Should the Democrats Keep Pelosi?
In the wake of losing at least 60 seats in the House—their largest defeat in 70 years—there have been widespread calls for currrent Speaker of the House Nancy Pelosi (D-CA) to step down from her leadership position in the Democratic caucus. Republicans had urged voters to get to the polls to “Fire Pelosi.” Now that the Democrats have lost their majority in the House and Pelosi has to step down as speaker, Republican Whip Eric Cantor (R-VA) says that if Pelosi stays on as Minority Leader it will be a sign that Democrats “just didn’t get the message from the voters this election.” In an editorial Sunday, The New York Times agreed that the Democrats need someone who can do a better job of selling their policies. Conservative Blue Dog Democrat Heath Shuler (D-NC)—who is interested in the post for himself—has also suggested that it is “time to move forward in a different direction.”
Pelosi is nationally very unpopular. Just two weeks before the election, Gallup found that just 29% of Americans approved of the job she was doing. The New York Times is right to suggest that she is not as gifted a spokesperson as she is an inside political player. And being from notoriously liberal San Francisco does make her especially vulnerable to political attacks. But a lot of her unpopularity comes with the job. As ranking Democrat in Congress and the primary force behind health care reform, she made a lot of enemies and became the major target of Republican attacks. Part of the reason that Pelosi—arguably one of the most effective Speakers in American history—is so hated by conservatives is that she managed to get so much legislation passed that they opposed. Pelosi was also targeted by a record-breaking $65 million advertising campaign—involving more than 160,000 ads—making her the face of everything wrong with Democratic Party. Nor should it be any surprise that the highest-ranking female politician in American history should be subject to vitriolic and often sexist attacks.
As unpopular as Pelosi may be, it’s not her fault the Democrats took such a beating in last week’s elections. She’s not the reason the economy continues to falter. Nor is she the reason Congress has been so dysfunctional. As I have argued, the real problems lay in the Senate, although it’s House Democrats who paid the major price for partisan infighting. And, as I have written, the Democrats were never likely to hold on to the seats in normally Republican districts they won in 2008 in with Obama on the ballot.
Pelosi’s unpopularity may make her an easy target, but Heath Shuler would be subject to the same kind of attacks if he took her job. In any case, the Minority Leader’s job is not primarily to be a spokesperson, but to build and hold together legislative coalitions. That’s exactly what Pelosi, who doesn’t sound like she is ready to step down, knows how to do. The Democrats are going to need her expertise in the next Congress, when the new Republican majority in the House maneuvers to cut off funding to Democratic programs and undermine the last Congress' accomplishments. As Greg Sargent says, “the key thing to understand is that we are about to enter a period of bruising procedural wars—precisely the type of thing that Pelosi has already excelled at.”
Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."
- Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
- Patients from low-income neighborhoods are most at risk of negative health impacts.
- Thankfully, health care professionals are not alone. Upstreamism is increasingly part of our cultural consciousness.
- A huge segment of America's population — the Baby Boom generation — is aging and will live longer than any American generation in history.
- The story we read about in the news? Their drain on social services like Social Security and Medicare.
- But increased longevity is a cause for celebration, says Ashton Applewhite, not doom and gloom.
Can you make solar power work when the sun goes down? You can, and Dubai is about to run a city that way.
- A new concentrated solar plant is under construction in Dubai.
- When it opens next year, it will be the largest plant of its kind on Earth.
- Concentrated solar power solves the problem of how to store electricity in ways that solar pannels cannot.
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?
But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.
What's dead may never die, it seems
The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.
BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.
The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.
As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.
The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.
"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.
An ethical gray matter
Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.
The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.
Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.
Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?
"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."
One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.
The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.
"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.
It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.
Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?
The dilemma is unprecedented.
Setting new boundaries
Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."
She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.
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