National Academies on Gene-Drives

Why would you read all the coverage of the National Academies Gene-Drives report when you could actually read the report itself? My thoughts will appear here later, after I've read the report itself.

Criminalization of Drinking While Pregnant in UK?

A council on northwest England plans to bring legal action to establish liability for criminal damages by women who drink while pregnant, with resultant damage to their newborns. A tribunal in 2011 had ruled that a child had sustained personal injury "directly attributable to a crime of violence," and so was eligible for a payment from its mother. The holding came in spite of the fact that the mother had never been criminally convicted. The court simply held that, regardless of the lack of prosecution or conviction in her case, she had in fact committed the crime of maliciously administering poison so as to inflict grievous bodily harm, a crime under section 23 of the Offences Against the Person Act 1861. The upper tribunal of the Administrative Appeals Chamber reversed the holding, however. (The opinion can be downloaded here.) The Appeals Chamber agreed that there had been “administration of a poison or other destructive or noxious thing, so as thereby to inflict grievous bodily harm,” but found that the fetus who was damaged by the mother's drinking was not a "person" in legal terms at the time of her injury. The case now goes to the Court of Appeal.

It's important to recognize that the case at bar would set precedent for cases quite unlike it in the future. In the case at bar, adoptive parents of a child damaged by fetal alcohol syndrome are seeking payments from the child's biological mother--payments due them pursuant to criminal law. But if drinking-while-pregnant is criminal, the ordinary case of prosecution in the future may look rather different. It will involve not payment of damages by a biological mother to a third-party adoptive parent, but imprisonment of a new mother shortly after her child's birth.

Criminalization of drinking-while-pregnant seems like a terrible idea. It is obviously true that drinking while pregnant can damage one's fetus. It is also obviously true that the majority of women who drink while pregnant do not thereby damage their fetuses. The relevant studies seem to show no genuinely "safe" level of drinking during pregnancy, but also show that significant drinking during pregnancy often results in no harm to the fetus. In these circumstances--and given the addictive nature of alcohol--can it really be true that criminalization of drinking-while-pregnant is really the best, or even a reasonably good, method of reducing harm to fetuses from maternal drinking?

Criminalization will make it difficult for pregnant women to speak to their physicians or nurses about their drinking habits. Threat of criminal prosecution for drinking could be used as a lever against pregnant women by abusive men. Criminalization will subject visibly-pregnant women not only to prosecution, but also to public abuse and accusations from strangers, even though the actual danger to fetuses from moderate later-term drinking is minimal.

Women should be informed of the dangers to their fetuses of drinking. Alcoholic pregnant women should be offered help. The state's money is better spent on public service announcements and counseling sessions than on prosecutions and jail-cells. I'm guessing that no one who knows that drinking during pregnancy might damage her child, but who drinks anyway, does so with malicious intent, or does so without regard to the dangers to her child. People who don't know the damage they may be causing, or who simply cannot stop their drinking due to addiction, need help rather than punishment.

India Eradicates Polio

Monday marked India's third year without any new polio cases, so the country will soon be WHO-certified as having eradicated the disease. Meanwhile, in neighboring Pakistan, where the disease is still rampant, Taliban are executing vaccinators as possible spies. This is apparently because the US used a fake vaccination program as cover for its search for Osama bin Laden. Aagh!

An Interesting Infographic on Jobs in Public Health

A bit tough to read in places, but worth a look!

Canadian AIDS Researchers Oppose HIV-Exposure Prosecutions

The current CMAJ includes this letter from three researchers at the British Columbia Centre for Excellence in HIV/AIDS, arguing for an end to Canada's criminal prosecution of people who allegedly expose sexual partners to HIV. The letter points out that the actual risks of transmission to sexual partners are quite low for well-controlled HIV; that prosecutions have never been shown to reduce rates of infection: and that they may in fact discourage or interfere with HIV testing and treatment. In this interview, one of the co-authors also notes that while Canadian rates of prosecution for HIV exposure have been on the rise, there is no similar policy of prosecuting those who expose partners to other potentially serious viruses like HPV.

Republicans De-fund Needle Exchanges

House Republicans have restored the ban on US federal funding of needle-exchange programs--programs which have been proven effective, time and again, at reducing HIV and hepatitis transmission, and which therefore also reduce the costs of medical care. Art Caplan has more here.

I'm Not Lovin' It

So, San Francisco last year prohibited the inclusion of free toys in kids' meals that fail to meet nutritional standards. The so-called "Happy Meal Ban" goes into effect on December 1. So what are San Francisco McDonald's restaurants doing? Charging ten cents for the toy.

Update: Burger King, too.

Global Health Fund Suspending New Grants

The Global Health Fund to Fight AIDS, Tuberculosis and Malaria, which pays for about half of all AIDS treatment in developing countries, is in financial crisis and will not make any new grants for the next two years. This is a serious blow to global health. Details here and here.