Bioethics Might Take Medical Ethics' Place

Dr. Edmund Pellegrino says that medical ethicist and bioethics should be working together for the good of patients. Dr. Pellegrino, Professor Emeritus of Medicine and medical Ethics at the Center for Clinical Medical Ethics at Georgetown University Medical Center, spoke at Duquesne University about medical ethics' relationship with bioethics. Medical ethics is the system of ethics that is applied to physicians and patient care, while bioethics is interdisciplinary and focus on the question that arise from bio-science.

Pellegrino says that bioethics was formed out of three main events, the first being the cultural shift that began in the 1960s away from previously trusted authority figures. He says that this distrust that happened around the time of the Watergate scandal caused the second event, a mistrust of physicians and medical ethics.

The third event was an acceptance of multiculturalism. "And that's all fine, but then again it began to confuse one cultural set of values with the right rules and this fed into the idea of individual determination. 'What's right and wrong is what I say it is, what I say it is, what I believe. And don't tell me anything different and don't argue with me."

Dr. Pellegrino stresses that instead of just accepting the values that one already has, there needs to be discourse and public examination of whether those are right or not. He says that without examination of whether things are actually beneficial to society or a patient there can be no true progress.

Pellegrino says that he sees two possible futures for bioethics. One is where bioethics take the place of Medical ethics. "No matter how highly organized we can be, not matter how technical we can be, how scientific we can be. The human condition of being will and wanting to be helped, cured if possible, at least relieved of pain and suffering will be universal. Don't leave that to this vague notion of bioethics. I'm asking you to leave it to physicians."

The second future would be one which he most likes, one where bioethics and medical ethics can work together. He says that the aim of both types needs to be figuring out how to best look at the human condition of being ill and working in the best interest of people.

Safe Drug Disposal

On April 30th "Drug Take Back Day" will be in effect throughout the Pittsburgh region and across the nation. The Pennsylvania Resources Council (PRC) and Highmark Blue Cross Blue Shield will sponsor an event at The Mall at Robinson to dispose of prescription drugs instead of flushing or throwing them away. David Mazza, Western Regional Director for the PRC says there is no limit to what prescriptions can be brought.

"Everything from pills ointments and creams. We are also accepting both controlled and non-controlled substances. So, when we talk about controlled substances we are talking about prescription pharmaceuticals things like Vicodin, Oxycontin, Demerol, so any of the narcotic-type prescription medications. All of those will be accepted."

He also notes that flushing medications is dangerous because the wastewater system is not meant to digest prescription compounds, meaning that they could end up in the water system. Also, throwing them in the trash can make it easier for the drugs to get into the wrong hands, or damage the environment by being in a land fill. Since prescription drug abuse is more of a recent epidemic, Mazza says that there is no safe way to dispose of medications other than attending semi-annual Drug Take Back event. From the event, dropped-off medications will safely be incinerated.

Mazza says that individuals can drive-through, but suggests blacking-out personal and doctor information on the label before dropping the medications off at the event.

Mazza says that there are 133 collection sites in Western Pennsylvania. To find a site near you, visit www.dea.gov

UPMC Performs Less-invasive Aortic Valve Replacement

UPMC surgeons performed the first round of procedures that replaces patent's aortic heart valve without having to perform open heart surgery. The hospital is one of 40 hospitals nation-wide participating in the Medtronic CoreValve® Clinical Trial evaluating a non-surgical procedure as an alternate to open-heart surgery for aortic stenosis patients. The procedure requires doctors to channel a catheter through a small opening in the femoral artery to reach the patent's heart, then the CoreValve is guided to the aortic valve where it self-expands to replace the diseased valve.

William Anderson, director of Interventional Cardiology at UPMC, says that this procedure is different than other methods. "The gold standard of therapy for aortic valve replacement is to do it through open heart surgery, and that's an operation that we've done for a long time and we're very familiar with. The disadvantage to it is that it is maximally invasive and it has a relatively long recuperation period."

Anderson says that the procedure has yet to show whether or not t will be a commercial success. He says that there are two other valve replacements being made available commercially relatively soon and we should see in the next 12 months if either is successful.

Aortic stenosis prevents the heart's aortic valve from properly opening which leads to less healthy blood flow from the aorta to the rest of the body. Approximately 300,000 people suffer from aortic stenosis worldwide, one third being deemed too high risk for open heart surgery.

The CorevValve System will be available commercially until the end of its clinical trial and approval of the FDA.

Pitt Researcher Creates Database for Pregnancy Complications

Dr. James Watson, a researcher at the University of Pittsburgh, is spearheading a project to research prevention and treatment for preeclampsia along with creating a database for future studies. “We’re trying to bring together groups of individuals who have data and biological samples that have studied preeclampsia in the past with the idea that we can maybe pull sources to answer questions pretty quicky,” Watson says. The database method has been successful in other research, including cancer and heart disease. Watson is the senior advisor to PRE-EMPT or PRE-Eclampsia Monitoring, Prevention, and Treatment, a group that is funded by the Bill and Melinda Gates Foundation through a $7 million grant over four years. His goal is to create a research database filled with blood, urine, and other biological samples from ethnically diverse women across the globe. This database will facilitate the first goal of finding a specific marker of the disease, but can also be used in future pregnancy research. “We’re hoping that we can move pretty quickly. It’s our initial goal to find something along the line of a predictor,” Watson says. Preeclampsia is a pregnancy complication that involves high blood pressure in the mother and affects five to ten percent of pregnancies. It is the second leading cause of maternal death worldwide.

ACHD Calls for Reserve Medical Volunteers

Volunteers are needed for the local Regional Medical Reserve Corps, an emergency response group covering 13 counties in southwestern Pennsylvania.

Allegheny County Health Department spokesman Dave Zazac says the Reserve Corps is called up in times of medical emergency, like any natural or man-made disaster.

“For instance, if indeed we had an oil spill up here as opposed to down in the Gulf; if we go back to Hurricane Ivan, whenever there was flooding in certain sections of the county; other really wet-weather events perhaps at this time of year.”

You don’t need to be a doctor or a nurse to apply – Zazac says the Health Department would also need non-medical personnel to help contain crowds and provide clerical support. He says the Health Department provides free training online and in classrooms.

Reserve Corps chief Ed Schwartz says in emergency conditions, the state or federal government would cover any liability if a medical error should occur.

Southwestern Pennsylvania’s Region 13 chapter currently has 485 members. To apply, call the Health Department at 412-578-8349 or visit their website.