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Friday, 14 November 2003     ·     Issue 101
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BIOETHICS: UK authority rules out sex selection

IN THIS ISSUE OF BIO-EDGE


     
Aborted tissue a scarce and useful resource, says Australian researcher
     
Nitschke to use Vegemite jars in suicide workshops
     
Tighter regulation of American IVF sought
     
High approval for Australian IVF
     
PGD in Sydney used mostly for sex selection
     
IVF coming to Kenya
     
Euthanasia mooted in Nigeria
     
British women trade off children for the "good life"
     
Call to make brain scans confidential
     
Face transplants premature, says UK report
     
Singapore issues guidelines on embryo research
     
Psychiatrists cannot be forced to act against conscience
     
IN BRIEF: foetal cell transplants ~ UK euthanasia
        ~ EU stem cell funding ~ Israeli sperm harvesting

Aborted tissue a scarce and useful resource, says Australian researcher

Professor Bernie Tuch, Diabetes Transplant Unit Tissue from more than 100 second trimester foetuses is picked over annually and distributed to Australian researchers by the Diabetes Transplant Unit (DTU) in Sydney, writes Dr Bernie Tuch in the Medical Journal of Australia. Dr Tuch argues that human foetal tissue is a "scarce resource" and that the benefits of research with it deserve more recognition. Experiments using aborted foetal tissue for growing organs and for stem cell research could even begin again in the near future. However, he complains that his work could be hampered by red tape which may be required to use tissue from foetuses aborted before eight weeks.

In a review of the field in Australia between 1994 and 2002, Dr Tuch and colleagues reveal that aborted foetal tissue has been used by 19 researchers at four universities, six major teaching hospitals and two research institutes. About 265 samples are distributed annually by the DTU, with each foetus yielding three tissue samples. The most commonly used tissues come from the eyes, bone and cartilage, brain and spinal cord, kidneys and the pancreas. An index of their usefulness, says the article, is that 74 publications in international peer-reviewed journals have relied on aborted foetal tissue.

The age of most of the foetuses is between 14 and 18 weeks. According to 1983 NHMRC guidelines, foetuses must be less than 20 weeks, as there is a remote chance of survival after this time. The tissue has been used for feeder cells for growing human embryonic stem cells, for drug testing and for studying tissue development, viruses and diabetes.

Dr Tuch complains that the media has taken little notice of research on aborted foetal tissue, even though he outlined what was happening in an MJA article in 1993. His most recent attempt to raise public awareness may have fallen on deaf ears as well, as the media seized upon articles dealing with IVF and smoking in the current MJA and largely overlooked his current contribution. ~ MJA, Nov 17 

Nitschke to use vegemite jars in suicide workshops

Vegemite A jar of Vegemite, a bottle of sauce and some carbon monoxide are all you need to kill yourself. This is the latest message from assisted suicide activist Dr Philip Nitschke. His contraption, nicknamed the "CO Genie", can be built for around A$52. Dr Nitschke says that 200 people across Australia have booked in for his workshops on how to build it. He denied that promoting his device was irresponsible and that young people will use it. "We will endeavour to ensure that the only people who come and take part in these workshops are people that have a good reason to, and this will be elderly Australians," he said. "But will the technology slip out? Look, it's not rocket science. Anyone who has done high school chemistry can build one of these machines." ~ Courier-Mail (Brisbane), Nov 17 

Tighter regulation of American IVF sought

IVF The US President's Council on Bioethics wants to rein in the American IVF industry. Although the members of the Council do not agree on the ethics of IVF, they have managed to reach a consensus on several practical measures in a discussion paper. If adopted, these would force the IVF industry to disclose more about its practices and impose "interim prophylactic measures". Amongst the procedures which could be restricted or banned are animal-human hybrid embryos, the creation of embryos with genetic material from more than two parents and possibly surrogate motherhood.

The Council also supports the need for government-funded studies of the health of children born from assisted reproductive technology (ART), the health of women who use ART, and the effects of reproductive genetic technologies. IVF clinics would be told to provide more user- friendly reporting of data, the side-effects and risks of procedures and their cost. All embryos created would have to be accounted for.

The discussion paper has two underlying themes. The first is that too little is known about the what actually happens clinically and what are the risks of ART procedures. The second is that the dignity and special character of human procreation must be preserved and that women and children should be protected against "exploitative and degrading practices". It was posted on the Council's website but passed nearly unnoticed until the Wall Street Journal publicised it this week.

The proposals will face stiff opposition. Pamela Marsden, of the American Infertility Association, immediately savaged it. "The government has no business knowing about our personal, private reproductive decisions," she said. Others claimed that the document foreshadowed a back-door attempt to give legal protection to embryos. ~AP, Nov 21; kaisernetwork.org, Nov 21; bioethics.gov.org 

High approval for Australian IVF

The Australian public overwhelmingly approves of advances in assisted reproductive technology (ART), says a team from Monash University. In an article in the Medical Journal of Australia, Professor Gab Kovacs and IVF pioneer Dr Carl Wood say that market research over 20 years shows that approval for the simple case of infertile married couples is as high as 86%. Approval for the use of donor sperm by lesbians rose from 7% in 1993 to 31% in 2000. Almost as important as support for ART itself is widespread community support for Medicare funding, which rose from 70% in 1981 to 79% in 2000. Professor Kovacs attributes community acceptance to positive media coverage and the fact that nearly 2% of all births are now due to IVF in Australia. ~ MJA, Nov 17 

PGD in Sydney used mostly for sex selection

Embryo biopsy Six out of every 10 patients at one of Australia's leading IVF clinics are using pre-implantation genetic diagnosis (PGD) to select the sex of an embryo rather than to test it for a medical condition. The Daily Telegraph reports that the number of parents using PGD for sex selection has increased four-fold in three years. More than 250 couples have had sex selection done at Sydney IVF since 1995, with 120 of them in 2002. About one-third resulted in a pregnancy. Details of the procedure are outlined on the clinic's website.

Despite fears that parents would choose only boys, the director of PGD at Sydney IVF, Dr Kylie de Boer, says that 64% wanted a girl and that when only one parent wanted to select the sex, it was nearly always a mother who wanted a daughter. ~ Daily Telegraph, Nov 10; Sydney IVF  

IVF coming to Kenya

The establishment of an IVF clinic in Kenya has sparked protests from Christian and Muslim leaders. Three scientists at the Kenya Medical Research Institute intend to do IVF for less than half the price of what it costs Kenyan couples who seek help overseas. No births have yet resulted. Anglican, Catholic and Presbyterian clergy all accused the scientists of playing God. A spokesman for the Chief Kadhi, Sheikh Hammad Kassim, agreed, saying that the Koran is against human manipulation of procreation. However, the Kenyan team argues that IVF "should not be denied to others who are willing because it will be against their constitutional rights".

IVF in African society has complications unfamiliar in the West. Infertility in Kenya is seen as a disgrace. Men sometimes marry a second wife to have children and the barren wife can be mistreated by her husband, the second wife and her in-laws. However, even with a bargain-basement US$5,300 price tag, most couples will be unable to afford IVF. ~ allafrica.com, Nov 17; The Standard (Nairobi), Oct 12 

Euthanasia mooted in Nigeria

A leading judge in Lagos has urged doctors to consider the merits of euthanasia. Justice Moronke Omotayo Onalaja, of the Lagos Court of Appeal, suggested that the Nigerian National Assembly should set up a commission to investigate mercy killing for a patient who is experiencing "living death and [is] a liability to her family who were to give her comfort and care." The proposal was rubbished by Catholic Cardinal Olubunmi Okogie, who described the idea as morally inept. "Euthanasia is wrong in its totality," he said, "because the fact that a person who is about to die of natural causes does not justify a human decision to attack human life." ~ allafrica.com, Nov 11; This Day News, Nov 21 

British women trade off children for the "good life"

British women are having fewer children and having them later in life to hang on to a comfortable lifestyle, says the Institute of Public Policy. A report sponsored by Lever Faberge, the detergent company, reveals that "later maters" regard children as a mixed blessing with clear penalties for parents, especially women. "People have begun to indulge in 'consumption smoothing' where they try to accumulate as much wealth as possible to lessen the impact of kids on lifestyle," says the report. Surprisingly, the report found that many women in their 30s were not desperate for children. The current British birth rate is 1.64 children per female, marginally higher than the European average of 1.53. ~ BBC, Nov 14 

Call to make brain scans confidential

A leading American scientist, the editor of the journal Science, Dr Donald Kennedy, says that insurance companies and other businesses should be barred from access to brain scans of potential customers. The scans, he said, might disclose the person's health, personality or mental state. "I don't want anyone to know it, for any purpose whatsoever, including those offered in my own interest. It's way too close to who I am and it is my right to keep that most intimate identity to myself," he told the Guardian.

The interpretation of brain scans is still in its infancy, but some scientists believe that they can reveal a predisposition to diseases like Alzheimer's or multiple sclerosis. Researchers recently announced, for instance, that they could detect racial prejudice in brain scans. ~ Guardian, Nov 20 

Face transplants premature, says UK report

Face/Off The first study of the feasibility and ethics of face transplants has concluded that the risks of the operation outweigh the benefits -- for the time being. The UK's Royal College of Surgeons says that the procedure would be quite hazardous, with one in ten face grafts failing within a year and as many as half failing in the long-term. Because patients would need high doses of immunosuppressant drugs, there would also be a risk of diabetes, infections and cancer. Other critics say that patients might have psychological problems after surgery since facial expressions are such an important part of our identity.

However, a keen supporter of the surgery, Dr John Barker, a plastic surgeon at the University of Louisville, in Kentucky, says that the problems associated with tissue rejection can be overcome. Many of these issues will only be resolved as more patients undergo the surgery, he told New Scientist. "They said there should be a moratorium on hand transplants five years ago," he commented. "Now more than 16 people have had the surgery and it's considered a success." ~ New Scientist, Nov 19 

Singapore issues guidelines on embryo research

Singapore plans to ban human reproductive cloning and to require government approval for research cloning or human embryonic stem cell research. Its proposed legislation would also ban cross- species research. Researchers will have to be suitably qualified and be "of good character and reputation". Singapore currently has some of the world's most permissive regulations on embryo research and is attempting to build a reputation as a biotech hub by luring foreign scientists. The proposed restrictions may be intended to allay fears of an ethical free-for-all. ~ kaisernetwork.org, Nov 18 

Psychiatrists cannot be forced to act against conscience

gavel Psychiatrists cannot be forced to act against their conscience, the House of Lords has ruled in the UK. The judgement came after tribunal granted a patient with paranoid psychosis a provisional discharge from a mental asylum provided that a psychiatrist supervised his treatment in the community. Local psychiatrists contended that his discharge was "clinically inappropriate and unsafe". The patient claimed that his right to liberty was being breached, but the House of Lord said that health authorities have no right to compel psychiatrists to act against their conscientious professional judgement. ~ BMJ, Nov 22 

IN BRIEF: foetal cell transplants ~ UK euthanasia ~ EU stem cell funding ~ Israeli sperm harvesting

  • Transplants of foetal brain cells have failed to improve the symptoms of patients with Parkinson's disease, says a researcher at the University of South Florida. "Based on this profile of safety issues, the use of foetal tissue cannot be recommended," Dr Thomas Freeman told the Society for Neuroscience annual meeting in New Orleans. He added that these results should be taken into account when studying the possibility of using stem cell-based therapies. ~ Doctor's Guide, Nov 13

  • The controversial issue of euthanasia is to be studied again by the British House of Lords, ten years after it was rejected by its committee on medical ethics. Its Liaison Committee says that experience in the Netherlands and Oregon must be studied and recent polls showing that 80% of the public favours euthanasia should be taken into account. ~ BMJ, Nov 22

  • The European Parliament has voted to allow EU funding for embryonic stem cell research, despite a fierce campaign from Ireland, Germany and Austria to uphold a ban. The Parliament's vote is not binding, but sends positive signals to biotech companies who fear losing a competitive edge to Asian countries like Singapore, China and Korea. The BBC says that "stem cell research is regarded by many as one of the most promising and profitable areas of biotechnology, with European companies leading the way". A final decision rests with the EU's trade and industry ministers. ~ BBC, Nov 19

  • Doctors will be allowed to harvest the sperm of dead Israeli men without their consent if their wives or partners request it, according to guidelines announced by Attorney-General Eliyakim Rubinstein. However, a man's explicit instructions that his sperm should not to be used for artificial insemination would have to be followed. Guido Pennings, of the European Society of Human Reproduction and Embryology ethics committee, says that no other country allows sperm to be used without written consent. ~ Reuters, Nov 13 

     

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    Australasian Bioethics Information
    ISSN 1446-2117
    Website:www.australasianbioethics.org
    Director: Dr Amin Abboud
    BioEdge editor: Michael Cook
    New Zealand Associate: Carolyn Moynihan


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