Tuesday, 30 November 2004 ·  Issue 144

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BioEdge 144: Scientists grappling with chimera ethics

IN THIS WEEK'S BioEDGE


bullet 
Scientists grappling with chimera ethics
      How far can mixing the species go?
bullet 
Koreans claim that adult stem cells cured paralysed woman
      Cord blood cells superior to embryonic cells
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Asian stem cell centres "mind-boggling"
      Impressive levels of funding and commitment, says UK scientist
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Evidence for health of IVF babies "relatively weak" -- UK report
      Calls for long-term study
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Animal rights extremists undermine democracy, says Oxford head
      Could become pattern for other groups
bullet 
Dutch euthanasia cases settled
      One conviction, one acquittal
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"Desperate" couples offered unproven IVF treatment
      Clinics exploiting poorly understood natural killer cells
bullet 
Switzerland gives green light to embryonic stem cell research
      Referendum wins by comfortable margin
bullet 
Doctors and lawyers duel over malpractice in Florida
      Three strikes and you're out becomes law
bullet 
IN BRIEF: oversight, transhumanism, Denmark, fertility

Scientists grappling with chimera ethics

chimeric mice The US National Academy of Sciences is studying the ethical limits of research with chimeras, or mixed-species animals, an issue which is becoming more urgent with the development of stem cell biology. Scientists are already developing animals which have human organs and cells: pigs with human blood, sheep with largely human livers and hearts; mice with some human neurons. They are useful for research on the development of cells and could become medical resources as well. Some scientists are growing partially human organs in animals, for instance.

However, there are concerns about how far mixing species should go. As Stanford University ethicist Henry Greely told the Academy last month, "there is a non-trivial risk of conferring some significant aspects of humanity" on animals. At one end of the ethical scale is adding human genes to animals so that they produce human proteins, such as insulin. At the other end is injecting human stem cells into an animal embryo and transferring the chimeric embryo into an animal's womb. But what if the human stem cells developed into sperm and eggs? It could happen that a human embryo would form in the uterus of a mouse.

Perhaps the most daring experiment is being proposed by Irving Weissman, of Stanford, an expert in chimeras who has created mice with a nearly complete human immune system, a development which has been invaluable in AIDS research. Now he is toying with the idea of making chimeric mice whose brains are 100% human. If they appeared to have a "human architecture", they could be killed.

According to the Washington Post, some prominent scientists and bioethicists have no ethical objections even to radical proposals such as placing human embryos in the uterus of animals or making mice with human brains. A bioethicist at the University of Wisconsin, Robert Streiffer, for instance, told the Post that creating a human-chimpanzee hybrid might not be a bad idea. "There's a knee-jerk reaction that enhancing the moral status of an animal is bad," he said. "but if you did it, and you gave it the protections it deserves, how could the animal complain?" ~ Rick Weiss, Nov 20   

Koreans claim that adult stem cells have cured paralysed woman

An unnamed Korean woman walks again after treatment with stem cells Researchers at Chosun University in South Korea claim that stem cells from umbilical cord blood injected into the spine of a woman paralysed for 19 years have helped her to walk again. The stem cells were injected on October 12 and within three weeks, she took her first steps with the help of a walker. Professor Song Chang-hun says that the technique will be tested on four more patients soon. The results will be published next year.

Another researcher, Professor Kang Kyung-sun, told the Korea Times that cord blood stem cells were superior in this case because they did not carry ethical baggage and did not create cancerous teratomas, as embryonic stem cells sometimes do. "Embryonic stem cells are omni-potent in that they can divide into anything, even including a tumour cell. But cord blood stem cells are developed enough not to cause such troubles while retaining as powerful a differentiation capacity at the same time."

And in the US, researchers at the University of California Reeve- Irvine Research Center have used mouse embryonic stem cells to create myelin, the insulating tissue for nerve cells. This raises hopes, they say, that people with spinal cord injury can recover some movement and sensation. ~ Korean Times, Nov 26; Medical News Today, Nov 23   

Asian stem cell centres "mind-boggling"

UK scientists returning from a visit to Asia report that a staggering level of technology and commitment is being put into stem cell research in Beijing, Shanghai, Seoul and Singapore. "I came back blown away by the whole thing," said Stephen Minger, of King's College London, one of Britain's leading stem cell researchers. "It was mind-boggling to everybody." In Seoul, he found that the labs of Hwang Woo-suk, the first scientist to clone human embryos, were better equipped than his own and that Hwang's team was cloning nearly a thousand animal embryos a day. In China there was a similar level of quality and commitment.

In terms of ideas and concepts, they're not out ahead; they're in the pack with the rest of us. But you do get the sense that it is moving more quickly toward the clinic, and in the right way, without cutting corners on ethics, either," said Dr Minger. (This does not quite square with reports that some Western researchers are moving to China precisely because it has looser ethical standards.) ~ The Scientist, Nov 22   

Evidence for health of IVF babies "relatively weak"

A surprisingly negative report from the UK's Medical Research Council (MRC) has concluded that contrary to popular belief, the evidence for the long-term health of IVF babies is "relatively weak" compared to other well-established clinical techniques. Some patients, it says, are "prepared to undergo any treatment that might help them conceive" and had not considered the long-term implications. "With couples willing to go to great lengths to have a child," the MRC says, "it is of paramount importance to safeguard the health of these children from the moment they are conceived until they grow up and want to start families of their own."

The UK's fertility watchdog, the Human Fertilisation and Embryology Authority, asked the MRC to review the potential health effects of artificial reproduction technology. Like most other studies, the MRC's survey highlighted the risk of implanting several embryos to increase the chance of having a single baby. It also pointed out that even single IVF pregnancies are "more likely than naturally conceived ones to have complications and poorer outcomes for mother and child."

The report, "Assisted reproduction: a safe, sound future", was the result of a two-year review of IVF, but it was barely covered by the media. In it the MRC called for more information on the on-going health of IVF children and a new system for evaluating new IVF techniques or refinements of old ones. Gathering the information, however, may be difficult, because of privacy considerations and the need for informed consent. ~ Scotsman, Nov 23; MRC website   

Animal rights extremists undermine democracy, says Oxford head

Chris Patten The new chancellor of Oxford University in the UK has made a blistering attack on animal rights extremists. In his first speech as Chancellor, Mr Chris Patten said that their violent tactics were undermining fundamental principles of liberal democracy. Capitulating to them would encourage extremists of other stripes to harass universities to discourage them from studying particular branches of science or history, or from employing staff of particular ethnic or religious backgrounds. "These are all issues that are on the frontier between an Enlightenment world of liberty and reason, and darkness," he said.

Last week Oxford was granted an injunction banning animal rights protesters from a 50-yard exclusion zone around a half-built primate research centre, and from 100 yards around the homes of all university staff, students and alumni, contractors, subcontractors, suppliers and shareholders. ~ London Times, Nov 19   

Dutch euthanasia cases

Two recent test cases in the Netherlands have helped to clarify the distinction between murder and palliative care. In the first, the Dutch Supreme Court rejected an appeal by an Amsterdam GP, Dr Wilfred van Oijen against a charge of murder. He had an 84- year-old patient in a coma who was expected to die within 48 hours. He injected 50 mg of alcuronium and soon afterwards she died. Dr van Oijen's defence was that this "help with dying" was palliative care. However, the Supreme Court rejected this argument. Because the patient was in coma, she was not suffering, and because she had not requested euthanasia, his "life-ending treatment" was murder. He was sentenced to one week in prison suspended for two years.

In the other case, a junior hospital doctor was acquitted after he increased the dose of morphine administered to a dying patient with breathing difficulties. As the patient's condition worsened, the doctor gave him midazolam and shortly thereafter he died. The doctor was arrested. The Supreme Court found that the drugs he used could shorten a patient's life, but in this case the doctor did not intend to do so. ~ BMJ.com, Nov 20   

Desperate" couples offered unproven IVF treatment

Unscrupulous fertility clinics are offering women unproven and potentially risky tests and treatments based on the theory that natural killer cells" in the womb may be responsible for recurrent miscarriages. According to a study in the British Medical Journal, many women who have high levels of these cells are being offered powerful treatments, such as steroids or immune-suppressant drugs, to reduce them. But at this stage, say the authors, there is no evidence to justify the tests and it is wrong to offer risky treatments which have not been licensed for use in reproductive medicine.

Dr Mark Hamilton, of the British Fertility Society, agreed with the thrust of the article. "The reproductive medicine community is acutely aware of how desperate couples either with a history of infertility or recurrent miscarriage are to have a baby... Great care has to be taken not to take advantage of couples merely because they are desperate and offer treatment which is sometimes expensive and often intrusive without adequate justification." ~ BBC, Nov 26   

Switzerland gives green light to embryonic stem cell research

map of Switzerland A nationwide referendum on embryonic stem cell research passed easily in Switzerland on Sunday with the support of two-thirds of the voters. Debates there had mirrored the pattern in other countries, with an alliance of religious, pro-life and green groups clashing with science and industry groups. The referendum was strongly supported by the Swiss pharmaceutical and biotech sector which, along with healthcare, accounts for about one-third of the total capitalisation of the Zurich stock exchange. Novartis and Roche, two of the world's largest drug companies, are based in Switzerland. Under the new legislation, stem cell production will be limited to embryos not more than 7 days old; therapeutic cloning, embryo trading and research on embryos themselves are all banned. ~ Financial Times, Nov 28   

Doctors and lawyer duel over malpractice in Florida

Three strikes and your doctor is out in Florida. A newly approved amendment to the state constitution stipulates that any doctor convicted of three instances of malpractice will have his medical licence automatically revoked. The measure was supported by lawyers. Doctors retaliated by supporting another amendment which reduces the percentage of an award a lawyer can take as a fee. This also passed.

Unsurprisingly, Florida doctors are unhappy. "It has branded the state as probably the most unfriendly state for physicians," says Dr Robert Yelverton, a gynaecologist and obstetrician from Tampa. Observers think that lawyers now have the upper hand, because doctors will settle rather than risk scoring a "strike". "In the next 10 years," says Lester Brickman, of Yeshiva University, in New York, "virtually every doctor in the state of Florida will have been sued." AP, Nov 26   

IN BRIEF: oversight, transhumanism, Denmark, fertility

Oversights: Six GPs who countersigned cremation forms for Dr Harold Shipman, Britain's worst mass-murderer, are being investigated by Britain's General Medical Council. It is alleged that they failed to detect suspicious circumstances and missed many opportunities to stop Shipman, who is believed to have killed more than 120 of his patients. ~ BMJ.com, Nov 27

Transhumanism: philosopher Nick Bostrom, of Oxford University, and bioethicist James Hughes, of Trinity College in the US, have formed a new transhumanist think-tank to promote research into immortality and the improvement of the human species through genetic engineering and cyborg technology. It is called the Institute for Ethics and Emerging Technologies. ~ IEET website

Great Danes: Sperm-banking has become "a power-house industry" in Denmark, according to the New York Times. Cryos International is now the world's leader and exports sperm to 40 countries around the world. Its fastest-growing market is single women and lesbians, who now make up 20% of Cryos's client list. One Cryos client has sired 101 children -- and he doesn't know about any of them. ~ New York Times, Nov 26

Fertility: The latest American lifestyle magazine is "Conceive", whose target demographic is couples who are struggling to have their own children. Two American entrepreneurs raised US$500,000 in seven weeks to create the magazine. Critics accuse them of pressuring women into thinking that motherhood should be the centre of their lives. ~ Boston Herald, Nov 21

Schiavo inverted: In a mirror image of the Terri Schiavo case, a 73- year-old Florida man in a coma who did make a living will is being kept alive by a spouse who has power of attorney and insists that he is conscious. Last week a judge upheld the living will and Alice Pinette is considering an appeal. She says that her husband Hanford is a cognisant mind trapped in a weak body. Mr Pinette's doctors have testified that he is incapacitated, cannot make his own decisions and is unlikely to recover. ~ AP, Nov 26   

 

  

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