Life as an Extreme Sport

White Collar Crime? We Want Your DNA!

Adrian Lamo is in trouble again. Not for cracking any new computer systems, but because he won’t give the federal government a blood sample so they can isolate his DNA and add it to the FBI’s Combined DNA Index System (CODIS). He did bring nail clippings and hair samples, but those in charge will only accept blood for the sample.

Now, I’ve known about CODIS for a while. The point is to be able to store the DNA of sexual predators and violent criminals. What I hadn’t realized is that the 2004 Justice for All Act expanded the CODIS purview to include samples from all newly convicted federal criminals. Including white collar criminals – people who commit crimes that rarely leave any traces of DNA for testing.

What, then, is the point to collecting the DNA of these white collar criminals? It makes me uncomfortable, because the government has ruled in the past that elements of your body – your blood, your cancers, your spleens, anything that can be taken from your body – are no longer yours once they are removed from your body. Including DNA.

This means that your DNA can be taken, stored, sequences, analyzed, and released to the public, without your say, without your benefit. And potentially to your detriment; there are growing fears that DNA samples showing proclivities for diseases will result in insurance companies denying coverage, for example.

What happens if the government sequences the DNA of one of these incarcerated criminals, and finds something of value, something that requires more samples? Criminals have very little rights over their bodies – will they then be able to just take what they (the government they, that is) want?

It’s concerning.

Granted, these concerns existed when CODIS was implemented to begin with, but many people deemed the benefit of DNA samples and ability to match future DNA to known criminals who’re at high risk to returning to criminal behaviour, worth the potential abuses of having that DNA.

But now we’re talking about people with low rate of recidivism, who aren’t dangerous, per se, who’re having their DNA added to this system, for who only knows what reasons.

The ethics of this, and the potential for abuse of the policy, is worth thinking, and even perhaps worrying, about.

Women Are Clearly Not Little Men

There is a new artificial knee joint on the market, and it claims it’s for women only. This is interesting, because as is noted in the article, there are nearly two dozen differences between a man and a woman’s knee. Yet, like most medicine, the artificial knee joints were designed for and tested in men, not women.

Women are typically excluded from medical trials of all sorts, because of fear that they might become pregnant and sue, or a lingering bias that says the different hormone levels over the course of a month will skew data results. Of course, the immediate response to this is “well, then, if that’s a problem, shouldn’t it be considered before giving it to women? And, btw, what the hell about the difference in hormone levels in men and women to begin with?”

These differences, and the fact that women are so rarely in clinical trials, is often held up as the reason that drugs, once they hit the ‘real’ world, work poorly in women and not men. (Children is a whole ‘nother Pandora’s box, rife with similar problems.)

So it’s interesting that there is now a knee being marketed for women – hype, trying to create a new and expanded market for the company, in the grand tradition of capitalism and growth, or a legitimate medical need? Kind of hard to say, although the idealist in me does truly hope for the latter.

What I’m Reading Today

The miscellanious round-up, while I wait for the coffee to infuse my system enough to pack and wander my way towards the airport.

Pfizer Boldly Advertising Celebrex Again – but with a big ol’ warning about the risk of heart attack and/or stroke.

I took Celebrex for a year, maybe more, and have to admit it made my life a lot easier during that time. At the very bottom of the article, Michael Krensavage, a drug industry analyst at Raymond James, says “I would try an ibuprofen first.” Well, thanks Michael K – but I did, and I was taking like 10 ibuprofen a day, which is never good for the liver, and still getting no pain relief. One Celebrex later, and I could move without wanting to cry (this was back when my rotar cuff was torn).

All drugs carry risks and benefits. It’s up to you and your doctor (note: doctor, not pharmacist) to determine what the right drugs are for you.

And lest anyone think last weeks Bones episode The Graft in the Girl, was just more scary science fiction, Stolen body parts linked to patients’ illnesses; several lawsuits claim tissue transplants were infected with viruses and other germs. Four men, one of whom worked for a tissue provider, have been charged with carving up corpses and selling their parts without consent. And oh yeah, they’re diseased and old and damaged parts.

Quite literally the entire plot of the last Bones, down to almost the exact same name of the tissue company. Life, meet art. Art, meet life.

GlaxoSmithKline, Europe’s biggest drugs manufacturer, yesterday defended itself against accusations that it is turning healthy people into patients by “disease mongering” and pushing “lifestyle” treatments for little-known ailments. Charming, ‘cept I don’t believe a word of it. I’m actually having fun collecting a list of all the drug advert commercials I see – I figure it will make a nice column for The Daily.

I particularly love the line “It is easy to trivialise things when you don’t have them. If people did not want the treatments, they would not seek them.” …or, you know, people wouldn’t think about it being an issue if they weren’t told it was one. We spent a while talking about the concept of taught illness in my philosophy of medicine class last quarter. Perhaps I should interview Sara for the article, heh.

Wired has another take on the pill pushers, noting that although Novartis employs some of the most brilliant minds in the pharmaceutical research field, developing impressive leukemia fighting drugs like Gleevec, their fourth most profitable drug is Lamisil.

Lamisil treats toenail fungus. It’s not life threatening. It turns your toenails yellow. And for three months and about $850, you can cure it. And 10 million Americans have, or are trying. And yet, in those numbers, a very small percent have had what you might call a significant reaction to Lamisil – they’ve died.

And yet because of their effective marketing campaign, with Digger the Dermatophyte, a campaign costing them $236 million in three years, Americans are lining up to take a drug that only completely cures 38% of them.

That’s a pretty low cure rate for a mostly invisible (after all, most of us wear closed-toed shoes) fungal problem that does nothing other than making your toe nails yellow.

Can I market a new cure for toenail fungus? I’ll call it… Polimisil. It’s a simple treatment, involving the application of a tinted liquid substance that dries to the toenail, masking the originating colour of the nail. You get approximately 60 treatments per bottle, each treatment lasting about a week. And for this amazing cure, I’ll only charge you $40 a bottle! That’s less than $1 a treatment!

C’mon, you know you want to!

On the other side of the pharmaceutical fence, (wow, I’m just all big pharma lately), Genzyme won FDA permission to sell a new drug to treat Pompe disease, a rare inherited enzyme disfunction. One of the problems with big pharma is that since they are businesses, they have incentive to develop and produce drugs for common problems, like arthritis, so they can make lots and lots of money. Practically speaking, this means that rare diseases, like Pompe, are often overlooked, because there is simply not the client base that would justify the research and development costs.

In doing something right for a change, our government has developed an incentives program for companies developing treatment for these rare illnesses; in fact, that’s what Genzyme specializes in.

Stolen Themes – What I’ve Been Reading

The kind folks over at AJOB* have a neat feature that summarizes what they’re reading in the daily news. Once again, I have too many open windows and not enough time to write a full op-ed on each one, so I pay homage to the idea.

Report Faults Video Reports Shown as News – great. Next time you’re watching the news, just ask yourself whether or not it’s news, or actually an advertisement. The Daily Show covered this several months ago, but it’s still frustrating to see how widespread it actually is. Add this to another reason why I get the majority of my news from a frakkin comedy show.

Lessons in Conflict of Interest: The Construction of the Martyrdom of David Healy and The Dilemma of Bioethics
– mules, COI, KOL – betcha never knew bioethics had so many acronyms. It’s like the government, only less headache inducing! Seriously, this is a really interesting article that I read when it originally ran in the print edition of AJOB. I came across it again recently, when it was brought up in a discussion on the AJOB blog. It takes a look at conflicts of interest in bioethics, and how two major journals, The Hastings Center and AJOB, handled the situation when unreported conflicts of interests came to light. It also raises some really interesting comments about COIs, all amidst a fascinating and indepth discussion of the Healy affair.

Pioneering surgery on girl, 12, reverses heart transplant – how cool is this? The girl suffered heart failure at age 2, and had a donor heart “piggy-backed” onto her own. This leaves her own heart in place, but the donor heart does all the work. 10 years later, she begins to reject the donor heart, and through a rather interesting and dramatic series of events, her own heart is reconnected… and works fine! How fabulous for this girl, and how monumentally important for medicine.

Pope condemns geneticists ‘who play at being God’ – The title basically says it all here, but in his Good Friday meditations, the Pope condemned geneticists playing at being God. This comes at interesting timing, what with there being a new clinic just opened solely for the purpose of creating tissue-matched siblings (see further down). It also indicates Benedict’s commitment to becoming a more conservative Papa.

Runners’ bar codes may help health officials: Boston Marathon provides training ground for tracking disaster victims – basically, runners bibs are being imprinted with a bar code. If they require medical assistance, they will be scanned as the enter and exit medical tents, providing tracking of movement. The theory is, in natural disasters, you slap a wristband on someone with a similar bar code, and track them as they are removed from the site of the disaster and moved around the country, providing better tracking. An aside of the technology, race designers will be able to see if there are hazards over the course forcing people to drop out, and epidemiologists will be able to analyze similar.

How long do you think it will be before we start hearing about the number of the beast (again)?

Print me a heart and a set of arteries – what else do you say to this, other than how fucking cool? I’ve been following this technology for several years now, when I first saw the concept on a Discovery-affiliate. Basically, bioink dumps cells designed to flow like liquid onto a supporting gel (biopaper), and the ink flows and grows together. Within a day, the chicken heart cells were beating in tandem… So let me just reiterate: how fucking cool. I love technology.

Do we still need the Cartagena Protocol? – a prominent proponent of the Cartagena Protocol says we don’t need it anymore, and that GM crops don’t harm people or the environment. …did he forget to talk to butterflies? Or maybe GM foods cause long term memory loss…

Siblings of Disabled Have Their Own Troubles – this was an area of study for my sister when she was in school. Interesting to see it continued.

Lab-Grown Bladders Successful in Humans – speaking of growing organs… this is cool in its own right (although admittedly not as neat as printing an organ). Click the link to take a look at the picture, if nothing else!

My Black Skin Makes My White Coat Vanish: Even in one of the world’s most diverse cities, I have to convince my patients that I am the doctor. – an interesting personal take on the prejudiced faced by being a black, female doctor. That the bias is being continued by other black women is especially interesting, and speaks to greater problems than just getting through the bias in the established medical community.

UK team to open “designer baby” clinic – the Women’s Bioethics Blog saves my op-ed skin and presents an interesting tidbit about a new, designer baby, clinic opening in Britain. But it’s not just a designer baby they’re creating, but saviour babies…

*And I don’t say that just because some of them will be my professors in the upcoming years. They really are genuinely nice folks, and I’ve enjoyed all my interactions with them, which would be a large reason why I opted to throw my name in their grad program hat to begin with.