Tim Bayne, of Macquarie University, and Neil Levy, of the University of Melbourne, rely mostly on their understanding of informed consent. They say that there are no compelling arguments against this quirky desire. "BIID sufferers meet reasonable standards for rationality and autonomy: so long as no effective treatment for their disorder is available, surgeons ought to be allowed to accede to their requests," they argue. They also assume that mind and body are not integrally united: "in an important sense, a limb that is not experienced as one's own is not in fact one's own." ~ Journal of Applied Philosophy, 1, 2005; blog.bioethics.net
Blending humans with animals is not the sort of ethical issue that most people deal with from day-to-day. But it is becoming increasingly important in stem cell science. Esmail Zanjani, of the University of Nevada at Reno, has already created adult animals with human cells integrated into their bodies. Irving Weissman of Stanford University has created mice with fully human immune systems to study AIDS.
There are currently no international standards for experiments which mingle human and animal tissue. The resulting beings, called chimeras, are useful research tools which enable scientists to study how cells function. But there are fears that scientists could blur the line between animal and human. Dr Weissman has proposed, for instance, creating a mouse whose brain is composed of human neural cells. This is unlikely to become Stuart Little -- but what if he used a chimpanzee?
This ethically fraught area could be the next battleground for stem cell science. In March Senator Sam Brownback introduced a Human Chimera Prohibition bill. Also in March, the President's Council on Bioethics teased out some of the moral implications of such research in a meeting in which it became clear that both the questions and the answers about this controversial research are quite muddled. Then the National Academy of Sciences recommended that the creation of most types of chimeras be permitted. Now New Scientist magazine has argued that "revulsion is not enough to stop [this] new research".
A debate over chimeras could easily become a proxy debate over evolution. David P. Barash, a psychology professor at the University of Washington, enthusiastically endorsed the creation of viable chimeras recently as a way of discrediting creationism. "In these dark days of know-nothing anti-evolutionism... a powerful dose of biological reality would be a very healthy event. After all, perhaps the most important take-home message from evolutionary science is the one that radical fundamentalists find most unacceptable: continuity [between the species]. And this is precisely the message that chimeras, hybrids or mixed-species clones would drive home." ~ Scientific American, Jun 27; Seattle Post-Intelligencer, May 25; New Scientist, Jun 25
Adult stem cells begin clinical trials
The Boston Globe has profiled the financial and therapeutic potential of adult stem cell treatments being developed by Osiris Therapeutics, a company in Baltimore. Osiris currently has three therapies in human trials and recently raised US$50 million in funding, double what it anticipated.
Its products are an anti-rejection therapy for leukaemia patients, regrowing meniscus in damaged knees, and replacing tissue damaged by heart attacks. The company now has enough funds to run three clinical trials, after overcoming scepticism in the market and a multi-million lawsuit with a former CEO.
The scientists conducting the trial are enthusiastic about their potential. "Unbelievably significant," says Dr Alan Levine, a former director of the blood disease program of the National Heart, Lung and Blood Institute at the National Institutes of Health. "One of the most exciting innovations in heart attack therapy," says Dr Joshua Hare, who is running Osiris's Phase I trial for heart repair. Every 10 or 20 years, there is a brand-new insight. I would say that what is happening with stem cell therapy for these chronic diseases is sort of the new insight for the 21st century." ~ Boston Globe, Jun 20
Adult stem cells learn multiplication
One of the criticisms levelled at adult stem cells is that they cannot multiply in the laboratory nearly as well as embryonic stem cells. But research at Children's Hospital of Pittsburgh, published in the journal Molecular Biology of the Cell, appears to show that this is not necessarily true, according to Dr Johnny Huard. A colleague, Dr Bridget Deasy, has succeeded in doubling muscle-derived stem cells more than 200 times, while retaining their ability to regenerate muscle. Multiplication is essential for successful therapies, because large numbers of cells will be needed.
"Scientists have typically believed that adult or post-natal stem cells grow old and die much sooner than embryonic stem cells, but this study demonstrates that is not the case," said Dr. Huard. "The entire world is closely following the advances in stem cell research, and everyone is interested in the potential of stem cells to treat everything from diabetes to Parkinson's disease. But there are also many ethical concerns surrounding the use of embryonic stem cells, concerns that you don't have with post-natal or adult stem cells. My belief is that this study should erase doubts scientists may have had about the potential effectiveness of post-natal stem cells," he says. ~ Science Daily, Jun 25
IVF developments featured in Copenhagen conference
The annual conference of the European Society of Human Reproduction and Embryology took place in Copenhagen this year, drawing thousands of experts on fertility and embryology. Each conference offers a window on current developments in the controversial world of assisted reproduction. Below are some of the highlights of the papers presented.
Infertility will double in Europe over the next 10 years, says a leading UK fertility expert. Professor Bill Ledger, from Sheffield University, said that obesity and sexual diseases like chlamydia plus declining sperm quality were factors in an alarming rise in infertility. "The sustainability of the population of Europe is at risk because there are too few children being born. it is a risk to the future," he said. At the moment, one in seven couples has trouble conceiving, but this could rise to one in three. ~ BBC, Jun 20
ESHRE has extended a five-year moratorium on human cloning, but only for one year. Its executive committee says that in the light of data from animal cloning, it would be "totally irresponsible, as well as unethical, to start human reproductive cloning". ~ BioNews, Jun 20
The scarcity of human eggs for research could be overcome by using immature eggs, say Belgian researchers. Scientists at Ghent University Hospital have shown that immature eggs which are not suitable for fertility treatment can be grown in the laboratory. They created cloned embryos and grew them to the 8 to 16 cell stage, too early to create stem cells. "Our final goal is to use human therapeutic cloning for infertility treatment by creating artificial eggs and sperm for patients who are infertile because of absence or premature loss of eggs or sperm," said Dr Bjorn Heindryckx. Controversy has dogged this study. Although research cloning recently became legal in Belgium, the scientists jumped the gun and did their work before a government committee had been set up to authorise it. ~ Expatica, Jun 28
Other Belgian IVF researchers have found that children conceived through ICSI score slightly higher than normally conceived children on intelligence tests, allaying fears that the technique could be responsible for developmental problems. ICSI, or intracytoplasmic sperm injection, involves injecting a sperm into the egg. Earlier studies suggested a higher level of birth defects and some developmental delays. ~ New Scientist, Jun 21
ICSI has overtaken conventional IVF as a method of assisted reproduction in Europe. Figures presented at the conference showed that there were more than 122,000 ICSI cycles, compared to nearly 113,000 IVF cycles in 2002. Dr Anders Nyboe Andersen, of Copenhagen University Hospital, thinks that infertility may be becoming more a male problem, perhaps due to declining sperm quality. ~ ESHRE, Jun 22
Reproductive tourism in Europe is not a medical failure, but a safety valve to avoid moral conflict, says Guido Pennings, a bioethicist at the University of Ghent, in Belgium. Thousands of people are travelling to Eastern Europe because IVF rates are less expensive there and to Spain for egg donation because women are allowed sell their eggs. Patients find out about foreign clinics on the internet and some clinics offer packages including visas, hotels and interpreters. ~ BioNews, Jun 13
American doctors profess their faith
American doctors are a religious lot. A survey of 1,044 doctors has found that 76% believe in God, 59% believe in an afterlife, and 55% allow their religious beliefs to influence how they practice medicine. "We were surprised to find that physicians were as religious as they apparently are," said Dr Farr Curlin, of the University Chicago's MacLean Center for Clinical Medical Ethics. The president of the American Medical Association, Dr J. Edward Hill, commented that belief in a supreme being is "vitally important to physicians' ability to take care of patients, particularly the end-of-life issues that we deal with so often." ~ AP, Jun 22
IN BRIEF: killer nurse; cancer ignorance; anthrax kids
A former nurse who has already admitted to killing 24 patients in New Jersey and Pennsylvania has remembered that he killed another five. A lawyer for Charles Cullen, 45, explained that his client believed that his victims were terminally ill and that it was dehumanising to prolong their lives by artificial means. He was also depressed and having a hard time, a police detective explained. Cullen was arrested in December 2003. ~ AP, Jun 27
Nearly half of all Americans mistakenly believe that surgery can spread cancer and more than one in 4 thinks that a cure for cancer already exists but is being held back by a profit-driven industry. Nearly one in five believe that pain medications are ineffective in treating cancer pain. These figures emerged from a survey of 957 adults with no history of cancer, which was published in the journal Cancer. ~ Jun 27
Anthrax vaccines will be tested on 100 children in first and second grade by the National Institutes of Health. The US government is eager to develop an effective vaccine to protect civilians from terrorist attacks. Barbara Loe Fisher, of the National Vaccine Information Center, says that it is unlikely that children will ever be exposed to anthrax. "Children are involved in trials of vaccines that benefit children, but this vaccine will not do so." ~ Hartford Courant, Jun 23
The first drug targeted at a racial group will go on sale in the US after being approved by the Food and Drug Administration. The drug, a heart failure treatment called BiDil, makes it easier for the heart to pump blood by relaxing blood vessels. For some reason, it appears to be most effective when used by African-Americans. The manufacturer, NitroMed, paid the Association of Black Cardiologists US$200,000 to help organise its research. Some critics have complained that FDA approval endorses the discredited notion of race as a biological category. ~ New York Times, Jun 24
US Army doctors are lending unethical cooperation in the interrogation of terror suspects at Guantanamo Bay, an article in the New England Journal of Medicine has alleged. Dr M Gregg Bloche, of Georgetown University, and Jonathan Marks, a British barrister, say that there has been "wholesale rejection of clinical confidentiality" at the camp, contrary to practice in US military and civilian prisons. The assistant secretary of defense for health matters, Dr William Winkenwerder Jr, strongly denied the allegations and said that the article was "an outrageous distortion".
Even Terri Schiavo's burial plot is marked by controversy. Her ashes have been buried in a Florida cemetery under a grave marker designed by her husband Michael which says that she "departed this earth" on February 25, 1990, the day she collapsed. March 31, the day of her death, is described as the day she was "at peace". At the foot of the plaque are Michael's words "I kept my promise".