IN THIS WEEK'S NEWSLETTER
Genetic screening for elite sportsmen
The gene, ACTN3, has two variants, one of which disposes people to become sprinters and the other to become stayers. Although elite sportsmen need fitness, motivation, coaching, state-of-the-art equipment and a host of other qualities as well to succeed, Dr North believes that 10 to 30 genes may be crucial determinants of sporting ability. Her studies of elite athletes at the Australian Institute of Sport (AIS) will probably place genetic screening amongst a battery of tests on young hopefuls.
Because of the ethical implications of this and other discoveries, the Australian Law Reform Commission is currently preparing a position paper on sport and genetics. And in July the Australian Sports Commission brought together 70 leading expert in genetics, sports medicine and the law for a Genetics in Sports Forum.
Dr North's discovery raises such touchy questions as whether aspiring athletes whose genetic profile is not statistically promising should get sports scholarships. Successful selection is crucial if Australia is to continue to excel in world sport. "If we simply sit back and let the cream rise to the top, we're in trouble," says Dr Jason Gulbin, the national talent search coordinator at the AIS. With Olympic gold medals "costing" Australian tax-payers about $37 million each, genetic testing could play a key role in keeping down costs. ~ The Bulletin, Aug 27; New Scientist, Aug 27; Genome News Network, Aug 7 Your DNA is you, say New York cops
However, some experts have reservations about Mayor Michael Bloomberg's initiative. "Statutes of limitations exist for sound reasons of justice and fairness as well as practicality," says Ben Rich, a bioethicist at the University of California Davis School of Medicine. "Someone who is put in the position of defending himself against criminal charges decades after he allegedly perpetrated the offence is placed at an incredible disadvantage." ~ The Scientist, Aug 21 "Terminal sedation" is not euthanasia, say Dutch doctors
A recent study of end-of-life decisions in the Netherlands suggested that between 4% and 10% of all deaths (between 6,000 and 14,000 patients) occurred as a result of terminal sedation. The line between euthanasia and TS might seem clear, but in practice, it can overlap with euthanasia.
Health minister Clémence Ross clarified that terminal sedation was reducing patients' consciousness with drugs so that they are no longer aware of their surroundings and sufferings. He described it as part of normal medical practice. Euthanasia, on the other hand, occurs at a patient's request and results in death in a short time.
Critics of TS have pointed out that in the US euthanasia campaigners have settled on TS as a kind of slow euthanasia which gets around legal bans on mercy killing. And Nancy Valko, an American nurse who is an severe critic of euthanasia, claims that TS as a form of "comfort care" may well be approaching epidemic proportions. ~ BMJ.com, Aug 30 Depression amongst elderly can be deadly
Depression can be hard to detect in older people, say doctors, even though it may affect about 20% of America's elderly. They can even have all the symptoms of depression except feeling depressed, a condition experts term "depression without sadness".
"The person may also look apathetic rather than overly depressed and is likely to deny he or she is depressed," says Dr Howard Berkowitz, of Maimonides Medical Center in New York City. Social support plays a big part in depression. "Usually the depressed patient is an isolated patient," says Dr Vincent Marchello, of the Metropolitan Jewish Geriatric Center. "Getting patients out of the house, getting them more involved, is so important." ~ HealthDayNews, Aug 24 Parkinson's cure with aborted foetuses fails again
Dr Olanaw fears that this failure will reduce support not only for the use of tissue from aborted foetuses but also for stem cell research. "Unless we resolve this, it will have a tremendous impact on this and other issues in stem-cell research," he says. The dyskenesias seem to be caused by poorly functioning transplants which have been disabled or destroyed by the patient's immune system. This is a troubling precedent for stem cell therapies.
Paradoxically, the leading journal Nature contended in an editorial that Olanaw's failure showed the need for more government funding, rather than less, for similar experiments. Publicly funded research was ethical and open to peer review, it said, and failure can be analysed by other scientists. Privately-funded research conducted behind closed doors was secret and unavailable for critical review by other scientists. ~ Nature, Aug 28 Australian breakthrough with embryonic stem cells
Culture medium may damage IVF embryos
Animal reproduction physiologist George Seidel, of Colorado State University, says that the problem seems to be long-term culture of embryos before implantation. The genes tend to be altered in different ways, depending upon the ingredients used in the culture medium. The problem could be made worse by using foetal calf serum.
The essential message is that the more an embryo is manipulated, the more damage may be done. "There seems to be a progression," Dr Seidel says. If an embryo is cultivated just briefly, "there may be a little problem. If IVF is used, it's a little worse. And if you've matured an oocyte," it's even worse. Cloning is the most damaging of all. ~ Newsday, Aug 26
13 years to uncover IVF error
From the age of five, Daniel asked whether the man was really his father and his mother requested a DNA test. Mr E, however, refused and it took six years, 80 secret hearings of the Family Division of the UK's High Court and 100,000 pounds in legal fees to force him to acquiesce. The tests showed that Mr E was not in fact the father and that there had been an error in the IVF process. With much of the paperwork missing from the clinic, which no longer does IVF, it will be impossible for Daniel to trace the real father. ~ Evening Standard (UK), Aug 22 
Australian Jana Pittman's stunning victory in the 400 metre hurdles in this week's world championships in Paris might happen a bit more often after a discovery by a Sydney geneticist. Dr Kathryn North of the University of Sydney has found a gene specifically linked to athletic performance.
The DNA of unknown sex offenders will be charged with their crimes in an effort by New York City police to circumvent the statute of limitations. The John Doe Indictment Project will make it possible for a rapist to be tried for a crime committed more than ten years ago, the time after which no prosecutions are permitted.
The Dutch ministers of health and justice have rejected a call by the attorney-general to have "terminal sedation" (TS) governed by the same legal controls as euthanasia. Dutch doctors angrily rejected his proposal and described the prospect of legal meddling in normal medical practice as "frightening".
Undiagnosed and untreated depression is significant cause of death amongst the elderly in the US, according to an article in HealthDayNews. Although people 65 and older comprise only 13% of the American population, they represented 18% of all suicides. However, depression also kills simply by reducing the ability of elderly people to cope with their illnesses by taking medication and eating correctly, says Barry Lebowitz, director of treatment research at the National Institute of Mental Health.
Controversial research using transplanted nerve tissue from aborted foetuses to cure Parkinson's disease has failed for a second time. Scientists at the Mount Sinai School of Medicine led by Warren Olanaw injected foetal tissue into the brains of patients with Parkinson's disease without recording any significant improvement. In fact, the treatment caused more than half of them to suffer dyskinesias, or jerky involuntary movements. In an earlier experiment by Dr Curt Freed, of the University of Colorado, only 15% had dyskinesias.
Scientists at the National Stem Cell Centre have turned embryonic stem cells into lung cells, a first step towards therapies which would allow lung cells to cure themselves. Research leader Dr Richard Mollard, an Australian who recently returned from France to work for Professor Alan Trounson, says that this is the first time that lung cells have been grown successfully. He said that it was still too soon to begin clinical trials. ~ Herald-Sun, Aug 24
The culture media used in IVF is responsible for a small number of very serious birth defects, US researchers have told a conference of science journalists. A genetic control pattern called imprinting can sometimes be disrupted and cause a disorder called Beckwith-Wiedemann syndrome (see ABI, No 56). "We believe that a five per cent prevalence of children conceived after assisted reproductive technology is most likely an underestimate," says Dr Andrew Feinberg, of Johns Hopkins Medical Institutions.
More facts have emerged about the 13-year-old British boy who discovered that he was an "IVF mistake" (see last week's newsletter) which show that IVF and family breakdown are a toxic mix. The boy, Daniel, was conceived through IVF when his mother Pauline was married to Mr E in an effort to save their rocky marriage. It failed and the couple divorced, with Pauline marrying again. However, Mr E demanded fortnightly weekend custody of Daniel.
Dozens of hospitals in the US are adding operating rooms for surgery which shrinks the stomachs of severely obese people. With some bariatric surgeons fully scheduled 12 months in advance, hundreds of doctors have entered the field. At an average cost of US$25,000 per procedure, spending on bariatric surgery is now approaching US$3 billion a year.
As many as 20,000 people may have died in the heat wave which has swept through Europe in August. The toll was worst in France -- 14,000 deaths -- and prompted a national crisis of conscience. Most of the dead were elderly and died alone at home or in overwhelmed hospitals or nursing homes. At least 450 of them were unidentified and will be buried in pauper graves. "450 forgotten deaths. Everyone is guilty" screamed Le Parisien newspaper. ~ Reuters, Aug 27
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Australasian Bioethics Information
ISSN 1446-2117
Website:www.australasianbioethics.org
Director: Dr Amin Abboud
Editor: Michael Cook
New Zealand Associate: Carolyn Moynihan