Crowdfunding treatment

Resource allocation is not a glamorous topic, but it can be a matter of life or death. We often pride ourselves in the UK that we have a health system that allocates funding according to need rather than ability to pay. That is unless you have a rare condition for which the only treatments are experimental or not yet licensed or funded on the NHS. There is an increasing trend to use crowdfunding websites to raise money to pay for such treatments for individuals. If you are a child with a sympathetic story that will attract funding, that can potentially be the difference between life and death. But spare a thought for those who have less 'fashionable' or appealing disease stories and cannot elicit public sympathy for their crowdfunded treatment. Furthermore, those who raise the funding can sometimes do so for a treatment with marginal or no benefit, over those who don't get the attention for treatments that might actually improve or save a life. Access to healthcare should not be based on a 'beauty contest'. The Guardian 20 May 2019 bit.ly/2WI9LJe

Stem cells offer heart transplant alternative

Yes, stem cell medicine is once again making hearts beat. Quite literally in this case, as tissue patches made of stem cells have been shown to repair damaged heart tissue and restore normal function in animal tests. The hope is that this will enable the repair of cardiac tissue damaged by ischaemic heart disease, restoring function, reducing mortality and reducing the need for heart transplants. Human clinical trials are a way off, and there are still many questions to address, but the potential benefits of adult stem cell medicine are becoming more and more apparent. The Times 4 June 2019 bit.ly/2Rb93OW

Pregnant women's 'safety bubble' expands in third trimester

The annoying habit of putting one's hand on a pregnant woman's stomach may be even more annoying than people realise. According to researchers at Anglia Ruskin University and Addenbrooke's Hospital, women's sense of personal space alters significantly in the third trimester, possibly as a protective mechanism. Or maybe it's just because they are irritated at people prodding and poking them in the name of research! Either way, next time you are tempted to place an unsolicited hand on a pregnancy bump, think twice, stand well back and ask permission first! The Independent 13 June 2019 ind.pn/31zNRa4

Death of a Dutch teenager

Frenzy erupted in the English-speaking press after it was reported that doctors had euthanised 17-year-old Noa Pothoven in the Netherlands. Noa suffered anorexia nervosa and had asked to have her life ended because of unbearable suffering. In reality, she was refused euthanasia as she did not meet with the criteria set out in Dutch legislation. However, with doctors and her parents, she had come to an agreement that she could starve herself to death with no intervention. Hysterical reporting of such stories does not help us to weigh up the ethics of allowing someone to die because of a mental illness, and of the real human tragedy for Noa and her family. The Times 5 June 2019 bit.ly/2WBWZY3

Freedom of conscience in Canada

CMF's sister body, CMDS Canada, along with several other pro-life and faith-based physician groups have made appeals to the Canadian courts against the issue of forced referrals for assisted suicide and euthanasia. By misrepresenting this as purely an issue of religion, the wider issue of the precedent set by forced referral on all areas of freedom of conscience has largely been overlooked by the Canadian courts and media. Many in the Canadian legal and medical professions now argue that freedom of conscience is 'one of the foundations of a democratic society', and that respecting this is not a binary conflict with the interest of patients. We wait to see if Canada resolves this, as the implications across 'The Pond' will be significant. The Epoch Times 28 May 2019 bit.ly/30ShxyC

China toughens gene editing rules

In late 2018, He Jiankui, a clinical researcher in Shenzhen, China, announced the birth of twins whom he had genetically modified for HIV immunity. This first (as yet unattested) case of human germline gene editing caused a global outrage, not least because of the lack of knowledge about the potential unintended consequences of such genetic engineering. The Shenzhen hospital where this happened now claim that He had no formal ethical approval for the procedure, and he was subsequently fired. The Beijing government has republished its guidelines, insisting that all such research requires full ethical approval and that human germline alteration is forbidden. China now joins most of the rest of the world in resisting human germline engineering. The Hindu 2 June 2019 bit.ly/2IS8HJp

In utero keyhole surgery for spina bifida

In a world first, surgeons at King's College hospital operated on a 27-week fetus in utero to close the exposed spinal cord of a baby with spina bifida. While the child was born prematurely six weeks later, early signs are good. Long-term, if he fares well and others are operated on successfully, this technique could reduce the number of children born with severe disabilities from spina bifida. It should also reduce the number of spina bifida babies being aborted because of the condition. BBC News 17 May 2019 bbc.in/2VwA3sL

AI is better than specialist doctors at diagnosing lung cancer

Yes, it seems that in addition to robot surgeons and caring machines, we also have expert systems that are taking over diagnostics. Researchers at Northwestern University in Illinois found that an Artificial Inteligence (AI) system was able to detect early cancer and pre-cancer in lung x-rays with greater efficiency than human radiologists. This has the potential to increase the efficacy of screening programmes and save lives. While it is stressed that this does not dispense with the need for human diagnosticians altogether, it is another area where machine learning has the potential to replace or diminish the role of professionals. Regardless, the role of diagnosticians will change as they work more and more closely with AI to improve the accuracy of diagnoses. BBC News 20 May 2019 bbc.in/2JBjN8r