What Is Death?

July 26, 2018

It’s another edition of Midday on Ethics, in which we explore some ethical questions pulled straight from the headlines. Guiding us in that exploration is Dr. Jeffrey Kahn, the Director of the Johns Hopkins Berman Institute of Bioethics. He joins Tom in Studio A from time to time to help us examine how ethicists are framing these very complex questions.

We begin with the story of Jahi McMath, a 13-year -old girl in California who was declared dead in late 2013, after a routine surgery went wrong. Then, last month, 4½ years later, she was declared dead, again, in New Jersey. It’s a tragic story that raises issues about end of life that has pitted the medical profession against people with deeply held religious beliefs. Just like there is no consensus on when life begins; there is also a lack of agreement about when life ends. How do we define death? And who gets to define it?

Another ethical conundrum Tom and Dr. Kahn discuss today involves infertile couples who undergo in vitro fertilization, or IVF treatment, in which a woman’s harvested egg is fertilized with her husband’s sperm in a laboratory medium, and then re-implanted in her uterus for normal gestation. IVF couples sometimes produce a surplus of embryos, which are saved for possible future use in hopes of achieving pregnancy. But what if those couples split up? The legal consensus has been that the embryos cannot be used unless both people agree, on the theory that nobody can be forced to be a parent. A new law in Arizona turns that consensus on its head.

 


Jeffrey Kahn, PhD, MPH,  Andreas C. Dracopoulos Director of the Johns Hopkins Berman Institute of Bioethics, regularly stops in to visit WYPR’s Midday show with Tom Hall to discuss pressing ethics issues related to current scientific and technological advances.

 


Prof. Kahn’s past appearances on Midday with Tom Hall:


Quality of Life Transplants and Privacy & Genetic Info

May 29, 2018

Today, it’s another edition of Midday on Ethics. We’re exploring some ethical questions pulled straight from the headlines. We begin with the ethics of organ transplantation, amid news of a medical breakthrough — a transplant performed just weeks ago at Johns Hopkins Hospital here in Baltimore. For the first time, anywhere, doctors successfully performed a total penis and scrotum transplant on a service member who was injured in Afghanistan. Now that it’s possible to transplant a penis, or a uterus, what are the ethical issues that donors, recipients and transplant surgeons need to consider? Should we think about life-saving transplants like hearts and kidneys in the same way as non-lifesaving surgeries, the so-called quality-of-life transplants?

Plus, another news story caught our eye: California investigators used publicly available genetic information that was posted on an ancestry website to identify someone that they say is the Golden State Killer. He has been charged with murders police say he committed more than 30 years ago. Is your genetic information publicly available? Should it be, and if so, should it be more private than it is?

Dr. Jeffrey Kahn, the director of the Johns Hopkins Berman Institute of Bioethics, is Tom’s guest today in Studio A. Dr. Kahn stops by from time to time to help us explore how ethicists frame these kinds of very complex questions.

 

Vaccination Matters

 

January, 25, 2018

 

How are you feeling today? Flu-ish maybe? If so, you’re not alone. We keep hearing that this is the worst flu season in years. And if you’ve had this year’s flu, that’s no doubt how it feels. In fact, it is probably the worst flu season in the past three years, and we’ll have to wait until it’s over before the CDC can rank it more definitively.

 

Here’s what we do know in this — the 100th anniversary of the 1918 Influenza pandemic, which infected 500 million people worldwide.

 

This year’s flu is now widespread in 49 states — all but Hawaii. The number of children who have died from flu this winter has now reached 30. Three years ago 148 children died from the flu, according to the CDC. The number of adults who die from flu in any given year is less clear. But what is clear is that the flu is serious.

 

Dr. Jeffrey Kahn, the Director of the Johns Hopkins Berman Institute of Bioethics,joins Tom today. He stops by from time to time to help us explore how ethicists frame some very complex questions, in a segment we call Midday on Ethics.

 

Unintended Consequences of Gene Editing?

 

November 28, 2017

 

We’ve talked several times over the past year about gene editing, and the ethical questions that go along with potentially editing the genes of plants and animals, including humans. Today, we revisited these questions with Dr. Jeffrey Kahn, the Director of the Johns Hopkins Berman Institute of Bioethics. Why? Because there is some news, perhaps a new way of thinking, about a technology developed only four years ago. It’s called Crispr, and it allows scientists to edit genes precisely, to do things, potentially, like reduce the risk of passing along an inherited disease, or eliminate the risk all together. Or, for example, to eliminate the mosquitoes that carry malaria.

About a year and a half ago, scientists proposed what to many people seemed like a good idea at the time — using Crispr to save endangered animals that were threatened by an invasive species by implanting a so-called gene drive — a gene that would reduce the fertility of the invasive animals, thus giving the endangered species in the same area a better chance at survival. Last week, the news caught our eye that the very scientist who had proposed this originally now says that field testing the gene drive would be a bad idea. So why is that? What are the unintended consequences of gene editing, including human gene editing? Dr. Jeff Kahn stopped by to help us explore how ethicists frame complex questions like this and to answer your questions.

 

 

Human Gene Editing & Gene Therapy

October 4, 2017

 

On this edition of Midday on Ethics, Dr. Jeffrey Kahn stops by Studio A to discuss human gene editing and some of the ethical questions that surround its implementation.  We also take a look at some of the first successful gene therapies, including one that the FDA recently approved for the first time in its history.

 

The approved therapy is aimed at adults and some children with B-cell acute lymphoblastic leukemia, a common form of the disease. It  involves genetically modifying immune cells from a patient’s blood and then infusing them back into the same patient.

 

Life and Death Decisions – The Case of Charlie Gard

July 31, 2017

 

Today, we’re having a conversation about the ethical questions surrounding the case of Charlie Gard. He’s the infant in Britain who died on Friday, a week shy of his first birthday.  He was critically ill for all of his short life.  He had a rare genetic condition that left him brain damaged and unable to move or breathe on his own.

 

His parents sought permission from UK courts to do what they thought was best for their son.  First they wanted to take him to the U.S. for experimental treatment.  More recently, his caregivers said that there was nothing more than could be done to help him and that he would die without artificial life support.  His parents wanted to take him home from the hospital to die.  In both instances, the courts ruled that what the parents wanted was not in the best interest of little Charlie.

 

This sad case reminds us that there are ethical questions that parents of very sick children and their doctors face all the time.  What does it mean to act in the best interest of a critically ill child and who gets to decide?   And when does the parents’ right to make life and death decisions for their infant begin and when does it end?

 

Diversity in Clinical Trials

June 13, 2017

 

Tom talks with Dr. Jeffrey Kahn about clinical trials and diversity. Why is so much medical research still done with white subjects — and more often with men rather than women — and what are the consequences of that, particularly for women and people of color? If clinical trials are done by examining only parts of our society, what does that mean for the efficacy of the findings, and how reliably can those results be extrapolated to apply to the rest of the population? And what are the consequences when that research is then used to develop treatments? Will they be effective for everyone, or primarily just for the group at the heart of the research? To wit: African Americans have a far greater incidence of Alzheimer’s Disease and a far lower rate of inclusion in clinical trials. What, if any, is the connection between those two realities?

 

Informed Consent and the Extraordinary Story of Baltimore’s Henrietta Lacks

April 5, 2017

 

Midday on Ethics: HBO and Oprah Winfrey will bring the story of Henrietta Lacks to television. The film, “The Immortal Life of Henrietta Lacks,” based on the best-selling book of the same name by Rebecca Skloot, premiers on April 22.  You may already be familiar with the story of Henrietta Lacks, who lived in southeastern Baltimore County in the early 1950s. She had cancer, and in 1951, doctors at Johns Hopkins Hospital did a routine biopsy. She died eight months later. But her cells live on, because without her consent, and without the knowledge of her family, cells taken during the biopsy were used, for decades, in medical research around the world.   In fact the HeLa cell line — H-E for Henrietta and L-A for Lacks — revolutionized medical research, and, by some accounts, has resulted in billions of dollars worth of medical breakthroughs. None of the proceeds, however, went to Ms. Lacks or to her descendants. Could the same thing happen today? We’ll try to untangle the ethical questions in this conversation about Informed Consent. How much have standards changed in the 65 years since Henrietta Lacks was a cancer patient at Hopkins? What are today’s standards?

 

New Report Sets Guidelines for Genome Editing

February 15, 2017

 

Genome editing, that is the ability to make additions, deletions, and alterations to the genome of a human or animal, is not a new. Scientists have been experimenting with it in labs for a while to better understand the way some diseases and disabilities work. But now a new report released yesterday from the National Academy of Sciences and the National Academy of Medicine sets international guidelines for genome editing. New editing tools like CRISPR have opened up the doors for more lab and clinical research projects. The scientists behind the report hope their guidelines will serve as a roadmap to help other scientists avoid the ethical concerns associated with gene editing.

 

Bioethics With Dr. Jeffrey Kahn: A Question Of Assisted Suicide

January 24, 2017

 

Some people call it “assisted suicide.” Others prefer the terms “death with dignity,” “aid to the dying,” or “the right to die.” Whatever the label, nearly 20 percent of Americans now live in places where it’s legal. Washington, DC is one of those places. Maryland is not.  Should it be?

 

Bioethics With Dr. Jeffrey Kahn: Autonomous Car Safety

December 15, 2016

 

Every scientific advancement comes with a slew of questions. Take autonomous cars, for example.   In an accident, whose lives should a driverless vehicle be programmed to protect?   Passengers in the car, or people on the street? The field of bioethics addresses the complicated ethical dilemmas that researchers and policy makers face in an ever-changing modern world.

 

Questions in Bioethics: Genetically Modified Animals, and Now Humans

October 13, 2016

 

We thought we’d start by talking about the public health issue that has dominated the headlines since this summer. The Zika virus grabbed the public health spotlight and spread like crazy in certain parts of the world, including an outbreak that has been controlled in the Miami area. One of the approaches to eliminating the virus that scientists are considering involves genetically modifying mosquitoes and then releasing them into the environment. On the surface, it may seem that changing the genetic make-up of some insects shouldn’t be cause for alarm. But like so many of the issues that Jeff Kahn and his colleagues consider, it’s not that simple.

Dr. Kahn also weighs in on the topic of babies now being born with more than two biological parents. They actually carry the genetic material of three parents. To the parents who otherwise might not have biological children, the technology that makes this possible is a blessing. But is it a good idea? What are the consequences of these new possibilities? Tom asks Dr. Kahn about framing the questions we should be asking in bioethics, to find the answers we need.

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One Response to “Jeffrey Kahn on WYPR Midday”

  1. […] technologies at the 2017 TedXMidAtlantic conference in Washington, D.C. I’ve also become a regular guest on WYPR’s Midday with Tom Hall (Baltimore’s NPR affiliate). This public forum allows me to connect with listeners on relevant […]

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