In 2015, California became the fourth state to pass legislation designed to allow terminally ill patients to end their own life under certain prescribed conditions (see this blog, Sept 17, 2015). The law, called the End of Life Option Act, has always been somewhat controversial. And last week, opponents of the law won a battle in court when a Superior court judge declared the law unconstitutional, according to an article in the LA Times.
On what grounds is the law unconstitutional, you might ask? It turns out that the judge's decision had nothing to do with the law itself; his decision was based solely on the fact that the law was passed during a special session of the legislature devoted solely to health care issues. The judge declared that the law was not a health care issue, and so it was unconstitutional to pass it during the special legislative session.
Really? Not a health care issue when a terminally ill patient is in excruciating pain? California's Attorney General has already filed an appeal to the judge's ruling with the 4th District Court of Appeal. He's also asked that the law stay in place while the matter is under appeal.
The matter could end up with the Supreme Court. Or, the law might need to be considered all over again in a regular session of the legislature.
Wednesday, May 23, 2018
Monday, May 21, 2018
Ebola Outbreak Spreads to a Nearby City
Health officials at the World Health Organization (WHO) reported this week that the most recent Ebola outbreak, which began in a remote village of the Democratic Republic of the Congo (see this blog, May 12, 2018), has spread to a nearby city of over a million people. Only one case of Ebola has been reported in the city so far, but the fear is that the outbreak could spread more quickly now, making containment more difficult. In a city, tracking down and potentially vaccinating every individual who has been exposed to a patient becomes much more difficult.
Keep your fingers crossed. We'll be watching this outbreak closely.
Keep your fingers crossed. We'll be watching this outbreak closely.
Sunday, May 13, 2018
How DNA Analysis Led to the Golden State Killer
More than 30 years after his last crime, a suspect has finally been arrested in the infamous Golden State Killer case. The suspect, a 76-year-old former police officer named Joseph DeAngelo, is believed to have committed over 50 rapes and 12 murders in California between 1976 and 1986. How did police solve a crime spree that ended more than 30 years ago? (Drum roll, please.....) DNA analysis, that's how!
It turns out that police had DNA samples from the Golden State Killer, collected from several of his crimes many years ago. But they had no suspects to try to match them to. Companies like 23andMe have lots of DNA samples, but they are not searchable by the public or the police. However, there's a small company called GEDmatch that analyzes DNA samples and makes them available for free for research purposes. Police detectives searched the GEDmatch database recently, and identified a DNA sample that was close enough to the killer's DNA that it had to belong to a relative (for more on how that works, see this article). Studying that person's family tree led them to Joseph DeAngelo as a possible suspect in the Golden State Killer case.
To find out for sure, the police covertly collected a DNA sample from Mr. DeAngelo (it wouldn't be hard to do - we discard DNA every day on coffee cups and soda cans, for example). It was a match to the killer's DNA samples that they'd had on file for 30 years!
Case closed, finally.
It turns out that police had DNA samples from the Golden State Killer, collected from several of his crimes many years ago. But they had no suspects to try to match them to. Companies like 23andMe have lots of DNA samples, but they are not searchable by the public or the police. However, there's a small company called GEDmatch that analyzes DNA samples and makes them available for free for research purposes. Police detectives searched the GEDmatch database recently, and identified a DNA sample that was close enough to the killer's DNA that it had to belong to a relative (for more on how that works, see this article). Studying that person's family tree led them to Joseph DeAngelo as a possible suspect in the Golden State Killer case.
To find out for sure, the police covertly collected a DNA sample from Mr. DeAngelo (it wouldn't be hard to do - we discard DNA every day on coffee cups and soda cans, for example). It was a match to the killer's DNA samples that they'd had on file for 30 years!
Case closed, finally.
Saturday, May 12, 2018
Another Outbreak of Ebola
The Ebola virus that killed more than 11,000 people in four African countries in 2014-2015 has broken out again - this time in a remote village in the Democratic Republic of Congo. So far, 17 people have died from the newest outbreak, including one nurse who was caring for victims.
The 2014-2015 outbreak was so deadly because the countries involved and various medical aid agencies were slow to respond. This time around, health officials are taking no chances. The World Health Organization is mobilizing a rapid response force that includes medical experts, equipment, and medical supplies, including a new Ebola vaccine. The affected area is just three hours away by road from a city of over a million people. If the virus reaches the city, containment of the outbreak could become much more difficult.
From past experience, health officials believe that by attacking viral disease outbreaks early and hitting them hard, outbreaks can be stopped in their tracks before they can spread very far. It worked (minus the new vaccine) in stopping a previous Ebola outbreak in the Democratic Republic of Congo in 2017. Let's hope it works again.
The 2014-2015 outbreak was so deadly because the countries involved and various medical aid agencies were slow to respond. This time around, health officials are taking no chances. The World Health Organization is mobilizing a rapid response force that includes medical experts, equipment, and medical supplies, including a new Ebola vaccine. The affected area is just three hours away by road from a city of over a million people. If the virus reaches the city, containment of the outbreak could become much more difficult.
From past experience, health officials believe that by attacking viral disease outbreaks early and hitting them hard, outbreaks can be stopped in their tracks before they can spread very far. It worked (minus the new vaccine) in stopping a previous Ebola outbreak in the Democratic Republic of Congo in 2017. Let's hope it works again.
Sunday, May 6, 2018
Testing Zika Vaccines
Here's a question for you. Suppose that you had been working on a vaccine for the Zika virus, and now you have what you think might be a good one. How are you going to prove its safety and effectiveness?
Testing your vaccine for safety would be relatively easy; you'd give it to just a few people at first, and then to dozens, then hundreds of volunteers until you could prove that it was free of dangerous side-effects. But the real difficulty would be to prove that it is effective; that is, that it actually would prevent a Zika virus infection. Zika infections are relatively rare, even in Zika-infections regions. And you can't just test the vaccine on the persons who do become infected; vaccines have to be given before an infection occurs, not after.
So here are your options: 1) Administer the vaccine (or a placebo) to tens or even hundreds of thousands of healthy people in a Zika-infected region, so that just by chance you will have vaccinated a few people who will contact Zika at some time in the future, and then wait, or 2) administer the vaccine (or a placebo) to perhaps a few hundred volunteers and then deliberately infect them with the Zika virus.
Because Zika infections are relatively rare, the first approach is likely to be prohibitively expensive, time-consuming, and might never achieve the desired result. That's why researchers are proposing the second approach; deliberately infecting vaccinated and unvaccinated volunteers with Zika. The researchers argue that a Zika infection, like the flu or a cold, is a relatively minor illness for an adult. The real danger is to a woman who is pregnant, because a Zika infection during pregnancy can lead to serious birth defects in an infant. For that reason, the researchers say that any women in the proposed study would have to agree to avoid pregnancy for the duration of the study.
Still, some ethicists are queasy about the proposed study. Accidents (including unplanned pregnancies) happen. And this study would be of no benefit whatsoever to the persons who would choose to volunteer; they'd have to be doing it solely out of altruism.
What do YOU think?
Testing your vaccine for safety would be relatively easy; you'd give it to just a few people at first, and then to dozens, then hundreds of volunteers until you could prove that it was free of dangerous side-effects. But the real difficulty would be to prove that it is effective; that is, that it actually would prevent a Zika virus infection. Zika infections are relatively rare, even in Zika-infections regions. And you can't just test the vaccine on the persons who do become infected; vaccines have to be given before an infection occurs, not after.
So here are your options: 1) Administer the vaccine (or a placebo) to tens or even hundreds of thousands of healthy people in a Zika-infected region, so that just by chance you will have vaccinated a few people who will contact Zika at some time in the future, and then wait, or 2) administer the vaccine (or a placebo) to perhaps a few hundred volunteers and then deliberately infect them with the Zika virus.
Because Zika infections are relatively rare, the first approach is likely to be prohibitively expensive, time-consuming, and might never achieve the desired result. That's why researchers are proposing the second approach; deliberately infecting vaccinated and unvaccinated volunteers with Zika. The researchers argue that a Zika infection, like the flu or a cold, is a relatively minor illness for an adult. The real danger is to a woman who is pregnant, because a Zika infection during pregnancy can lead to serious birth defects in an infant. For that reason, the researchers say that any women in the proposed study would have to agree to avoid pregnancy for the duration of the study.
Still, some ethicists are queasy about the proposed study. Accidents (including unplanned pregnancies) happen. And this study would be of no benefit whatsoever to the persons who would choose to volunteer; they'd have to be doing it solely out of altruism.
What do YOU think?
Saturday, May 5, 2018
Hawaii Passes a Death With Dignity Law
Hawaii becomes the sixth state (plus Wash. D.C.) to pass a Death With Dignity law, permitting terminally ill persons to choose to end their own life in certain situations. Like the laws in other states, Hawaii's law requires agreement of two doctors that the patient is mentally sound and has less than six months to live. If such conditions are met, the patient is prescribed a lethal dose of a medication (usually a powerful barbiturate) that they may use (or not) at their own discretion.
Death With Dignity laws continue to gain traction. One reason is that both a majority of Americans and a majority of doctors now support them. High-profile cases such as that of Brittany Maynard (see Johnson's Human Biology; Concepts and Current Issues, 8e. p. 480) have kept end-of-life issues in the public eye. And it helps that there has been no evidence of misuse or abuse of such laws in the first few states that passed them.
The number of people who choose to take advantage of Death With Dignity laws remains small. In Oregon, which has had a Death With Dignity law since 1997, only 218 people requested lethal prescriptions in 2017 and only 143 people used their prescriptions to end their lives. Most were cancer patients over the age of 65.
Death With Dignity laws continue to gain traction. One reason is that both a majority of Americans and a majority of doctors now support them. High-profile cases such as that of Brittany Maynard (see Johnson's Human Biology; Concepts and Current Issues, 8e. p. 480) have kept end-of-life issues in the public eye. And it helps that there has been no evidence of misuse or abuse of such laws in the first few states that passed them.
The number of people who choose to take advantage of Death With Dignity laws remains small. In Oregon, which has had a Death With Dignity law since 1997, only 218 people requested lethal prescriptions in 2017 and only 143 people used their prescriptions to end their lives. Most were cancer patients over the age of 65.
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