More controversy is swirling around the Korean scientist who announced in February that he had successfully cloned human embryos and created a stem cell line. This time the issue is whether women were pressured into donating their eggs to further his research. Korean bioethicists, human rights activists and the leading journal Nature have all suggested that the donors included junior members of a research team headed by Woo Suk Hwang. Nature was told by a PhD student on the team, Ja Min Koo, that she and another woman in the lab had donated eggs. She subsequently changed her story, blaming her poor English for a misunderstanding. Hwang and the ethics committee which approved the research refused to provide further information.
When the news of the experiment first broke, many non-Korean scientists expressed their astonishment that Hwang had been able to persuade 16 volunteers to provide him with 242 eggs for his research. Egg donation is uncomfortable at best and at worst can be life-threatening. In the US, for instance, stem cell researcher Jose Cibelli paid women thousands of dollars and obtained only 20 eggs. In an editorial comment Nature said that egg donors should all be genuine volunteers with no direct connection with the research. "If the air is not cleared quickly, the consequences for Korean science -- and for research into therapeutic cloning internationally -- could be severe."
Hwang and his IVF colleague Shin Young Moon became instant celebrities in Korea and around the world when they provided proof of principle for therapeutic cloning. In April Hwang received the South Korean government's most prestigious science award and was included in Time magazine's "A-list of the world's most influential people". Apart from therapeutic cloning and animal cloning, Hwang is also experimenting with human-cow hybrids although only 9% of his hybrid embryos have reached the stage at which embryonic stem cells can be harvested.
In South Korea's hyper-patriotic society, questioning the research methods of a prominent figure like Dr Hwang is a delicate issue. "No one wants to debate the ethics because the government is so excited about it," a scientist at Seoul National University told Nature. "Most scientists are also worried about a lack of students in science, so they don't want to break the excitement either." ~ Nature, May 6
Living wills don't work, says study
Living wills offer a false promise of control over end-of-life treatment, claims a study in the bioethics journal Hastings Center Report. Researchers at the University of Michigan based their conclusions on hundred of studies of living wills, end-of-life decisions and the psychology of making choices. A "durable power of attorney" is a far better option, they contend.
Dr Angela Fagerlin, of the University of Michigan Medical School, says that living wills fail all standards of workability. "First, most people don't even have living wills. Second, those who do rarely know what care they would truly want in some hypothetical future. Third, it's surprisingly hard for people to state their wishes accurately and understandably. Fourth, the document is often unavailable when decisions need to be made. Fifth, even when it is available, surrogate decision makers usually cannot reliably apply its instructions to the patient's current health condition."
Co-author Carl Schneider adds that most people cannot predict their preferences about next week's groceries. "If they have trouble predicting what is familiar," he asks, "why should we expect them to succeed when they are predicting what they will want in circumstances they have never experienced and can't foretell?"
The authors argue that a power of attorney is simpler, allows the decision-maker to act in the light of the current situation and costs less. They also found that there is no convincing evidence that living wills save money by reducing the cost of end-of-life care. ~ University of Michigan press release, May 10
Conjoined twins have "well-adjusted, rich lives"
Conjoined twins can have such "well-adjusted, rich lives, made possible by the development of cooperation strategies" that we can all learn from them, suggests a new book from Harvard University Press. The author of "One of Us: Conjoined Twins and the Future of Normal", Alice Dormurat Dreger, asks "should people with unusual anatomies be treated as if their socially challenging bodies are inherently diseased?" Dreger points out that while life as a singleton is certainly easier, conjoined twins generally accept it as part of their identity. Although last year's unsuccessful operation to separate Iranian conjoined twins Ladan and Laleh Bijani was reported around the world, most twins never consider separation. The original "Siamese twins", Chang and Eng Bunker, travelled widely, married and had 22 children between them. Like them, most conjoined twins just get on with their lives.
As if to confirm Dreger's point, the BBC recently profiled 42-year-old American conjoined twins Lori and Reba Schappell. They are joined at the head but still manage to lead independent lives, even though Reba has spinal bifida and cannot walk. She has made a career as a country and western singer and Lori works part-time in a hospital laundry. Reba told the BBC: "I like my life as I see it now. It's great! I'm healthy, that's what's the most important. I believe in 'you make your own hell, or you make your own heaven.'" ~ Nature, May 6; BBC, May 2
Chicago IVF clinic creates five "saviour siblings"
Pre-implantation genetic diagnosis of 199 eight-celled embryos has resulted in the birth of five saviour siblings, an IVF clinic in Chicago has announced. Writing in the Journal of the American Medical Association, Dr Yuri Verlinsky says that tissue from the babies will be used for treatment of siblings with acute lymphoid leukaemia, acute myeloid leukaemia or Diamond-Blackfam anaemia. Of the five babies, only one has actually saved a sibling. Three of the affected siblings are in remission -- although they may need stem cell transplants later.
Dr Verlinsky dismissed misgivings about the ethics of creating babies to serve as medical treatments. "It offers the opportunity to save the life of an existing child with an otherwise untreatable disorder and allows couples to avoid confronting the difficulties of prenatal diagnosis for [antigen] typing in mid-pregnancy, with selective abortion of foetuses who are poorly matched with the affected child," he wrote in the JAMA.
A recent survey by the Genetics and Public Policy Center at Johns Hopkins University appears to show that Americans would support "saviour siblings". "There is strong support for using these technologies when there is a health benefit, even when that benefit is for another person," said Kathy Hudson, the director of the Center. However, an unrelated survey by Public Agenda Alert about US attitudes towards cloning points out that people are often ignorant of the details of medical research and the level of support for new developments depends heavily on the wording of pollsters' questions. ~ Washington Post, May 5; Chicago Tribune, May 5; Public Agenda Alert, May 6
US exporting contraception to Afghanistan
Part of the US plan for rebuilding Afghanistan is the introduction of contraceptive products developed and marketed specifically for Afghans. With the slogan "Be a NumberOne/OK family, live a comfortable life", Population Services International and the US Agency for International Development hope to promote reproductive health for women. PSI says that its marketing has been "culturally adapted" to Afghanistan -- a challenging task in a fiercely Muslim country where where discussion, let alone advertising, of sexual topics is still taboo. This month it has launched a public awareness campaign with radio advertisement, sponsorships and billboards. PSI is also distributing 1.6 million condoms at a subsidised price in Afghanistan's major cities. ~ PSI press release, May 6; news24.com, May 3
Embryos needed to cure diabetes, claims Harvard scientist
A vocal proponent of embryonic stem cell research, Harvard professor Douglas Melton, claims that there is "no evidence whatsoever for the existence of an adult pancreatic stem cell". In an experiment on mice reported in the leading journal Nature, he tracked the development of new insulin-producing beta cells as the mice recovered from surgical trauma to their pancreas. All the new beta cells came from older beta cells rather than from stem cells. In the absence of adult pancreatic stem cells, he argues, scientists will have to use stem cells derived from embryos.
Professor Melton's paper will undoubtedly be used as ammunition in the highly-charged controversy over federal funding for therapeutic cloning in the US. Diabetes is probably the disease with the highest profile in the debate and has the most powerful lobby. However, not everyone agrees with Melton's interpretation of his experiment. Vijay Ramiya of the University of Florida told the Washington Post that the results were unrealistic because the mice did not have diabetes. And fellow Harvard researcher Denise Faustman feels that the best way to generate beta cells may not involve stem cells but drugs which encourage beta cells to multiply. ~ Washington Post, May 6
Morning-after pills will not be sold over the counter in the US
The emergency contraceptive Plan B cannot be sold over the counter, the US Food and Drug Administration has ruled. The agency said that the application was denied because only 29 of the 585 women studied by the manufacturer, Barr Laboratories, were under 16. However, it suggested that Plan B might be approved for over-the- counter sales if Barr could show that it was safe for adolescents.
The FDA's decision was unexpected and controversial because an advisory panel had decided by a vote of 27 to 0 that the drug could be safely sold over the counter. Echoing other critics, a Planned Parenthood spokesman, Dr Scott Spear, said that politics had corrupted good science. But some women's groups approved of the move. Wendy Wright of Concern Women for America told the Washington Post that "there's too much potential for harm to women and girls if it's easily available. It's the right decision to not have it next to candy bars and toothpaste." ~ Washington Post, Newsday, May 7
IN BRIEF
The Melbourne-based National Stem Cell Centre has received an extra A$55 million from 2005 to 2001 in the recent Australian federal budget. The current focus of centre's research is blood and cardiac disease. ~ The Age, May 7
The first Chinese IVF baby conceived with a frozen egg was born in a healthy condition on April 29, only two years after the first frozen egg baby was born in the UK. The Beijing Youth Daily said that the possibility of freezing eggs gives busy women a chance to postpone their baby until later in their career. However, the price of the procedure is likely to be quite high, allowing only the wealthy to access the technology. ~ AFP, May 12
French police believe that 14 suspicious deaths at a hospital in the town of Besançon could be cases of euthanasia. Four patients died after lethal injections and the other 10 after being given tranquillisers to trigger a "respiratory slowdown leading to death". ~ Guardian (UK), May 12
Former US first lady Nancy Reagan has given embryonic stem cell research her strong backing. She believes that destroying embryos for their stem cells could lead to cures for degenerative disorders like Alzheimer's and Parkinson's disease. Her husband, former President Ronald Reagan, suffers from Alzheimer's and can no longer communicate with her. ~ AFP, May 10
A US government agency has uncovered ethical lapses in eight Harvard Medical School experiments involving human subjects. Harvard's ethical review panel mistakenly approved six experiments in which patients were given inadequate or confusing consent forms. In the other cases, the board did not conduct a review. Harvard has acknowledged the lapses, which happened both in the US and overseas. ~ AP, May 13
A Brazilian missionary has accused government officials in Mozambique of covering up trafficking in human organs in the country's northern provinces. Sister Maria Elilda dos Santos said that she had been forced to leave Mozambique after making the allegations. In February another Brazilian nun who had supported the trafficking claims was strangled and beaten to death. The Mozambique Human Rights League also believes that trafficking is going on. ~ BBC, May 13; Mercury (SA), Apr 6
