Australasian Bioethics Information

Friday, 17 October 2003 · No. 96         ISSN 1446-2117
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BIOETHICS: World scientists go to bat for research cloning

IN THIS WEEK'S NEWSLETTER

  • Chinese doctors create babies with two mothers
  • Chinese tightening standards in bioethics
  • French president calls for bioethics treaty
  • Test threaten disappearance of Down Syndrome children
  • German researchers "willingly" worked for Nazis
  • Florida court lets brain-damaged woman die
  • Italian health minister attacks euthanasia
  • Adult stem cell research advances
  • Adult stem cell potential challenged
  • Frozen embryos pose risk of ectopic pregnancy
  • IN BRIEF: doctors and violence ~ C-sections

    Chinese doctors create babies with two mothers

    Chinese doctors and an American fertility specialist have reported the creation of babies with the cloning technique which produced Dolly the sheep. Researchers at Sun Yat-sen University in Guangzhou implanted three embryos in the womb of a 30-year-old infertile woman last year. A triplet pregnancy resulted, they announced at the annual meeting of the American Society for Reproduction Medicine in San Antonio, Texas this week. One of the foetuses was "reduced" to ensure the viability of the pregnancy, but the other two died anyway at 24 and 29 weeks.

    With this technique, called nuclear transfer, the doctors fertilised an egg from their patient and an egg from a donor. Two embryos resulted. The nucleus of both women's embryos was extracted, and the patient's genetic material was inserted into the empty "eggshell" of the other embryo which, however, contained mitochondria with the other woman's DNA. The procedure gives the infertile woman's embryo the healthy mitochondria it needs to develop -- but it also results in a child with genetic material from one father and two mothers.

    Dr James Grifo The American specialist, Dr James Grifo, of New York University School of Medicine, said that it was irresponsible to confuse his technique with cloning. It simply allows a couple to have their genetic baby, he said, not a clone. Experts in reproductive medicine, however, were taken aback by Dr Grifo's cavalier attitude towards both US and Chinese regulations.

    After the US Food and Drug Administration had given him two warnings about past experiments with nuclear transfer, he brought his work to China where he could work without onerous restrictions. Even IVF pioneer Lord Robert Winston said that it was an unethical and unjustifiable experiment.

    Prominent US bioethicist Jeffrey Kahn, of the University of Minnesota, asked why Dr Grifo, a former president of the Society for Assisted Reproductive Technology, wanted to escape regulations in his own country. "What's next," he said. "A ship out in international waters?" And he pointed out that although Dr Grifo and his colleagues did not clone a baby, his experiment does show that cloning may be possible.

    One of the scientists who helped create Dolly the sheep, Alan Colman, now the chief scientific officer of ES Cell International in Singapore, had reservations about the wisdom of evading regulatory hurdles. He noted that Germany holds stem-cell scientists accountable for their actions no matter where they do their work. If a German researcher does unauthorised research abroad, he can be prosecuted when he returns. ~ Baltimore Sun, Oct 17; New York Times, Oct 15 

    Chinese tightening standards in bioethics

    Chinese scientists are trying to tighten lax standards in bioethics, says a New Zealand academic after a visit to Chinese medical schools. Professor Donald Evans, of the Bioethics Research Centre at the University of Otago, believes that China does not have a deliberate policy of encouraging research which is proscribed in other countries.

    In fact, China recently banned human cloning, trading in eggs for profit, and human nuclear transfer (as reported above). Its apparent "Wild West" approach is more the result of the difficulty of monitoring bioethics standards in such an immense country. He has recently been asked to train Chinese in bioethics. "There is an awareness at the highest levels that much need to be done to bring ethical review practices more into line with international standards," he says. ~ CNSNews.com, Oct 16 

    French president calls for bioethics treaty

    French President Jacques Chirac French President Jacques Chirac has called for an international treaty to set standards in bioethics in the face of challenges like euthanasia, surrogate motherhood and trafficking in human organs. In a speech to UNESCO, Chirac said "These are no longer just the worries of prophets of evil. These are the realities of today, driven by the absence of morality, the bait of profit or even madness." He also called for an independent body of experts with "high moral values". ~ AFP, Oct 14 

    Test threatens disappearance of Down's children

    ABC's 7.30 Report has reported that a new pap smear which can accurately test for Down Syndrome babies could lead to their elimination (see ABI, July 18). "It's now clear that without a major education campaign to accompany mass screening for Down Syndrome, we may never see children like this again," says journalist Mark Bannerman. At the moment, 80% of Down Syndrome children are born to women who have not been tested. A survey in a Melbourne hospital has suggested that 98% of women who are tested will have an abortion.

    Bannerman tried to redress widespread misconceptions about Down Syndrome. He interviewed a young Down Syndrome woman who is working with computers and has played roles on stage and TV shows. The potential of people with Down Syndrome "doesn't seem to have filtered through to those most in need of hearing it... doctors," says Bannerman. Instead, most doctors advise women to have an abortion. One mother told him that she would probably have aborted her Down Syndrome daughter if she had had the test. Now she feels differently: "She is my joy. She makes my heart burst, she really does." ~ 7.30 Report, Oct 14 

    German researchers "willingly" worked for Nazis

    German's medical and scientific establishment gave the Nazi regime willing cooperation in the Hitler years, its main research agency (DFG) has concluded after a thorough review of archives. "We have proven that the DFG was willingly involved in the full range of medical crimes during the Nazi era," says Wolfgang Eckart, of the University of Heidelberg.

    Correspondence shows that the head of the DFG's medical section was quite aware of the ghastly Nazi research projects. In one letter, for instance, the head of an anthropology institute spoke of "excellent conditions for researchers in Auschwitz". A tropical disease expert infected 1,200 POWs, including many Polish priests, in search of a malaria vaccine. About 400 died. "During the war, the DFG deliberately subordinated medical ethics to the production of fast results," says Marion Hulverscheidt, a science historian at the University of Heidelberg. ~ Nature, Oct 16

  • After sifting through recently discovered documents, German historians have given a name to the first victim of Hitler's euthanasia program. He was five-month-old Gerhard Kretschmar, the son of a farm hand who had written to the Fuhrer requesting euthanasia for the blind and deformed child. Until now, Gerhard had only been referred to as "Case K". A new report gives the names and case details of 200,000 victims of an estimated 275,000 victims of "mercy killing". ~ Telegraph (UK), Oct 12 

    Florida court lets brain-damaged woman die

    A long and bitter end-of-life case in Florida is drawing to a close after a court ordered a feeding tube be removed from a woman who had been in a persistent vegetative state since 1990. She is expected to die "comfortably" within a fortnight.

    For the last five years the husband and the parents of 39-year-old Theresa "Terri" Schiavo been at loggerheads in a five-year court battle to keep her alive. Her husband Michael contends that she is unconscious and did not want her life prolonged artificially.

    Her parents believe that the husband just wants his wife's money. They claim that shortly before her brain damage she had told them that she wanted a divorce. They are convinced that she is conscious and responds to them. Doctors have testified on their behalf that with intensive therapy she could eat and even speak.

    The case has polarised public opinion across the US. Florida Governor Jeb Bush, the President's brother, supported the campaign for Terri's right to live. The "ugliest end-of-life case ever", commented bioethicist Kenneth Goodman, of the University of Miami. ~ Reuters, Oct 16; New York Times, Oct 15 

    Italian health minister attacks euthanasia

    Italian Health Minister Girolamo Sirchia In sharp contrast to the outcome of the Schiavo case, the Italian Health Minister, Girolamo Sirchia, has described calls to remove forced feeding tubes of incompetent patients "one of the subtle ways to carry out euthanasia". The week before he explained that he was not inspired to oppose euthanasia by "religious motivations, but by foundations on which society is based... [we] cannot accept that someone, even when asked by someone who is suffering and perhaps is upset by the conditions of the sick person, can put an end to someone's existence. Accepting this would open a terrible scenario." ~ AGI, Oct 9,13

    In neighbouring France, the Justice Minister has launched an internet debate about euthanasia on the ministry website following the mercy killing of the blind and mute quadriplegic Vincent Humbert (see ABI, Sept 26). The French Parliament has also created a special commission to investigate the issue. ~ AFP, Oct 12 

    Adult stem cell research advances

    Within five years adult stem cells taken from the eye could help to cure some forms of blindness, says a researcher from the University of Toronto. Dr Derek Van der Kooy told an international stem cell conference in Melbourne that the first disease to be treated would probably be retinitis pigmentosa, which kills photoreceptor cells in the eye which react to light. Dr Van der Kooy says that "we haven't been able to grow retinal cells from embryonic stem cells yet. This will be one disease that is treated with adult stem cells first." ~ Age, Oct 12

    German scientists have found that damage from a heart attack can be reduced by infusing bone marrow stem cells into the coronary arteries that supply blood to the heart muscle. In an article in the journal Circulation, they said that the reduction in damage size was directly related to improvements in cardiac function. They emphasised that large randomised trials are need to prove the success of the technique. ~ Reuters Health, Oct 13 

    Adult stem cell potential challenged

    Studies which suggested that some types of bone marrow stem cells were just as versatile as embryonic stem cells were wrong, say researchers from the University of California at San Francisco. In an article in Nature, Dr Arturo Alvarez-Buyalla contends that these adult stem cells fused with heart, liver and brain cells rather than changed into them. Dr Alvarez-Buyalla and the chairman of the Stem Cell Task Force at the National Institutes of Health used the results to argue that experiments on embryonic stem cells must continue since a less ethically controversial alternative may not exist for some types of therapies.

    A team from Stanford University has reported a similar phenomenon in the journal Science. It found that adult bone marrow cells fused with cells in the brain known as Purkinje neurons. Professor Helen Blau also used experiment to insist that all types of stem cells should be studied, not just adult stem cells. ~ Washington Post, Oct 13 

    Frozen embryos pose risk of ectopic pregnancy

    frozen embryos in IVF laboratory Women who conceive using frozen embryos are 17 times more likely to have a dangerous ectopic pregnancy than conventional IVF patients, according to research presented at the American Society for Reproductive Medicine (ASRM) conference in San Antonio, Texas. US researchers at Brown University found that nearly one-third of all frozen embryo pregnancies are ectopic, with the embryo implanting in one of the Fallopian tubes rather than in the uterus.

    In Australia, about 15% of assisted reproduction pregnancies are achieved with frozen embryos. About 1 in 2,000 women with ectopic pregnancies dies in Western countries. Dr David Keefe said that no reason had yet been found to explain why frozen embryos lead to ectopic pregnancies. ~ Times (London), Oct 15

    ASRM San Antonio conference In other reports from the ASRM annual conference:

  • Most American couples who have produced frozen embryos are uncertain what to do with them and had not foreseen how difficult it would be to make decisions about their fate. Dr Robert Nachtigall, of the University of California at San Francisco, says that all couples recognised their embryos' potential for life, with some believing that they were living beings capable of suffering and others believing that they were children with interests to be considered. ~ Reuters Health, Oct 14

  • Women who have multiple births as a result of IVF treatment are more likely to be depressed and unhappy with the results than mothers of single babies, say researchers from Harvard Medical School. Many women were left questioning whether they should have had IVF treatment. (About 1 in 5 of Australian IVF pregnancies results in multiple births.) "The results indicate that multiple births results in significant social risks which compound previously recognised medical risks," says Marcia Ellison, the lead researcher. ~ Independent (UK), Oct 16

  • The American public believes that scientists working in genetics and in reproductive medicine do not have internally or externally imposed ethical limits on their research and cannot be trusted, the Genetics and Public Policy Center at Johns Hopkins University reported to the ASRM conference. Focus groups highlighted concerns that new developments will be hard to regulate because doctors and scientists and their patients can travel to more liberal jurisdictions. There was also concern that the technology will go underground. ~ Reuters Health, Oct 15

  • Oregon scientists at the National Primate Research Center have achieved the first-ever live birth using transplanted ovarian tissue with a rhesus monkey. When the technique is refined for humans, it will make it possible for women to freeze ovarian tissue and reimplant it after chemotherapy or later in life when they are ready to have children. ~ BBC, Oct 13

  • A scientist at the University of Utah has proposed a donor egg card scheme. It would allow doctors to harvest eggs from young women killed in accidents so that childless women could have children. Reproductive ethics groups rejected the idea, arguing that it would create babies whose mothers would have died before they were even conceived. ~ Evening Standard (UK), Oct 17 

    IN BRIEF: doctors and violence ~ C-sections

  • The threat of violence has become an accepted part of the job for many doctors in the UK, a report has found. Half of all doctors experience some form of violence or abuse from patients, including verbal abuse and physical assaults. GPs, accident and emergency doctors and doctors working in psychiatry and obstetrics and gynaecology were the most likely to experience abuse. ~ BMJ.com, Oct 18

  • Increasing evidence that caesarean sections are safe and decreasing numbers of children could lead to natural births becoming obsolete, doctors have warned in an article in the Australian and New Zealand Journal of Obstetrics and Gynaecology. If evidence mounts that C-sections are just as safe, or safer, doctors would begin recommending them as a matter of course. "Everyone practices defensively now," says Dr Stephen Robson, from the Canberra Hospital. "People are so nervous they would abandon vaginal delivery with any excuse." ~ Age, Oct 16 
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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