The New Compassion: California Is the Fifth State to Legalize Physician-Assisted Suicide

John is an 18-year-old young man who has struggled with depression for most of his life. He has tried to commit suicide in the past. Now that he is an adult, he has decided to take his own life and end his struggle. He purchased a gasoline-powered water pump to poison himself with carbon monoxide.   Mark is a 40-year-old man who just received a diagnosis of terminal cancer. He has a wife and young children. He would like the option to take a lethal drug that would allow him to die peacefully before his health declines to the point that he is in unbearable pain and a burden on his family.   Amos is an 81-year-old man who is in generally good health, but is unable to do some of the things he used to enjoy doing. He feels that he has led a good life and is ready to move on before he physically declines any more than he already has. He would like to go to a clinic in Europe to die. ~~~ Somewhere in the last twenty years, the idea of compassion changed. adidas nmd dzieci?ce There was a time when compassion meant caring for the suicidal person, not enabling him to go through with it. Compassion used to mean stepping into a messy situation and convincing the person that he didn’t have to end it all, that his life still had meaning and value. Now compassion means providing a way for certain groups of suicidal people to end their lives because they want relief from physical, emotional, or financial pain more than they want to continue living. In the above examples, John’s story is based on an incident out of Massachusetts in which a young man’s girlfriend, who lived 50-miles away, encouraged him to follow through with his plan to commit suicide over text messages and phone calls. Currently, there is a lawsuit to determine whether she is guilty of manslaughter. Amos is a fictional character inspired by a nurse who decided that she did not want to grow old and physically decline. She was a healthy 75-year-old woman with a partner of 25 years and adult children who stay in contact with her. asic gel lyte iii on feet She didn’t want to age, and she didn’t want to be a burden on people.

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  • She went to Switzerland to die. Mark is a fictional character loosely based on a man who chose to go to Switzerland to die after he found out he had cancer. In the real-life case, the man was not terminal, and his wife and daughters did not want him to go through with it. Maglie Milwaukee Bucks These stories can help us understand the new legislation out of California. California is the fifth state to legalize physician-assisted suicide. Advocates tout the bill (ABX2 15, “End of Life Option Act”) as providing an option for terminally ill people who wish to end their lives peacefully and at a time that they desire. Detractors say that the bill opens the door for abuse and exploitation, and if other countries are any indicator, physician-assisted suicide will expand beyond the terminally ill. adidas stan smith pas cher The California bill is for people like Mark. Or, real-life people like Brittaney Maynard, the 29-year-old woman who was diagnosed with terminal brain cancer. She died by assisted suicide last year after moving from California to Oregon where physician-assisted suicide is legal. Her case sparked a national debate over legalizing physician-assisted suicide in various states, including California. In our three examples, the arguments for why it is okay to provide pills to let someone like Mark commit suicide could easily apply to John or to Amos. The argument for physician-assisted suicide is based on the newer version of compassion, one that elevates choice and autonomy over care and dignity. An argument from compassion could apply to John and Amos’s cases as much as it does to Mark’s case. sac a dos kanken pas cher Indeed, all three would qualify for assisted suicide in places like Belgium or the Netherlands where laws have expanded to include physician-assisted suicide for people with depression or for children over the age of twelve. Advocates of physician-assisted suicide tell stories of their loved ones being placed on machines at the end of their life or undergoing painful chemo, suffering and in pain until the end. Often people will say that they never want to go through what one of their parents or a loved one went through before they died. To them, the option of a peaceful death via suicide keeps them from this bitter fate. goedkoop air max 2017 However, there are other options that do not involve suicide and maintains the dignity of the individual. There is comfort care. A quote attributed to Hippocrates reads that physicians should “cure sometimes, treat often, and comfort always.” In medicine there is an in-between state where the goals are no longer curing, but switch to comfort so that the person can still have meaningful interactions with her loved ones and not suffer unbearable pain. For example, a person can decide not to undergo chemo therapy and, instead, have a better quality of life for her last few months. A palliative care physician who taught one of my clinical ethics classes said that there have been great advances in palliative care therapy. People do not have to die in pain. As to the fear of being hooked up to machines, there are times when a machine would be burdensome and yet due to its minor efficacy, should not be part of a patient’s treatment plan. new balance 1600 daytona ronnie fieg This isn’t giving up on a patient. It is not negligence, and it is not physician-assisted suicide. Fjällräven Kånken Big It is recognizing that this machine will cause more harm than good by burdening the patient rather than helping him. There are even cases when it would be ethical to withdraw machine support because the machine is doing nothing to help the patient’s condition and is not staving off the progression of the disease. This can be an ethically gray area where the clinical details make a difference, but in the cases when treatment is not working, then the patient is often weaned off of the machine and the goals are switched to comfort care as the untreatable disease finally takes the person’s life. Often, the person who wishes to have physician-assisted suicide says that she does not want to be a burden on anybody. While this is a noble sentiment, it is wrong. Every one of us, from the moment we came out of the womb as a vulnerable, helpless baby, has been a burden on our loved ones and on society. That is part of being human. Even in the prime of our lives, we affect the people around us. We can burden them and we can help others carry their burdens. Indeed, love is often about helping someone carry their burden. As noble as the sentiment sounds, it dismisses what it means to be human and live in community. However, there is one burden that a person does not have a right to require of someone. It is the burden of taking another life. The physicians who prescribe these medicines are asked to carry the burden of administering death, a burden that physicians were never meant to carry. Originally, the Hippocratic Oath said that a physician should not give poison to anyone even if asked to do so. adidas y3 hombre Physician-assisted suicide changes the role of the physician from doing no harm to doing what the patient asks whether it brings him harm or not. Governor Jerry Brown ultimately decided to sign the bill because he would want the option of physician-assisted suicide in the face of “prolonged and excruciating pain.” Not only does this fly in the face of medicine, but it ignores hospice and palliative care. Rather than adopting legislation that would provide adequate comfort care to those populations that do not have access to it, something that is badly needed in our skewed healthcare system, the California bill and Governor Brown’s reasoning helps promote the notion that suicide is at best, as compassionate an option as palliative care, and at worst, the only option in the face of suffering at the end of life.

    Can We Make an Embryo in a Dish?

    Induced pluripotent stem cells and embryonic stem cells are functionally equivalent, but should we be concerned about making embryos in a dish? Induced pluripotent stem cells (iPSCs) have been hailed as the discovery of the decade, providing an ethical alternative to embryonic stem cells (ESCs). Both types of stem cells are pluripotent, which means they can potentially make all of the cells in they body. This is contrasted to totipotent cells, which can give rise to an entire organism. The very early embryo consists of totipotent cells. Induced pluripotent stem cells have technical advantages over ESCs because the patient’s cells can be used rather than donor cells, and they are easier to control compared to ESCs. However, one of the concerns with iPSCs was whether they are truly equivalent to ESCs because of the various transcription factors that need to be turned on or off to get the cells to regress back to their pluripotent state.

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  • This debate was laid to rest with a new research report in Science, demonstrating that while iPSCs are genetically distinct from ESCs, they are functionally equivalent. New Balance 373 mujer Before deeming every iPSC procedure ethical and effective, consider the question several researchers from Australia, The Netherlands, and the U.K. ask in a Nature Methods commentary “What if stem cells turn into embryos in a dish?” Their reason for asking stems from research that shows how pluripotent stem cells (both iPSCs and ESs) can form organoids, small three-dimensional clumps of cells that are comprised of a particular organ’s cell type.

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  • The techniques to make pluripotent stem cells undergo the self-assembly and morphogenesis required to form an organoid also causes these cells to have many of the properties of embryos at the gastrulation stage of development. Without delving too deeply into the complexities of embryonic development, the gastrulation stage is a key point when it comes to regulations for human embryo research. (See here for a simple summary of recent research about stem cells that have been dubbed “gastruloids”). The U.K. has a fourteen-day limit on human embryonic research. Human embryos are not allowed to remain intact in vitro beyond the fourteen-day point or after the formation of the primitive streak, whichever comes first. scarpe nike air max bambino scontate Australia has similar regulations. The pluripotent cells that appeared to reach the gastrulation stage seemed to form a primitive streak and showed signs of forming the beginnings of the Central Nervous System. There are two things to consider. First, while these are hallmarks of a particular point in embryonic development, it is not the case that this clump of cells is an embryo. The stem cells are self-organizing, but they are without the same kind of holistic directionality that an embryo has. So while these stem cells proliferate in a more “organized” way than, say, a tumor, they lack key embryonic features. Nike Air Max 2016 Heren However, the authors pose an important question that needs to be addressed because the technology could eventually make embryos in a dish.

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  • Consider two situations in which it is possible to make an embryo without two genetic contributors, a mother and a father. The first is cloning, or somatic cell nuclear transfer, and the second is making gametes using iPSCs. Somatic cell nuclear transfer has been successfully done in both animals and humans, although only animal cloned embryos have been implanted and birthed. Cloned animals tend to be unhealthy and often die young.

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  • This continues to be an area of research, as evidenced by a recent article in Cell Stem Cell in which researchers from South Korea reported more efficient methods for cloning human embryos.* Gametogenesis is another active area of research. If induced pluripotent stem cells could be induced to differentiate into gametes (egg and sperm), then this would theoretically allow the creation of an embryo. This embryo may only have one parent if the egg and sperm were made from the same donor. Or, it could be made from two parents who are the same gender. Nike TN Requin 2017 This is not yet possible because the oocyte is particularly tricky to form, but there is ongoing research attempting to produce both types of gametes from induced pluripotent stem cells.

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  • Whether one uses somatic cell nuclear transfer or gametogenesis via iPSCs, the creation of a human embryo is ethically problematic for many reasons. The authors of the Nature Methods commentary raise important questions that hinge on when an embryo becomes an embryo in the laboratory setting. There are valid reasons to give the embryo a special status whether it is ever implanted in a uterus or not. Adidas Superstar Schoenen Dames As technology allows us to unravel the complex operations that go into meiosis and embryogenesis, we must carefully consider where moral lines are drawn. Because making an embryo in a dish would be taking the technology too far, drawing ethical lines may require a nuanced approach to just what types of experiments are okay and where in the technical process the line must be drawn so that pluripotent stem cells remain at the pluripotent stage. * Technically, “clones” like Dolly the sheep are really chimeras, meaning there is a small amount of DNA from the oocyte donor that is different from the nuclear DNA. The clone would produce an embryo from one genetic source if both the original cell and the oocyte came from the same animal.

    Synthetic Biology and Making Morphine in the Lab

    Prescription pain medicine addiction has become prevalent and widespread with several areas in the U.S. calling it a public health crisis. Opiates include prescription pain medicines, such as Vicodin, OxyContin, or fentanyl. The surge in opiate drug addiction can be traced to changes in the increase in prescriptions for opiate drugs beginning in the 1990s. Now headlines tout the possibility of a “home-brewed heroin.”

    If we unpack the headline, it turns out this “home-brewed” heroin is not exactly here yet. Scientists have replicated all of the metabolic processes that opium poppies use to turn glucose into morphine. They have replicated parts of this process in yeast strains in an effort to make less addictive pain medicines as well as other analgesics. This synthesis of cellular processes is called synthetic biology. By way of a quick review, synthetic biology involves creating the digital DNA code to make proteins, the internal machinery of a cell, in the lab. Yeast and e.coli are simple organisms and are often used to insert the DNA in a cell fitted with the necessary equipment to replicate and express the DNA. Craig Venter, in his book on synthetic biology, Life at the Speed of Light, calls DNA the software and yeast provides the hardware. Scientists want to tweak the software to make tailor-made drugs.

    Synthetic biology overlaps with genetic engineering, but where it differs is that synthetic biology allows scientists to replicate an entire cellular pathway within an organism, such as yeast, as opposed to inserting or deleting mutations in a DNA strand and then inserting it in a cell.

    The metabolic pathway reported in Nature (See the Nature News article) is the first part of the glucose-to-morphine pathway. The second part of the pathway, as well as a reaction that links the two parts, was recently reported by other research groups. All of these parts have been demonstrated separately in various yeast strains. If scientists were to combine these parts in one yeast strain, then theoretically, they would be able to convert glucose to morphine. This has not been done yet, but will likely occur soon.

    The process for making morphine from glucose is complex (it’s approximately eighteen steps), and because scientists do not know the whole genome for the opium poppy, they have had difficulty identifying the enzymes that catalyze each step in the reaction pathway. To overcome this hurdle, scientists turned to enzymes in other organisms to that catalyze similar reactions. The most recent research that identifies the first half of the morphine pathway used an enzyme from sugar beets that scientists mutated to ensure that it produced the product they needed without unwanted byproducts.

    The question remains, are we at a point where people can brew their own synthetic morphine? The short answer is no, not yet.

    First, all of the steps have not been combined into a yeast strain. While this may be the next step in making synthetic morphine in the lab, it will need to be tested, and it may not work at first. Once scientists succeed at creating a yeast strain that can accomplish all of the steps, the process will need to be refined and optimized.

    Secondly, in order for someone to brew their own morphine, he would have to acquire the yeast strain containing the synthetic DNA. This would mean acquiring the yeast from someone who not only knows the DNA code, but also has a PCR machine or some way to make synthetic DNA and then incorporate it into yeast.

    Lastly, even if someone did acquire the yeast strain, according to Christine Smolke of Stanford University whose lab has made a semi-synthetic opioid using yeast, in an interview with Wired, said that the fermentation process would require specialized equipment and conditions that would be difficult to do outside a laboratory. It would also not produce enough morphine to make it cost effective.

    While we are not at the point of worrying about home-brewed liquid morphine, the authors of the study were concerned about future consequences of their research. One of the motivations for designing the synthetic pathway is to tweak it to make less addictive pain medicine or to make medicines for other uses. This same ability to tweak the morphine-producing pathway could also be used for nefarious purposes.

    The authors of the study sought ethical guidance from biotechnology-policy specialists Kenneth Oye, of MIT and Tania Bubela, of the University of Alberta. They published an article in Nature with Chappell Lawson, also from MIT, that came out in tandem with the research article. Oye, Bubela, and Chappell delineate the ethical and legal considerations for such research and provide four broad areas that should be considered:

    • Engineering – The yeast strains could be engineered to make them less appealing to criminals and more difficult to cultivate outside of a laboratory setting, similar to biocontainment practices with e. coli.
    • Screening – Since the DNA sequence would need to be ordered from a lab, there could be a screening process in place that flags orders of opiate-producing yeast strains
    • Security – They could employ biosecurity measures, such as watermarking yeast made from certain labs and background checks on people working with the strains.
    • Regulation – Opium is a globally controlled substance. The laws that apply to opium could be extended to cover opiate-producing yeast strains.

    Overall, the headlines are a little misleading in that we are not yet on the cusp of people brewing their own morphine. However, the authors should be commended for considering the consequences of publishing their research and seeking ethical guidance. It is a good example of pre-emptively considering the hazards and consequences of technological advancement rather than responding to a crisis.

    For more information, see my article in Salvo 31, “Dying to Feel Good: Modern Self-Realization & the Painkiller Addiction Epidemic

    NFL and Prescription Drugs

    The NFL is being sued by 1,300 former players for the way it distributed prescription pain medicines so players can get back in the game. The former players claim that they were not informed of the side effects of potent pain killers such as Percodan, Percocet, Vicodin, and Toradol. Percodan, Percocet and Vicodin are all opioid painkillers and Toradol is a strong non-steroidal anti-inflammatory (NSAID) drug.

    Many of the former NFL players involved in the lawsuit played during the 1980s and 1990s when practices for administering powerful painkillers, both opioids and NSAIDs, were cavalier. Today they are, in theory, more regulated. The players state that the “NFL medical staffs routinely violated federal and state laws in plying them with powerful narcotics to mask injuries on game days.” They also claim that medical staff was negligent by keeping important information on the players’ medical conditions from them, such as markers for kidney disease or broken bones.

    At issue are 1) whether doctors and trainers violated the law by illegally administering prescription drugs, and 2) whether players were adequately informed of the side-effects of the drugs as well as informed of any medical issues that doctors found that might affect their decision.

    Doctors Behaving Badly?

    In an attempt to investigate whether illegal practices were going on, the DEA paid unannounced visits to several professional teams in November (2014) in which they questioned team doctors and trainers after the game. This investigation was to ensure that doctors were prescribing and distributing drugs appropriately, that they were handling controlled substances properly when crossing state lines, and that they had a license to practice in the state. Thus far, the DEA has not found evidence of illegal activities in their investigation.

    However, an investigation from Vice Sports into how and where NFL doctors acquired such large amounts of prescription drugs, shows that, at least in the past, they were likely obtaining drugs illegitimately. From 2009 to 2010, several NFL teams, as well as other professional and college sports teams, acquired large amounts of opioids and NSAIDs from a company called SportPharm, an illegal drug distributor operating behind the legitimate company, RSF Pharmaceuticals. RSF Pharmaceuticals eventually shut down, and SportPharm was re-branded as a subsidiary of Champion Health Services, which is still in operation. Many teams would fill prescriptions in player’s names without the player knowing so that the actual quantities would fly under the radar.

    Informed Consent

    The second issue has to do with players’ rights, and whether they were adequately informed of what drugs they were given, their medical options given their current medical situation, and the long-term side effects.

    Many of the players received opiate drugs without being told about their addictive nature, and were often told to take them for longer or in higher dosages than what is recommended by the FDA. Furthermore, many players were given prescription pain medicine without a doctor’s evaluation or monitoring. One former player reports that while playing for one team, an assistant trainer would pass out unlabeled manilla envelopes with pain medicine for any player that raised his hand and said he needed them. Another former player said that envelopes with prescription pain medicine would be waiting in the seats on the airplane for the players.

    Player testimonies from the class action law suit website show that many players were given powerful pain medicine instead of being told that they needed rest and recovery or that the problem was actually much worse and required surgery. Several players said that NFL doctors knew of existing health issues, but did not inform the players. Two players’ testimonies state that NFL doctors knew that they had indicators of kidney problems but did not tell the players. Both former players now have renal failure.

    Another former player, Rex Hadnot, said in a Washington Post interview that he was given Toradol pills and/or injections once-per-week for nine years. He was never told that Toradol should not be administered for more than five days due to risk of kidney damage, heart attack, and stroke.  He said that sometimes he would receive both a shot and a pill on the same day, a much higher dosage than the FDA recommends.

    The Mountain Climber Problem

    Part of the problem with discerning the ethics of safety for football players is exemplified in what H. Tristam Engelhardt calls “the mountain climber problem.” In general, climbing a mountain is more dangerous than not climbing a mountain, but we do not consider it unethical to allow a mountain climber to scale a mountain if he so desires. Similarly, playing sports is inherently more dangerous than not playing sports. Football players take on additional risks by choosing to play the sport. Therefore, what protections, if any, are football players owed?

    There is a tension between restricting someone’s freedom and allowing them to put themselves in harm’s way. Typically, with the mountain climber problem, ethicists will say that it is unethical to allow additional harm to come to the person such that he or she could not accomplish the stated goal of climbing the mountain. For example, while mountain climbing is inherently dangerous, the climber should still use a harness and ropes. In the case of football players, while it is an inherently dangerous sport, one can enforce safety precautions to ensure that players are not injured in such a way that they cannot play the sport. This is the motivation behind stricter rules to prevent concussions, helmet design, and padding.

    The difference between the mountain climber and the football player is that collisions are part of the sport. Pain is a given. The former players who are suing the NFL claim that their health was sacrificed in the name of sales. But, other players criticize the lawsuit as nothing more than a money grab on behalf of former players because they knew what they were risking by playing the sport.

    Despite whatever motivations are behind the lawsuit or the NFL’s medical decisions, it is unethical to de-humanize athletes, even if they willingly chose to engage in de-humanizing activities. Let’s take a non-football example: If a woman choses to trade sex for money, she is willingly commodifying herself and ultimately engaging in a de-humanizing activity. While this may have been her free choice, it does not mean that if she goes to a doctor, the doctor is no longer ethically obligated to treat her with human dignity. In other words, even if she chooses to engage in activities that are de-humanizing, that does not mean it is okay for medical health professionals to treat her as less-than-human.

    In the case of football players, even if they may choose short-term returns at the expense of long-term injury, they need to be given the opportunity to make an informed choice on the matter because, ultimately, they are the ones that have to live with the consequences.

    In the latest issue of Salvo Magazine (Winter, 2014) I cover the larger issue of prescription pain medicine addiction, what opiate drugs actually do to the brain, and how one becomes addicted. The former NFL players’ claims about the over-prescribing of prescription painkillers may be part of a larger national problem that saw a peak in opiate drug prescriptions during the years that many of the former players were active in the NFL.

    Cell Phone Addiction, Texting Anxiety, and Email Bankruptcy

    A new study in the Journal of Behavioral Addictions by Roberts, et al looks at the incidence of cell phone addiction among college-age males and females. The study also looked at what types of programs or behaviors had a positive correlation to addiction. As it turns out, some people do seem to be addicted to their cell phone, but perhaps the more accurate statement is that people are addicted to Facebook, Twitter, Instagram, and Pinterest.

    Incidentally, I am writing this as I am sitting at a Starbucks, the enabler, par excellence, of socially acceptable addictions. Both men and women are sitting on their cell phones doing something with their thumbs. If any of these people were to leave home without their cell phones, would they suffer from withdrawal? That’s one of several questions from the study. Another is whether you find yourself using your cell phone more and more.

    Withdrawal is one of several indicators of addiction. Roberts, et al use the standard definition of addiction to identify whether college co-eds are addicts. They look for the presence of salience, euphoria, tolerance, withdrawal symptoms, conflict, and relapse, as well as the incidence of continued use despite negative consequences. They found that many people have a cell phone addiction that is comparable to a behavior addiction, like compulsive shopping or compulsive gambling. (This is different from a substance addiction, which can involve not only neurological changes due to the formation of a habit, but also neurological effects that are a result of how the substance interacts with the body). In an effort to determine how and why a cell phone addiction forms, they focused on identifying the “tipping point” in which the cell phone goes from being a tool that people like to use, to becoming a need.

    When exactly this tipping point occurs is difficult to identify. Incidence of phone addiction seems to correlate with the prevalence of Smart Phones, which means the underlying issue is what the phone is being used for. Furthermore, many of the students they surveyed consider their cell phone an integral part of their identity, meaning that the cell phone is viewed as something more than a tool or business or diversion. According to Kent Dunnington in his book Addiction and Virtue in which he looks at addiction from the perspective of Aristotle and Aquinas, addiction has an orienting nature to it that provides a semblance of identity and order (priorities) in a disordered, fragmented world. As the authors of the study point out, “Cell phones have become inextricably woven into our daily lives – an almost invisible driver of modern life.”

    The study determined that men and women, who are addicted to their cell phones, use the cell phone slightly differently. Activities that positively correlate to cell phone addiction in men were number of emails sent, reading books, Facebook, Instagram, Twitter, number of phone calls, and number of texts. Activities that positively correlate to cell phone addiction in women were Pinterest, Instagram, Amazon, Facebook, number of calls made, and number of texts and emails. Women spent significantly more time on their phones compared to men (10 hours per day versus 8 hours per day), but had the same number of calls, texts, and emails as men. Women spent more time on Facebook, but Facebook was a stronger predictor of addiction in men.

    The authors contend that the addiction has to do with being socially connected. Gaming, for example, was not strongly correlated with cell phone addiction, while social media was. Furthermore, mental health issues as a result of cell phone use indicate that social connection is much more important to people than entertainment. Consider two issues that have arisen since Smart phones became popular: Text bubble anxiety and email inbox overload.

    Ben Crair has a thought-provoking piece in the New Republic on the concept of “text bubble anxiety” or the sense of tension someone has when they know that another person is typing a message but the message has not been sent. The longer someone takes to type, indicated by ellipses on iPhones or “Bob is typing…” in Google Chat, the more anxious the other person becomes because the longer someone types, the more we tend to assume it is something bad. In reality, the other person may have been interrupted by another phone call or had to re-type the message for some other reason. When the person finally does send the text, and it happens to have trivial content, then we tend to be disappointed. This roller coaster ride of assumptions takes an emotional toll. Jessica Bennett, in an op-ed in the New York Times, confesses that her therapist recommended turning off the typing awareness indicator because it was causing her mental distress.

    Another mental health issue is due to an overwhelming email inbox. Some people become so burdened by a burgeoning inbox that they must declare what Sherry Turkel, sociologist at MIT, calls “email bankruptcy.” Similar to financial bankruptcy, email bankruptcy is when your inbox becomes so full of unread or unaddressed emails, that it has become too unwieldy. This can cause some people additional stress and anxiety. One solution is to archive all emails, clear their inbox, and send a message to contacts saying that if they want to continue to do business with you to send a new email.

    When it comes to addiction, the behavior is really a symptom of a deeper problem. This study indicates that cell phone addiction is really an addiction to mediated socializing. Dunnington says that addictive behavior, which is based on something more than mere sensory pleasure, can tell us what human beings most deeply desire. While addictions, like addictions to social networking, may begin as diversions to deal with boredom, they morph from diversions to addictions because they provide a sense of purpose or, in this case, a sense of community that is lacking in our modern individualistic culture.

    Sherry Turkel says that it is important for people in our culture to demarcate sacred spaces where one will not engage in internet mediated socializing because people need to interact with one another in a more substantive way. She also says that people need to learn the practice of privacy and solitude, or put another way, people need to set personal boundaries and to cultivate an ability to be alone without being lonely.

    While this study certainly has its limitations (e.g., the test subjects were college students), it is telling that the activities that have a positive correlation to cell phone addiction are not gaming or entertainment, but social networking.

    Creepy Critters in Our Gut

    What is the microbiome? The microbiome is the bacteria that reside within and on our bodies. Often these bacteria do more than just hang out with us. Some bacteria fight off disease, while some cause disease. asics gel pulse 8 m?skie Others will help us digest foods or reject bad food. Nike Air Max 2016 Heren grijs For this post, I am going to focus on the gut biome, the bacteria that live in our large and small intestines, because the gut has made for some interesting headlines lately. The “microbiome” refers to all of the bacteria on the body. The small intestines have a plethora of bacteria that act symbiotically with us to help us digest and process foods. Scientists have been studying the gut biome for many years, but it is only recently that it has garnered public attention. There have been several theories lately that have suggested the gut biome is responsible for everything from food allergies to autoimmune diseases to autism. nike air max 2016 goedkope Furthermore, new diet fads, fecal transplants, and probiotic supplements have emerged as a result of the gut biome hype, many of which are untested or whose claims are unsubstantiated. As is the case with pop-science trends, the microbiome is becoming the poster child for pseudo-scientific claims and grandiose promises. What does the research show? Let’s start with some facts because the gut biome does affect our health and well-being. air max homme pas cher The National Institute of Health is currently working on the Human Microbiome Project. This project seeks to identify and characterize the bacteria (and fungi) that are associated with the human body. Similar to the Human Genome Project, the original plan was to characterize the microbiome of healthy individuals and then to compare it to unhealthy individuals in hopes of understanding the role the microbiome plays in disease. However, those goals may need to be adjusted. The Human Microbiome studies have revealed two things: 1) no two human microbiomes are alike, and 2) the microbiome is dynamic. Because each person has a unique microbiome, there is not a gold-standard, “healthy” microbiome by which to compare “diseased” microbiomes. Also, because the gut biome changes with diet and environment, it is difficult to determine a particular signature for a person. It’s composition is just too dynamic. Asics Mexico m?skie Additionally, the microbiome’s composition (the types of bacteria that make up the biome) are different at different times depending on the individual’s diet and environment. This is especially true with the gut biome. There are hundreds of different species of bacteria that could potentially live in our digestive system, and those species may be in different abundances at different times. Furthermore, sometimes studying two different parts of the same sample will show different results. This is a classic sampling problem. Imagine that you wanted to find the amount of lead in soil in a field. Jameis Winston – Florida State Seminoles You could collect soil from the top of the ground, which might give you a different lead concentration than if you took soil that was one foot underground or you might get different results if you took samples that were 100 feet away from each other. The gut biome has a similar problem. Apparently, the biome composition is different depending on where in the digestive tract you retrieve the bacteria (e.g., from a fecal sample or from the small intestines). With these caveats, scientists have still observed some trends. Air Jordan 7 Uomo For one, an individual’s gut biome changes after taking antibiotics. This makes sense because antibiotics are meant to kill bacteria. What is unclear is how long the changes persist and how this affects a person’s health. Scientists also know that the gut biome plays a role in aiding digestion of certain hard-to-digest foods, such as carbohydrates. Furthermore, they have found differences between the gut biomes of obese people and non-obese people and between people with digestive diseases, such as Crohn’s disease. However, whether the different gut biome is the cause or is the result is unclear. Healthy skepticism There are several other correlations between the microbiome and physiological effects. The difficulty is whether these are merely correlations or causation. William Hanage has an excellent article in Nature, “Microbiology: Microbiome Science Needs a Healthy Dose of Skepticism” in which he discusses five key questions to help discern the truth from the hype:

    1. Can experiments detect differences that matter?
    2. Does the study show causation or just correlation?
    3. What is the mechanism?
    4. How much do experiments really reflect reality?
    5. Could anything else explain the results?

    Many studies show that the gut biome is very responsive to diet and environment, which means the differences we see in people with a certain disease (or condition) may be the gut responding to the disease rather than causing it. The gut biome is a new area of research that may shed some light on digestive disorders and the effects of antibiotics on the body.

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  • However, Hanage cautions us to not fall into the same kind of non-discretionary, cure-all thinking that we’ve seen in other new areas of science such as the Human Genome Project, stem cell research, genetic engineering, or nanotechnology. He also remind us not to blame the microbiome for all of our ills: “In pre-scientific times when something happened that people did not understand, they blamed it on spirits.