Broadcaster: Channel 4
Length: 3:16 mins
When an infant has an illness that will, in all probabilities, prove fatal their parents face an agonising choice. Do you follow all possible interventions, or do you reach a point where you recognise that it is in the best interests of the child to withdraw treatment?
This dilemma is brought into stark relief by Charlie Gard who, at the time of writing, is the subject of a High Court case at the Royal Courts of Justice. There are several aspects that make this case particularly tricky, and particularly interesting from a medical ethics standpoint.
Charlie was born in August 2016 with a rare mitochondrial DNA depletion syndrome. He is deaf and blind, it is tricky to know how much pain he is aware of at present. Doctors at Great Ormond Street Hospital want to move to a regime of palliative care only. A crowdfunding project has raised over a million pounds parents and his parents want to take Charlie to the USA where a doctor is willing to enrol him on a trial of nucleoside bypass therapy, an experimental treatment which has an extremely low probability of alleviating some of his symptoms. He will almost certainly still die.
The case shines a spotlight on different medical culture in the UK and the USA. In the UK doctors tend to take a more cautious approach whereas doctors in America are more willing to try experimental procedures if the patient (or in this case, their parents) want to try and have the money to do so.
For further coverage of the case see: The Guardian and ITV News and a later report from the BBC.
Review by June Adams
In 2011, comedy writer Paul Mayhew-Archer (whose work includes The Vicar of Dibley) became one of about 127,000 people in the UK diagnosed with Parkinson’s disease each year. At that time, he was told to expect “five good years”. Since then laughter, chocolate, medication and exercise classes run for Parkinson’s patients by the English National Ballet have helped keep his spirits up and his symptoms relatively in check. However with those five good years now passed, Paul begins to ask what the coming years may hold for him and his condition.
As you can imagine from the title, this is not a serious scientific documentary – but there are short sections that might prove useful to demonstrate different forms of intervention being used to understand more about Parkinson’s, to treat the symptoms and/or to find a potential cure. With the help of various Departments of Oxford University, Paul investigates:
- Tests for Parkinson’s, including development of a phone app that help doctors with an early diagnosis of the disease (this clip, 1.47 mins)
- Deep brain stimulation for controlling tremors (this clip, 3.30 mins), and
- News of a possible cure involving stem cells (this clip, 1.54 mins).
Along the way, Paul meets other people with Parkinson’s and discovers how everyone’s experience of the disease is different; each has a unique combination of symptoms, some of which are much more troubling than others. As he summarises in closing:
“A philosopher once said, I think it was Forrest Gump, “Life is like a box of chocolates. You never know what you’re going to get.” And Parkinson’s is like a particularly rubbish sort of box of chocolates. Every symptom, every chocolate is particularly disgusting. But some are more disgusting than others. And let’s hope, as I come to the end of my five good years, that I won’t end up with the orange cream.”
Broadcaster: NHK World
(originally broadcast Aug 2015)
Review by June Adams
This short clip from the English-speaking Japanese channel announces the introduction of a regulatory body for genetic testing in Japan. Establishment of The Council for Protection of Individual Genetic Information (CPIGI) was prompted by a number of concerns. For example, companies offering tests Direct-to Consumer (DTC) genetic testing have not necessarily given sufficient diligence to the security of private genetic information, or to the interpretation of the results. This is especially true for diseases that result from the interaction of multiple gene products as well as the influence of environment on expression of those genes (so called GxE interactions). The clips cites diabetes and Alzheimer’s disease as examples where a correlation with a particular allele at a particular gene may be hard to quantify.
The CPIGI, which launched in Oct 2015 (after the initial broadcast of this episode) is an umbrella group for 25 companies and offers a checklist of over 200 items intended to enhance trust between genetic test providers and clients. This includes the importance of genetic counselling. The launch of CPIGI has been controversial (e.g. see here), especially regarding the lack of consultation.
See this post for details of clips from Newsnight and BBC Breakfast in 2014, regarding the UK launch of DTC genetic service 23andMe.
Broadcaster: BBC Radio 4
Genre: Panel discussion, Fire-side chat
In this special episode of the BBC radio programme All in the mind (28 mins), host Claudia Hammond discusses the basis of memory formation with three leading researchers Tim Bliss, Graham Collingridge and Richard Morris who have been major players in developing our understanding of memory.
Tim Bliss draws attention to Donald Hebb’s pivotal book The Organization of Behavior and the aphorism “Cells that fire together, wire together”. Graham Collingridge then introduces the notion of long-term potentiation (LTP) as the molecular basis of memory, and particularly the role played by NMDA receptors in learning and AMPA receptors in memory. Errors in the functioning of any of hundreds of proteins can have detrimental impact on memory. Under-activation of LTP can be a contributory factor to schizophrenia. Continue reading
Sprinter Tim Montgomery was the 100 metre world record holder, but was later caught using performance-enhancing drugs and was banned
Broadcaster: Al Jazeera
Review by Ella Yabsley
In this Al Jazeera Investigates documentary, former UK hurdler Liam Collins embarks on an undercover investigation seeking to expose ‘the dark side’ of professional sports; blood doping and the use of performance enhancing drugs (PEDs) by professional athletes. This 16-minute clip splices together key sections of the documentary (The full programme can be seen on YouTube as well as on Box of Broadcasts).
“I can take a guy with average genetics and I can make him a world champion. I can with drugs. Oh absolutely.”
The documentary stirred controversy, primarily for featuring accusations regarding several NFL footballers, notably Peyton Manning, who went on to steer his Denver Broncos team to success at Superbowl 50 before announcing his retirement. More importantly, the documentary highlights loopholes in the drug testing regimes of several popular sports. Athletes play a ‘cat and mouse game’ with the testing system; timely drug administration combined with an awareness of testing procedures results in athletes coming up negative in tests. Continue reading
Increasing global population and food demands drive the discovery for new food sources and imminent dietary change
Broadcaster: BBC TWO
Review by Ella Yabsley
This 4.5-minute clip from BBC Two’s Food & Drink could serve as a useful discussion-starter when considering the ethics of global meat consumption. The clip begins with the introduction of a new type of food source, cultured beef or in vitro meat (IVM). A team from Maastricht University (Holland) claim that IVM was produced for numerous reasons: IVM is more sustainable compared to traditional animal farming practices; it could solve the current (and future) food crisis; and it could also help to combat climate change. Regardless of your ethical standpoint, this clip highlights some of the ethical, economic and health-related tensions that the ‘Western World’ is facing with regards to animal agriculture. Continue reading
COPD is linked to smoking
Broadcaster: Sky News
Review by Ella Yabsley
The 2.5 minute clip from Sky News breakfast programme Sunrise is a good scene-setter, providing examples of how chronic obstructive pulmonary disease (COPD) affects the physical stamina of individuals. Broadcast at the end of December, it is timed to influence people considering giving up smoking as a new year’s resolution. The clip includes coverage of Olympic athlete Iwan Thomas climbing the stairs whilst wearing a restrictive mask that mimics the effects of COPD.
Each year, around 25,000 people in the UK die from COPD. COPD is an umbrella term for emphysema, chronic bronchitis and other chronic obstructive airways diseases that affect the respiratory system (principally, the lungs). The report highlights smoking as a major risk factor for COPD development; increases in smoking directly correlates with more severe COPD symptoms. In addition to 25,000 people per annum dying from COPD, it is estimated that a further 3 million people in the UK are living with the condition.
“To start with it’s often just a smoker’s cough with some phlegm at the back of the throat. People write it off and say “oh, that’s normal”; but it inexorably goes downhill so that they get so bad that they’re short of breath all the time” – Dame Sally Davies, Chief Medical Officer for England
For an up to date review on early COPD and risk factors please see this article published by The Lancet.
The specialist “embryo flushing” team can implant up to 1500 surrogates in a year.
Broadcaster: BBC 1
Genre: Documentary, Magazine
A seven-minute clip from the popular BBC rural affairs programme Countryfile, looking at “embryo flushing” a modern IVF-based method that is replacing traditional selective breeding on many farms.
Embryos are removed from a pedigree cow using a saline flush and she is later fertilised by a bull in the traditional manner. The quality of the harvested embryos can be examined at the on-farm laboratory and the best placed into other non-pedigree cows. In this way it becomes possible for the cow with desirable characteristics to be the biological mother of perhaps six calves at one time. As the technique gains in popularity, the specialist can transfer as many as 1500 embryos in a year.
Other applications of this approach include being able to breed using the best genetic stock from around the world, and allowing for deep freezing of embryos as a safeguard against some catastrophic outbreak. The approach was recently used to re-introduce 100 long-horn cattle into Australia.
The first film in the re-launched franchise is rich in ethical dilemmas
Broadcaster: Film 4
Year: 2014 (cinema release 2011)
Genre: Film, Fiction, Science Fiction
Rise of the Planet of the Apes is the first of the re-launched film series (followed by the vastly inferior Dawn of the Planet of the Apes). The film is a veritable feast of bioethics issues. To find out more please take a visit to our sister site Bioethicsbytes (follow this link). The IMDb page for the film can be found via this link.
More details about the potential uses of this film for teaching can be found at Bioethicsbytes
Selective breeding of foxes over the past 50 years has been used to produce foxes that are especially tame, and especially aggressive
Broadcaster: BBC 2
Review by Dr Steve Maw (University of Leeds)
This 8.5 minute clip is taken from Horizon: The Secret Life of Dogs and gives an overview of a long-term breeding experiment of Silver foxes in Siberia. The clip demonstrates some of the extraordinary changes that simple selective breeding (in this case for non-aggression) can make over a few generations and as such provides a model of how domestication may have taken place. It also highlights some of the side effects of this breeding programme (e.g. colour changes) which show remarkable similarity to some domestic dog characteristics.
As well as natural section I also teach artificial selection. There are a number of discussion points that can potentially come out of the clip. Firstly the power of simple selective breeding and that not all changes are due to GM! Secondly it illustrates that these genes are already in the population. As some foetuses were swapped reference can also be made to the nature v nurture argument. I think it also could be used to in ethical discussions.
WARNING: There is a word of caution, however, as the foxes are kept in conditions people may find distressing.