Two very different stories percolating through this morning's news share one of the key themes of modern life: When making any decision on behalf of yourself, your neighbors, or strangers, how much risk is tolerable, and at what cost?
In our own lives, how we answer that question in one case rarely translates to the next. (How many of you new parents who tossed out all your plastic baby bottles in fear of BPA still yak on your cell phone while driving?) Fear, convenience, and competing costs and risks all play a role in how we decide.
And so it is with today's news -- one story about where to build a bio-safety lab and another about how stringent a surgical team should be to make certain they don't spread a very rare disease.
First, on the weather front: Texas and Kansas have been tussling for several months over whether the government should build a new $523 million bio-safety lab in Kansas, as the Homeland Security Administration has been planning. A group of Texans sued to stop the project, claiming that putting a research lab that studies foot-and-mouth disease, African swine fever and other high-risk viruses in Tornado Alley is asking for trouble. The Cattleman's Association agrees. But Kansans are crying foul -- they say the court case is just sour grapes from Texans still hoping to grab the job-rich facility for themselves.
Watch for the battle to escalate this week. The Washington Post this morning reports that the Government Accountability Office thinks the Department of Homeland Security "greatly underestimated the chance of accidental release and major contamination" of such research. The issue is likely to boil over again, the Post says, at a Congressional hearing planned for Thursday.
(More on tainted scalpels and the cost of protecting blood from brain disease after the jump)
Meanwhile from the operating room: The University of Wisconsin Hospital late last week had to warn 53 patients that they have an
'extremely small risk' of contracting a rare, fatal brain disorder because of the instruments that were used in their operations,
according to the Milwaukee Journal Sentinel. The problem arose when surgeons reused surgical instruments that they'd used on a woman who they later discovered had Creutzfeldt-Jakob disease (CJD), a rare but infectious brain condition caused by a mis-folding protein similar to the one that's behind Mad Cow Disease.
The instruments had been surgically sterilized, but not put through the extra cleaning needed to kill prions, the infectious proteins that trigger CJD. A Denver specialist in the illness says the Wisconsin surgical team's decision not to do the more stringent cleaning routinely was understandable. He told the Journal Sentinel,
The metal gets corroded and pitted after a few cycles. These instruments are ridiculously expensive. It would cost tens of thousands of dollars to throw out instruments like that.
UW hospital officials say that if they'd known the patient had CJD they would have used disposable instruments.
But in the United Kingdom, where CJD has been a rare, but continuing problem for years, a health advisory committee last week told the National Health Service that a filter that removes CJD particles from blood that's to be transfused is "too expensive" for routine use.
According to the Daily Mail, British health officials will decide in October whether to start using the filter anyway. The Daily Mail story quotes the wife of a man who died in 2003 after contracting vCJD through a blood transfusion.
As a nurse, I know there has to be good evidence that it is safe and it works. As the wife of someone who died...I think cost should not be the reason to stop it being introduced.
And that, friends, is one of healthcare's biggest conundrums: How much risk do we damp down, at how much cost?
What do you think?