Tuesday, 18 October 2005 ·  Issue 180

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BioEdge 180: New techniques of producing embryonic stem cells fail to quench controversy

IN THIS WEEK'S BioEDGE


bullet 
New stem cell techniques fail to quench controversy
      Both camps puzzled by implications of new research
bullet 
More reports of medical ethics violations at Guantanamo Bay
      Hunger strikers being force-fed
bullet 
Stem cells may cause cancers
      A different kind of differentiation
bullet 
New test for defects in unborn children
      Hong Kong scientists use blood samples
bullet 
Animal rights activists threat to Oxford
      Radical target tradesmen and contractors to hurt University
bullet 
Genetic testing in US
      Employers may want to know your genetic profilel
bullet 
Lobbing bioethical grenades in America's culture wars
       "Progressives" close ranks to change policy
bullet 
IN BRIEF: IVF; stem cell trial; Dutch tolerance

New stem cell techniques fail to quench controversy

It may be possible to obtain embryonic stem cells without killing embryos, according to two papers published in the latest issue of Nature. Although many stem cell scientists regard these techniques as a time-wasting concession to irrational ethical scruples, others hope that they will break the impasse on embryo research in American courts and legislatures.

In a technique called altered nuclear transfer, researchers at the Whitehead Institute for Biomedical Research in Cambridge, Massachusetts, successfully disabled a mouse embryo by altering the gene which controls the development of the placenta. This means that an embryo clone created in this way could never develop into an adult, but it would still yield ESCs. The reasoning behind this technique is that if the embryo is clearly fated never to develop properly, it is ethical to destroy it.

Dr Rudolf JaenischHowever, even if ESCs can be obtained efficiently this way, it is unlikely to quench the debate. "The success of this procedure in no way precludes the need to pursue all forms of human embryonic stem cell research," says Whitehead researcher and MIT professor Dr Rudolf Jaenisch. "Human embryonic stem cells are extraordinarily complicated. If we are ever to realise their therapeutic potential, we must use all known tools and techniques in order to explore the mechanisms that give these cells such startling characteristics."

The other technique, which is similar to pre-implantation genetic diagnosis, has been proposed by Advanced Cell Technology, a private company in Massachusetts which does cloning research. A team headed by Robert Lanza successfully removed a cell from an 8-cell embryo and used it to cultivate ESCs, without apparent harm to the embryo.

There has been much scratching of heads over the merits of these experiments, even amongst opponents of destructive embryo research. They were amongst several alternative approaches to obtaining ESCs first proposed by William Hurlbut of Stanford University last year. The experiment conducted by Dr Jaenisch involves such an unnatural way of creating human life that that it is not clear whether the resulting organism is a human being or just a clump of human cells. And it is still possible that the cell removed in the PGD procedure might be totipotent, or able to develop into a human being. Hence it could be regarded as an embryo in its own right. "This is just the beginning of the conversation," Hurlbut said. "It's time for everyone to humbly enter a constructive dialogue and listen deeply here." ~ Christian Science Monitor, Oct 17; Washington Post, Oct 17   

More reports of medical ethics violations at Guantanamo Bay

Detainee at Guantanamo Bay More allegations of ill-treatment of Guantanamo Bay prisoners by medics have been met with more denials by the US Government. Lawyers for detainees on a hunger strike claim that military medics have tried to discourage them by forcing finger-thick feeding tubes through their noses without anaesthetic. They also allegedly recycled dirty feeding tubes used on other prisoners.

A lawyer for the Bush administration, Todd Henry, called the allegations "outrageous" and described them as "story-telling, exaggerations, misunderstandings, or miscomprehensions of what is going on." However, US district Court Judge Gladys Kessler took the claims seriously and ordered the government to supply a written response with a week.

Of 107 prisoners who began the hunger strike in early August, 24 have persevered. Seven have been hospitalised and many of the rest are being force-fed to keep them alive. Doctors critical of the way the prisoners are being treated say that unnecessarily harsh feeding tube techniques may be a serious violation of medical ethics. ~ Boston Globe, Oct 15   

Stem cells may cause cancers

The unfolding science of stem cells has surprises for both layman and scientist. Anyone tracking its development is familiar with stem cells in the liver, nerves, fat, blood, muscle and other tissues and their therapeutic potential. Now it appears that the body's medicine cabinet includes cancer stem cells, too.

A growing body of evidence suggests that cancers can be caused by rare mutant stem cells. This might explain why some resist chemotherapy. This targets quick-growing cancer cells, but fails to knock out slow-growing cancer stem cells. These linger on in the body to produce more tumours later. "It's like trying to kill a dandelion," says John Dick, of the University of Toronto. you can kill the leaves, but you have to kill the taproot to kill the plant." Dr Dick feels that stem cells may be "the apex of all" malignant growth.

Until recently many researchers were sceptical about the stem cell theory of cancer. But over the last two years, the evidence has become more persuasive. Significant experiments have shown that injecting tens of thousands tumour cells into a mouse was not enough to cause cancers. But if as few as a hundred cancer stem cells were injected, tumours were triggered.

This dramatically changes the way we think about cancer," says Dr JeanMarie Houghton, of the University of Massachusetts. "If this model applies to human cancer, we will need to revise our approaches to prevention and treatment." ~ Philadelphia Inquirer, Oct 9   

New test for defects in unborn children

Hong Kong scientists report that they may have discovered an easier way to test for foetal birth defects. In an article in the Proceedings of the National Academy of Sciences, Professor Dennis Lo says that he has been able to identify traces of foetal DNA in the mother's blood. This will make it very easy to assess the health of a child without risking a miscarriage with amniocentesis or chorionic villus sampling. At the moment, the technique is quite laborious, but new technology should simplify it.

This development could pose some ethical conundrums. If it becomes widely available, it will certainly be used to detect and abort more children with birth defects. It could also be used for sex selection. Parents could also obtain a genetic profile of their baby and see whether it will be susceptible to a genetic disease at some stage in its life. ~ London Telegraph, Oct 4   

Animal rights activists threat to Oxford

Nearly 30 builders and decorators in the UK have received threatening letters from the Animal Liberation Front because they are working for Oxford University and Oxford is building new research laboratories in which animal testing will be carried out. Work for the university will be done "at your peril", says the letter. Police and the university are taking the threat seriously as there have already been arson and bomb attacks.

The activists are following a successful policy targeting people and groups who have nothing to do with the research in order to intimidate their primary target, the University. The research buildings are only half completed at the moment because a contractor pulled out after its shareholders were threatened. ~ London Telegraph, Oct 12   

Genetic testing in US

IBM has pledged never to use genetic testing in deciding whether to hire employees or give them benefits. IBM chairman and CEO Sam Palmisano called the policy "the first of its kind for a major corporation". Bioethicist Arthur Caplan commented that "there's also no one yet who's stepped forward and said, 'We're going to enforce genetic testing in the workplace... [but] I think that's all going to change in the next few years."

Genetic testing recently featured in US sports news when basketball player Eddie Curry told the Chicago Bulls that he would not take a DNA test to determine whether he had a heart ailment. The Bulls promptly traded him to the New York Knicks. Last season Curry had an irregular heartbeat before a game and missed the last 19 games of the year. "His case will only be the start of the sports world's nervous march into the brave new world of genetic testing," observed USA Today's sports columnist, Christine Brennan. ~ Chicago Sun- Times, Oct 11; USA Today, Oct 12   

Lobbing bioethical grenades in America's culture wars

Frustrated with the success of so-called "conservative" bioethicists in influencing public policy in the US, several "progressive" bioethicists have aligned themselves to the Democratic Party to shift public policy from right to left. Or, in the words of Dr Arthur Caplan, of the University of Pennsylvania, from "religious fanaticism" and "narrow intuitionism" to "pragmatic principalism".

As a seminar organised by the Center for American Progress, a left- leaning Washington thinktank with close links to the Democratic Party, several "progressive" bioethicists described their initiative in terms which suggest that US bioethics has fissured into nearly irreconcilable camps operating with completely different philosophical frameworks.

According to the speakers at the seminar, progressives believe that bioethics should concern itself with social justice issues, and that human dignity is best promoted by providing the necessities of life, like healthcare, food and education. Conservatives, on the other hand, want "government enforcement of majoritarian prejudices that are based on emotion and instinct and repugnance". To use the words of R. Alta Charo, of the University of Wisconsin, Madison, its recent interest is "foetus fetishism".

Daniel CallahanThe vehemence of the opinions expressed at the seminar appears to confirm the melancholy observation of Daniel Callahan, one of the pioneers of American bioethics, in a recent issue of the Cambridge Quarterly of Healthcare Ethics. He wrote: "Other fields and disciplines, such a political science and economics, have their liberals and conservatives, but they are in the same field -- not one side in and one side out -- and their reputations as fields do not notably suffer from the disagreements. It is otherwise with bioethics. The general public, and the medical and health policy world, will find it all too easy to dismiss bioethics as ideology driven, left or right politics in sheep's clothing. If we besmirch each other long enough, the public will soon conclude that we are all frauds." ~ Nature, Oct 13; Center for American Progress website; Cambridge Quarterly of Healthcare Ethics, October   

IN BRIEF: IVF; stem cell trial; Dutch tolerance

IVF: Many American fertility specialists choose to ignore voluntary guidelines urging them not to implant too many embryos into the wombs of their patients. Several European countries have banned the implantation of more than three embryos. According to a report in the Wall Street Journal, many US doctors cite competition with other clinics and insistence by their patients for a successful outcome. ~ kaisernetwork, Oct 7

Stem cell trial: UK doctors have launched a trial to see whether heart disease can be treated with a patient's own stem cells. "If proven to work, these cells could revolutionise the way we treat heart disease and could transform the lives of millions of people not only in the UK but around the world," says the leader researcher, Dr Anthony Mathur. The trial is being conducted by a new charity, the Heart Cells Foundation, funded by a man who received successful stem cell treatment for his heart ailment in Germany two years ago. ~ BBC, Oct 11

Tolerance: The Netherlands has a well-deserved reputation for tolerance, with its liberal laws on drug use, euthanasia and gay marriage. However, it is now set to become the first country in Europe to ban the burkha. Interior Minister Rita Verdonk reportedly said that the "time for cosy tea-drinking" with Muslim groups is over. The government says that the ban is a security measure. ~ rediff.com, Oct 13

New Orleans: The Louisiana attorney-general's office is investigating rumours that staff members at the city's Memorial Medical Center had repeated discussions about euthanasing patients who they thought would not survive the ordeal. ~ CNN.com, Oct 12   

 

  

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Australasian Bioethics Information
ISSN 1446-2117
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BioEdge editor: Michael Cook
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