A study of Dutch euthanasia in the Archives of Internal Medicine has found that doctors follow the reporting requirements prescribed under Dutch law. The results support the view that a controversial law allowing euthanasia and assisted suicide has enough safeguards to keep patients from being killed against their will or when they are not of sound mind.
However, in an accompanying editorial, bioethicist Susan M. Wolf, of the University of Minnesota, says that "there are substantial reasons to doubt this reassurance". She points to a number of limitations of the research: that only pro-euthanasia doctors were surveyed; that all of then had recently been trained or reminded of the rules; that there was no control group; and that it was based entirely on what the doctors remembered, not objective data. Furthermore, doctors were only asked about the latest explicit request for euthanasia they had received and not about euthanasia without any request. This may have excluded instances of involuntary euthanasia.
There have been repeated reports that many Dutch doctors do not follow reporting requirements, observes Dr Wolf, and it is difficult to believe" the main finding of the current study. She cites a report on Oregon's assisted suicide law: "Under-reporting cannot be assessed, and non-compliance is difficult to assess because of the possible repercussions for non-compliant physicians reporting data".
The Dutch authors also found that the most common reasons for requesting euthanasia were pointless suffering, loss of dignity and weakness -- not unbearable pain. They also admit that the degree of clinical depression might often be underestimated in their article, as no objective scale was used, and some patients might not admit to being depressed, lest their request be denied. In 13% of cases, patients withdrew their requests. ~ Archives of Internal Medicine, Aug 8/22; AP, Aug 8
German doctor may be tried for involuntary euthanasia
A woman doctor in Germany has been charged with second-degree murder after the alleged involuntary euthanasia of eight of her cancer patients. Prosecutors said that the patients of the 55-year-old doctor, whose name has not been released, had not expressed a wish to die. She denies this and says that she gave them a fatal injection of morphine at their request.
The investigation into the deaths at a hospital in the town of Langenhangen, near the northern city of Hanover, began two years ago after a public health insurance company pressed charges. In the wake of the ensuing investigtion the woman has lost her medical licence and closed the private practice which she ran next to the hospital. Now a Hanover regional court is to decide whether she should stand trial. ~ Deutsche Welle, Aug 5
Slaves, animals: what's the difference?
The powerful lobby group People for the Ethical Treatment of Animals is reconsidering its use of posters which compare animal abuse with black slavery. PETA's animal liberation campaign includes 12 panels which juxtapose images of black people in chains with shackled elephants and other provocative images. However, they have been inundated with complaints from black civil rights groups. "PETA operates by getting publicity any way they can," says John White, of the National Association for the Advancement of Colored People. They're comparing chickens to people?"
However, the head of PETA, Ms Ingrid Newkirk, doesn't appear remorseful. "We are all animals, so get over it", says an entry in her blog. "Only supremacism makes us think that 'our kind', our narrow view of ourselves as Protestants, Muslims, white, black, a woman, a man, a human being, is more important than the rest. But a broader definition of ourselves is simply that we are all animals. Our indignation at injustice to fellow whatever-we-are should go further -- to indignation at injustice to anyone. Otherwise, what are we but selfish little supremacists?" ~ Boston Globe, Aug 13; www.ingridnewkirk.com, Aug 13
Mentally disabled woman fights forced sterilisation
A 26-year-old mentally disabled Illinois woman is fighting attempts by her guardian to have her sterilised against her will. The woman, Kirsten Johnson, cannot care for herself properly but says "I would love to have the opportunity to take my time taking care of a baby". She is being represented by an advocacy group for the disabled.
Her aunt, Vera Howse, wants her to have a tubal ligation because Kirsten is sexually active and has already expressed a wish to get married. Although Kirsten has agreed to use various forms of birth control, none of them seem adequate. She reacted badly to Depo-Provera, gaining weight and suffering from high blood pressure.
Under Illinois law, it is possible to force Kirsten to be sterilised, as the courts examine what the wards would decide for themselves if they were competent and what is in their best interest. The judge hearing the case insists that it has nothing whatsoever to do with compulsory sterilisation of "mental defectives" -- a policy which resulted with tens of thousands of Americans and Canadians being sterilised and ended only about 30 years ago. "Only Kirsten Johnson's best interest was at issue here," wrote Probate Judge James Riley. ~ Chicago Tribune, Aug 11
Embryos could be screened for cancer risk as adults
The British fertility authority is to consult the public about the possibility of allowing embryos to be screened for genes which carry an increased risk of cancer in adult life. If the response is favourable, the Human Fertilisation and Embryology Authority plans to grant licences early next year. In the past the authority has only approved screening for a condition which invariably leads to a untreatable disease or for one that strikes in childhood.
The HFEA was criticised last year for allowing screening for a bowel cancer gene without consulting either Parliament or the public. Now it wants to test the waters about screening for BRCA1 and BRCA2 genes, which raise the risk of breast cancer to between 60 and 80 per cent, and a handful of other cancers. "What we are asking people is whether it is appropriate to use embryo screening technology to stop children being born with faulty genes when there is a chance they may never go on to suffer the cancer," says Angela McNab, the chief executive of the HFEA. ~ London Times, Aug 12
US researcher working on artificial womb
Artificial wombs are a possible but distant solution to infertility, says an IVF researcher who has created them for mice. Dr Hung-Chin Liu, of Cornell University's Center for Reproductive Medicine and Infertility in Manhattan, believes that her team will create a viable mouse womb in 5 to 10 years and, if restrictions on foetal experiments are lifted, a human womb within another 10 years. In 2003, she managed to nurture a mouse embryo in one of her creations almost to term. She has also created artificial human wombs by using tissue engineering to grow endometrium cells on a matrix. She experimented for a while with left-over IVF embryos but quit in 2002.
The success of this endeavour is far from certain. The environment of the womb is highly complex and thus far the perfect mix of blood, hormones and proteins which make up the amniotic fluid has eluded researchers. Furthermore the interaction between mother and developing child which affects a baby's personality and character could not be duplicated in an artificial womb. Scientists and ethicists are both sceptical of the value of artificial wombs.
But the possibility is intriguing. Some radical feminists have described it as a way of freeing women from "the tyranny of their sexual- reproductive roles", while others worry that it would make women unnecessary. Some foes of abortion see it as proof of the viability of an aborted foetus. Bioethicists fear that it will make child- bearing a consumer item. Liu sees her work as a way of designing a replacement organ for infertile women who want to bear a child themselves. ~ Popular Science, Aug 1
IN BRIEF: paternity discrepancy; organ trafficking
Amongst the consequences of rising levels of genetic testing is the unwelcome revelation of "paternal discrepancy" -- or the disclosure that a person's father is not his or her biological father. Not only does this raise personal and social issues, but it also affects a person's health, as he or she will have a different genetic profile than they thought. A UK-based research team has reviewed the literature on paternal discrepancy between 1950 and 2004 and found that rates range from less than 1% to as much as 30%. The generally accepted figure is about 4%. The rate appears related to early pregnancies, poverty, and co-habitation rather than marriage. ~ Reuters Health, Aug 11
More arrests are expected in South Africa's organ trafficking scandal. More than 100 kidney transplants, mostly from poor Brazilians to wealthy Israelis, were carried out in St Augustine's Hospital in Durban, between 2000 and 2003. Two South African middlemen have already pleaded guilty. ~ Tribune (SA), Aug 14
ABI in the media
"How a minority in the BMA got their way on euthanasia".
By Michael Cook. Spiked. August 9
