Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

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/pdf/acc-aha-2005-guideline-update-for-the-diagnosis-and-4hik65ngbe.pdf

ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult

In 1974 an article appeared in Science magazine with the dry-sounding title “Judgment Under Uncertainty: Heuristics and Biases” by a pair of psychologists who were not well known outside their discipline of decision theory. In it Amos Tversky and Daniel Kahneman introduced the world to Prospect Theory, which mapped out how humans actually behave when faced with decisions about gains and losses, in contrast to how economists assumed that people behave. Prospect Theory turned Economics on its head by demonstrating through a series of ingenious experiments that people are much more concerned with losses than they are with gains, and that framing a choice from one perspective or the other will result in decisions that are exactly the opposite of each other, even if the outcomes are monetarily the same. Prospect Theory led cognitive psychology in a new direction that began to uncover other human biases in thinking that are probably not learned but are part of our brain’s wiring.

Thinking fast and slow.

ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure).

Mariell Jessup, MD, FACC, FAHA, Chair [*][1]

William T. Abraham, MD, FACC, FAHA[†][2]

Donald E. Casey, MD, MPH, MBA[‡][3]

Arthur M. Feldman, MD, PhD, FACC, FAHA[§][4]

Gary S. Francis, MD, FACC, FAHA[§][4]

Theodore G. Ganiats, MD[∥][5]

Marvin A. Konstam, MD, FACC[¶][6]

Donna M.

/pdf/2009-focused-update-incorporated-into-the-acc-aha-2005-3z9lhvyqwq.pdf

2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation

/pdf/what-if-anything-is-wrong-with-cloning-a-human-being-sg6qm4bjyd.pdf

What if anything is wrong with cloning a human being

In the quest to provide treatment for COVID-19 patients, available therapies that have been approved for other indications but have insufficient evidence of safety and efficacy for use against COVID-19 have been considered. One of the unintended consequences of this approach is the potential creation of shortages, depriving existing patients who are benefiting from products based on their proven indications. Here, a pharmaceutical company outlines their ethical decision-making framework to guide decision-making and ensure equity of access to products.

/pdf/drugs-of-unproven-benefit-for-covid-19-a-pharma-perspective-w1sprfztsr.pdf

Drugs of unproven benefit for COVID-19: a pharma perspective on ethical allocation of available therapies.

Wearing your organ transplant on your sleeve.

It is hard to dispute some of the conclusions of Geron's Ethics Advisory Board: stem cell research holds medical promise, is morally problematic, and suggests a need for careful political oversight to ensure responsible progress, the support of the public, and the fair distribution of benefits and costs. And as participants ourselves in several corporate efforts to develop ethical standards for research and oversight mechanisms within biotechnology, we applaud Geron for sponsoring a position statement on moral issues. The effort of the Geron EAB participants to walk a fine line between sponsored research and apologetics is also commendable. However, there is a long way to go, both in developing bioethical review of corporate-based science and in encouraging moral analysis of stem cell research. One area where Geron's brief report needs work is in elaborating the subtle issues associated with the moral status of human stem cells. As reported by the EAB and in Science, Geron investigators' research into human embryonic stem cells (hES) has resulted already in the successful isolation and establishment of cell lines. Such research holds great promise for tissue transplantation, gene therapy, pharmaceutical development, and human embryology. Human and transgenic stem-cell-based research also promises a secondary wave of progress in related areas of science and technology--the "double effect" of stem cell research. For example, while Geron's and other teams working on stem cells may not be directly invested in reproductive genetics, one likely effect of Geron's work would be the acceleration of research on reproductive cloning. In their report, the EAB distinguishes between stem cell research that involves cells derived from blastocysts and research that involves cells from fetal tissue obtained from an abortus. We do not quibble with EAB's view of the issues involving tissue from aborted fetuses. However, its defense of hES research on blastocyst-derived cells is insufficient. The report argues that the moral status of a human, and thus our responsibility to a developing embryo and fetus, grows in strict relation to its development. It accepts what EAB member Ted Peters (following dozens of others in genetics and ethics) terms a "developmental" approach according to which, roughly, an embryo gets more status as it becomes more like a person, with the transition to blastocyst marking an important jump. The developmental approach to embryo status appears helpful on its face. After all, it links moral status to scientifically ascertainable developments. It recognizes that capacities and potential are both important in deciding whether an entity has rights or other moral standing, and it distinguishes between material that is "headed" for human personhood and material that is merely a repository of some component of personhood. It also distinguishes, or could, between tissues in vivo and tissue stored on ice. Most importantly, it is (or at least Peters claims it is) a threshold concept, roughly separating material that can be thought of as an end in itself from material that is merely a means to some other end. Moral Status and Context However, in the work of the EAB, the idea of development as a moral barometer does nothing to clear up the moral issues faced by those who work on stem cells. Worse, it rests on a conceptual confusion that must be resolved before progress can be made in this area of research more generally. Embryonic and germ cell status is not a scientific matter. There is neither consensus nor fact from which to deduce the social meaning of different embryonic or fetal tissues. In fact, hES research, and other basic research on reproduction, radically enlarges the problem of defining basic facts about embryos. We call this problem one of determining "what is in the petrie dish." It is a problem with two parts. First, it is becoming possible to isolate and separate human germ cells and embryonic/fetal tissues from their ordinary environments. …

Human Primordial Stem Cells: What's in the Dish?

Immorally acquired information from Nazi experimentation or other sources infects the body of scientific and biomedical knowledge. Responding to this reality ethically means insisting on good teaching about the horrific history of such information's sources and careful deliberation about how it is referenced and described.

/pdf/how-should-we-regard-information-gathered-in-nazi-uelto3qd9s.pdf

Arthur L. Caplan

Papers

What if anything is wrong with cloning a human being

Drugs of unproven benefit for COVID-19: a pharma perspective on ethical allocation of available therapies.

Wearing your organ transplant on your sleeve.

Human Primordial Stem Cells: What's in the Dish?

How Should We Regard Information Gathered in Nazi Experiments