A Valentine’s Day Gift to our Readers…

Whether you have a special someone with whom to celebrate today or whether you just are a special someone, we wish you a Happy Valentine’s Day! And here are just a few links to stories that popped up when I googled Valentine’s Day + bioethics:

- Love is a powerful drug: “Love is a drug,” says Helen Fisher, an anthropologist at Rutgers University and author of “Why We Love: The Nature and Chemistry of Romantic Love.” “The ventral tegmental area is a clump of cells that make dopamine, a natural stimulant, and sends it out to many brain regions” when one is in love. “It’s the same region affected when you feel the rush of cocaine.”

- From the Situationist Blog: “It’s all about dopamine, baby, this One Great True Love, this passionate thing we’d burn down the house and blow up the car and drive from Houston to Orlando just to taste on the tip of the tongue.

You crave it because your brain tells you to. . . .Dopamine. God’s little neurotransmitter. Better known by its street name, romantic love. Also, norepinephrine. Street name, infatuation.”

- Valentine’s Day stories from NPR.

- And for those who prefer to celebrate, ahem, ‘privately’ or putting it another way, celebrate privacy, a little Valentine’s Day gift from a federal court in Texas: A federal appeals court has struck down a Texas law that makes it a crime to promote or sell sex toys, stating that “Whatever one might think or believe about the use of these devices, government interference with their personal and private use violates the Constitution.” Full opinion here.

The Logic or Rationale of the DNR Order

Whether we’ve discussed it or not, we’ve all thought about the prospect of Do Not Resuscitate Orders (DNRs). In most instances the need for them is no mystery nor does it require rocket science to understand when they become necessary. But now, in 21st century medical science comes the question: when do they not make sense?

See one perspective on a controversial ethics issue here.

Pain and personhood

Yesterday’s NYT Magazine ran a long article about whether fetuses feel pain. The author, Annie Murphy Paul, is working on a book about how our early experiences shape development, and she asks some interesting questions about what effects pain and stress might have on fetuses. The pain question is an interesting one, and experts disagree about whether, to what degree, and at what point in time fetuses can experience pain.

If fetuses can experience pain, it seems not only reasonable but morally necessary that they receive sufficient anesthesia when they undergo painful procedures (such as blood transfusions or surgical interventions–which, believe it or not, can actually be done in utero in certain specialized centers in the U.S.). Such a claim doesn’t rest on assertions of personhood, only of sentience. I would never let a veterinarian do surgery on my dog without anesthesia, but that doesn’t make him a person.

As Paul notes, some anti-abortion activists have seized on research that shows fetuses displaying a physiological response to painful stimuli. They want to use this information as an emotional weapon, making sure that women know that if they have an abortion, the fetus will feel pain. Therefore, the argument goes, they should not abort. But while such a statement might make a woman feel worse, I have a hard time imagining that it would really change the mind of a person who’d made a firm decision to abort. It might cause her to ask that anesthesia be provided, though, which seems like a good thing.

Setting aside the abortion debate, pain is awfully tricky. We tend to understand pain as a subjective phenomenon: two people exposed to the same painful stimulus might well have different responses. So what does it mean to talk about pain for the fetus, who can’t rate pain on a scale from 1 to 10, or even point at a frowny face? What do measures of cortisol or other stress hormones, or changes in blood flow, tell us about what the fetus is experiencing?

If we say that increases in certain metrics or decreases in others correlate with pain, what would it mean if we saw similar indications in a person in a persistent vegetative state? Paul comments that it might cause one to reconsider active euthanasia in such a situation, as a means of sparing suffering. But the connection between pain and suffering, between objective physiological measures and life as experienced, forces us to think about consciousness, about personhood, about respect for living beings (human and not), and about mercy. I can’t do the article justice here, but it’s definitely worth a read.

Embryonic Stem Cell Trials in Humans Could Begin in Months

If all goes as planned, a California biotech firm will begin human testing using human-based embryonic stem cells by Spring of 2008.

Dr. Thomas Okarma, CEO of Geron, said the firm plans to conduct embryonic stem-cell studies in subjects with spinal cord injuries, involving up to 40 patients. The planning, of course, is pending the greenlight to proceed from the FDA, which is said to be setting a “high bar” on regulations governing what is certain to be one of the most significant pioneering research procedures of the century. Economic analysts predict the regulatory process alone will be daunting, and time-consuming because these are uncharted waters. It will be the first time that the FDA reviews a human embryonic stem-cell application.

Controversy has raged on both sides over the debate of stem cells and the ethical use in human therapeutic applications. In 2001 President Bush placed limits on federal funding of experiments involving then-existing human-derived stem cell lines, and in 2007 vetoed an attempt by Congress to lift those restrictions. No doubt the impending research will only raise more ire, questions and a major regulatory conundrum of the likes never witnessed before.