Tube feeding debate in Melbourne
A Melbourne judge will decide next week whether dying patients must be kept alive with tube feeding or whether it can be refused by a patient or their guardian. Justice Stuart Morris, of Victoria's Supreme Court, has heard arguments about the fate of a 68-year-old woman known as "BWV" who has a progressive and incurable form of dementia and has been in a vegetative state for three years.

At the heart of the case is whether a feeding tube constitutes basic palliative care which should be given to every patient or whether it is a burdensome medical procedure which can be refused under State law. The Victorian Public Advocate, with the support of the woman's family, wants to withdraw the feeding tube.

The case is being followed with intense interest because the legal status of tube feeding is not clear and because of its implications for the euthanasia debate. (Euthanasia campaigner Dr Philip Nitschke made a brief appearance in the court on Friday.)

In practice, tubes are often withdrawn from dying and unconscious patients. However, hospitals feel unsure whether this is legal and are anxiously awaiting the outcome. A recent discussion paper drawn up by members of the Southern Healthcare Network's bioethics committee in Melbourne says that it is a medical procedure. "Many of my colleagues were concerned that people were being referred to them for tube feeding by other doctors because they felt they had to by law," says Dr Michael Ashby, the head of Monash Medical Centre's Palliative Care unit.

On the other hand, a barrister for Right to Life, Jeanette Morrish QC, said that legally sanctioned withdrawal of the feeding tube would create a dangerous precedent. She argued that guardians should not be able to make life and death decisions without scrutiny as they could be used to mask murderous intentions. ~ The Age, May 21, 22, 23, 24  

Nitschke to give death machine demo next week
Dr Philip Nitschke is hold a three-day conference in Sydney from May 30 at which he will demonstrate his carbon monoxide suicide machine for the first time in public. The conference, to be held at the YWCA Centre, is called Killing Me Softly: Death and Dying in Australia. It will be attended by some former federal ministers and several husbands who have helped their wives to die. Former Federal Health Minister Peter Baume is the opening speaker.

Later in the year, Dr Nitschke will also organise workshops in Brisbane, Sydney and Melbourne at which people can learn how to build their own machines. He says that he is prepared for a legal stoush over the legality of these workshops which are specifically aimed at people who are not currently sick. Police say that assisting a suicide is illegal but that workshops which instruct people how to kill themselves are probably not. ~ Exit Australia website; Australian, May 19, 20

NZ GPs who euthanase patients don't consult them
Some New Zealand doctors who have participated in cases of euthanasia have not obtained consent from their patient, says University of Auckland psychologist Kay Mitchell. According to a survey she conducted, 39 NZ doctors admit that they had performed euthanasia or helped a patient commit suicide in one year. The latest New Zealand GP magazine has now reported that 16 of these patients were not competent and one had signed a non-resuscitation order.

US scientists slam Bush's stem cell policy
An editorial in the leading magazine Science has criticised America's restrictive policy on embryonic stem cell research. At the moment, only 11 stem cell lines are currently available for federally-funded research and these are contaminated with the mouse cells used to spur their growth. The editor-in-chief of Science, Donald Kennedy, says that "much of the scientific community remains unconvinced that the cell lines now available meet research needs." Fund-famished scientists might be lured to the UK where embryo research is supported by the government, he warned.

There is powerful support for this view in Congress, where leaders of the Senate panel which funds medical research said this week that they were outraged by the restrictions. "The hands of the scientists shouldn't be tied in any way," said Senator Arlen Spectre. ~ AP, May 23; AFP, May 8  

Hungarian debate over sex selection
A leading Hungarian geneticist has stirred up a hornet's nest in his country by contending that legalising IVF sex selection techniques would help raise its plummeting birth rate. Endre Czeizel, a former director of the local World Health Organisation office and a former head of the National Health Institute's genetics department, says that most Hungarians who already had two or three children of one sex would have another child if they could be sure it would be of the opposite sex.

However, the Hungarian government maintains that sex selection is unethical. "We are against this technique and I think I can speak on behalf of the entire population," said a spokesman for the health ministry. The distinguished Dr Czeizel is a controversial figure. Last year he was convicted of participating in an illegal trans- Atlantic infant adoption scheme. ~ The Age, May 20  

Psychosexual disorder could hit IVF children
Adoption workers in the UK have warned that IVF children who are reunited with their siblings or parents are in danger of a psychosexual problem called "genetic sexual attraction". Post-adoption agencies say that nearly half of reunions between siblings or parents and offspring result in obsessive attachments and emotions which sometimes lead to incest. There has been no serious scientific research into the phenomenon, although there is abundant anecdotal evidence. A Chicago woman, Barbara Gonyo, has written a book describing the disorder. She believes that the romantic obsessions which sometimes occur following an adoption reunion are a result of "missed bonding". "Genetic sexual attraction associated with IVF births is a time bomb waiting to go off," warns Sue Cowling, the deputy director of the Post-Adoption Centre in the UK. ~ Guardian, May 17  

New bioethics magazine launched
A major new magazine on technology, ethics and politics has been launched in the US. The first issue of The New Atlantis, edited by Eric Cohen, a prominent figure in American bioethical debates, features articles by President Bush's top bioethics adviser, Dr Leon Kass, and a discussion of the future of bioethics. It will seek "to clarify the nation's moral and political understanding of all areas of technology -- from stem cells to hydrogen cells to weapons of mass destruction" and to provide "an ongoing survey of technology and society that provides brief commentary on the major scientific advances and political debates". The web address for the magazine is www.thenewatlantis.com.  

IN BRIEF: biotech and NZ abortions; bambino sold for spare parts; coma donor; sex selection technique