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Stanford’s SCOPE Blogs on Hank Greely and Genome Engineering

Our own Hank Greely has co-authored an article, published yesterday in Science, discussing the opportunities and challenges presented by genome engineering technologies. Krista Conger, writing for SCOPE, the Stanford Medical School’s blog, discusses the article in a recent post.  Read Krista’s post here.

In The Spirit Of Spring Break

It’s almost spring break here at Stanford, and in that vein, I thought I’d talk about a topic that is likely to be on at least a few spring breakers’ minds: marijuana.* Last week, a bipartisan trio – Senators Booker, Gillibrand, and Paul – proposed the Compassionate Access, Research Expansion, and Respect States (CARERS) Act, which has been described as the “first ever” Senate bill to “legalize” medical marijuana.

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This is Your Brain on Politics

It is a tautology to say that our political views affect our attitudes toward various societal issues. If I knew in advance whether you were a conservative or a liberal, for example, I could probably predict with better-than-chance accuracy your views on climate change, teaching evolution in public schools, or genetically modified foods.

But did you know that our political leanings can also alter our perceptions of reality?

This may seem surprising, but it’s true. A growing body of research shows that our political beliefs can influence not only the way our brains interpret and remember scientific information, but even our subjective perceptions of our physical environments.

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2014-2015 Workshop Series: Mini-Podcasts with Nathan Cortez & Margaret Foster Riley

Mini-podcasts for the latest two speakers in the 2014-2015 Law and the Biosciences Worshop series are up! Listen to Hank Greely discuss mobile health with Nathan Cortez from SMU and bioengineered meat with Margaret Foster Riley from UVA.

Three Reasons I’m Excited About Arctic® Apples

Malia McPherson

In mid-February, the USDA approved the first genetically engineered (GE) apples. These apples will be marketed as Arctic® apples, and have been modified to stall browning after cutting or bruising. In an interesting Q&A sheet, the USDA explained its approval process. It is required to approve (technically, to “deregulate”) a crop once sufficient evidence shows that the crop meets pest safety standards set by the USDA Animal and Plant Health Inspection Service (APHIS)—the crop must be unlikely to be a pest to other agricultural crops or plants. The Arctic® Apple passed these pest tests conducted in both Washington and New York states, which combine produce almost 70% of all apples grown in the United States.

The FDA is also involved. Although it considers deregulated biotech crops similar to their conventional counterparts, it provides a voluntary consultation process to help ensure food safety. The biotech company, Okanagan Specialty Fruits, is apparently still waiting for the FDA’s approval through this voluntary review process.

There has been, and will continue to be, controversy surrounding these apples. Characteristic of the larger food genetic engineering debate, the USDA stated that the majority of public comments received, “did not raise any specific disagreement with APHIS’ analysis of the pest risk of this GE apple. Rather, they expressed general opposition to GE organisms or GE apples.” The company has conceded that many stores might be hesitant to stock GE apples for fear of customer backlash. And other apple growers oppose the new technology, citing concerns that customers will associate all apples as GE apples (although in the age of organic, I’m skeptical about this complaint).

Despite these fears, concerns, and doubts, I’m optimistic that GE apples could be good for both consumers and for reframing the GE debate.

(1) The Technology

When a normal apple is cut or sliced, the enzyme polyphenol oxidase (PPO) is produced and is responsible for the immediate apple-enzymatic browning. But this pathway can be silenced when copies of low-PPO genes from other apples are inserted. This modification silences the normal PPO gene. The modified Arctic® Apples end up producing only 10% of PPO amounts compared to traditional apples, which is not enough to cause browning. PPO does not affect other apple pathways and Arctic® Apples will still undergo normal rotting.

For some opponents to GE technology, could this type of engineering be an acceptable form of GE? There might be less fear about crossbreeding or “Frankenfruits” or fear that these apples are “unnatural,” since they still only contain apple genes. There could be less confusion about what is being added to the fruits since it is a relatively easy process, and gene, to explain. Even without genetic modification, consumers could imagine a similar mutation happening naturally after years of DNA replication, and then continued through selective breeding.

(2) The Public Health

Apples are healthy. Kids (generally) like apples. Kids (generally) like apple slices even more. Cheaper, more appetizing, and easier to package fruit could help transform cafeteria lunches and reduce cafeteria waste. And apples that don’t turn brown as quickly or as often meet all those criteria.

Additionally, as with Golden Rice, the public understands that we need nutritional solutions both in developing and developed settings. These apples provide another example of biotechnology that could help with obesity and poverty. It is inherently easier to support something that is healthy, compared to something like corn that is used in high fructose corn syrup or even the GE potato (which might be the next approved new GE crop).

(3) The Small Company

Monsanto didn’t create this! Okanagan Specialty Fruits is just a small company, without a reputation for profit seeking or pesticide advocating products. As cynical as this sounds, it is great that a smaller biotechnology company created this apple—not just for public perception, but also for opening the field of genetic possibilities to smaller companies. Biotechnology doesn’t always have to be associated with Big Agriculture!

There are still many challenges regarding public acceptance of GE fruits before Arctic® Apples go mainstream. McDonalds and Gerber both announced that they had no plans to sell or use Arctic® Apples. But I do hope that products like these will help further meaningful and informed conversations about what types of technology we are willing to accept in our foods.

For more information about the company, the products, and what these apples are all about, visit Okanagan Specialty Fruits.

Malia McPherson is a 2L at Stanford Law School

Cloned, Cloned Horses, We’ll Ride Them Today (With Profuse Apologies to the Rolling Stones)

The American Quarter Horse is a breed that excels at sprinting over short distances—Quarter Horse races may range from 220 to 870 yards. It is the most popular breed in the United States, and the American Quarter Horse Association (AQHA), headquartered in Amarillo, TX, is the largest horse breed registry in the world. Because of the interest in this breed, Quarter Horses have become the subject of commercial efforts at reproductive cloning. One company, Viagen, has produced over 150 cloned foals. The cloning is achieved via somatic cell nuclear transfer (SCNT), the technique that famously created Dolly the Sheep. As some readers may be aware, Dolly was the focus of In re Roslin Institute (Edinburgh), 750 F.3d 1333 (2014), an important patentable subject matter eligibility case decided by the Federal Circuit last May.

While Roslin dealt with animal cloning and patent law, a recent Fifth Circuit case, Abraham & Veneklasen Joint Venture v. American Quarter Horse Association, No. 13-11043, 2015 WL 178989 (Jan. 14, 2015) (Fifth Circuit Opinion), addresses antitrust law issues raised by animal clones. AQHA registry is essential for the owners of Quarter Horses to have profitable horse breeding businesses. According to the Fifth Circuit, “[w]ithout access to AQHA’s breed registry, . . . the cloned horses cannot participate in the lucrative racing, breeding or horse shows.” Id. at *1. AQHA registers horses born from in vitro fertilization and artificial insemination techniques, but it does not allow the registration of clones. Interestingly, the Jockey Club, which is the breed registry for Thoroughbred horses in the United States, Canada, and Puerto Rico, does not allow registration of horses produced by any assisted or artificial reproduction techniques. In contrast, cloned polo ponies are allowed to compete in events alongside their natural-born counterparts. So AQHA is somewhere in between.

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2014-2015 Workshop Series: Mini-Podcasts with Tim Caulfield and Michele Goodwin

Mini-podcasts for the last two speakers of the Fall installment of the 2014-2015 Law and the Biosciences Worshop series are up! Listen to Hank Greely discuss “The Obesity Gene” with Tim Caulfield and fetal protection laws with Michele Goodwin.


The Nuances of Preemption in the Generic Drug Context

On Tuesday, the Supreme Court declined to review a California court’s decision that a plaintiff could sue generic drug companies on certain failure-to-warn claims. If you’ve been following the Supreme Court’s drug-labeling-preemption decisions over the last 5 or 6 years, you might find this news a little surprising at first glance. After all, as I explained in a blog post about a year ago, state failure-to-warn claims are generally preempted by federal law for generic drugs. But, once you dig into the facts of the California case – Teva Pharmaceuticals v. Superior Court – the outcome isn’t all that surprising, and it highlights some of the nuances of when state failure-to-warn-claims are, and are not, preempted in the generic drug context.

So what happened in this case?

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New podcast posted!

In this edition, we discuss sunscreen regulations, fetal DNA testing patents, intermittent fasting, and Ebola.

Intermittent Fasting: Try This at Home for Brain Health

If you’re a regular listener to the CLB podcast, you’ll hear me, in our next episode (coming soon!) discussing the latest neuroscience research on intermittent energy restriction (IER). IER, as the name implies, involves intermittently restricting energy intake, or calories. You can do this in several ways. In one method you severely restrict calories (think 400-500 total intake per day) two to three days a week; in another you confine your food intake to an 8-hour period every day; and in yet another you fast once a week for  a 24- to 36-hour period.

Sound intriguing? Difficult? Impossible? Read on . . .

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Chao and Womack on Patentable Subject Matter Rejections at the PTO

An article published last month on Law360 (behind paywall) discusses recent developments in the law of patent eligibility, which is enforced through Section 101 of title 35. We have covered patent eligibility issues on this blog before in connection with diagnostic patents and patents on isolated DNA, and these posts (and others) have a great deal of helpful background information on the applicable law. By way of a brief recap, Section 101 limits patent eligibility to processes, machines, manufactures, and compositions of matter. The courts have held, however, that even if a patent claim nominally falls into one of these categories, the claim is not patent eligible if it is directed to a law of nature, a product of nature, or an abstract idea. The courts have recently explained that, to survive a patent eligibility challenge, the claim must be directed to an inventive application of a law of nature or abstract idea. And if the material is alleged to be a product of nature, it must be markedly different from the natural counterpart.

The authors of the article, Professor Bernard Chao of University of Denver Sturm School of Law and Lane Womack of Kilpatrick Townsend & Stockton LLP, briefly survey the landscape of Section 101 case law and go on to discuss a few patent applications that the U.S. Patent and Trademark Office (PTO) recently rejected on patent eligibility grounds. Although the highest-profile patents are those that have been the subject of court cases, Chao and Womack—though based on an “admittedly unscientific and small sample”—show how the law works on the ground. The authors focus on rejections of composition of matter claims under the product of nature doctrine. In particular, they document a PTO rejection of claims to isolated human monoclonal antibodies that “neutralize[] a HIV-1 virus in vitro” because these antibodies are not markedly different from antibodies amplified from patient B-cells. The authors also discuss a patentable subject matter rejection of claims to compositions that include peptides for interfering with replication of cancer.

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Watching Your Spouse Die on a Television Reality Show: De-Identification as a Myth, in Death and Life

Much biomedical research relies on the idea of “de-identification.” The Common Rule, the federal regulation on human subjects research, applies, as a general matter, if the researchers make some kind of intervention with the research subject or if they use “identifiable private information” about the research subject. But the “Private information must be individually identifiable (i.e., the identity of the subject is or may readily be ascertained by the investigator or associated with the information) in order for obtaining the information to constitute research involving human subjects.”

If the private information was not collected by the researcher (it comes from someone’s medical record or was collected as part of someone else’s research) and the research subject’s identity is not known to and cannot “readily be ascertained” by the researcher, it doesn’t count. No consent is required, no IRB review is required – it isn’t “human subjects research.”

And why should it be? If no one knows it is you, you cannot be hurt, or so the argument goes.

On January 2, the New York Times published an extraordinary article entitled Dying in the E.R., and on TV Without His Family’s Consent by Charles Ornstein, a reporter for ProPublica. It recounted how Anita Chanko, a 75-year-old widow, watching an ABC reality television show, NYMed, suddenly realized that she was watching her husband’s death in the emergency room. More than a year earlier, the 83-year-old man had been hit by a garbage truck while crossing the street and had died in the NewYork-Presbyterian hospital. The televised version blurred his face, but not the face of the surgeon, the description of the accident, or the sound of her late husband’s voice, asking “Does my wife know I’m here?”

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Tailored Drug Ads: Creepy or Who Cares?

Yesterday, Bloomberg reported that drugmakers are working with third-party companies to link pharmacy records with online accounts, to tailor drug ads to a person’s particular needs.  In other words, if you buy drug X at the pharmacy – the example drug trotted out in the Bloomberg piece is Viagra – a drugmaker will know you bought drug X, and will tailor online ads accordingly (buy more of drug X! buy drug Y, which treats the same condition as drug X! etc). The links between pharmacy records and online accounts, called “matchbacks,” are made without names changing hands, meaning drugmakers don’t know the names of the patients that they are targeting with particular ads.  But, nevertheless, a number of quotes in the article raise privacy concerns.  And when I tweeted this story, my spouse’s immediate response was “creepy.”

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Video of CLB’s Genetic Testing Conference is Available!

If you missed our October 13th conference on how the United States should regulate genetic testing, you can now watch video of the conference.  It was a fascinating day, with speakers from industry, government, professional associations, genetic counseling, and academia contributing their perspectives.  Check it out here!

You Don’t Miss the Cow Until the Barn is Empty*

As someone with training in both neuroscience and the law, it is maybe not surprising that I’m inclined to think (speculate, worry, etc.) about how current and future scientific and technological advances might affect society for good or bad. Luckily for me, as a fellow with the Stanford Program in Neuroscience and Society (SPINS) it’s also my job to think and write about these things, and so I do. I also read the work of many others—scientists, ethicists, lawyers, and journalists—who think and write about these issues.

But living and working in the microcosm I do, it’s easy to suffer from distorted perception—specifically, to make certain incorrect assumptions about how others process the topics I think about daily. I recognize that not everyone shares my position on a particular issue. But this recognition, in itself, overlooks a third option: that many simply may not care about the issue as much as I do. Or maybe even at all.

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2014-2015 Workshop Series: Mini-Podcast with Teneille Brown

Check out our latest mini-podcast with CLB workshop speaker Teneille Brown (University of Utah). Teneille spoke with Hank Greely about her paper “Cancer Exceptionalism and False Hope at the End of Life.”

Tun-Jen Chiang on Patentable Subject Matter

Patent law is usually justified on utilitarian grounds. To be sure, significant contrary views have appeared in recent scholarship. For example, Professor Robert Merges’ work provides a partly Lockean  account of intellectual property. The dominant view, nonetheless, is that the rules of patent law serve consequentialist goals of inducing invention, commercialization, and disclosure.  In support of this view, scholars often cite the moribund state of the “moral utility” doctrine and the Constitution itself, which empowers Congress to enact laws that would “promote the Progress of Science and Useful Arts.” Professor Tun-Jen Chiang’s forthcoming article, “Competing Visions of Patentable Subject Matter,” challenges this account as a descriptive matter insofar as it relates to the judicially recognized exclusions from patentability.

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Friedman & Lithwick on King v. Burwell: Stay Calm and Stay Calm?

Barry Friedman and Dahlia Lithwick have a post in Slate entitled “Obamacare Is Doomed! Everybody Panic!” Here.

I regularly read, enjoy, and respect SLS grad Dahlia’s work and I hope she and Professor Friedman (of NYU) are right.  And they are clearly right that panic is a not good reaction.  Panic is the worst emotion: never useful and never even enjoyable. I recommend in this case concern and righteous anger.

Cases do get taken without circuit splits, sometimes in situations of overwhelming importance, sometimes when the Court thinks a lower court decision is just blatantly wrong.  These subsidies don’t seem, to me at least, to fit the first category. I worry, a lot, that at least four and maybe five justices think they fit the second.

Friedman and Lithwick argue that this is a case that is important to decide quickly because of the disruption a negative ruling would cause.  But why, exactly, would finding out in June 2015 that you won’t have health insurance be less disruptive than finding out in, say, February 2016?

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Bad News for Obamacare – and America

Or so I think.

On Friday, November 7, the U.S. Supreme Court agreed to hear (granted the petitioner’s writ of certiorari) in King v. Burwell. In King, a panel of the Fourth Circuit unanimously rejected the argument that the federal government cannot, under the Affordable Care Act, subsidize low income consumers who buy health plans in the 36 states where the federal government, and not the states, runs the system’s “health exchanges.”

As a fan of this expanded health coverage, I think that’s bad because it puts that expansion at risk based on a drafting glitch in the Act. More broadly, though, I think it is bad because the Court’s decision to take a case like this now, with only one appellate court decision on the topic, looks unnecessary, political, and, indeed, partisan. And that, too, is bad for the country ­– and the Court.

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Audio of Prof. Mello’s Talk Is Posted!

For those who missed it, audio of Prof. Michelle Mello‘s really interesting talk, “Clinical Trials and Big Data: Moving Forward with Data Sharing,” is now available.  Listen here!