Australasian Bioethics Information

Australasian Bioethics Information ISSN 1446-2117
Links Home Archive Links Media	Friday, 21 December 2001
	Published weekly for health and legal professionals
	ABORTION / Tasmania legalises abortion WRONGFUL LIFE / French doctors may strike CLONING / Cost may make embryo cloning impractical CLONING / NZ rushing to ban human cloning STEM CELLS / Australia's first private cord blood bank LANGUAGE / The name's the thing TESTS / Breast cancer screening questioned IN BRIEF / Medical errors... the pill... older mothers ABORTION / Tasmania legalises abortion Abortion in Tasmania was effectively legalised this week after an emergency sitting of State Parliament. The new legislation allows abortions if two doctors consent, one of them a gynaecologist or obstetrician, and if continuation of the pregnancy endangers a woman's physical or mental health. It does not specify a time limit after which a child cannot be aborted. It also retrospectively legitimises abortions performed in the past. After 16 hours of debate in the lower house, the bill, which had been drafted by Minister for Health Judy Jackson, passed by 15 to 8 on a conscience vote. Three amendments aimed at restricting access to abortion moved by Deputy Premier Paul Lennon were also passed. In the debate Mr Lennon said that the bill "as currently drafted is not for the protection of women and certainly not for the protection of the unborn, but the protection of a very small group of medical professionals whose medical indemnity insurance among other things may be somewhat compromised by their actions." Ms Jackson and other MPs were vehement that the legislation was not "abortion on demand", but simply a "clarification" of existing practice. However, one Hobart doctor commented to ABI that existing practice was abortion on demand. The medical student whose complaint about abortions at the state hospital brought on the crisis, Armin Tadj, confirmed this, saying that medical consultants were approving abortions simply because a woman did not want her child. One consultant had told him, "I'm actually lying when I fill out the forms." Mr Tadj said that he felt compelled to blow the whistle on the practice. "Everyone is entitled to the truth and I'm a firm believer that the truth is what fixes problems." -- Mercury, Dec 20; Sunday Tasmanian, Dec 16 RETURN TO TOP WRONGFUL LIFE / French doctors may strike Top prenatal specialists in France have vowed to go on strike on January 1 over a court ruling allowing compensation for disabled children whose mothers were not given an opportunity to abort them. In a letter to Le Monde earlier this month, they said that the ruling "encourages doctors to worry about their own protection rather than that of their patient. It is impossible for us now to perform our work, which moreover will become uninsurable very soon." In France, all pregnant women have an ultrasound scan and they are all informed of the results. If there is the slightest suspicion that the foetus may be disabled, the mother-to-be has the right to request further tests. The head of the French college of ultrasound scanning specialists said that in Paris last year, 90% of prenatal genetic abnormalities were detected -- and only 8% of the mothers decided against abortion. Dr Xavier Mirabel, of the Collective against Handiphobia, said that "certain judges think that it is better to be dead than to be handicapped." He observed that in northern France, 85% of parents with mentally handicapped children send them to specialised schools in Belgium because the French system cannot accommodate them. -- Washington Times, Dec 17; Reuters, Dec 4 RETURN TO TOP CLONING / Cost may make embryo cloning impractical The creation of human embryos by cloning may never be useful for therapies even if the technique is perfected, the New York Times reports. "It's too laborious and costly to employ as a routine therapeutic procedure," says Dr Alan Colman, the research director at PPL Therapeutics, the Scottish company which helped to clone Dolly the sheep. Some of the obstacles are: Lack of eggs. "Therapeutic cloning" currently requires large numbers of eggs -- from 30 to 100 per patient. More than one egg donor might be needed. Dr Alan Trounson, of Monash University, says "they're never going to have enough women's eggs available to do it". Sceptical investors. Useful results may be many years off and even if the process is successful, it may not be as profitable as mass- produced drugs. The cost of customising tissue. The cost of creating a cloned embryo for each patient could be hundreds of thousands of US dollars. Regulatory problems. Because the therapy is customised for each patient, it is hard to verify the safety of each tissue batch. Dr Robert P. Lanza, of Advanced Cell Technology, the company which recently cloned human embryos, concedes that "therapeutic cloning" will be expensive, but he contends that it would be worthwhile for life-threatening diseases. Friends or relatives, he said, would donate eggs to create clones, just as people now donate kidneys. -- New York Times, Dec 18 RETURN TO TOP CLONING / NZ rushing to ban human cloning The New Zealand parliament is rushing through legislation to ban human cloning by scientists like Italian doctor Severino Antinori. It will also ban putting animal parts into human beings and genetically engineered babies. The bill will expire after two years. In the meantime the government will study the issue more closely. -- nzoom.com, Dec 19 RETURN TO TOP STEM CELLS / Australia's first private cord blood bank Australia's first private cord blood bank opened in Sydney this week. The Sydney-based company Cyprosite, which runs the bank, says that its services will be available to women across the country in hospitals which can courier blood to Sydney within 24 hours. Umbilical cord blood is a significant source of blood stem cells which can replenish blood marrow, regenerate blood-forming cells and restore immune function in people with blood disorders. The cost of the private service is $2000 for collection and $150 a year for storage. Supporters of the publicly funded National Cord Blood Bank in Melbourne criticised the initiative. Only members of the donating family can access the private bank, while public banks are open to everyone. -- Australian, Dec 18 RETURN TO TOP LANGUAGE / The name's the thing The words used to describe cloning will help to determine the outcome of the debate in the US, says the political magazine National Journal. Here are a few variants: Ronald Green, ethics adviser to Advanced Cell Technology: cloned embryos should be called "cleaved eggs" which are not "human" but "cellular human material". Johns Hopkins researcher Bert Vogelstein: "therapeutic cloning" should be called "nuclear transportation" and the word "reproductive" should be dropped from "reproductive cloning". The word "cloning" should only be used when the embryo is "intended for birth". Mary Ann Liebert, the publisher of the Advanced Cell Technology article which announced the first human clones: "embryo" is a bad word; "nuclear transfer" is also bad because it connotes nuclear reactors. Carl Feldbaum, president of the Biotechnology Industry Organisation: "embryo" should not be used to describe "a group of four to six cells" because it connotes "a child in the womb". Brent Blackwelder, president of Friends of the Earth: researchers are seeking to describe their experiments in some other way to avoid being regulated. Bill Saunders, of the Family Research Council: there is no distinction between therapeutic and reproductive cloning because both create a living human being. -- kaisernetwork.org, Dec 18 RETURN TO TOP TESTS / Breast cancer screening questioned A new study in the Lancet questions the effectiveness of mammograms in fighting breast cancer. Researchers from a Copenhagen research centre claim that the data shows that catching breast cancers early, before they can be felt, does not preventing women from dying or from having mastectomies. Cancers are equally treatable, or equally deadly, whether they are found early or late. The statistical arguments are controversial, but as a result of the study, Switzerland has decided against setting up a national mammography screening program. A number of American experts say that the Danish analysis is unconvincing and that women should continue with check-ups. A similar problem emerged recently with breast self- examination, another highly-promoted method of detection. The American Cancer Society quietly stopped promoting it after studies showed that it did not decrease cancer deaths. -- New York Times, Dec 9 RETURN TO TOP IN BRIEF / Medical errors... the pill... older mothers The number of people dying in UK hospitals from medication errors and the adverse effects of medicine rose dramatically from 200 in 1990 to 1,100 in 2000, says an audit commission. Most errors happened when the prescriber did not have access to accurate information about the medicine, patients' allergies, other medical conditions, or laboratory results. -- Reuters, Dec 18 RETURN TO TOP Women who take first or second-generation oral contraceptives are at twice the risk of having a heart attack as women who do not use them, according to a new study in the New England Journal of Medicine. The results were based on a survey of 1,173 Dutch women between the ages of 18 and 49. -- kaisernetwork.org, Dec 20 RETURN TO TOP One in ten Australian women is 35 or more when she gives birth for the first time. Sixteen per cent of all women giving birth are over 35. There are dangers in the trend. An Australian Institute of Health and Welfare study, Australia's Mothers and Babies 1999, shows that women over 35 are more likely to have low birth weight babies or babies born earlier than 37 weeks. After teenage mothers, mothers over 35 had the highest rate of stillbirths. -- The Age, Dec 17 RETURN TO TOP To subscribe to our weekly email newsletter, click here for the HTML version. click here for the text version. To cancel your newsletter subscription, click here. Australasian Bioethics Information ISSN 1446-2117 www.australasianbioethics.org Director: Dr Amin Abboud PO Box 975, Chatswood NSW 2057, Australia Editor: Michael Cook 31 Alexander St, Sandy Bay TAS 7005, Australia