Ethicists Debate New York State's Decision To Pay Egg Donors Who Aid Stem Cell Research
New York state"s decision last month to allow state-funded embryonic stem cell researchers to pay women for donating their eggs had drawn support from many scientists and doctors but fueled debate among some ethicists, Long Island Newsday reports. The state"s Empire State Stem Cell Board said that researchers can pay women up to $10,000 as compensation for their time and the invasive nature of the procedure.Scientists and research advocates say the decision could boost important research into cures of serious diseases while attracting investments and new jobs to the state. Opponents raise ethical concerns about using taxpayer money for research that some people find morally objectionable. Some also contend that payment might exploit low-income women, according to Newsday. The National Academy of Sciences and NIH do not permit payments to research participants beyond reimbursement.Thomas Berg -- director of the Westchester Institute for Ethics and the Human Person and a Roman Catholic priest opposed to embryonic stem cell research -- cast the sole dissenting vote in the stem cell board"s decision. Berg said the board ignored his suggestions to open the discussion to the public. However, Samuel Packer -- a member of the board and chair emeritus at the North Shore-Long Island Jewish Health System"s Department of Ophthalmology -- said the decision was made during a public meeting following a "long, lively debate." Packer said, "At some point the dissenting voice can"t stop the progress of science or anything else in society." He added, "There is a direct link between having better eggs and doing better research" (Ochs, Long Island Newsday, 7/9).
Endocrinology
Medicare Expenditures Decrease For Glaucoma Surgery As Number Of Procedures Increases
The overall number of glaucoma surgical procedures appears to be increasing, but payments by Medicare for the procedures have been decreasing, according to a report in the July issue of Archives of Ophthalmology, one of the JAMA/Archives journals. Glaucoma is one of the leading causes of blindness worldwide and currently affects more than 2 million people in the United States, according to background information in the article. "Management and treatment of glaucoma can be costly, and it has been estimated that glaucoma is the primary reason for ophthalmologist visits in the United States," the authors write. One previous study estimated that annual Medicare payments for glaucoma exceeded $1.2 billion each year between 1991 and 2000. "An important driver of glaucoma treatment costs is surgery." Surgery is typically used to reduce intraocular pressure (pressure within the eye) when medications fail to do so. Jordana K. Schmier, M.A., of Exponent Inc., Alexandria, Va., and colleagues conducted an analysis of Medicare claims and payments for glaucoma surgery between 1997 and 2006. The most common surgical treatments for glaucoma include laser trabeculoplasty, in which a beam of light changes the drainage angle of the eye to relieve pressure; filtering surgery, in which surgeons use a surgical tool to create a drainage hole; shunt surgery, which involves placement of a small plastic tube with an attached pouch; and cyclodestructive procedures, used to reduce the production of eye fluid in severe cases of glaucoma. "Overall, there were decreases in both the number of glaucoma surgical procedures and the amount of annual payments from 1997 to 2001 but an increase in the number of procedures in the following years," the authors write. "Trends in claims and payments vary according to procedure. Average payments for trabeculectomies decreased over time, while annual payments for cyclophotocoagulation [a type of cyclodestructive procedure] and shunt-related procedures have increased." After an initial decline, the number of trabeculoplasties increased, coinciding with advances in technology and changes in the global period for reimbursement (the amount of time after a surgery during which additional billing is limited; in 2002, this period changed from 90 to 10 days for laser trabeculoplasty). The analysis examines only direct medical fees paid to physicians, which may be less than half of total glaucoma-related expenditures, the authors note. "Regardless, Medicare payments remain an important component of the cost of glaucoma in the United States and the overall trend toward lower-cost surgical procedures (i.e., fewer trabeculectomies) despite the increased use of newer technologies (i.e., more glaucoma drainage devices) observed in this analysis may have a substantial impact on national glaucoma expenses," they conclude. "Further advances and the application of new technologies may help to moderate the cost of providing glaucoma care to all who require it." Arch Ophthalmol. 2009;127[7]:900-905. Archives of OphthalmologyBreast Enlargement commented:
The information is good and I am sure that it will clear some of the doubts of the peopleThe information is good and I am sure that it will clear some of the doubts of the people
19.04.2012