Paul Root Wolpe

Treatment as prevention and cure towards global eradication of hepatitis C virus

The availability of curative, direct-acting antiviral drugs against hepatitis C virus (HCV) sparks an ethical call for HCV eradication and provides essential tools to spearhead the effort. Challenges include increasing awareness of the chronic hepatitis C epidemic, garnering sufficient public, private, and governmental financial will to invest in the necessary resources, developing pangenotypic drug regimens for global application, and mitigating ethical concerns. To achieve these goals, stakeholders including clinicians, public health professionals, legislators, advocates, and industry can employ a variety of strategies such as increasing HCV screening, implementing treatment as prevention, and improving linkage to care, as well as developing innovative pricing and payment solutions, stimulating innovation through local drug development in high-prevalence regions, continuing vaccine development, and creating efficiencies in the marketing and distribution of educational materials and drug treatments.

Ahead of Our Time: Why Head Transplantation Is Ethically Unsupportable

An ethical approach to evaluating the attachment of a donor head and a donor body1 1. In actuality, under current parlance, as Ren and Cenavero note, the procedure is a body transplant onto a head, as the body is considered the “donor” material. However, given my objections as described in the following, I use “head/body transplant” in this discussion and consider the two as equivalent. is challenged by two opposing temptations. On one side, it is easy to succumb to the common initial response of shock, repulsion, and knee-jerk opposition, which, in this case, is fueled by Sergio Canaveros flamboyant and un-self-critical public and professional presentation. Ethical outrage is an easy response. Equally tempting is a sober analysis of the proposition itself, a discussion of whether head/body transplants are in and of themselves objectionable, and if so, under what circumstances, without discussing the actual context or personalities who are (they claim) preparing to attempt the procedure.

Personalized medicine and its ethical challenges.

Personalized medicine is an emerging term for a medical philosophy that uses a persons individual clinical, genetic, genomic, and environmental information to tailor a treatment plan that will maximize efficacy and safety for that individual. While the technology offers much promise, it also is also challenged by some ethical and social questions in both its clinical application and in its research enterprise. Questions about privacy, safety, phenotypical expression, drug interactions, and genetic vs. social group identities will challenge clinical pharmacogenetics. Research studies raise some similar issues, as well as fairness in subject selection. Finally, personalized medicine will change the economics of drug production and distribution. Issues such as these and other complications of the coming focus on personalized medicine are discussed.

The Research Subject as Identified Problem

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content.

The American Journal of Bioethics today.

The American Journal of Bioethics (AJOB) now stands as one of the must-read journals of bioethics. The impact of AJOB is in its structure; not a series of reports, as in most journals, but a conver...

The Oys of Yiddish

Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content.

Science needs a universal symbol

In the face of irrational opposition, its time for the scientific community to have its own bumper sticker

Review of James Cameron's Avatar

As a youth, I read a lot of science fiction. One story that has always stuck with me was Call Me Joe, a 1957 novella by the acclaimed genre writer Poul Anderson. Human beings are exploring the planet Jupiter from a base on one of its moons. Jupiter is uninhabitable by humans, even with spacesuits, so scientists have created an artificial life form adapted to the planet’s harsh climate and powerful gravity. Highly trained individuals sitting on the moon don helmets that allow them to connect telepathically to individual animals and experience firsthand what the planet is like, with full control of the creatures’ behavior. Among the most skilled at linking to his Jovian body is Ed Anglesey, a paraplegic who inhabits a being named Joe. Unfortunately, the equipment that connects Anglesey and the others to their Jovian counterparts has started breaking down, and no one knows why. Authorities suspect Anglesey may be resisting being projected onto the planet, and that his resistance is gumming up the circuits; it turns out that, to the contrary, life on the planet is so much more compelling to Anglesey than his true existence that he is resisting coming back into his human body, and that is what is jamming the circuits. He revels in Joe’s freedom and extraordinary physical power, in contrast to the physical limitations of his human form. Eventually, Anglesey abandons his impaired earthly body altogether, merging completely with Joe to begin life as the leader and father of a new Jovian race. Some have accused James Cameron of stealing Anderson’s concept in his current blockbuster, Avatar. Now the highest grossing movie of all time (surpassing Cameron’s Titanic), Avatar is set in the year 2154 on a verdant moon called Pandora, where a soulless corporation is mining the precious mineral “unobtainium.” The moon, however, is inconveniently inhabited by blue, 10-foot-tall humanoid beings called the Na’vi. Jake Sully, a paraplegic, is brought to the moon to link telepathically with manufactured human/Na’vi genetic hybrids, with the idea of using these avatars to control the native population. Predictably, Sully soon grows to love the simple pantheism, ecologism, and general pacificism of the Na’vi (at least in part by falling in love with the Na’vi equivalent of a princess), and turns into a fighter and savior of the Na’vi. The movie ends (spoiler alert!) with Jake abandoning his human body altogether and becoming a permanent member of the Na’vi. Sound familiar?

Sir John Maddox and the Ethics of Heresy

On Sunday, April 12, 2009, Sir John Maddox died. Sir John, as the British obituaries called him, was the editor of Nature from 1966 to 1973 and again from 1980 to 1995. Over his 22 years as editor he was largely responsible for developing and diversifying one of the top general science journals in the world. Sir John oversaw the expansion of Nature into its daughter journals, such as Nature Biotechnology and Nature Genetics, and so set a standard that other journals have since tried to emulate. He was known for his work ethic as well as his unreasonable demands, which were tolerated because they were tempered by his charm and enthusiasm. However, Sir John was also responsible for one of the more bizarre incidents in the modern history of science journalism. His obituaries suggest that he was ultimately proven right; but the story is much more complicated than that, and it poses a challenge for those of us whose interests concern the ethical and social implications of medicine. In June, 1988, Nature published an article by the immunologist Jacques Benveniste which made a startling claim (Benveniste, 1988a). Benveniste, a Doctor of Medicine, was the former Research Director at the French National Institute for Medical Research, and so was well known and respected. He was quite prominent in his field, which was the mechanisms of allergy and inflammation. For example, in 1971 he discovered PAF (Platelet Activating Factor), a key mediator of leukocyte function, with implications for things as diverse as asthma, ovulation, and general inflammation. In 1984, while working on hypersensitive (allergic) systems, by chance, he began to find what he described as immune responses from human cells to increasingly diluted solutions of allergens. Even though the solutions were so diluted that they contained only water molecules, and none of the original allergens, he reported that the highly diluted solution initiated a reaction in the cells as if molecules of the allergen were still present in the water. He concluded that water somehow kept a trace, or memory, of the allergen molecules present at the beginning of the dilutions, and so could induce reactions even in the absence of those molecules. Benveniste submitted the finding to Nature. The journal held up the paper for two years while Sir John, on the