Friday, 12 March 2004 · Issue 112
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IN THIS WEEK'S BIOEDGE  Cadaver scandals rock US: employees sold bodies to research labs
Ethical deficit is research asset for Chinese stem cell science: permissive leglislation allows research on embryos
Australian clinic creates two "saviour siblings" : but excites little comment
Leading US cancer institute "withheld risks" of experiment: Nobel laureate accused
"Parachute research" for drug companies hits ethical nerve: drug trials in Eastern Europe and Russia
Sacked scientist campaigns for unbiased US science policy: former bioethics council member claims view distorted
Menopause dogma could be a myth: eggs may keep growing
Save me from my doctors, says UK patient: fears of withdrawal of hydration
Watching the watchdog: professional bodies too lenient, says council
IN BRIEF: Israeli surprise; Vatican appointment; Singapore sperm shortage; Australian IVF; stem cell trials
ODD SPOT
Two scandals over cadavers donated to medical schools have rocked US universities. The University of California at Los Angeles has stopped accepting corpses for its medical students and research pending the outcome of an investigation. It is alleged that two men, including the director of UCLA's Willed Body Program, sold body parts to other research labs for their own profit. According to a report in the Los Angeles Times, over the last five years 496 cadavers were illegally sold for a total of US$704,600.
And Tulane University, in New Orleans, has admitted that some of its donated cadavers were blown up in Army land mine experiments. The university sold seven surplus cadavers to a New York-based distributor of corpses, which sold them on to the US Army to test protective footgear. Tulane sold the cadavers for less than US$1,000 each, but the distributor resold them to the Army for between $25,000 and $30,000.
The scandals highlight the high demand in the US for body parts for transplants, medical training and research. The American human tissue market is said to be worth hundreds of millions of dollars each year and demand always outstrips supply. Technically it is illegal to sell body parts for transplants, but non-profit organisations charge hefty acquisition and handling fees. Bodies obtained for research or medical education can be sold. "It's a wild, wild West out there in tissue land, with few sheriffs and a lot of shady characters meeting in the back rooms," says bioethicist Arthur Caplan, of the University of Pennsylvania. ~ AP, Mar 8,10; The Age, Mar 11; Ethical deficit is research asset for Chinese stem cell science 
In five to ten years China could become a world leader in therapeutic cloning and related research, a US stem cell scientist has predicted in the journal Nature. Xiangzhong Yang, of the University of Connecticut, contends that China's main asset is that it lacks the ethical qualms which have hampered the development of research on human embryos in Western countries. "In addition," he says, "the relatively easy access to human material, including embryonic and foetal tissues, in China is a huge advantage for researchers".
Chinese scientists have already achieved notable progress towards therapeutic cloning. They have produced transgenic rabbits, goats and cows; they have cloned goats, cattle and rats. At Shanghai Second Medical University they have extracted stem cells from embryos by creating rabbit-human hybrids and at Xiangya Medical College in Changsha they have cloned human embryos to the multicellular blastocyst stage. Since the Chinese cannot possibly be internationally competitive in all fields overnight, Dr Yang urges them to focus on human embryo research and related biotechnologies. He also foreshadows collaborative projects of Western researchers with their colleagues in China. While they focus on animal models, their Chinese partners in stem cell centres could work on human research. Dr Yang also insists that more oversight by the Chinese government is needed to guarantee minimum ethical standards. "Regulations are often not followed," he says, "and some very sensitive embryo-based studied are conducted with little or no institutional review, and researchers suffer no consequences for not following institutional or national regulations or guidelines, if they exist." ~ Nature, Mar 11 Australian clinic creates two "saviour siblings" 
An IVF clinic has claimed an Australian first by achieving two pregnancies of "saviour siblings". Sydney IVF said that it had culled embryos for tissue compatibility so that they could provide "spare parts" for a sick sibling. When their child is born, a Tasmanian couple will be able to treat a 4-year-old son who suffers from a rare condition called hyper IgM syndrome. Another couple will be able to treat a child with leukaemia. Although other IVF clinics have created "designer babies" which are free from a specific genetic defect, this is the first time in Australia that embryos have been tested for tissue compatibility.
Although a similar case in the UK last year was debated for months, the news of the "saviour sibling" excited little comment in the Australian media. The medical director of Sydney IVF, Professor Robert Jansen, said that the procedure was clearly ethical. "Everyone involved in it is in a better position. There is just no down side for a child in this situation... We respect the views of people in the community who are not directly affected by these issues. but we don't necessarily feel that they have the right to attempt to influence those people who are directly affected," he commented. ~ Daily Telegraph (Sydney), Mar 8,9 Leading US cancer institute "withheld risks" of experiment 
A court case involving one of America's leading medical research centres has opened up a discussion of the limits of informed consent. The Fred Hutchinson Cancer Research Center in Seattle and three of its researchers are disputing allegations that they misled participants in an experiment which ran from 1983 to 1991. The defendants include Dr E. Donnall Thomas, who won the 1990 Nobel Prize for his pioneering work in bone marrow transplants.
At the heart of the complex case is whether the patients understood what they had agreed to. "The Hutch", as it is known in Seattle, has denied that any of the 85 patients enrolled in the experiment, called Protocol 126, was misled or that information was withheld from them. At least 83 of the 85 patients died when the novel transplant method failed. The spouses of five of the patients are now suing the Center. Although a number of expert witnesses will be testifying that Protocol 126 was ethical, the lead researcher Dr Paul Martin, acknowledges that "patients were not told about the experiment until a meeting with doctors hours before treatment was to begin," according to the Seattle Times. Some of the participants had a disease with at least 50% chance of survival with a conventional transplant, but nearly all died after Protocol 126. Claims of financial conflict of interest -- Dr Thomas, Dr Martin and another researcher owned shares in a biotech company at the same time as they were testing the company's antibodies in Protocol 126 - - were thrown out by the trial judge. He said that there was not enough evidence that the research would have led to a useful product. ~ Seattle Times, Mar 10 "Parachute research" for drug companies hits ethical nerve But what happens when the trials finish? Do the companies take special care of subjects who risked their health to take part in a study? In most cases, the answer is No. When the trial is over, patients have to give up medicines which may have vastly improved their quality of life. Sometimes companies do not sell their drugs in the countries where they were tested. And if they do sell them, few participants can afford them. Bioethicist Ruth Faden, of Johns Hopkins University, is perplexed by this "parachute research". "Do we have an obligation to everyone in the trial or to everyone in the community, the province, the nation, the region or the world?" she asks. "We haven't really figured this out." ~ New York Times, Mar 5 Sacked scientist campaigns for unbiases US science policy 
Menopause dogma could be a myth But research on mice at the Massachusetts General Hospital in Boston has shown that new follicles, the tiny sacs in which eggs grow, are being created well into adult life from stem cells. "These are basic biological findings that may change everything in our field" says Dr Jonathan Tilly. "Although there is no way to say how long it may take for these finding to actually affect the care of patients, we are very excited." Now that the egg stem cells have been identified, it may be possible to delay the ageing of the ovaries and to extend female fertility and delay menopause. Eggs could also be created with therapeutic cloning. However, this development has yet to be confirmed in humans and a leading figure in reproductive biology, Professor Roger Gosden, is sceptical. "If we have been wrong, I will be astounded," he told the Telegraph. ~ Telegraph (UK), Mar 11; NewScientist.com, Mar 10 And in another medical development which could extend female fertility, a US team has reported in The Lancet that it successfully thawed ovarian tissue which had been frozen for six years and created a healthy embryo using IVF techniques. They say that it offers hope for women whose fertility is lost because of cancer treatments. ~ New York Times, Mar 9 Save me from my doctors, says UK patient Mr Burke's barrister argues that the guidelines could breach his right to life and his right to be spared inhuman and degrading treatment under the European convention on human rights, as well as his right to autonomy and his right to a fair hearing. The counsel for the GMC described the scenario painted by Mr Burke as unrealistic. ~ BMJ.com, Mar 6
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A scientist who tried to poison his wife and covered up his crime by lacing products on supermarket shelves with poison is teaching medical ethics at the University of Manchester in the UK. Paul Agutter, 57, was released from jail in 2002 after serving 7 years of a 12-year sentence. A few weeks ago he was engaged to teach philosophy and medical ethics for two hours a week at night school. ~ AP, Mar 10
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