After almost two weeks without food or water, the death of brain-damaged Florida woman Terri Schiavo is imminent. Her husband, who has succeeded in having her feeding tube removed after more than 12 years of litigation, has announced that there will be an autopsy to prove the extent of her disability.
With the end near, both sides in the bitter debate over end-of-life care are pondering the lessons of the case. A number of journalists and bioethicists advised people to draw up advance directives, or living wills, in case they find themselves in similar circumstances. Opponents of euthanasia will probably lobby to redefine artificial nutrition and hydration as a basic need rather than as medical treatment.
Disability activists have used the case to complain that many people feel that death is better than living with a disability. The American disability lawyer and activist Harriet McBryde Johnson contends: This belief that withdrawing a feeding tube is different than other killing -- why is that a reasonable distinction? I haven't heard anybody say it would be OK to kill Terri Schiavo if she weren't on a feeding tube."
There seems to be no agreement on whether Terri is suffering as she is starved and dehydrated. Her husband's attorney, George Felos, visited her recently and said "She looked beautiful. In all the years I've seen Mrs Schiavo, I've never seen such a look of peace and beauty upon her." Her parents, naturally, dispute that. Former US presidential candidate Jesse Jackson joined them in their plea to restore her feeding tube.
"I feel so passionate about this injustice being done, how unnecessary it is to deny her a feeding tube, water, not even ice to be used for her parched lips," Jackson said. "This is a moral issue and it transcends politics and family disputes." ~ Los Angeles Times, Mar 29; AP, Mar 29
Scientists need code of ethics in an age of terror
A Canadian bioethicist and an American scientist have used the leading journal Science to float a proposal for a ethical code for researchers in the life sciences to reduce the risk of bioterrorism. Margaret Somerville, of McGill University, and Ronald Atlas, of the University of Louisville, argue that scientists must be aware of their ethical obligations, including the obligation to abide by government regulations and to blow the whistle on unethical research.
They acknowledge that a formal code will receive a frosty reception from many scientists. Some will be sceptical of its success; some will fear that it will shut down science; some will think that science is value free; some will feel that scientists are already ethical and don't need a code. However, they respond that "as long as a small clustered nucleus of ethical voices remain, ethics has a high probability of reasserting itself". ~ Science, Mar 25
Hair stem cells can morph into nerve cells
Adult stem cells in hair follicles can morph into neuron and other cells associated with neurons, according to research published in the Proceedings of the National Academy of Sciences. A team headed by Yasuyuki Amoh, of AntiCancer Inc, isolated stem cells from the whiskers of mice and found that they could change into neurons, astrocyltes and oligodendrocytres. They also believe that they can form skin and muscle cells. Their research, say the scientists raises possibilities of therapeutic applications". ~ Scientific American, Mar 29
Frankenstein report" splits UK parliamentary committee
A UK parliamentary committee has published libertarian proposals for a radical change of direction for government policy on reproduction and fertility treatment. It endorses sex selection, the creation of mixed-species embryos and anonymity for egg and sperm donors. It also calls for the scrapping of the current requirement that IVF clinics make the welfare of the child their first concern. Most controversial of all, it says that a total ban on reproductive cloning cannot be justified without further debate on fundamental issues, even if it is unsafe at the moment.
Although the report by the House of Commons' select committee on science and technology was widely publicised, it was disavowed by half of its members, with one of them dubbing it "the Frankenstein report". The five dissenting members issued their own statement: "We believe this report is unbalanced, light on ethics, goes too far in the direction of deregulation and is too dismissive of public opinion and much of the evidence," they said.
The committee's chairman, Ian Gibson, countered that "There's a rightwing drift in the world and in the country. A report like this makes people think in a much more open way about how babies are selected and the technologies and the science." ~ Guardian, Mar 24
Australian moratorium on IVF embryos to lapse
Australian researchers will have unrestricted access to spare" IVF embryos from next month. Prime Minister John Howard has decided not to press for an extension of a ban on the use of embryos created after April 5, 2002. Earlier this year he asked the states and territories to extend a three-year moratorium until 2006, but he was unsuccessful. As a consequence, embryos left over after IVF treatment will be available for destructive research provided that researchers obtain consent from the parents.
The decision was welcomed by an outspoken supporter of therapeutic cloning, Senator Natasha Stott-Despoja. However, special minister for state, Senator Eric Abetz, claimed that some scientists were trying to hoodwink the public that it was necessary to engage in destructive embryo research. "There has not been a single scientific success in the field of embryonic stem cell research," he said. "It is my personal belief that scientists should concentrate their efforts on adult stem cell research, which has shown very promising results." ~ Australian, Mar 28
Speed bumps slow progress for stem cell institute
California's new stem cell institute has hit speed bumps which are delaying commencement of its controversial research into embryonic stem cells and therapeutic cloning . The California Institute for Regenerative Medicine was set up after voters endorsed a US$3 billion funding proposal. However, the initiative has come under fire not only from those who opposed it last year, but from legislators who claim that it is secretive and vulnerable to conflicts of interest. Two lawsuits challenging the legality of the sale of bonds have been lodged by taxpayer groups and opponents of embryonic stem-cell research.
Two state senators are also trying to apply brakes to the project. They have proposed a three-year moratorium on women donating eggs for research and a constitutional amendment to tighten CIRM's conflict-of-interest rules, force its governing committee to hold its meetings in public and guarantee that CIRM's products will be available to low-income Californians. As a result, the first grants will probably not be doled out until autumn, at best. ~ Nature, Mar 24
Australia's tiny sex selection industry closes its doors
Australian IVF clinics will no longer be able help couples choose the sex of their baby after the Federal Government's Health Ethics Committee ruled that sex selection was not in the interest of the resulting child. "Admission to life should not be conditional upon a child being a particular sex," said the authority. It also contends that the procedure, which involves discarding embryos of the "wrong" sex, might undermine the parent-child relationship. However, it still supports sex selection for couples whose children might suffer from sex-linked genetic diseases.
Only two fertility clinics in Australia have been offering sex selection. They will abide by the decision, but complain that it was partisan and unreasonable. Prospective patients are asking "why their autonomy has been taken away from them," said the deputy medical director of Sydney IVF, Dr Mark Bowman. ~ Sydney Morning Herald, Mar 25
Amputation obsession not harmless
A Scottish surgeon who has amputated the limbs of healthy patients at their request is trying to get their psychological disorder formally recognised so that the amputations can be covered by the National Health Service. Dr Robert Smith had performed two of these operations before his hospital, the Falkirk Royal Infirmary in Glasgow, forbade him to do any more.
The desire to have healthy limbs amputated is a rare but well- documented disorder which goes under several names: apotemnophilia (love of amputation), factitious disability disorder, amputee identity disorder, or body integrity identity disorder (BIID). The notion of mutilating or removing healthy tissue is already accepted by the medical profession. Sex reassignment is the most extreme example, but cosmetic surgeons make a living out of nose jobs and breast reductions. The same reasoning is used to justify sterilisation and vasectomies. But people suffering from BIID have failed to convince doctors that they should be given what they want.
The condition is slowing filtering into soap operas and popular culture. One of the winners of the New York International Fringe Festival last year was Armless, a play about a middle-aged suburbanite with the disorder. However, BIID is not just a weird joke. In 1998 the urge to become an amputee led a 79-year-old New Yorker to have a deregistered California surgeon cut off his leg in Tijuana, over the Mexican border. The man later died of gangrene and the doctor was jailed. ~ New York Times, Mar 22
IN BRIEF: Nitschke; Nazi experiments; population
Nitschke: Australia's best-known euthanasia advocate, Dr Philip Nitschke, has just published a book, Killing Me Softly, with journalist Fiona Stewart. The publicity blurb says that "they offer a future where a 'Peaceful Pill' could revolutionise euthanasia just as the contraceptive pill transformed birth control a generation ago."
Nazi experiments: New research has revealed that the Nazi extermination camp experiments of Dr Josef Mengele were supported by a network of elite German scientists. Dr Susanne Heim has told the Guardian that "it was formerly believed that scientists in Germany were oppressed by the Nazi regime, that there were only a few guilty people. But in truth, these doctors were in paradise. The distinction between politics and science was hazy and doctors had the freedom to do as they liked, so long as they could prove that their goal was to breed a super-race of strong soldiers for the advancement of warfare." ~ Guardian, Mar 22
Population: The serious sex imbalance in China after two generations of the one-child policy could worsen the AIDS crisis in cities, according to a recent article in the journal AIDS. Although the article is largely speculative, Dr Joseph Tucker, of the University of North Carolina's Center for Infectious Diseases, points out that there are precedents for this in Chinese history. A sex-ratio imbalance cause by mass migration to Shanghai in the 1930s led to rampant sexually transmitted infections. ~ Nature, Mar 24
ABI IN THE MEDIA
UN moulds human ethics with clone ban
by Amin Abboud, Sydney Morning Herald, March 24
When doctors can't be trusted
by Michael Cook, Herald Sun (Melbourne), March 24
