Life as an Extreme Sport

Hollywood, Heredity and Humanity

Academics

The Scientist has a neat article on Hollywood’s take on heredity and genomics, going through a quick review of movies dealing with the potential of human nature and science – with science almost always unleashing the beast and the bad. In and of itself, it’s an interesting list of movies, and an interesting question: why does science fiction always portray a rather dystopic future, especially when it comes to genomic modifications? The technology is almost always portrayed as possible, but morally problematic.

I answered this question, briefly, a few years back, arguing that we weren’t afraid of the future but the now. It looks like another stab has been taken at explaining it, and this one is a book talking about the genome in popular culture, and the almost spiritual tone scientists use to describe the genome. This would bring about interesting conflict – we have a pretty embedded notion that we should not profane the holy, and wouldn’t manipulation of the holy be the ultimate in profane, to move it away from what is intrinsically holy?

I’d like to read this, it sounds interesting. But I’m also a touch sad – this is very similar to a project Phillip (Thurtle, my former adviser) was working on the last year or so I was at the University of Washington. To my knowledge, his book hasn’t been published yet, and it would have been nice to see him receive groundbreaking credit for something that he’s been working on, both alone and with his students, for several years.

House (M.D.) Trivia

Academics, Bioethics, House MD, Pop Culture

Occasionally it’s fun read the IMDB trivia page for TV shows. For example, while I’ve long dismissed the criticism that there’s no such thing as a diagnostician team/division of diagnostic medicine in hospitals (while I am willing to accept I sometimes have a creative mind, I’m not yet willing to believe I’ve completely made up people I know, working in hospitals, who are working in that field), I’ve been puzzled by Chase’s title, intensivist. According to IMDB, an intensivist is doctor who specializes in intensive care. This specialty is new and uncommon in the United States, but well-established in Australia, where the character is from. Neat, eh? A good attention to detail, which is something I can appreciate.

(For those who might have missed out, I’m actually working on a project about television, media, medicine and responsibility. And by working on, I mean doing a lot of reading, and debating justifying the purchase of the first two seasons of House, MD…as research, of course.)

Open Access Hospice

Bioethics

The New York Times is doing a series of articles on new approaches to address common shortcomings in our health care system, and the first is on hospice. Interestingly enough, it’s the insurance companies who are starting to say what some of us have said (and known, empirically) for years: hospice can often extend the quality of life of the patient to the point that they actually live longer. It’s not uncommon for someone to enter hospice with the 6 months or less until death sentence on their head, only to beat those expectations and live much longer.

The problem is, until recently, hospice has required people give up conventional treatment. So if people are living better, and longer than expected in hospice without any treatment, just how would they do while still being able to receive treatment?

Seems that the least usual suspect stepped up to find out: insurance companies, and the results are promising. Promising enough that major insurance corporations will be changing the way they allow and pay for hospice care. Well, with the exception of one of the largest insurance companies in the country, Medicare, which is still making you choose between treatment and palliative hospice care.

Can you imagine being in that position, of being told that you can have the benefits of hospice – people coming to your house to help out, home nursing care, massage, even something as basic as cooking and cleaning for you – or you can keep being treated for your disease, but not have both? No wonder so many people choose to fight the disease until the very end, ringing up huge medical bills in the process. The current paradigm asks people to either fight or give up, and most of us are indoctrinated to not give up.

Shifting towards integrating palliative hospice care with traditional treatments for disease seems like it would, in the end, benefit everyone involved. It would make the patient’s quality of life ever so much better, appears that it would extend that life, plus would decrease the end of life ER runs, ICU stays, and other things that cause medical bills to skyrocket and makes death one of the most expensive medical conditions.

But it is still weird seeing the big insurance companies, so often painted as part of an evil capitalist conglomerate, doing something proactive and good.

why bioethics?

Academics, Bioethics

The other day, a friend of mine asked me, rather out of the blue, “why bioethics?” It’s a fair question, and it’s not one I’ve ever really explained to people. But trying to think through the process of why and how is a bit of a challenge – I didn’t go back to school planning on a career in bioethics, and the decisions I made that landed me here are ones I largely made by myself. And if you think my external thought process is messy, you should see what it’s like inside my head.

Matt’s not the only one who’s asked, recently, “why bioethics?” Most of the applied ethics job candidates have some background in bioethics, and want to know why I want to go into the field. That makes sense; chances are good I’ll be working with whomever comes on board in some capacity or other, and knowing my motivations is important. Now if only I could articulate them – perhaps I should ask my sounding board (Michael); he might remember things I don’t.

But anyhow, while I’m still internally mulling and externally mumbling about my own decision for bioethics – for the rest of you reading this who share the field, why bioethics? Why did you decide to devote your life to this? What drew you in? Why are you here in this particular gloom and doom level of hell with me? (Not that I’m complaining, mind you – company is always better when you’re contemplating such things!)

Back at ASBH, one of the journal editors was really pushing the idea of approaching certain journals about editing one-off issues on a special topic. I kept thinking about a story Bob Veatch told in August, and the idea of origins. I mean, which of us was bitten by that radioactive bioethicist, and who found a ring laying on the ground, and who had the early childhood trauma? (And I did have this idea prior to the bioethicists as superheroes piece that came out in the ASBH Exchange today, thank you very much.)

So entertain me, fellow crazy people: tell me your origin story. Here, in the comments, or in email if you’re shy…but I do want to know. And when I figure out how to give words to my reasons, I’ll post it…right after I call Matt to let him know what the answer to his question is.

a nanny city gone too far?

Politics

First NYC bans transfats in their fast food, an understandable health move but a questionable infringement, at least in some moral and political circles, on individual rights/liberties (and the right to be utterly stupid if you so choose). Now a Democrat from NYC is proposing to force iPod (and other audio device) listening pedestrians to unplug before crossing the street. Seems there have been a couple of death’s in NYC because people have been run over while crossing the street, not paying attention to their surroundings because of their iPods.

…and this is new with the iPod? I realize that the proposed legislation would outlaw all manner of Things in Ears That Could Distract You, including cell phones, but does anyone see that actually flying in NYC? I have a hard time imagine everyone at 56th and Broadway getting off the phone for that quick walk across the street, just to get back on it at the other corner (let alone down on Wall Street!).

The thing is, you can’t legislate people using their brain. I’ve walked the length and width of Manhattan a few times now, and it’s relative common sense to pay attention when crossing the street. Manhattan, streets, cars and pedestrians is a rather interesting game of Human Frogger, and if you’re so tuned out that you’re not aware of the risks and doing your best to mitigate them, no law is going to change that.

Kruger, the Democrat proposing this bill, is right – if someone is so involved in their electronic device that they can’t see or hear a car coming, this is indicative of a larger problem. But it’s a larger problem that’s stemming from an entitlement culture, one that seriously believes “that bus will stop for me” or “no car would actually hit me, because I’d make too much money off the lawsuit”. It’s a problem that isn’t stemming from an audio device that provides some form of distraction, because we’ve had those things since I’ve been a kid (if not for longer – I’m not certain when the portable cassette deck came onto the market).

We do need the state to propose a certain class of laws. This? This is not one of them, and does nothing more than carry us firmly over into a nanny state that so many oppose Democrats for on sheer principle. And this is certainly not the sort of thing Democrats should be doing if they want to retain the control they’ve gained in 2008. Systematic, stupid laws like this will do nothing more than swing the vote back to Republicans, especially if they as a party re-adopt what’s now viewed as a libertarian, individual’s rights view.