Bioethics News Stories (August–October 2023)

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“Cannabis Use Disorder Is ‘Common’ Among Marijuana Users, Study Finds”

by Matt Richtel, New York Times, August 29, 2023

More than one-fifth of people who use cannabis struggle with dependency or problematic use, according to a study published on Tuesday in The Journal of the American Medical Association Network Open. . . . Cannabis users who experience more severe dependency tended to be recreational users, whereas less severe but still problematic use was associated roughly equally with medical and recreational use.

“MDMA Therapy Inches Closer to Approval”

by Rachel Nuwer, New York Times, September 14, 2023,

MDMA-assisted therapy seems to be effective in reducing symptoms of post-traumatic stress disorder, according to a study published on Thursday [September 14]. The research is the final trial conducted by MAPS Public Benefit Corporation, a company that is developing prescription psychedelics.

As more and more states legalize the recreational and medicinal use of marijuana and other drugs, such as MDMA and psilocybin, studies continue to show that these drugs are not as harmless as some claim. Several studies have reported that cannabis is addictive, leading to tolerance, uncontrolled escalation, and mental and physical health problems. A multi-year study out of Denmark last summer showed that 30% of schizophrenia cases in young men could have been avoided if they had not used marijuana (“Young Men at Highest Risk of Schizophrenia Linked with Cannabis Use Disorder,” Medical Xpress). CNN reported last September that there is little evidence that marijuana helps with anxiety and pain and may worsen these conditions along with worsening cognitive function, especially in people who started using when they were under 25 (“How Marijuana Impacts Pain, Sleep, Anxiety and More, According to the Latest Science”). Additionally, several articles have pointed out that researchers do not really know what psychedelics, like MDMA, psilocybin, and ketamine actually do to the brain (“As Psychedelics Near Approval, There’s No Consensus on How They Work,” Stat News).

While there does seem to be evidence that some of these drugs alleviate symptoms of PTSD, it is difficult to give informed consent to a therapy with unknown long- and short-term side effects.

Canada and Assisted Dying

“Vancouver Hospital Defends Suggesting MAID to Suicidal Patient at Risk assessment Tool”

by Andrea Woo, The Globe and Mail, August 9, 2023

Instead, Ms. Mentler says a clinician told her there would be long waits to see a psychiatrist and that the health care system is “broken.” That was followed by a jarring question: ‘Have you considered MAID?’

“Canada Will Legalize Medically Assisted Dying for People Addicted to Drugs”

by Manisha Krishnan, Vice, October 19, 2023

Canada will legalize medically assisted dying for people who are addicted to drugs next spring, in a move some drug users and activists are calling “eugenics.”

Canada will expand its medical assistance in dying laws to include people who are suffering from mental illness, and discussions are underway to determine if that includes people who have substance abuse disorder. Critics say that better guidelines and treatment for substance abuse are needed. Canada’s medical aid in dying laws lack clear guardrails and guidelines, making even proponents of assisted dying uncomfortable with how quickly the laws have expanded to include people who are not terminally ill.

Artificial Intelligence’s Real-Life Costs

“Microsoft, Google, and OpenAI Are Getting Questioned about Their AI ‘Data Labelers’”

by Michelle Cheng, Quartz, September 13, 2023

US lawmakers are probing nine tech giants—Microsoft, OpenAI, Anthropic, Meta, Alphabet, Amazon, Inflection AI, Scale AI, and IBM—on the working conditions of data labelers. Data labelers are human workers tasked with labeling training data and rating chatbot responses to make sure that AI systems are safe and reliable.

“Using Generative AI to Resurrect the Dead Will Create a Burden for the Living”

by Tamara Kneese, Wired, August 21, 2023

With ChatGPT and other powerful large language models, it is feasible to create a more convincing chatbot of a dead person. But doing so, especially in the face of scarce resources and inevitable decay, ignores the massive amounts of labor that go into keeping the dead alive online.

Planned obsolescence means even digital archives will eventually die.

Even though AI systems are digital interfaces, they are made possible because of real-life labor and consumption of resources. Last September, U.S. lawmakers looked into the working conditions of data labelers of the nine major tech companies that are building artificial intelligence systems. Many of these workers are outsourced from other countries, are paid poorly, subjected to traumatic content, have no benefits, and work grueling hours.

Yet, some people want to “resurrect” dead loved ones using systems like ChatGPT. However, the upkeep on these systems will cost living people time and resources to maintain. Additionally, AI systems require a large amount of energy to run. For example, OpenAI spends about $700,000 per day to run Chat GPT and reportedly will go bankrupt in 2024 without Microsoft’s continued financial support.

Genetically Modified Pigs and Organ Transplantation

“Pig Kidney Works a Record 2 Months in Donated Body, Raising Hope for Animal-Human Transplants”

by Lauran Neergaard and Shelby Lum, Associated Press, September 14, 2023

Dozens of doctors and nurses silently lined the hospital hallway in tribute: For a history-making two months, a pig’s kidney worked normally inside the brain-dead man on the gurney rolling past them. The dramatic experiment came to an end Wednesday as surgeons at NYU Langone Health removed the pig kidney and returned the donated body of Maurice “Mo” Miller to his family for cremation.

“Scientists Just Tried Growing Human Kidneys in Pigs”

by Emily Mullin, Wired, September 8, 2023

In a first, researchers in China have used pigs to grow early-stage kidneys made up of mostly human cells. The advance is a step closer to producing organs in animals that could one day be transplanted to people.

Two experiments reported last fall involved the use of pigs to eventually ease the shortage of human organs needed for transplantation. Both experiments made use of CRISPR to modify pig cells. In one experiment, researchers made a single edit to a gene to modify the sugars on cell surfaces so that the pig’s organ would not be rejected by the human immune system. The genetically modified pig kidney was transplanted into a brain-dead person. The kidney worked for two months until the experiment was stopped. Some questions whether it is ethical and scientifically sound to keep a brain-dead person on a ventilator while conducting this experiment, even with consent from the person and their family.

In another experiment, Chinese scientists used CRISPR to knock out two genes to keep pig embryos from developing a kidney. The embryos were then combined with human induced pluripotent stem cells that had two genes overexpressed to prevent the cells from dying and improve their chances of integrating into pig cells. While the resulting embryonic kidneys had 65% human cells, the experiment was highly inefficient—about 1800 pig embryos were used—and there is no way to know if the chimeric kidneys would be rejected by a donor recipient.

New Definitions: Reproductive Ethics

“New Definition of a Human Embryo Proposed amid Rapid Scientific Advances”

by Megan Molteni, STAT News, August 17, 2023

The mainstreaming of IVF, or in vitro fertilization, has familiarized new generations of people with what the earliest stages of human development entails. But earlier this summer, when scientists revealed they’re now able to create blobs of stem cells in the lab that self-organize into the same sorts of structures embryos themselves build during those first few weeks, it blasted wide open whatever ideas of the embryo we used to have.

“New Infertility Definition a ‘Game-Changer’ for Hopeful LGBTQ+ Parents”

by Carly Mallenbaum, Axios, October 23, 2023

A new, more expansive definition of ‘infertility’ could lead to more help for hopeful LGBTQ+ or single parents.

Once the embryo could be created outside the body, it became something that could be studied, manipulated, and possibly replicated. Scientists have made embryo-like models using induced pluripotent stem cells. For all intents and purposes, the models look and behave like an embryo, but they lack some key features that would allow them to implant in the uterine lining and continue developing. Because these embryo models reside in a legal vacuum and a moral gray area, leading scientists in the field have called for a change in the definition of an embryo that gives clear guidelines for when their models might be considered embryos or not.

Similarly, the American Society for Reproductive Medicine has called for a change in the definition of infertility to include “the inability to get pregnant because of the patient’s medical, sexual and reproductive history, age, physical findings and diagnostic testing” and “the need for medical intervention such as donor eggs or sperm to achieve pregnancy.” This would allow single people and non-heterosexual couples to have insurance coverage for assisted reproduction technologies like egg freezing and IVF.

Brain Implants, AI and Speech, Thought Decoders, Neuralink

“Neuralink, Elon Musk’s Brain Implant Startup, Set to Begin Human Trials”

by Jennifer Korn, CNN, September 20, 2023

After receiving approval from an independent review board, Neuralink is set to begin offering brain implants to paralysis patients as part of the PRIME Study, the company said. PRIME, short for Precise Robotically Implanted Brain-Computer Interface, is being carried out to evaluate both the safety and functionality of the implant.

“The Gruesome Story of How Neuralink’s Monkeys Actually Died”

by Dhruv Mehrotra and Dell Cameron, Wired, September 20, 2023

Fresh allegations of potential securities fraud have been leveled at Elon Musk over statements he recently made regarding the deaths of primates used for research at Neuralink, his biotech startup.

Elon Musk wants to make science fiction a reality by connecting thoughts to a computer interface. His company Neuralink has been approved, first by an independent body and then by the FDA, to begin human trials for its brain-computer interface (BCI). The company is interested in recruiting paralysis patients to test the safety and efficacy of their implants. However, a non-profit group, Physicians Committee for Responsible Medicine, sent letters to the SEC showing that Musk made misleading and inaccurate claims about the monkeys used to test Neuralink’s BCI. Interviews and documentation showed that all the monkeys, which were young and presumably healthy, had to be euthanized because of failures of the implant. If this was the case, then there is a problem with informed consent for Neuralink’s experiments. Patients need to be aware of the true risks of receiving an implant using Neuralink’s methods.

Musk’s company is not the only place working with brain-computer interfaces. Researchers at the University of California San Francisco were able to help a young woman who could not speak due to a stroke communicate using brain implants that translate facial expressions and words to a computerized avatar (“A Stroke Stole Her Ability to Speak at 30. A.I. Is Helping to Restore It Years Later.” New York Times).