Swine Flu: The Next SARS Virus?

The recent news of a discovery of a new virus has the health institutions around the world on their toes. It has been reported that hundreds of people in Mexico and at least twenty people in the United States have shown symptoms of a new virus named the swine virus because of the similarity of its outer protein receptors to a virus that is common in pigs. The disease seems to be contagious through the air, and symptoms do not become present until the fifth day onward, although it is still transferable from day one.

The existing logic for such a sensational story is the fact that there are so many methods of contracting such a highly contagious disease in today’s fast-paced society that a real pandemic is very likely. Examples of this include the outcry of the SARS virus and the avian bird flu. These diseases can travel with airplane travelers to the most distant parts of the globe, and strike the population when least expected. A new virus that is little known about will strike even more swiftly because there is no existing contingency plan in place.

While I believe that these are very real threats, I also know that the media has a tendency to blow up affairs regarding various new diseases; emphasis is placed on the sensation factor rather than actual extent of impact on society. It’s a business, and simple medical articles and affairs need to have a doomsday appeal to them if views are to be generated. While SARS and the avian flu remain very real and infectious, comments about them have faded away; they never evolved into the earth-shattering plagues that we were led to believe. So take the latest news about the swine flu with a grain of salt: it might be a very real threat, but just don’t regard as the next Spanish Influenza of 1918.

Website Relevant to my post:
http://www.newscientist.com/article/dn17026-swine-flu-what-you-need-to-know.html?full=true

Crazy Talk

Sometimes I doubt the value of freedom of speech. Ethically I’d normally consider it as a basic human right. Each of us owes to the rest of mankind, in order to ensure individual identity, representation, and freedom. But I just read something that made me wonder if some things that would usually be considered basic human rights, such as freedom of speech, are actually rights that people should be earned rather than just be given. And the complication is that, at least with this case, the person who abused his freedom of speech and harmed the greater good, was, in his mind, trying to make a suggestion that would provide positive advice.

This person, a blogger posting to the “UK Coalition,” is suggesting that we apply Darwinian natural selection to those living in and suffering from HIV/AIDS in Africa. He say’s “shouldn't we let people die until only those with a greater resistance to the disease emerge?” He argues that through the current care that is provided to African populations with HIV/AIDS, does not cure them but rather lets them live so that they can continue to spread it “through ignorance.” After this statement he cites the tragic yet true problem that some Africans believe that sleeping with a virgin will cure their HIV/AIDS, which according to a Reuters’ article has vastly increased incidence of rape. This piece of evidence simply shows the additional level of commitment that the world still owes Africa. As mentioned in the Reuters article, simple education programs in Africa appear to have dispelled this belief in younger age groups. What comes through most is that to follow through with this plan of action proposed by the blogger would mean the avoidable death and suffering of millions of Africans. How this blogger thought this fact could be avoided escapes me…

Should we be concerned with the undermining spread of such an unethical argument? Is there any legitimate worry that such dangerous logic will spread enough to undermine the relief effort in anyway? I would answer my own question and say, “probably not,” but still, the very existence of such publicly projected thoughts worries me…

Sites used:
http://www.ukcoalition.org/AIDS-Cure/12538.htm
http://mobile.alertnet.org/thefacts/reliefresources/107036097535.htm?_lite_=1&via=lnav

What is So Wrong about a DNA Database?

The Federal Bureau of Investigations plans to expand the size of its DNA database 17-fold, to include profiles of perpetrators of “lesser and suspected crimes.” The prospect of saving the DNA of people who haven’t even been proven guilty has many up in arms, citing violations of constitutional rights.

But is this really such an egregious encroachment on the privacy and civil liberties of blameless citizens? The database would be used solely to solve crimes (but of course, this is assuming that you trust the F.B.I. to use the information as it says it will, which is another matter entirely). An innocent, law-abiding citizen can feel confident that his or her DNA will not show up as a “crime scene sample,” so his or her DNA profile will never be used for anything. Isn’t it worth sacrificing a tiny bit of privacy to help the investigation of horrific crimes go more quickly and smoothly? Isn’t expediting the identification and capture of dangerous criminals a worthwhile goal? Wouldn’t this prevent further harm to others, as well as allow crime victims and their families to begin to heal as soon as possible?

http://www.nytimes.com/2009/04/19/us/19DNA.html?_r=1&hp

Pushing the ethical limits of embryonic stem cell research

NIH released it's newly composed (draft) guidelines on the 17th governing the funding of embryonic stem cell research in light of President Obama's executive order a month ago. The gist of the changes boils down to NIH OK'ing the funding of stem cell lines derived from embryos unused from IVF, with no prior intent on research. Lines created from embryos conceived for the explicit purpose of future research are off-limits (funding of the actual derivation of embryos is unavailable by order of Congress).

This change frees up significantly the amount of leeway researchers have in investigating potentially life-saving technologies, which will have invaluable benefits in the long run. More than 760 current lines could be funded under the new guidelines, which will undoubtedly speed progress. Opponents of stem cell research are unsuprisingly decrying the new developments, but interesting to note is the discontent some proponents for research are making known.

Proponents acknowledge that these changes are certainly a step in the right direction, but some do not think it is enough. They want embryo lines created from "research" embryos, not only IVF embryos, to be OK'd as well. They claim that specific cell lines will not be able to be generated with the current limitations.

I personally think NIH's changes are enough, at least for now. It is already an extraordinary compromise for both sides to limit research to discarded cells that would otherwise be destroyed, versus creating cells for the explicit sake of destroying them for research. Stem cell research is still a new science, and ethical constraints are sure to slacken in the coming years, so it will be a slow process. The argument that specific cell lines won't be able to come to fruition is a little questionable to me, because I don't really think the science is at a point where embryos can be picked for specific "stem cell" purposes. To work with what is already available (and there is PLENTY available) is already fine by my book.

http://www.nature.com/news/2009/090417/full/news.2009.373.html

http://scienceblogs.com/scientificactivist/2009/04/nih_stem_cell_guidelines.php?utm_source=nytwidget

A Pressing Problem for Harvard

While we arguing issues whose ramifications are exotic and interesting, we sometimes forget that there are still very real, down-to-earth problems in science today. Students at Harvard Medical School recently uncovered a unacceptable policy with the University: the fact that many of the esteemed faculty members on campus were affiliated with various pharmaceutical companies. These professors then subsequently push for these drugs in classrooms to future doctors. Obviously, this is a very poor system to conduct education. One student even reported being harassed by a professor after he asked what the potential side effects of a drug that was heartily endorsed by the teacher.

In fact, the American Medical Student Association gave Harvard an F in terms of how they over watch drug industry money. The grading process is a great idea, but there should be more done. One idea is to set up a punishment system in order to prevent further transgressions. So far, no official entity regulates the flow of money; this must corrected. This will not prove easy, as the recent economic downturn sapped endowment returns and potential benefactors shy away. However, this is a question of fundamental ethics, and the right thing to do is obvious.

Mother vs. Fetus: Epilepsy vs. I.Q.

Having to deal with epilepsy is a difficult situation alone, but being pregnant further complicates the situation. Physicians treating these epileptic women are no longer obligated to care for the mother but also the fetus within her. However, in the interest of caring for the mother by using epilepsy drugs, the fetus could also be harmed. Previous studies have found valpropate, but sold as “Depakote” to increase malformations and developmental difficulties of the fetus. But most recently, a new study soon to be published compared valpropate to other antiseizure medications. The study found that children and toddlers born from mothers who have taken valpropate during her pregnancy displayed lower I.Q. scores. These results suggest valpropate to have serious cognitive consequences on the welfare of the fetus. As pointed out by Dr. Kimford, a neurology professor at Emory University, “If I put the patient on valpropate as a first choice and the baby has cognitive impairment or a malfunction, I can’t repair that.” Despite these findings, specialists still do not advise pregnant women to discontinue their use of valpropate without consulting their physicians.

Amidst these findings, a few other issues concerning this study surfaced. Can I.Q. points really reflect accurately the cognitive abilities of these children born from valpropate-using mothers? How should the physician prioritize the interest of his two patients: the mother and the fetus? But more importantly, was it ethical for the researchers to study pregnant women using valpropate versus other antiseizure medications when it is previously known that they may cause developmental harm to the fetus?

Source:
http://www.nytimes.com/2009/04/16/health/research/16child.html

Natural Bone Marrow Regeneration?

Scientists from the University of Montreal have developed a method to mass produce stem cells from a small number of blood stem cells from a patient’s bone marrow. This would allow for far easier transplants since the inserted cells could be grown, eliminating the difficult search for compatible donors. According to the article, nearly 4,000 individuals in North America wait for such donors without success. The feat was accomplished by identifying 10 proteins found in bone marrow stem cells which force the cells to multiply in the lab setting. The scientists hope that even one of these proteins will also allow the regeneration of bone marrow directly in humans, completely eliminating the need for even a transplant.

In addition to simply marrow replenishment, the technique also has other implications for organ recipients. Normally, organ transplants are complicated by the possibility of harmful reactions towards the transplanted organs, and must therefore take medication to suppress the effects. Furthermore, since the transplanted organs are generally permanent, the negative effects could remain for the rest of their lives. However, mouse studies exist that suggest bone marrow transplants could prevent rejection against organs. The immune system cells created by the bone marrow are responsible for these reactions. Thus, marrow transplants could eventually result in acceptance of the organ as one of the body’s own.

I feel that this research is a remarkable development. This technique seems as if it is both easy and inexpensive, two qualities which I think are necessary for it to become a widespread treatment. As such, I am eager to read more about its success on direct marrow regeneration. My only question is about the time frame mentioned. Why should it take a few years to be implemented as mentioned in the article? If the cells are indeed from the person’s own culture, what remains to be so extensively tested?

Source:
http://www.biologynews.net/archives/2009/04/16/world_premiere_in_stem_cell_research_in_montreal.html

Is Infanticide Such A Crime?

Infanticide was a rare but acceptable procedure for most of ancient classic period. In societies such as ancient Greeks and Romans, it curbed the disabled population (Plato especially advocated for these methods). In times of famine or plague, infanticide often meant one less mouth to feed, preventing the welfare of the family from worsening. The advent of the three major monotheistic religions, Christianity, Judaism, and Islam, stopped this practice dead in its tracks. From a religious perspective, such an action violated the most basic of human rights, and was a one way ticket to damnation. Everything regarding the procedures was quickly buried away, having been regarded as unacceptable no matter the situation

Yet the issue of infanticide has arisen yet as a byproduct of the current debate on euthanasia and physician-assisted suicide. In some ways, it is even more controversial compared to euthanasia and PAS, because it is not the individual making the choice; rather, the power lies with the parents or legal guardians of the infant. Personal choice is thus thrown out the window. I personally think that it is best to trust the parent’s judgment as long as it is in reason. Despite the ethical problems this entails, there is little doubt that no one knows that personal whims and wishes of a suffering child better than his or her parents. The courts seem to agree with me on this. Recently, a Dutch physician, Dr. Eduard Verhagen, was brought to trial for the mercy killing of four babies after he was given parental permission. Although, his actions were illegal under Dutch law, he hasn’t been prosecuted by for the court for them. To me, this demonstrates the acceptance of an imperfect but most suitable system.

The Misguided Quest for Childhood Beauty

A growing phenomenon in our society is people’s willingness to go under the knife to change a certain aspect of their appearance. However, the youngest members of our society, now more than ever, are beginning to undergo cosmetic surgery for non-medical reasons. These surgeries include breast enhacement, liposuction, and a westernizing eye surgery mainly performed on people of Asian decent. There is no specific medical implications behind these surgeries; simply a parent’s quest for beauty in their children at increasingly younger ages.
The ethical issue behind these cosmetic surgeries performed on youth is the fact that parents are the ones giving consent to this surgery, even though their children are still in the developmental process. Undergoing these procedures at such a young and vulnerable age limits the children’s autonomy by taking away their right to make a decision that should really be made later on when they are adults. Not only are these procedures going against nature, but moreover, cosmetic surgery is meant for those who have developed fully and who have made the personal decision to change an aspect of their appearance.
In effect, parents giving consent to their children going under the knife to improve their looks places too high of a value on beauty and perfection in the youngest members of our society. We need to place a higher value on children and their natural development into healthy adults, rather than attempt to perfect them physically before they have had a chance to determine for themselves what aspects of their appearance they desire to change.
The article touches on the controversial issue that parents of children with gender identity disorder face when deciding whether to intervene with psychotherapy or accommodate the gender with which their child identifies by allowing them to undergo surgery for the cooresponding male or female characteristics. Although I agree that this issue is one of the most sensitive involving cosmetic surgery, I think that they more important question we should ask is whether we need to do anything at all at such a young age in a child’s development. Though developing in a body that one feels is not the correct gender may be somewhat of a traumatic experience, I feel that parents should provide support to their child by nurturing them just as they would any other child. In this way, once these children reach adulthood and can make decisions for themselves, they have the autonomy to decide whether they want to undergo gender changes. Above all, parents should not be making decisions for non-medical cosmetic surgery for their children, but rather should be loving and supporting in the natural development processes of their child in order to raise a child who is confident and has a good sense of his or her internal and external beauty.

http://www.medicalnewstoday.com/printerfriendlynews.php?newsid=136762

What Will His Life Look Like?

When Nikolas Evans unexpectedly died in a fight, he left behind a mother and a spoken desire to have children. In the past, this event would simply be tragic. Now, however, because of modern technology, the situation has become ethically complicated. Evans' mother has a new option that she has chosen to use: harvesting her dead son's sperm and using it to fulfill his wish of having a child. The ethical issues here are profound, ranging from whether Nikolas would have wanted to have a child posthumously to the lack of time available for the grieving mother to reconsider her choice: sperm must be collected from the dead body soon after the passing of the future father.

However, the issue that struck me most was one brought up by Tom Mayo, director of Southern Methodist University's Maguire Center for Ethics and Public Responsibility. "That child's biological father will be dead. The mother may be an egg donor, anonymous or gestational surrogate...This is a tough way for a kid to come into the world. As the details emerge and the child learns more about their origins, I just wonder what the impact will be on a replacement child."

Is this a legitimate ethical issue to raise? Can we really decide whether or not to bring a child into the world on the basis of speculation about what his life will be like? On the one hand, it seems wrong to bring a child into the world unnaturally when it is entirely possible that the child's life will not be optimal. On the other hand, it seems paternalistic to make a decision as large as whether or not another human being should exist based on one's own personal views about the potential of their future life. Should we really assess the quality of a future child's life every time somebody wants to conceive a child through nontraditional means?

http://apnews.myway.com/article/20090411/D97G8FD00.html

Sperm Product Liability

Brittany Donovan was born with mental impairments as a result of a genetic disorder known as fragile X syndrome. Now at age thirteen, she is suing the “sperm bank that provided her with a biological father” under product liability laws. These are the same laws that individuals use to sue companies that sold defected products that caused injury to the buyer, for example faulty car brakes that resulted in an accident. How can one apply product liability laws to the sperm bank when they did not manufacture the sperm? If you buy a faulty product do you sue the store where you bought it or the company that manufactured it? Furthermore, in order to test a sperm for defects it would have to be completely destroyed so that its DNA could be analyzed, which makes it impossible to test each individual sperm before insemination. Surely if Brittany wants to sue for product liability, she should not be suing the sperm bank but instead she should be suing her biological father. However, if Brittany were allowed to sue her biological father, it would open the floodgates for many similar cases? Any child with any genetic defect would be able to sue their parents.

Sources:
http://www.newscientist.com/article/mg20227032.400-sperm-bank-sued-under-product-liability-law.html

The Stork’s Dilemma: To whom should life be brought?

I’m referring to the storybook stork, the one that safely and smoothly delivers bundled new born infants into their parents’ arms – the story that a parents tells their children when they asking uncomfortable and complicated questions about from whence they came. Well unlike in the stories the reality is that sometimes the stork’s delivery doesn’t always go smoothly, sometimes it’s rough, and the infant suffers along the way. Two such newborns, Kaylee Wallace and Lillian O’Connor, unfortunately both suffered very bumpy rides, in that their development has proceeded far from “smooth and safe.”
Kaylee was born with an extremely rare brain condition known as Joubert syndrome. Kaylee’s brain stem is not and will not completely develop, because of this she is now incapable of breathing on her own – she must be attached to a breathing machine in order to survive. At one point her natural breathing stopped 100 times an hour. Lilly on the other hand was born “with a congenital heart defect called truncus arteriosus and has been given only weeks to live.” Although Lilly will survive and may progress to be for the most part a completely healthy individual if she receives a heart transplant. Faced with no cure, no other options, and Kaylee’s eventual death her parents decided to remove her from life support and, upon her passing, have her heart donated to Lilly, who’s touching, compelling, and saddening story they had read about in a Toronto news paper (the Hospital where both babies are located is in Toronto). Kaylee’s parents took solace in the fact that the death of their daughter, which otherwise would have brought about nothing but remorse, would now be giving life and happiness to a family in a similar situation as their own.
Although the circumstances got increasingly more complicated, since initially the hospital would not qualify Kaylee as an appropriate donor. After public outcry the hospital reversed its decision and allowed the transplant to go through. But to add another even more complicating factor, after Kaylee was removed from her breathing apparatus she survived for more than an hour under her own power, again making her under hospital regulations ineligible as a donor.
Regardless of the twists and turns that have occurred here it is important to reflect on the ethics that are embedded within this story. Yes, Kaylee and Lilly’s situation is touching and emotionally powerful in its sympathetic appeal, but it should be noted that public outcry alone was sufficient to make the hospital overturn its original decision to not allow the transplant. This effectively overthrew the hospitals protocols, which are based on maintaining the greatest safety, efficacy, and benefit that a transplanted organ can bring. Ethically, if the public believed it was the right thing and demanded it, should that mean that the hospital should have folded its carefully constructed principles? Also in normal cases where organs are transplanted from the deceased, anonymity is maintained to avoid biased selection, by the donor, of who should receive the donated organ. It is believed that doctors should make that decision based on their ability to determine who the organ would best serve with the best chance of success. Although Kaylee and Lilly’s situation seems far from ethically troubling it does set a precedent for the biased selection of organ recipients, which has the potential for scarce organs to be distributed along lines of race, gender, religion, socio-economic status or education level instead of simply to those who have been determined to need them most.
Personally I would like to witness this stirring transplant occur, but these important matters of ethical precedents should at least be addressed, as it appears that they were entirely overlooked by all but one out of thirty of the articles that covered this story.

Sources used:
http://www.torontosun.com/news/columnists/michele_mandel/2009/04/05/9009771-sun.html
http://www.torontosun.com/news/torontoandgta/2009/04/07/9045136.html
http://www.google.com/hostednews/canadianpress/article/ALeqM5gBE_Fo4Q8COxWBfjikp0fAPX61AQ

Corruption in Pharmaceutical Research

Money talks. As trite as that saying is, its validity is demonstrated time and again.

Dr. Joseph Biederman, a child psychiatry bigwig, is in the midst of a nasty conflict of interest investigation regarding his dealings with Johnson & Johnson. Biederman has wielded his “Olympian” influence for years to propound his pro-medication stance on psychiatric disorders in children. However, he neglected to report the vast majority of the millions of dollars in profits he earned while conducting clinical trials for the pharmaceutical company. Furthermore, it was recently revealed that he designed his trials with the express purpose of proving (rather than objectively determining) the effectiveness of the experimental drug.

Biederman’s obvious bias towards the welfare of the company that lines his pockets has resulted in his flagrant disregard for the basic principles of good science. The safety and efficacy of every antipsychotic drug whose success was facilitated by his work (and there have been many) is now under a dark “shadow” of doubt. The widespread pediatric use of these drugs—a policy that came into being largely as a result of Biederman’s championing—is now viewed with suspicion, raising the dreadful possibility that doctors may have been administering unnecessary or even harmful treatments to children as young as two.

But this issue has even broader implications. It serves to discredit biomedical research as a whole. The field is already associated with enough ethical controversy; this serious of a blow to its reputation is the last thing it needs.


http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/03/26/EDAF16N963.DTL

http://www.nytimes.com/2009/03/20/us/20psych.html?_r=2&ref=health

Forget all about that MOL exam!

Couldn't help myself ;)

For those of you who couldn't be bothered with reading Professor Zwicker's email, here's a quick synopsis of the article from the NY Times. Basically scientists are on the verge of being able to surpress one's memory, logically of a traumatic and psychologically debiliating event. Controlling a molecule called PKMzeta, using the ZIP drug to surpress it, memory in mice was erased. And researchers contend that humans are not too far behind.

So what are the applications of such a treatment? Say you had some sort of horrible experience, and the memory of said experience limited your ability to carry out daily activities. Or you were addicted to some drug, and erasing the body's memory of taking said drug would cure your addiction. From this standpoint, the therapeutic benefits of memory wipes are clear, and frankly should be wholeheartedly pursued, as we've already discussed how therapy is relatively mild compared to "enhancement" and things of that nature.

Does memory determine who we are? Would I be the same if a terrible happening that altered who I was was wiped from my mind? The fact that such a mood-altering event is unnatural and not something you're inherently born with might argue no, but what of the events that make you a better person, that improve your outlook and general well-being? You weren't born with those, so should we wipe them out? But if we should use this argument, what of life-altering conditions such as cancer? Surely such an earth-shattering disease might have a large influence in a person's "being," but who would hesitate to eradicated it at first thought? In that, I think that "bad memories" can just be considered another disease to be cured.

There are concerns about the risks of multiple memories being inadvertently lost, or erasing memories of crimes or bad behavior, "blocking your conscience" in a way. But if this technology is used in a highly scrutinized and limited way, and is failproof, then I suppose we don't have to worry about these qualms, until we the true nature of memory wipes.

On the topic of conscience blocking, however, take for example a serial killer that repents, and then forgets his crimes. Arguably it wouldn't be right to absolve him or her from these weighty memories that form the moral conscience. But what of someone that accidentally killed a pedestrian while driving with poor visibility? Should he or she be able to wipe that memory, even if they were charged of manslaughter? Just some food for thought.

Seeing Isn’t Believing?

Usually, the validity of theories is debunked once evidence suggesting the opposite exists. The same could not be said for the usage of beta-blockers in heart treatment. Theoretically, beta-blockers slow the straining heart in order to minimize oxygen consumption (NYT). Thus, beta-blockers have been widely prescribed in treating heart problems involving clotted arteries that could lead to heart attacks (NYT). What we learn from the textbooks do not necessarily translate to the actual mechanisms of the human body. It is one thing for studies to offer additional and supplementary information and another to have a study present information that counters the conventional scientific theories.

What is even more discomforting is that studies have suggested beta-blockers to act in the opposite direction compared to what they should theoretically be doing for our body. Instead of saving lives as intended, the beta-blockers “caused a definite increase in heart failure.” (NYT) Despite such opposing data, doctors had still prescribed beta-blockers after the study (NYT). Although, as of April 1, 2009, beta-blockers will no longer be a government advised form of treatment, this situation have sparked some interesting questions. As David Newman, writer for the New York Times article, asked, “ Can we handle what the evidence reveals? Are we ready for the truth?” But more realistically, are we willing to let go of what we have believed in for so long? Thus, what is the most troubling is the inconsistency between application and theoretical science. After all, much of today’s successful medical advancements work in accordance to scientific theories. If today’s theories could be replaced by study results, then these results could also be replaced in the future. How reliable scientific information are is still uncertain and thus study results also should not be emphasized more than theoretical science.

http://well.blogs.nytimes.com/2009/04/02/the-ideology-of-health-care/

Invasion of the Body Snatchers

The topics we discuss in class, through this blog, during our elevator rides and on our subsequent walks to Late Meal have yet to be truly applicable in my personal life. That is, until now. Alan brought up the interesting case of the BodyWorlds exhibitions and the numerous copycat projects cropping up around the world that display plastinated human bodies for the purposes of art and public education. 2008 saw a rupture of criticism against the popularity of such ventures. Human rights groups emerged with the argument that human body exhibitions "violate laws that protect the dignity of the human body," according to the Associated Press.

But how do we define the dignity of the human body? And how important is it that we protect this dignity in the search for effective medical therapies, widespread health awareness of the general public, and the education of our health practitioners? 

It seems as though much of the concern arises from the charge that the industry caters to "voyeurism and morbid curiosity," as if the internet did not do so much already. As for the dignity of the human body, I would argue that silencing the open viewing and discussion of the human body promotes the exclusivity, the esotericism of the medical industry that may preserve the profit of hospital care but keeps much of the public in the dark when knowledge can be made readily available which is a true ethical concern.

It seems that medical knowledge flooding the public domain is something that has yet to establish a strong precedent in societies. Yet it is not difficult to imagine that a public with greater awareness of their body and its organs and systems will in turn mean a healthier public. It may then be plausible that the means toward such an education is what truly respects the "dignity of the human body."

In reference to,
http://www.philly.com/philly/wires/ap/news/world/20090401_ap_frenchjudgeaskedtoshutcadaverexhibit.html