September 24, 2011
Worth Reading This Week
David Challoner & William Vodra, Medical Devices and Health — Creating a New Regulatory Framework for Moderate-Risk Devices, N Engl J Med
Micah Berman, A Public Health Perspective on Health Care Reform, SSRN/Health Matrix
Lorian Hardcastle, A Critique of the Governmental Health Sector Tort Jurisprudence, SSRN
International Neuroethics Society Meeting, November 11 and 12, 2011
The International Neuroethics Society Annual Meeting will be held on Thursday, November 10, and Friday, November 11, 2011. This meeting will be held in conjunction with the meeting of the Society for Neuroscience, a 30,000 person plus meeting in Washington, D.C., which will be held from Saturday, November 12 through Wednesday, November 16, 2011.
Of particular interest will be the law panel which will focus on neuroscience in real cases. The three speakers, each of whom was involved as a professional in one of the iconic cases involving law and neuroscience, will briefly present his thoughts on his case and then participate in a question and answer period. As described by Professor Hank Greely:
∙ Steve Greenberg is the lawyer who introduced fMRI evidence of psychopathy into a capital sentencing case (the Dugan case in Illinois). There's a fascinating write-up of that case in Nature magazine - 464 Nature 340 (Mar. 18, 2010).
∙ Houston Gordon is the lawyer who tried, unsuccessfully, to introduce for the defense some fMRI lie detection evidence into a federal criminal trial. This led to a 2 day evidentiary hearing and an extensive written opinion in United States v. Semrau.
∙ Russell Swerdlow is a neurologist who was the treating physician for a man who pleaded guilty to sexual molestation of his 12 year old step-daughter after a year or so of increasing interest in pornography. Just before sentencing, the man was found to have a tumor the size of a chicken egg pressing on his left frontal lobe. When the tumor was removed, the defendant reported that his urges disappeared. He was released on probation; about 10 months later, his urges returned. So had the tumor. When the tumor was surgical removed again, so were the urges. See the case report at 60 Arch. Neurol. 437 (2003).
This session is scheduled for 2:45 to 4:00 on Friday, November 11, 2011.
The Annual Meeting has a poster session on November 10 in the evening. If you are interested in participating in the poster session, please submit a 500 word abstract by October 1. The top 25 abstracts will be published in an on-line issue of The American Journal of Neuroethics - Neuroscience. Submitters of the top 5 abstracts will be presented orally at the Annual Meeting. And the two best abstracts will win $250 each in travel reimbursement from the Society. See the Call for Abstracts here.
The meeting will be at the Carnegie Institution for Science, 1530 P Street, Washington, D.C. Registration for the meeting is $135 for members who register before September 15 and $145 if after September 15. For any questions, please contact Professor Hank Greely. [KVT]
September 23, 2011
Obama Retreats on Ozone Standards, but Improvements are Going Forward
Earlier this month, the Obama administration withdrew draft ozone ambient air quality standards that the U.S. Environmental Protection Agency (EPA) was about to issue. However, it is important to understand that despite the retreat, the ”fallback” ozone standards are still an improvement over the 1997 standards we have in place today. But it is too bad politics and jobs rhetoric intervened.
In a statement, the President indicated he was abandoning the proposed scientifically recommended ozone standards of 60-70 parts per billion, due to concerns about easing regulatory burdens during this time of economic recovery. According to the Bloomberg news article, the EPA rule was one of the seven most costly rules to business, since it would create many new non-attainment areas where businesses would need to spend considerable money to achieve compliance. According to the L.A. Times, Obama’s decision was a direct result of criticism by the business community and the Republican Party that such rules would be “job killers.”
However, the proposed standards had also been strongly supported by others, with the EPA Administrator herself admitting that the standards promulgated under Bush, were “legally indefensible, as reported by the N.Y. Times.
The decision to back down on the stricter standards upset many health and environment factions. A Huffington Post article quoted Janice Nolen, assistant vice president of the American Lung Association, as being "outraged," given that "the current standard used was based on the science as of 14 years ago -- before we knew that ozone killed people." The National Latino Coalition on Climate Change issued a report criticizing this decision as “leaving hundreds of millions of people in the United States facing unacceptable level of risk” and that ozone risks disproportionately affect Latinos, since they live in areas with the most exposure. The American Academy of Pediatrics, American Thoracic Society and the American College of Preventive Medicine are among many organizations that supported the now-abandoned standards, according to the American Medical Association news.
This seems to be another example of where Obama has chosen to back down on health measures and capitulated to criticisms that his measures would hurt jobs. In commenting on the President’s lack of spine, I think Al Gore said it the best in his blog:
“Instead of relying on science, President Obama appears to have bowed to pressure from polluters who did not want to bear the cost of implementing new restrictions on their harmful pollution—even though economists have shown that the US economy would benefit from the job creating investments associated with implementing the new technology. The result of the White House’s action will be increased medical bills for seniors with lung disease, more children developing asthma, and the continued degradation of our air quality.”
The lack of spine is regrettable but perhaps understandable. The President's proposed American Jobs Act is a centerpiece of his activites this month, highlighted in his speech at joint session of Congress two weeks ago. He may view this action as heading off criticisms that he claims to be creating jobs while killing them off by regulations. However, to bolster his leadership, he could have deflected criticisms by defending the proposed standards, asserting that a need for new ozone control technology would create jobs (as Al Gore suggests above). Now the President is open to criticims that he is weak, and appears to flip flop on science based issues.
However, as mentioned above, the news is not completely bad. The 2008 Bush-era standard (75 parts per billion instead of the proposed 60-70 ppb standard) is still an improvement. Because these 2008 national standards had been suspended while the new proposal was being promulgated, since 2008 states have been allowed to enforce an earlier, 1987 standard of 84 ppb. The history is explained well in a recent Wall Street Journal article.
Expensive Glasses: Monopol-eye?Why are eyeglasses so expensive? Take a listen to this podcast. If you're like me, you'll learn a lot about how to save on your next pair. And there's a lesson or two about the failures of contemporary antitrust law. Finally, it mentioned a company called WarbyParker.com, which apparently not only has reasonable prices, but also gives away a free pair to the needy for every pair it sells. [FP]
September 21, 2011
State Medical Boards Can Place Restrictions on Physicians in Practice Specialties
Puerto Rico regulations that prohibit physicians from performing cosmetic surgery if they are not trained in that specialty do not violate the U.S. Constitution pursuant to a federal appeals court ruling in Gonzalez-Droz v. Gonzalez-Colon, 1st Cir., No. 10-1881, 9/16/11. According to BNA Reports,
In upholding the regulations, the court found Puerto Rico reasonably determined that a general license to practice medicine was insufficient to ensure patients were not injured and that the regulations were needed to guide and protect patients. Using board certification in dermatology or cosmetic surgery was a reasonable surrogate for classifying those authorized to provide those services, the court said.
September 20, 2011
Drug Deaths Now Outnumber Traffic Fatalities
According to a story in the LA Times, drug deaths now outnumber traffic fatalities:
Propelled by an increase in prescription narcotic overdoses, drug deaths now outnumber traffic fatalities in the United States, a Times analysis of government data has found. Drugs exceeded motor vehicle accidents as a cause of death in 2009, killing at least 37,485 people nationwide, according to preliminary data from the U.S. Centers for Disease Control and Prevention. While most major causes of preventable death are declining, drugs are an exception. The death toll has doubled in the last decade, now claiming a life every 14 minutes. By contrast, traffic accidents have been dropping for decades because of huge investments in auto safety.
September 19, 2011
The Flu Season Is Coming, But Where Is Tylenol?
"Summer is ending and that means we can look forward to the flu season. But reaching for the Tylenol is no longer a sure thing, since the venerable pain reliever remains largely out of stock. This is due, of course, to ongoing manufacturing difficulties that Johnson & Johnson has had for nearly two years thanks to bottles that smelled musty, contained too much active ingredients or metallic specks, among other things." Read More. Hat to tip Pharmalot. [KVT]
Florida Law Prohibiting Firearm Questions Fails First Amendment Scrutiny
According to BNA Reports:
Roche Halts Delivery To Greece Over Payments
For the second time since Greece began facing a fiscal crisis, a big drugmaker has stopped delivering drugs to the beleaguered nation. More specifically, Roche is no longer sending meds for cancer and other afflictions to state-owned hospitals that have not paid their bills and the drugmaker may do the same in other countries, such as Spain, Italy and Portugal, where bills are going unpaid. Read More. Hat tip to Pharmalot. [KVT]