In its just-published report Taking Exception on the allocation of cancer drugs by UK Primary Care Trusts, the Rarer Cancers Forum (http://www.rarercancers.org.uk) provides further evidence of a ‘postcode lottery’ operating within the UK National Health Service. For example (p. 26), the Mid-Essex PCT has granted 96% of requests to its ‘exceptional cases panel’, while neighbouring South-West Essex PCT has granted none.
If, like
me, you were one of the kids whose preferred superpower was invisibility, you
may soon be in luck. The BBC reports
today that US scientists have
created a material that could one day be used to make people and objects invisible. The material, which has so far been created
only on a microscopic scale, neither absorbs nor reflects light,
meaning that anyone looking at an object covered in it would see what
lies behind the object rather than the object itself. It’s likely that such technology will be
snapped up first by the military, but perhaps, in years to come, invisibility
cloaks will be available to all.
For some,
the idea of being invisible is distasteful. Being invisible means being able to get away with anything – and
why bother to act morally when you can be sure that you’ll never be caught
out? In this case, would a world full of
people who can turn invisible at the drop of a hat be a world full of thieves,
cheats, and sneaks?
Read More »Would you rather be invisible or be able to fly? (Or: are you a sneaky superhero?)
Yesterday’s Daily Mail online contains an opinion piece bemoaning the decision by NICE – the UK body responsible for rationing healthcare resources – to decline funding for four new treatments for Kidney Cancer. The Mail complains:
…what does NICE offer by way of explanation? A cold, calculating statement that, while the drugs work for many of those with advanced kidney cancer, they are not ‘cost-effective’.
What a clinical way to assess whether a person should be afforded precious extra months and years of life, or consigned to a ‘death sentence’.
I don’t want to defend NICE’s decision in this particular case, but the Mail’s attack on NICE’s "clinical" decision-making process is clearly unjustified.
Scientists in Korea have for the first time successfully cloned a dog commercially. Cloning of dogs is notoriously difficult. This brings us closer to human cloning. The film Boys from Brazil , made in the earlier 80s, portrayed accurately and vividly the process of cloning that produced Dolly. The later film The Sixth Day depicted… Read More »One step closer to human cloning
The Guardian yesterday reported the death of the man who had been so tragically shot in Antigua, with his wife, three weeks after their wedding. It began like this:
"Ben Mullany, the newlywed who was shot on honeymoon in Antigua in an attack that killed his wife, Catherine, died in hospital in Wales yesterday after his life support machine was switched off. The 31-year-old trainee physiotherapist, who had suffered a fractured skull and had a bullet lodged in the back of his head, was flown back to Britain while in a coma on Saturday. Tests carried out when his condition stabilised after the 24-hour journey established he was brain dead."
This is a familiar way of describing such happenings, even among clinical professionals. Brain death is pronounced, so the life support machine is switched off, and the patient dies. The clear implication is that brain death is not death. The machine is still keeping the patient alive, and it is switching off the machine that causes real death.
Nature reports that in response to analysis done by bioethicist Robert Streiffer (and published in the Hastings Center Report), Stanford University may withdraw the use for research of several of its publicly funded stem cell lines because of concerns about consent. In 2001 President Bush decreed that only lines already in existence would be eligible for federal funding – 21 lines were subsequently approved by the NIH.
House prices have been falling quickly in both the US and, more recently, the UK. Newspaper reports tend to use negative language to refer to this fall. For example, todays edition of The Independent says:
Today’s gloomy data, which is worse than economists had forecast, …
However, it is not at all obvious that low house prices are a bad thing.
Climate change will impact the well-being of future
generations, directly by, for
example, increased intensity and frequency of extreme weather events such as
heavy storms. It will have also indirect
impacts on human heath – via cardiovascular diseases or by a rise in epidemics as emerging disease leave
the tropic and go North.
The beginning of this year, the British Medical Journal
declared that since climate change impacts public health, doctors have to deal
with it. And in tackling the problem, John Guillebaud, emeritus professor of
family planning and reproductive health at University College London , and GP
Pip Hayes from Exeter suggest that doctors should talk to their patients about
climate change and encourage them to think about the environmental impacts of
having a big family: see for example the Editorial
or an article
in the Daily Telegraph, or the Guardian.
After all, “each UK birth
will be responsible for 160 times more greenhouse ags emissions […] than a new
birth in Ethiopia.”
Fair enough, the world is
interconnected: environmental changes involve impacts on the population, and
changes in the population impact the environment. But is it sensible to treat
environmental problems not primarily as such, but making them problems of
family planning?
Drug scandals again tarnish the Tour de France. Last week three riders, Spaniards Manuel Beltrain and Moises Duenas and Italian climber Riccardo Ricco, winner of two mountain stages, failed tests for the banned performance enhancer EPO. This year has seen fewer spectacular expulsions, but of course the game is not over.
Does this mean the drug testers are winning the war on drugs? It might. But it might also mean that cyclists and their doctors are getting better at evading testing. A recent BBC investigation supports the latter conclusion. WADA labs have been proven to fail to pick up positive results. There are 80 copy-cat drugs, produced in China, India and Cuba, which are difficult to detect. And labs apparently collude with doctors to “exchange knowledge” on testing procedures. Expert Professor Bengt Saltin, a leading anti-doping expert and a former winner of the IOC Olympic Prize, the highest honour in sports science, said
"I would think that most of the medal winners and many in the finals of endurance events – there is a big risk for them having used EPO."
So despite the numbers of athletes being prosecuted for EPO declining by two-thirds between 2003 and 2006, Professor Saltin concluded this was due to evasion, not a reduction in use.
"The reason that I am still a little bit upset with the whole situation is that I have seen too many suspicious samples that are clearly abnormal. Athletes are getting away with it. Look how many have been caught for EPO misuse recently."
The response is predictable: widen testing critieria. Experts have suggested that urine samples should be tested for any evidence of naturally produced EPO. If there is none, it should be classed as suspicious because the use of artificial EPO for doping causes the body’s own production to shut down. These experts also call for testing of blood profiles as well as the urine. An analysis of the number of young red blood cells can also indicate doping.
Is this a solution? No. It will simply escalate the war to the next level. History has proven the ability of athletes and their doctors to ingeniously evade detection. We will never win the war on doping.
Yesterday the world celebrated the arrest of Radovan Karadzic, the ex-Bosnian Serb leader who has twice been indicted by the UN War Crimes Tribunal in the Hague, and is charged with – among other atrocities — ordering his forces to kill at least 7,500 Muslim men and boys in Srebenica in July 1995 as part of a campaign to terrorize and demoralize the population.
