Month: March 2009

Lifting the stem cell ban – was there any point?

President Obama has lifted the ban on embryonic stem cell research enacted by Bush, but I’m left feeling that this intervention came many years too late.

Pledging that his administration will “make scientific decisions based on facts, not ideology,” President Obama on Monday lifted the Bush administration’s strict limits on human embryonic stem cell research.

…

But Mr. Obama went on to say that the majority of Americans “have come to a consensus that we should pursue this research; that the potential it offers is great, and with proper guidelines and strict oversight the perils can be avoided.”

In making his announcement, Mr. Obama drew a strict line against human cloning, an issue that over the years has become entangled with the debate over human embryonic stem cell research.

As someone who works with stem cells I find this largely an empty, symbolic act, but one that needed to be done anyway. The reality is the damage was done by Bush already, and we’re fortunate that it was only a temporary delay in some of the most important research humans have developed to date.

What a lot of people don’t realize is that in 2006 a revolutionary result was discovered by Japanese scientists led by Shinya Yamanaka at Kyoto University. What they found was the reset button for mammalian cells, the genes that need to be expressed for a cell to revert to a pluripotent state. We wrote extensively about what results in these cells – induced Pluripotent Stem Cells or iPSC – mean for stem cell research and regenerative medicine overall. Basically, the ability to reprogram the cells of any individual to a totipotent state – one in which the cells may make any cell-type or tissue in the human body. Before some fool suggests this was due to Bush remember it was a Japanese group, the research started long before Bush, and it never would have been possible without ES cells from which they culled the critical genes for the transformation.

So why does it matter that Obama has reversed this policy? Not only are ES cells inferior compared to iPSC for human therapies, but wouldn’t it be easier not to upset the fundamentalists that would equate the value of our lives to that of a ball of undifferentiated cells?

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Rating your doctor online – is this a good idea?

I have just finished taking my last major exam of medical school – Step 2 of the boards (including Step 2 Clinical Skills, or CS, which costs 1200 bucks, requires you to travel to one of a few cities in the country hosting it, and is sealed by a EULA that forbids me from talking about what the test was like), and am winding down my medschool career in the next few weeks. It’s about 2 weeks from Match Day (the 19th), when I’ll find out for sure where I will spend the next 5 or so years of my life. I’ll be sure to have a post up a little after noon that day when I find out what the answer is. And then, around May 17th, graduation day, I’ll be a medical doctor, ready to start internship (also known as the hardest year of your life).

One of the things I’ve found universal to all medical students is that we really want to be good doctors when we are finished with our training. I don’t think I’ve ever met a medical student who was in this career for the money (you’d be crazy), or for other selfish reasons. They tend to be hard working, dedicated, humble people who, if anything, are sickeningly sincere about wanting to help other people. Maybe that’s just my school, but my experience is, these folks want to do good in the world.

But another universal is that not all doctors will be able to avoid making mistakes. Doctors are human, they all will eventually make errors, and the goal of any profession dedicated to improving the human condition should be constant self-reflection and efforts at self-improvement. This is not a simple thing to do however. Medicine is complex, and quality of medical treatment is very difficult to assess. We’ve discussed before, using metrics in medicine is challenging, and often rather than studying medical quality you end up merely assessing the social demographics of the physicians’ patients.

So it is with interest that I see reading boingboing that lots of people are upset because some doctors are forcing their patients not to rate them on sites like RateMD.com by having them sign a contract forbidding them from doing so.

The arguments for and against this practice are fascinating. We tread into the mucky waters of free speech, free enterprise, the practice of medicine, and the practical problem of assessing physician quality…

More below the fold…
Continue reading “Rating your doctor online – is this a good idea?”

Will the Lead Toy Industry Get Bailed Out?

Who cares about moral hazard anymore! AEI, Cato, where are you when we need you?

It goes something like this: A group of companies that chose to put lead in children’s toys, or to offshore their operations to countries with poor manufacturing controls in order to save money, are now upset that their schemes are going to cost them money. The government has the audacity to do something about this crisis, and guess what, it costs the industry money! Maybe they should have incorporated the costs of lead when they decided to offshore!

Joseph Pereira of the Journal reports:

Makers of children’s products and charities that run second-hand shops are stuck with more than $1 billion of inventory they can’t sell because of a new federal product-safety law, according to surveys by trade groups and the charities.

They’re stuck with this inventory because of a new federal product safety law? What a way to shift the blame! If the industry as a whole maintained quality controls, we wouldn’t be in a toxic toy crisis, and then the federal safety law would not have been passed. Consumer protection laws do not just pass out of the blue; they are motivated by serious, overwhelmingly problematic situations. Trust me on this, there are 100 lobbyists against any consumer protection matter for each advocate in favor of it. They only pass when agencies and Congress have no option but to side with the single advocate.

The Toy Industry Association estimates that more than $600 million in toys made illegal by the law are sitting in manufacturers’ warehouses or have already been shipped to retailers. A trade group for small apparel makers in New York called the Coalition for Safe and Affordable Childrenswear says its members have a $500 million problem. And the California Fashion Association, which represents many Western clothes makers, puts their troubled inventories at $200 million.

The trade groups were reluctant to disclose the names of the companies affected or provide documentation in support of their estimates.

Yep. Sounds like they’ll be next in line for a bailout.

WaPo’s ombudsman just doesn’t get it

Is he being purposefully obtuse? Once again the ombudsman decides to defend George Will, but only on a single point.

A key paragraph, aimed at those who believe in man-made global warming, asserted: “According to the University of Illinois’ Arctic Climate Research Center, global sea ice levels now equal those of 1979.”

Bizarrely, he acknowledges Will was wrong:

It said that while global sea ice areas are “near or slightly lower than those observed in late 1979,” sea ice area in the Northern Hemisphere is “almost one million sq. km below” the levels of late 1979. That’s roughly the size of Texas and California combined. In my mind, it should have triggered a call for clarification to the center.

But according to Bill Chapman, a climate scientist with the center, there was no call from Will or Post editors before the column appeared. He added that it wasn’t until last Tuesday — nine days after The Post began receiving demands for a correction — that he heard from an editor at the newspaper. It was Brewington who finally e-mailed, offering Chapman the opportunity to write something that might help clear the air.

Will’s column is grossly dishonest, as we and others pointed out it wasn’t just sea ice, but the repeated misquote of a scientific paper and a whole host of dishonest statements. He’s apparently been misquoting one paper to push this “global cooling” nonsense since 1992 and basically recycling this same BS article for almost two decades!

Alexander may be correct there is fact checking “on multiple levels”, but that does not change that it was incompetent, missed willful errors, and that there has not been a correction of Will’s mistakes or a repudiation of his incessant repetition of falsehoods like the myth of global cooling.

For yet another week the Washington Post has failed to demonstrate accountability for its errors.