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Sens. Likely To Raise Abortion-Rights Issues At Hearings For Supreme Court Nominee Sotomayor
The confirmation hearings for Supreme Court nominee Judge Sonia Sotomayor are scheduled to begin Monday, and members of the Senate Judiciary Committee are expected to question her about abortion rights and other "politically charged issues," the New York Times reports (Liptak, New York Times, 7/12). The hearing on Monday will include opening remarks from the 12 Democrats and seven Republicans on the committee, as well as an opening statement from Sotomayor. The questioning portion of the hearings is scheduled to begin on Tuesday (Sherman, AP/Houston Chronicle, 7/12). Although Sotomayor will be asked questions on abortion rights, race, foreign law and other contentious issues, she will "probably answer only a predictable few" and "will have little reason to deviate from the convention" of her predecessors, the Times reports. According to the Times, most Supreme Court nominees since former Justice Sandra Day O"Connor have followed the same strategy of speaking knowledgably about precedent and law without specifically saying how they would rule (New York Times, 7/12).According to USA Today, senators from both parties will use Sotomayor"s hearings not only to lay out their views but to "establish the tone for any future nominations" by President Obama (Biskupic, USA Today, 7/13). Because Sotomayor is replacing Justice David Souter, who retired in June, her addition to the court is not expected to change the balance of power (AP/Houston Chronicle, 7/12).Although committee members are expected to ask Sotomayor about her position on abortion rights, the issue is not likely to play as large a role as in previous Supreme Court nomination hearings, the Times reports. It is possible that Democrats will raise the issue as they seek reassurance that Sotomayor would uphold the tenets of Roe v. Wade if such a case were presented to her as a justice. While most court nominees have not explicitly said if they would uphold Roe, Sotomayor will probably "respond in a sort of code" and say that she respects precedent on court rulings related to abortion rights, according to the Times (New York Times, 7/12). Sotomayor has not ruled on a constitutional right to privacy, and the decisions she has written that briefly deal with abortion rights do not reveal a specific stance on that issue, according to USA Today. In one decision regarding the prohibition of federal funding from international family planning groups that support abortion rights, Sotomayor wrote that the government is "free to favor the antiabortion position over the pro-choice position, and can do so with public funds" (USA Today, 7/13).Nancy Northup, president of the Center for Reproductive Freedom, said the group has pressed Democratic senators to ask Sotomayor about her views on abortion rights. Northup said, "Constitutional protection for abortion rights should not be treated differently than other important questions of constitutional law" (New York Times, 7/12). Some women"s rights groups have remained relatively quiet in expressing their support for Sotomayor, citing her limited record on abortion rights, the AP/Google.com reports. National Organization for Women Vice President Melody Drnach said that the group has been publicly focusing on the health care reform debate but that it would soon step up efforts behind the scenes to lobby support for Sotomayor. She added that despite Sotomayor"s limited ruling on abortion rights, the group feels it would be "very, very surprising if the president and his team would nominate somebody who was not going to believe in full equality for women and girls to be a part of the highest court in the land." NARAL Pro-Choice America officials said the group has focused its res on urging senators to ask Sotomayor questions about the right to privacy during the hearings. Marcia Greenberger of the National Women"s Law Center said women"s groups are not withholding support for Sotomayor but have been busy examining her record. The National Association of Women Lawyers rated Sotomayor as "highly qualified" but noted that

COAG Should Maintain Focus On Improving Indigenous Health, Australia
Tomorrow"s Council of Australian Governments (COAG) meeting is a crucial opportunity to focus on achieving concrete long-term health improvements for Indigenous people, the AMA said.
News of the day
Obesity Charity Launches First Awareness Week
The country"s pre-eminent obesity charity, the National Obesity Forum is staging its first consumer awareness week in November this year.
Endocrinology

Alzheimer's Disease: Disclosing Genetic Risk Does Not Cause Psychological Distress

Researchers from Boston University School of Medicine (BUSM) have shown that disclosing genetic risk information to adult children of patients with Alzheimer"s disease (AD) who request this information does not result in significant short-term psychological distress. The report from the REVEAL Study*, which appears in the July 16 issue of the New England Journal of Medicine, is the first randomized trial to disclose to participants whether or not they carried the íµ4 variant of the APOE gene, a variant that has been found to increase the risk of developing AD. The study demonstrated that test-related distress was reduced among those who learned that they were APOE íµ4 negative, and was only transiently increased among those who learned they were APOE íµ4 positive. The study also showed that persons with high levels of emotional distress before undergoing genetic testing were more likely to have emotional difficulties after disclosure. The study comes at a time when gene variants that are associated with risks of common diseases are being rapidly discovered and genetic testing is now being marketed by direct-to-consumer genetics testing companies such as 23andMe, Navigenics and DeCodeMe. Considerable controversy has accompanied the launch of these companies and one area of concern has been the potential for psychological harm if individuals learn they are at increased risk for diseases that have no treatment, such as AD. The BUSM researchers, along with their collaborators at the University of Michigan, Weill Cornell Medical College and Case Western Reserve University School of Medicine randomly assigned 162 asymptomatic adults who had a parent with Alzheimer"s disease to two groups: the disclosure group, who received a risk assessment for their chance to develop AD that included their APOE genotyping results, and the nondisclosure group, who received a risk assessment for AD that excluded their APOE genotyping status. They then measured symptoms of anxiety, depression, and test-related distress six weeks, six months, and one year after disclosure or nondisclosure and found no significant differences between the two groups in measures of anxiety, depression or test-related distress. Comparisons between the subgroup of participants carrying the APOE íµ4 variant and those who did not learn their genotype revealed no significant differences, suggesting that learning about increased risk did not cause psychological harm. However, the íµ4 negative subgroup had a significantly lower level of test-related distress than did the íµ4 positive subgroup, suggesting a psychological benefit to those who learned they were at lower risk. "Study participants who learned they were íµ4 positive and were therefore at increased risk for Alzheimer"s disease showed no more anxiety, depression, or test-related distress than those who did not learn their genotype," said lead author Robert C. Green, MD, MPH, a professor of neurology, genetics and epidemiology at BUSM as well as a fellow in genetics at Harvard Medical School, "but those who learned they were íµ4 negative experienced considerable relief." "It"s important to recognize that our participants were carefully screened for pre-existing emotional problems and that trained genetic counselors disclosed the information," adds Green, "so it is not the same thing as simply providing risk information to anyone who asks. Nevertheless, our work supports the notion that learning genetic risk information can be a positive and empowering experience for some people, even when the disease is frightening and the genetic information has no clear medical benefit. " According to the BUSM researchers, larger studies that follow participants for more than one year will be required to detect uncommon and long-term effects, such as delayed emotional repercussions and injudicious life decisions. These studies are currently underway in new REVEAL Study trials. Funding for this study was provided by the Ethical, Legal and Social Implications (ELSI) Branch of the National Human Genome Research Institute (NHGRI); by a Mentoring Award from the National Institute on Aging; and by a grant from NHGRI at Duke University for Centers of Excellence in ELSI Research. *REVEAL (Risk Evaluation and Education for Alzheimer"s Disease) Study Disclosure: Two co-authors (Drs. Relkin and Farrer) received consulting fees from Smart Genetics, which provided direct-to-consumer APOE genotyping from March 2008 through October 2008, when it ceased operations. No other potential conflict of interest to this article was reported. Gina M. DiGravio Boston University Medical Center


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