the court says child pornography laws are in part "calculated to deter production of other material—including cartoons—that ... can fuel demand for material that does involve the abuse of children." Accordingly, "The depictions and representations of persons to which the definition refers include a drawing (or, for that matter, a model or sculpture) and, hence a cartoon, of a fictional character."
Does it matter that we're talking about the silly-looking Simpsons? No, says the court: "Even a substantial departure from realism will not necessarily mean that the depiction is not that of a person in this sense." The court upholds the initial ruling that the characters "were indeed depictions of persons" under the law. The convictions stand.
You have got to be kidding me.
Look: If you molest my kid, I'll see that you burn in hell. If you take a picture of my kid and Photoshop it so it looks like a sex act with you, I'll use any law I can find to put you away. If you make a sicko cartoon and digitally alter it so it looks like my kid, I'll throw the book at you. But if what you've made doesn't look like anyone's kid—if it's just a revolting mockery of the Simpsons—I'm supposed to convict you of child pornography? Really?
What's happening to child pornography is what's happening on the Internet and in software generally: Technology is blurring boundaries between action and thought, public and private, real and fake. On this point, the Australian court quotes the Supreme Court of Canada: "With the quality of contemporary technology, it can be very difficult to distinguish a 'real' person from a computer creation or composite." This gray area unnerves us, so we prosecute it. Two years ago, then-Rep. Mark Foley, R-Fla., was forced out of Congress for soliciting teenage boys online, though there's no evidence he ever touched a minor. This year, the U.S. Supreme Court upheld a ban on sexual images of children even if they're computer-generated or nonexistent. Apparently, more people are now arrested for using the Internet to solicit cops posing as kids than for using it to initiate relationships with real kids.
I understand why we do this: We're afraid that if we don't prosecute cyber-perverts, they'll move on to the real thing. But the danger runs both ways. How far will we extend felony prosecution into the realm of the private, the fake, and the abstract? If the Simpsons count as child pornography, what's next?
Actually, the Australian court has answered that question. Under the relevant child pornography laws, says the court, "a stick figure ... might well depict a representation of a person. No bright line of inclusion or exclusion can be sensibly described."
Well, then, come and get me. If there's no boundary between real and fake, between people and "depictions of representations," then prosecute me for my stick figures. Or admit it's ridiculous—and an insult to the real thing.
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The health police have crossed another line. Four months ago, they banned new fast-food restaurants in a 32-square-mile area of Los Angeles. In that case, they crossed the line from restricting food for kids to restricting it for adults. They also extended the practice of health zoning from liquor to food.
Now they've breach another line between paternalism for children and paternalism for adults. The Boston Public Health Commission has just banned the sale of all tobacco products at colleges. Not high schools. Colleges.
Anti-smoking activists are ecstatic. "Boston has taken another step that puts it in the forefront in the United States in protecting people against secondhand smoke," says the president of the Campaign for Tobacco-Free Kids. But the Boston regulations don't just restrict smoking. They forbid the sale of "any substance containing tobacco leaf, including but not limited to cigarettes, cigars, pipe, tobacco, snuff, chewing tobacco and dipping tobacco." Last I heard, there's no secondhand smoke from chewing tobacco. And the tobacco industry is constantly developing new products that confound the equation of tobacco with smoking. That's not because tobacco companies care deeply about public health. It's because secondhand smoke has become a political problem for them—and because, while addicting customers is good business, killing them isn't.
In a press release, the executive director of the Boston commission says the new regulations "will help reduce young people's exposure to tobacco products." Young people? That phrase used to mean minors. Now, apparently, it includes the targets of the new rule: students at "any public or private college, normal school, professional school, scientific or technical institution, university or other institution furnishing a program of higher education."
On what grounds do college students—not to mention students at professional schools—deserve the kind of paternalism previously reserved for minors? The commission offers two reasons. First, "educational institutions in the City of Boston also sell tobacco products to the younger population, which is particularly at risk for becoming smokers." Second, "the sale of tobacco products is also incompatible with the mission of educational institutions which educate the younger population about social, environmental and health risks and harms."
In other words, college students (henceforth known as "the younger population") are so vulnerable to smoking and to deception about the harms of smoking that their access to any tobacco products on campus must be legally forbidden.
It's true that laws across the United States set the legal drinking age at 21. But those laws are based on the argument that alcohol makes people aged 18 to 20 drive dangerously. Where's the evidence that chewing tobacco makes these people drive dangerously?
To repeat: I detest smoking. But if there's no secondhand smoke and no secondhand driving effects, what are the grounds for telling a 20-year-old college student—let alone a 25-year-old professional-school student—that tobacco is off-limits? And if that kind of paternalism can be extended so easily from minors to 25-year-olds, who's next?
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Earlier this year, I criticized Medicare for spending $35,000 on a heart implant for a woman who was about to turn 100. The basic argument was:
Should we means-test people on Medicare not just for wealth, but for age? ... The theory is that just as some people have enough money, others have had enough time. If you make it to 100 and can fund your own surgery, that's terrific. But Medicare should focus its resources on people who haven't been as lucky as you. Living to 99 is no tragedy. It's a blessing.
Several of you chastised me for callousness. And now a report from a recent American Heart Association conference backs you up. Marilynn Marchione of the Associated Press tells the story:
Eighty-year-olds with clogged arteries or leaky heart valves used to be sent home with a pat on the arm from their doctors and pills to try to ease their symptoms. Now more are getting open-heart surgery, with remarkable survival rates rivaling those of much younger people, new studies show. ...
In Florida, Dr. Paul Kurlansky led a study of 1,062 octogenarians who had heart bypass surgery at Mount Sinai Medical Center in Miami Beach from 1989 through 2001. ... Average survival was roughly six years—almost the same as similarly aged people who do not have heart disease. Overall, 90 percent survived their surgery to leave the hospital. This improved dramatically as the study went on, from 85 percent in the early years to 98 percent by its end. Even more impressive: 65 percent survived without surgery-related complications and even more without long-term complications ...
A Yale cardiologist draws exactly the conclusion I rejected: "Age itself shouldn't be an automatic exclusion." Marchione adds: "Not every older person can undergo such a challenging operation, but the great results seen in the new studies show that doctors have gotten good at figuring out who can."
This doesn't settle the underlying question of whether there's such a thing as having lived long enough, regardless of what a new device or surgery will do for you. But it does underscore that age, like race, is a crude basis for making individual projections.
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We saw this coming. More than 1 million procedures every year to implant artificial body parts. Two million patients with heart-regulation implants. And the big question:
You can fix a squeaky bike, but what about a squeaky hip? You can take a bum cell phone back to the store, but what about a heart implant? What do you do when the product you want to return is part of your body?
Latest example: an emerging fight over the interface between your heart implant and your heart. The FDA is on one side; Dr. Robert Hauser an Dr. Adrian Almquist of the Minneapolis Heart Institute, writing in the New England Journal of Medicine, are on the other. Their commentary is behind a subscription wall, so here's a summary of the debate from Barry Meier in the New York Times:
Federal regulators are about to approve use of a critical new electrical component for implantable heart devices without adequately testing for its potential risks, a prominent cardiologist warned Wednesday. The potential problem involves a new way of connecting defibrillators to the wires, or leads, that carry high-voltage electrical jolts between such units and the heart ...
Dr. Hauser argued that manufacturers should perform at least some clinical trials on patients to ensure that the new technology is not prone to short-circuiting, a problem that can prevent a defibrillator from delivering the life-saving electrical jolt ... The Food and Drug Administration, on the rationale that the new wiring connectors are simply a design modification and not a new technology, is not requiring human tests. Instead, it is requiring producers to carry out mechanical stress tests of the new connectors and study their performance in animals.
In other words, the FDA is treating the new technology as a detachable gizmo: You can test it in the lab, or in an animal, or whatever. Then you put in people and assume that since the last version worked, the upgrade will work, too. Hauser is treating it as a human body part: You have to test it in people, since that's where it's going to live, as it were.
Who's right? I don't know. Hauser has a better track record than the FDA does in assessing the safety of heart implants. But the key question, from what I can tell, is which standard of testing to apply. Should we let implant makers upgrade their devices just like other technology companies, or not? Think carefully. Because if you don't have an artificial body part today, there's a good chance you'll have one tomorrow.
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The latest encroachment of DNA testing: No conviction, or even prosecution, necessary. From Spencer Hsu in the Washington Post:
Immigration and civil liberties groups condemned a new U.S. government policy to collect DNA samples from all noncitizens detained by authorities and all people arrested for federal crimes. The new Justice Department rule, published Wednesday and effective Jan. 9, dramatically expands a federal law enforcement database of genetic identifiers, which is now limited to storing information about convicted criminals and arrestees from 13 states.
This comes after the U.K. launched a similar plan and got smacked down by European judges:
This month, the European Court of Human Rights unanimously ruled that a British policy to collect fingerprints and DNA of all criminal suspects, including those later deemed innocent, violated privacy rights.
If anyone here thinks the U.S. Supreme Court will take a similar line, I've got a few large automobile manufacturers to sell you.
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From today's piece:
I remember the day my first child was born. He lay sleeping, swaddled, in a plastic bin at the hospital. That's when I finally understood what it meant to be a parent. "If we leave this hospital without this baby," I told my wife, "we'll be arrested."
It was a joke, but it was also true. You arrive at the hospital as two people, and you leave as three. You can't just make a baby and walk away. It's yours forever.
Unless, that is, you make a baby through in vitro fertilization. In that case, you can put the embryo away in a freezer and decide what to do about it later. Or never. ...
More here.
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We have a late-breaking frontrunner for dumbest policy idea of 2008: defunding Planned Parenthood in the name of fighting abortion.
Stephanie Simon reports the latest developments in the Wall Street Journal:
Abortion opponents are pressing state and local governments to stop sending taxpayer dollars to Planned Parenthood, arguing that the nonprofit group has plenty of cash and shouldn't be granted scarce public funds at a time of economic crisis. ...
In recent weeks, Planned Parenthood chapters have lost public funds in two states as elected officials juggled tight budgets. Fulton County, Ga., which includes Atlanta, canceled a $420,000 contract as part of statewide cuts in health care. The move ended a teen-pregnancy prevention program and prompted a local Planned Parenthood clinic to raise fees to make up lost revenue. Sarasota County, Fla., ended years of subsidizing Planned Parenthood's sex-education programs with annual grants of as much as $30,000. ... The Family Research Council is developing a kit to help grass-roots activists dig through financial reports so they can make detailed presentations to elected officials about the assets and revenue of local Planned Parenthood chapters. The council has sent letters to 1,200 state legislators describing Planned Parenthood's strong financial position and urging "a second look" at public funding.
Defunding Planned Parenthood is hardly a new idea. What's new is the fiscal-responsibility angle. And from a pure cost-cutting perspective, you can make the case that Planned Parenthood brings in plenty of private funding and doesn't need public money. I think the pure cost-cutting perspective is a mistake, given the enormous social and economic benefits of preventing unintended pregnancies. But you can make that case, if you really believe in fiscal austerity.
What's insane, however, is the real motivation behind this push. The Family Research Council doesn't really care about economics. That's why, as you might have noticed, it's called the Family Research Council. The campaign to defund Planned Parenthood is really about abortions. FRC would like to see fewer of them. So would I. And that's the crux of the idiocy: The single best thing you can spend money on to reduce the number of abortions, not just in this country but around the world, is Planned Parenthood.
I'll say that again: If you define pro-life as preventing abortions, Planned Parenthood is the most effective pro-life organization in the history of the world. No, it doesn't give teenagers the idea of having sex. That idea comes to them quite naturally, thank you very much. What Planned Parenthood does, more comprehensively than anyone else, is to distribute the means and knowledge to control your risk of getting pregnant when you don't want to be pregnant. And those two things, combined with pressure to exercise that control assiduously, are the surest way to prevent abortions. If you wait till women are already unhappily pregnant, you're too late.
If you think Planned Parenthood is sufficiently funded, fine. Write your check or award your grant to some other, smaller organization that does similar work. But don't imagine that defunding birth control will buy you fewer abortions. It will buy you more.
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Looking for some extra income to make ends meet during the recession? Try selling eggs. Not chicken eggs. Your eggs.
Melinda Beck has the story in today's Wall Street Journal:
Here's another sign of the tough economic times: Some clinics are reporting a surge in the number of women applying to donate eggs or serve as surrogate mothers for infertile couples.
"Whenever the employment rate is down, we get more calls," says Robin von Halle, president of Alternative Reproductive Resources, an agency in Chicago where inquiries from would-be egg donors are up 30% in recent weeks—to about 60 calls a day. "We're even getting men offering up their wives. It's pretty scary." James Liu, a reproductive endocrinologist at University Hospitals, Case Medical Center, in Cleveland, says there is no waiting now for egg donors since his roster has swelled from the usual 4 to 17. Andrew Vorzimer, an attorney who represents prospective parents in Los Angeles, says the usual six-month wait for a surrogate in California has vanished as well. "Many of these women have college loans to pay off or they want to help buy a house or provide for their own kids' education," says Mr. Vorzimer, who is also CEO of Egg Donation Inc., a recruiting agency.
So the good news is, you have an exploitable asset in your ovaries. The bad news is, you have to compete with all the other young women—and apparently their husbands—who have realized the same thing. Did I mention the daily hormone shots? The prohibition on intercourse? The needle extraction?
Still, it's a better deal than lots of people in the developing world are getting. They're selling kidneys; you're only selling eggs. And you can make a lot more money than they can. Beck lays out the numbers:
The going rate for a surrogate is about $25,000. Egg donors generally receive $3,000 to $8,000. But a few agencies advertise that they'll pay much more for specific characteristics. One ad running in campus newspapers promises $25,000 for a donor who is "100% Jewish with ... High SAT Scores... Attractive, at Healthy Body Weight and Free of Genetic Diseases." ... "Now that we have more donors, it's become a buyer's market," Ms. von Halle says. "Some people are looking for a 6-foot Swedish volleyball player with 39 ACTs, and they'll take their time." ... Darlene Pinkerton, executive director of A Perfect Match in San Diego, which offers up to $50,000 for egg donors with high SATs ... [has] seen a doubling of inquiries recently. The American Society for Reproductive Medicine considers compensation above $10,000 to be inappropriate; Ms. Pinkerton argues that the offer brings in donors who might not otherwise be interested.
In other words, the egg market is working like any other market. A Perfect Match is offering big bucks for exactly the same reason the ASRM opposes this practice—because money can persuade people to do things they otherwise wouldn't do. Actually, the 50 grand supplies only half the persuasion. The other half comes from the recession. You need money; you're running out of options; here's a way to get it.
But ordinary eggs won't get you the 50 grand. For that, you'll need the SAT scores, and the face, and maybe a bit more height. You'll need to be tested for the wrong genes—and maybe for the right ones, now that we can project athletic potential from specific variants.
Do you find this scrutiny degrading? Does the whole tiered pricing system offend you? Then go look in the mirror. Catering to buyers' tastes is part of selling. I know it's a lousy economy out there. But if you don't want others treating your eggs as a commodity, don't treat them that way yourself.
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I've promised to make this page a reliable headquarters for anyone who wants a single URL or RSS for all the Human Nature stuff. So here's a link to yesterday's piece on the Indian woman who just broke the world record for being the oldest woman ever to deliver a child. Excerpt:
There will be mothers at 71 and 72. It will be done because it can be done, and because doctors such as Bishnoi see themselves as liberators. They're not just defeating society's strictures. They're defeating nature's.
More here.
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In case you missed it, here's an excerpt from Friday's piece:
I've had my share of arguments with people who deny that race is biologically meaningful. Many of them are dedicated to the proposition that all humans are created equal, not just in the sense of moral worth or treating each person on his merits, but literally, in the sense that no genetically based difference can be admitted in average ability between populations. That kind of egalitarian literalism—I call it liberal creationism—becomes harder and harder to sustain in the face of evidence such as the data on ACTN3.
More here.
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Good news for U.S. national security! We're finally flying surveillance drones over the treacherous border ... between us and Canada.
You're kidding me, right? William Arkin and Peter Feaver of the Washington Post have the same question I do: Why are we posting drones in North Dakota when we need them in Pakistan?
This weekend's national coverage of the first drone's arrival (courtesy of the AP and NYT) didn't really explain. So I moseyed over to the Grand Forks Herald (before I saw the same link at Danger Room, I swear) to see what I could find.
Answer: Pork. Here's the Herald:
At 2:28 p.m. Saturday, the unmanned aircraft touched down at the Grand Forks Air Force Base ... The Saturday landing's significance is about the new mission of the base, which has lost planes and people in large numbers in recent years. The Unmanned Aircraft System mission allows the base to continue, although in a reduced capacity. [Base commander Col. John] Michel said the base will be home to more than 20 UAVs in a few years. The Air Force portion of the 20 will be six Global Hawks, a bigger and higher-flying version of the Predator, by early 2011. "Our manpower will be shored up by 843 people by those Global Hawks," Michel said. "The UAS is the fastest growing part of the (Air Force) business."
How's that for irony? Drones, a technology we're fast-tracking and fast-deploying in the name of replacing personnel, are becoming a jobs program. Though I guess that's consistent with the current economic meltdown and the new emphasis on finding work for people instead of the other way around.
Among other things, it raises the question: What's the future of Air Force bases? How many will fly old-fashioned manned aircraft? How many will be more like NASA's mission-control facilities? That's one of the nice things about drones: You can operate them from anywhere. Which means we should be able to create drone-operation jobs in North Dakota while flying the drones over Pakistan, Afghanistan, or India, not Canada.