The London Bioethics Colloquium kicks off on October 10th with Dr Octavio Ferraz!

We are delighted announce the schedule of the London Bioethics Colloquium (previously KCL/UCL Joint Bioethics Colloquium) for the next academic year – please find it below.

The first speaker of the year will be Octavio Ferraz:

10 October 2016, 16:00-17:30
King’s College London, Strand Campus, Somerset House East Wing, SW1.17 (Ante Room)

Octavio Ferraz (King’s College London): Who should we treat? Rare diseases, universal health coverage and children’s right to health

For those of you who have attended the colloquium in previous years, there are two relevant changes.

First, we are relaunching the colloquium as the London Bioethics Colloquium so as to broaden the range of speakers and speakers. We remain committed to promoting exchange between bioethicists working at King’s and UCL, and we will continue to alternate sessions between both universities. But we are keen to foster the variety of both speakers and topics — and to make clearer that the Colloquium is a resource for bioethicists all over London.

Second, for the next academic year, we have had to shift the colloquium from the first Thursday of the month during term time to the first Monday of the month. The sessions continue to be held from 16:00-17:30 with the possibility to go for drinks afterwards.

Contacts: Dr Annette Rid: annette.ridATkcl.ac.uk OR Dr James Wilson james.wilsonATucl.ac.uk

London Bioethics Colloquium 

Schedule, Academic Year 2016-17

 

***

10 October 2016, 16:00-17:30
King’s College London, Strand Campus, Somerset House East Wing, SW1.17 (Ante Room)

Octavio Ferraz (King’s College London): Who should we treat? Rare diseases, universal health coverage and children’s right to health

***
7 November 2016, 16:00-17:30
University College London, location TBC

Jochen Vollmann (Ruhr University Bochum): Personalised medicine: priority-setting and opportunity costs at an international scale
***

5 December 2016, 16:00-17:30
King’s College London, Strand Campus, Somerset House East Wing, SW1.18 (Moot Court)

Arnon Keren (University of Haifa / King’s College London): Autonomy, ignorance and informed consent

***

6 February 2017, 16:00-17:30
King’s College London, location TBC

Garrett Brown (University of Sheffield): An ounce of prevention is worth a pound of cure: Global health justice and the new global health emergency financing facilities’
***

6 March 2016, 16:00-17:30
University College London, location TBC

Emily McTernan (University College London): title TBC

 

Posted in Bioethics | Tagged , , , , , , | Leave a comment

Read new blogpost by Dr Christine Aicardi: was Francis Crick’s scientific career just a fortuitous, multi-stop flight away from routine and boredom?

In this blogpost, originally published on Wellcome Trust blog here, GHSM Dr Christine Aicardi tells us how she came to the conclusion that there may have been one underlying motivation for all of Crick’s research choices across different scientific fields.

Although Francis Crick was already past thirty when he started his scientific career, he hopped between research fields several times: from protein crystallography, molecular genetics, developmental cell biology, the chemical origins of life, to the neuroscience of vision and finally, the science of consciousness. His move away from the broad domain of molecular biology and genetics to that of neuroscience, as he was turning sixty, was indeed more of a leap than a hop.

L0042297 Francis Crick lecturing in Mainz, Germany, 1969

Francis Crick lecturing in Mainz, Germany, 1969 Credit: Wellcome Library, London. Wellcome Images L0042297

These research fields all had something in common: when Crick entered them, they were not established scientific disciplines. Their scientific status ranged from ‘upstart challenger’ (molecular biology) to ‘downright unscientific’ (the origins of life and the study of consciousness). What Crick did for each of these fields was to try and help them take, and become scientifically respectable.

Why would he do such a thing? Why would he do it repeatedly? And why these particular research fields rather than others? Was there a thread running through them all, or was Crick’s scientific career just a fortuitous, multi-stop flight away from routine and boredom? These were questions irritating me while I was researching the Francis Crick archive at the Wellcome Library between 2011 and 2013.

It turned out that the missing link I was looking for was a missing book – ‘Of Molecules and Men’ (OMM) – and the all-encompassing answer to my questions came to be ‘anti-vitalism’. The book is a brutal manifesto against vitalism, understood in the broadest of terms as “some special force directing the growth or the behaviour of living systems which cannot be understood by our ordinary notions of physics and chemistry” (OMM p.16).

When I started researching Crick, I set out to read all the books that he had published. ‘Of Molecules and Men’ was not his most popular. According to its catalogue, the Wellcome Library held a copy of the original edition, but it was not on the shelves when I looked. For a while, I checked regularly to see if it reappeared, to no avail. Finally, Library staff admitted that it had not been seen in a long time, and it was declared ‘missing’.

Without the book, I dropped the ball, and soldiered on in the archives – until about a year later, when I became convinced that this overlooked little book, which I ended up purchasing online, was key to understanding what made Crick’s entire scientific career a very consistent endeavour.

‘Of Molecules and Men’, published in 1966, came out of the John Danz Lectures that Crick had given at the University of Washington in February and March of the same year. This series of three lectures was entitled ‘Is Vitalism Dead?’, a title that Crick would have happily kept but for his publisher:

Reviews of the book were not kind, with respected figures such as physicist Eugene Wigner in ‘Science’ and neurophysiologist Sir John Eccles in ‘Zygon’ feeling that the book was both unscientifically polemical and unsubtly trenchant (probably a reason why it is politely ignored in commemorations of Crick’s scientific greatness). Witness, its closing sentence: “And so to those of you who may be vitalists I would make this prophecy: what everyone believed yesterday, and you believe today, only cranks will believe tomorrow” (OMM p. 99).

For Crick, vitalism was a vestige of outdated religious values, its enemy was exact scientifically acquired knowledge, and there were three areas of biology where vitalist ideas were still lurking: molecular biology, the origin of life, and the brain. The brain especially was a “relatively speaking scientifically backward area of study,” as “[h]ere vitalistic ideas not only are commonplace among educated laymen, but are held by several of the leading workers in this field” (OMM p. 98).

In his autobiography ‘What Mad Pursuit’ (WMP), Crick wrote that when he became scientifically interested in the brain, an “aspect of the subject one was not supposed to mention … was consciousness. Indeed an interest in the topic was usually taken as a sign of approaching senility” (WMP, p. 156-157). He was vexed that belief in the immortal soul, separate from the body and seat of consciousness, was “held, and in many cases held strongly and aggressively, by the majority of human beings alive today” (‘The Astonishing Hypothesis’ (AH), p.4). Whereas in his view, “If the scientific facts are sufficiently striking and well established… then it will be possible to argue that the idea that man has a disembodied soul is as unnecessary as the old idea that there was a Life Force” (AH, p.261).

The mission of science was to bring light to the dark vitalist corners of biology, which covered precisely the areas of research where Crick was active as a scientist. He kept consciousness, the ultimate stronghold, for last. It is no surprise then that neuroscientists of a younger generation would pay homage to his crusading proclivities, picturing him as an “evangelical atheist” who “was building an army to help him take on consciousness”.

If anything, the example of Crick shows that the key to understanding what makes scientists tick is not always in their science.

 Author

Dr Christine Aicardi is a Research Associate on the Human Brain Project in the Department of Global Health & Social Medicine at King’s College London. She held a Wellcome Library Research Fellowship from 2011-2013.

 

 

 

 

 

Posted in Bioethics, History of Medicine, Medical Humanities, Medicine Science Society | Tagged , | Leave a comment

Workshop ” ‘Medicalized’ Childbirth as a Public Problem: Risk Culture(s), Gender Politics, Techno-Reflexivities”, Paris 29-30 September 2016

childbirthWhen: 29-30 September 2016

Where: Amphithéâtre François-Furet, 105 Boulevard Raspail 75006 Paris

Organizers:

Sezin Topçu (CEMS/IMM-CNRS-EHESS)

Ilana Löwy (Cermes3-INSERM-EHESS)

Contact: lowyATvjf.cnrs.fr

Presentation:

Obstetrical knowledge, technologies and practices have dramatically transformed women’s reproductive experiences worldwide. Medicalization of childbirth was accelerated in the 20th century by the displacement of childbirth from home to the hospital, and by the generalization of surgical techniques and pharmaceutical products. Medical interventionism took multiple, situated forms. Some countries (Brazil, China, Mexico, Turkey, Italy) normalized C-sections as a no-risk and no-pain alternative to “natural” birth; others, like France and Québec, generalized the use of epidural anesthesia; in many contexts, the induction of labor, its acceleration by oxytocin, and episiotomy became routinely employed techniques.

By the late 20th century, the “overmedicalization of childbirth” became a public problem. Critical voices that denounce the excesses of medical interventionism are, indeed, highly heterogeneous. They include, e.g., radical critique of technology and of medicine as an institution; a fierce defense of “natural” birth, often linked with the rejection of obstetrical techniques and instruments; a focus on the political and organizational aspects of childbirth; or a distinction between “justified” and “unjustified” applications of medical interventions and the rejection of the latter. Critiques of “technological drift” in childbirth are always situated. Obstetrical technologies can be framed in numerous ways, and have multiple meanings. While some Western feminists present intensive medicalization of childbirth as an oppressive and authoritarian meddling in a natural process; in countries in which many women do not have access to good quality health care, control of labor pain can be framed as a class privilege. When only affluent women receive pain relief, the possibility to choose an epidural anesthesia or even a cesarean section can be perceived as empowering for women, including from a feminist or a care perspective. Furthermore, criticism of obstetrical techniques is not limited to consumer groups or feminist movements. Medical and regulatory bodies question them, too. They react to ever-changing scientific evidence on the risk/benefit ratio of different obstetrical approaches, and to the rapid shifting of institutional, juridical and political environments. Highly divergent views thus exist on what counts as an “overmedicalization” of childbirth, but also what a “natural” or “normal” birth is; which interventions empower women and which disempower them; which should be perceived as safe, and which as too risky.

A substantial number of studies tackled the transformation of relations between medicine and childbirth in the 1980s and the 1990s, thereby highlighting the premises of the generalization of a large set of obstetrical technologies and instruments. In more recent scholarly debates however, a relative invisibility of “routine” childbirth technologies may be contrasted with a much greater interest in “extreme” or “dramatic” ones, such as ART (assisted reproductive technologies). With the ambition to remediate this imbalance, we aim to put the “naturalized” technologies/instruments and their subversive capacity at the very center of our analysis, so as to investigate how they transformed and continue to transform childbirth, remodel medical practices, alter maternal experiences, modify health policies and generate public debates. Our approach is firmly grounded in a comparative frame, which is an efficient way to highlight the various ways in which specific technologies, instruments and products are promoted, regulated, and refuted. Relying on cross-cultural investigations and field data from diverse national contexts (France, USA, Italy, Brazil, Senegal, Turkey, Switzerland, Canada…), this international workshop investigates how “technological” birth came into being, and how it is produced, problematized, framed, and negotiated in the 21st century.

 

 

* * *

 

Programme

Day 1 — (September 29th )

 

9h00-9h15 — Welcome & Introduction by the organizers

 

9h15-11h15 — Session 1: “Natural” vs. “Medicalized” Childbirth. Cross-Cultural Perspectives

  • Paula Michaels (Monash University, Melbourne), “What Makes a ‘Good Birth’? Lessons from the Lamaze Method in Transnational Perspective.”
  • Julie Jomeen (University of Hull), “The Physiology-Psychology Divide and the Cultural Construction of ‘Choice’ in the British Childbirth System.”
  • Chiara Quagliariello (CSU, Paris 8 University), “The Normativity of Alternative Models of Birth: Senegalese Women Facing Natural Childbirth in Italy.”

Discussant: Ilana Löwy (Cermes 3-INSERM)

 

11h15-11h30 — Coffee Break

 

11h30-13h30 — Session 2: Between the “Normal” and the “Pathological”: Representations of ChildBirth and of Woman’s Body in the Risk Society

  • Elisabeth M. Armstrong (Princeton University), “Maternal-Fetal Antagonisms: The Body as a Battleground.”
  • Gülhan E. Balsoy (Istanbul Bilgi University), “Representations and Disciplining of Midwifery and of ‘Traditional’ Birth in the Turkish Medical and Popular Culture: A Historical Perspective.”
  • Kirstie Coxon (King’s College, London), “Safe Nation? The Cultural Construction of Women’s Preference for Hospital Birth in UK.”

Discussant: Dominique Memmi (Cresppa-CSU)

 

13h30-14h45 — Lunch Break

 

14h45-16h45 — Session 3: National Dynamics of Medicalized Birth

  • Cecilia McCallum (Federal University of Bahia), “Technobirth in 21st Century Brazil.”
  • Sezin Topçu (CEMS/IMM-CNRS), “Between Risk, Politics & Modernity: ‘(Short)Cutting’ Birth in Turkey.”
  • Maud Arnal (Cermes 3-EHESS), “Epidural Anesthesia as a Public Problem in France and in Quebec: Expert-Lay Dichotomy and Institutional Change.”

Discussant: Charlotte Bigg (Centre Koyré-CNRS)

 

16h45-17h00 — Coffee Break

 

17h00-18h30 — Roundtable 1: Qu’est ce qu’un “accouchement naturel” et quand devient-il “médicalisé?” / What is a “Natural Childbirth,” and What is a “Medicalized” One? (This roundtable will take place in French.)

Participants: Dr. Claude Eguillon (obstétricienne, ancienne chef de service aux Bluets), Dr. Israël Nisand (obstétricien, CNGOF), Mme Jodi Garrod (sage-femme britannique), Mme Marianne Niosi (Calm), Mme France Artzner (Ciane)

Moderator: Sezin Topçu (CEMS/IMM-CNRS)

 

 

* * *

 

Day 2 — (September 30th)

 

 

9h00-11h00 — Session 4: Reshaping of Birth Temporalities and Modalities by Obstetrical Techniques and Instruments

  • Irène Maffi (University of Lausanne), “Technological Routines During Childbirth in Switzerland and Jordan. A Comparative Study of Birth Attendants’ and Women’s Experiences.”
  • Andreza Nakano (Fundaçao Oswaldo Cruz), “Risk Management among Brazilian Women and Obstetricians: Reengineering Risk Economy in the Birth Scene.”
  • Mathieu Azcué (University of Lyon 2), “When Physiological Birth Becomes the Norm within a French Maternity Hospital. Resistances, Transformations and Challenges in Case of the Reversal of Care Standards.”

Discussant: Maï Le Dû (CSU-Paris 8 University)

 

11h00-11h15 — Coffee Break

 

11h15-13h15 — Session 5: Empowerment/Dispowerment and Techno-Criticism

  • Marilène Vuille (University of Geneva), “Psychoprophylaxis: French Criticism of ‘Over-medicalisation’ of Childbirth since the 1950s.”
  • Zaira Jagoudina (University of Gothenburg), “Practices of Empowerment and Critique of Medicalized Birth in the Work of Swedish Doula-Interpreters.”
  • Geneviève Pruvost (CEMS/IMM-CNRS), “On Home Birth Activism and Techno-Nature in France.”

Discussant: Madeleine Akrich (CSI-Mines ParisTech)

 

13h15-14h30 — Lunch Break

 

14h30-16h00 — Roundtable 2: Obstetrical Technologies and Feminism

Participants: Madeleine Akrich (CSI-Mines ParisTech), Ayse Dayi (University of Lausanne), Paula Michaels (Monash University, Melbourne), Chiara Quagliariello (CSU-Paris 8)

Moderator: Ilana Löwy (Cermes 3-INSERM)

 

Posted in Bioethics, Sociology | Tagged , , , | Leave a comment

Shortage of organs for transplantation – is more research on human–animal chimeras the right approach?

Dr Silvia Camporesi and Giulia Cavaliere wrote a commentary on Insoo Hyun’s PLOS Biology perspective piece that human/ animal chimera research to create humanised animal models for organ transplant should go ahead.

You can read an excerpt of their commentary below:

It is time to discuss, once again, the lifting of a moratorium on research. We are not talking about the CRISPR genome-editing moratorium, but about the 20 August announcement by the US National Institutes of Health (NIH) to lift the moratorium on research involving chimeric human/non-human embryos (see BioNews 863). The use of federal funds for this kind of research had been previously banned by the NIH in September 2015.

Although it does not state it explicitly, the NIH announcement seems to have been triggered by Harvard professor George Church‘s research on growing humanised organ models in non-human animals, namely pigs.

Insoo Hyun, a bioethicist at the Case Western Reserve School of Medicine in Cleveland, Ohio, followed with a perspective piece in PLOS Biology, stating that the benefits of this kind of research are so great that we should no longer hesitate to fund it. He addresses traditional concerns in animal ethics, such as safety, the moral status of the non-human animal (in this case, the human/non-human chimera) and the exploitation of non-human animals in research.

We agree with his precautionary stance, which is consistent with the existing ethical standards for chimera research developed by xeno1the International Society for Stem Cell Research in 2007 and which has more emphasis on animal welfare than on speculative concerns about moral humanisation of the human/non-human animal chimera.

Hyun’s conclusions that ‘most, if not all, of these [traditional] concerns can be reasonably addressed’ are plausible. However, Hyun fails to address the elephant in the room: why should we invest significant resources in the creation of humanised animal models in the first place?”

 

You can read the full piece here:

http://www.bionews.org.uk/page_699184.asp

Posted in Bioethics | Tagged , , , , , | Leave a comment

Testing, Testing 1, 2, 3: PGS and PGD, September 13th 6 pm

A free-to-attend evening event in London about the latest scientific, regulatory and ethical developments in the testing and screening of human embryos.

Where: Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH
When: 13 September 2016 6pm (registration), 6.30pm-8.30pm (discussion)

The event is produced by the Progress Educational Trust (PET) . It will be chaired by Dr Sue Avery, with speakers including Dr Tony Gordon, Dr Christine Patch, James Lawford Davies and Professor Michael Parker.
Attendance is free, but advance booking is required. Please email Sandy Starr at sstarr@progress.org.uk to book places.
If tweeting about this event, please use the hashtag #PET123. If you use Facebook, you can join the Facebook page for the eventhere.

The possibilities for testing and screening human embryos have increased substantially in recent years. The science can be challenging to understand while law, regulation and ethical debate can struggle to keep pace.
Why are embryos usually tested?
To try to improve the chances of establishing a pregnancy.
To offer a reproductive choice to people whose children are at increased risk of genetic disease.
What are the most commonly used approaches?
PGS (preimplantation genetic screening), which involves checking an embryo for aneuploidy (abnormal numbers of chromosomes).
PGD (preimplantation genetic diagnosis), which involves checking an embryo for genetic mutations or chromosomal translocations that are associated with a history of disease in the patient(s) or their family.
PGS and PGD entered clinical use in the 1990s, since when they have both been transformed by rapid advances in genetic technology – particularly advances in DNA amplification (generating many copies of DNA from a small initial sample), DNA arrays (which allow many different sections of DNA to be studied simultaneously) and DNA sequencing (determining the precise sequence within a DNA molecule).
With the advent of technologies including next-generation sequencing (NGS) and a technique known as karyomapping, it is now possible to use PGS and PGD on an embryo at the same time – that is, after performing only one embryo biopsy – and to use PGD to test for more than one condition at a time.
This has implications for the way embryo testing is regulated, under both national law (the Human Fertilisation and Embryology Acts of 1990 and 2008) and international conventions (the European Conventions on Human Rights and Fundamental Freedoms and onHuman Rights and Biomedicine).
Earlier this year, the HFEA (Human Fertilisation and Embryology Authority) solicited views on how it should regulate PGS and PGD, in light of the latest scientific advances. Two sections of the HFEA’s Code of Practice (the Guidance Notes on PGS and on Embryo Testing and Sex Selection) have since been updated.
This public event will explore questions raised by these developments, including:
To whom should PGS and PGD be offered?
What does law and regulation currently permit? Might this change in future?
How many conditions should be looked for?
What are the implications of the latest embryo testing techniques for the cost of treatment cycles?
The more we know about embryos, the fewer embryos may appear suitable for transfer. How to manage this fact, when patients may not have many embryos to start with?
What sort of consent must be obtained from patients and when? What sort of counselling should be provided, and when? Should counselling be optional or mandatory? Should it be made available to patients’ wider families?
What facts are patients permitted to know about an embryo, and what facts are they permitted not to know? If they request notto know certain facts, how can this be dealt with in practice?
NGS and karyomapping create new possibilities for incidental findings – that is, discoveries with implications for the health of a future child that are not related to the reason the embryo was tested. What can lawfully be done with these findings? Whatshould be done with these findings?
New technologies create a greater need for embryo biopsies, embryo freezing and the interpretation of (increasingly complex) test results. Can professional competence and resources keep up? To what extent does responsibility for monitoring this rest with the HFEA?
Who has responsibility for the data from embryo tests? If an embryo is selected for transfer and results in a child, should that child – later in life – be able to access the data?
A panel of experts with different perspectives will debate these questions. In the PET tradition, much of the event’s running time will be devoted to letting the audience put questions and comments to the speakers.
We expect this event to be popular – book now by emailing Sandy Starr at sstarr@progress.org.uk
Posted in Bioethics | Tagged , , | Leave a comment