Medical ethicist Art Caplan joined Boston Public Radio Wednesday for his regular segment. Caplan is head of the division of medical ethics at NYU's Langone Medical Center. He talked about Angelina Jolie's decision to undergo surgery to decrease her chance of getting cancer; a proposed French ban on models who are "excessively skinny;" and the selling of breast milk.
Questions below are paraphrased, and Caplan's answers are edited where noted [...].
Angelina Jolie said she carries the mutation of a certain gene known to cause aggressive cancer. Last year she had a double mastectomy, this year she removed her ovaries and fallopian tubes to reduce her cancer risk. Is this wise? Is it good she's doing this publicly?
I think there's a lot of good. She's drawing attention to the fact that there are women out there who are at a high risk for hereditary [...] breast and ovarian cancer.
She's written in the New York Times about this. Is that the best venue to talk about this?
It's great that she writes for the New York Times [but] she is really writing for the one percent. Angelina Jolie could fly anywhere and get [medical] opinions from anybody. [...] The average person who doesn't have such great health insurance? They may not even get coverage for testing. [...] We're kind of looking at one of the most empowered women you can think of. [...] That's not the average person.
But you agree with her central medical advice here, right?
Steve Jobs — he delayed, and went down the alternative medicine path for his pancreatic cancer. [...] If he had gone to mainstream medicine most people think he probably could have been saved. [...] It's a net-plus. It gets people talking about an important health issue. [Jolie] is brave, she did it.
France has taken steps to prevent "excessively skinny" models on catwalks. Is this a good idea from a public health perspective?
I think it sends a message that [we] have requirements for job safety. Maybe ultra-thinness, anorexia, is a threat to the worker. [...] The message is good.
A recent New York Times piece profiled mothers in the US who sell breast milk for profit. Companies take this milk and turn it around to consumers. Is this dangerous, or genius?
Part of me thinks Les Misérables. It's sort of, Really, we're going to be selling our hair, and our nails, and our breast milk? [...] It's not like selling a kidney, it's replenishable. [...] The bad news is, you give people an incentive to lie about their health.
You liken it to selling blood, back before donations became the law of the land.
The day we said blood has to be donated — as opposed to sold — I think the hepatitis C rate in the blood [supply] just collapsed. It's safety, it's quality.
There is the corporate, factory-farm sort of idea at play, too.
The image of an animal getting milked and selling it I think is one that offends, but [...] I don't mean to offend when I say it. There's an angle here of dairy farming, or something. I mean, pump and pump and pump. [...] You get that notion of turning your body into a kind of factory.
And there's a demand.
It's not like we have an ample supply of breast milk, by the way. We do need it. [...] But you want to be careful.
A new study by the American Journal of Sports Medicine found that baseball players who suffered a concussion were ineffective hitters when they returned from the injury. The NFL just instituted a "Julian Edelman rule" to better address possible player concussions, too.
We all saw it. [Edelman] was knocked silly.
Are we any closer to preventing concussions or minimizing symptoms from them?
I don't see any big breakthroughs coming. [...] Part of the problem is, damage to the brain from concussive injuries seems to be a cumulative process. [...] There's no immediate short-term solution in sight to this, but we think reducing the number of times your head gets hit is important.
>> Art Caplan is the head of the division of medical ethics at NYU's Langone Medical Center. He's also cohost of the Everyday Ethics podcast. He appears every Wednesday on Boston Public Radio.
