The abolition of the UK's fertility regulatory authority has been suggested after a child psychiatrist announced that she was going to become Britain's oldest mother -- at the age of 63. Dr Patricia Rashbrook received fertility treatment in Eastern Europe from the notorious Italian IVF specialist Severino Antinori. Dr Rashbrook, a widow, already has two children aged 22 and 26 who are said to be delighted with their mother's pregnancy but she decided to have another child with a donated egg after marrying a 61-year-old academic, John Farrant. The couple reported used a Russian egg donor and paid 50,000 for the pregnancy.
She dismissed critics who said that she was mad and selfish for conceiving a child who will still be in school when she is 80. We take our responsibility very seriously and regard the best interests of the child as paramount," she said.
An editorial in the London Telegraph argued that Britain's regulation of IVF had failed. It was "extraordinary" that such decisions should made by "a quango of unaccountable placemen which, without reference to morals or public opinion, adjudicates over matters of life and death. If the Government takes these matters seriously, it should abolish the HFEA [Human Fertility and Embryology Authority] and allow real, public debate about the ethics of IVF."
Coincidentally, official figures were released last week which show that dozens of babies are being born to British women over 50 in private IVF clinics. According to the HFEA, the number of IVF births to women of all ages trebled between 1992 and 2002, but the number of IVF births to women between 45 and 49 increased from 15 to 106 and to women over 50 from 1 to 24. This is happening despite an unofficial guidelines discouraging treatment for women over 49 for the sake of their own health and the health of their child.
Even leading IVF specialist Dr Mohammed Taranissi said that the HFEA should set an age limit. "The HFEA is there to deal with these sorts of matters and it should stop sitting on the fence and do something," he declared. A spokesman for the HFEA, Vishnee Sauntoo, said that the HFEA's hands were tied: no age limit exists and the only criteria is the welfare of the child. Dr Rashbrook said that she had given much thought to the welfare of their "already much- loved baby". ~ London Telegraph, May 5
EXPLOITATIVE AND UNETHICAL" EGG TRADE BURGEONING
With the media buzzing about the fruit of Dr Rashbrook's old age (with the help of a Russian donor), recent articles are also claiming that an international market in human eggs exists which treats women like battery hens.
The UK's Observer conducted a special investigation in the Ukraine and Cyprus and found that Eastern European women are selling their ova to British would-be mothers to escape from desperate poverty. Despite strict medical and administrative guidelines set down by the UK, it is nearly impossible for authorities to oversee what happens in other countries. In the Ukraine, the Observer claimed, women are being paid on a sliding scale of fees for their eggs and seldom receive any psychological counselling. Sometimes they accept larger injections of fertility hormones in the hope of producing more eggs -- a potentially life-threatening procedure. One woman said that she knew another who had donated nearly 20 times. The average price for eggs in Kiev appears to be about US$300.
In Cyprus, IVF clinics with ties to the UK and the US rely upon women from the former Soviet Union -- both residents and visitors. One woman estimated that one in four immigrant women in their 20s had donated eggs. A nurse told the Observer that some women viewed egg donation as their main source of income and donated five times a year. Slavic women are attractive because their features are compatible with British women's.
The head of the UK's Human Fertilisation and Embryology Authority, Suzi Leather, commented: "The market in baby making is now global and these problems have to be tackled internationally." She described it as a "profoundly exploitative and unethical trade."
A similar trade exists in the US, although American eggs command higher prices. In 1984 egg donors were typically paid $250. Now university newspapers regularly run advertisements offering as much as $35,000 for a perfect donor -- usually Caucasian, blonde or brunette, with high academic results. However, most donors get far less -- between $2,000 and $8,000. "It's a bait and switch approach used by a lot of lawyers and brokers," says Dr Mark V. Sauer, of Columbia University. "It solicits huge responses and you might get one thousand inquiries. When donors don't match the exact criteria advertised, they're then offered a lower amount. To me it seems really sleazy."
The author of the book "Confessions of a Serial Egg Donor", Julia Derek, paid her way through college by donating her eggs 12 times. She says that "It's really easy to get hooked. For a student it's a ridiculous amount of money." Egg brokers claim that donors are simply being compensated for the risk, discomfort and inconvenience. But Ms Derek denies this. "It's being an egg seller. It's nothing else than that." In an interview with the student magazine Current, she urges caution for cash-strapped co-eds. "I think it's better to get a job." ~ Observer, Apr 30; Current Magazine, Summer
LIFE LOOKS BETTER TOWARDS THE END
The soundness of advanced care directives has been undermined by two recent studies in the Archives of Internal Medicine. One research team found that the people designated by patients to make decisions for them "incorrectly predict patients' end-of-life treatment preferences in one-third of cases". Even if the surrogates were appointed by the patient or had discussed treatment preferences with them, they were no more accurate.
Another report found that some patients become more tolerant of discomfort, disability and pain as their condition worsens and as time goes on. Furthermore, they cannot accurately predict how they will feel when they are actually confronted with a deterioration in their health. "These changes pose a challenge to advance care planning, which asks patients to predict their future treatment preferences," say the authors. ~ Archives of Internal Medicine, Mar 13, Apr 24
A BIOETHICS CHALLENGE AT THE END OF HISTORY
Control over human biology will be one of the main challenges to liberal democracy in the post-Cold War work, according to American social commentator Francis Fukuyama. In a new afterword to his famous 1992 essay "The End of History and the Last Man", he lists four movements which could derail the unfolding of secular liberal democracy: Islam, global governance, failed states in the developing world, and "our ability to manipulate ourselves biologically". The last of these, says Fukuyama, "will provide us with new approaches to social engineering that will raise the possibility of new forms of politics".
This is a theme that Fukuyama already elaborated in his 2002 book Our Posthuman Future. He feels that the threat posed by control over the human genome, by psychotropic drugs, by life extension and so on is more subtle than nuclear weapons or climate change because their drawbacks are closely linked to things that people want. ~ The End of History and the Last Man, 2nd ed.
SHADY STEM CELL DOCTORS TO EVADE IRISH BAN BY USING FERRY
Hundreds of Britons with multiple sclerosis and other neurological diseases are said to be queuing up for treatment in Ireland with a shady company touting the therapeutic value of stem cells. And because the Irish Medical Council is threatening to ban the treatment, Advanced Cell Therapeutics is planning to treat patients in international waters on the ferry from Cork, in Ireland, to Swansea, in Wales.
Demand from the UK has been huge, following reports in the tabloid press about remarkable recoveries and a televised interview with a clinic doctor. The treatments cost up to £12,000. Patients can also go to a clinic in Rotterdam, but it is being investigated by the Dutch healthcare inspectorate.
The Guardian newspaper has been conducting its own investigations of the company and has found that ACT has close links with a failed American company called Biomark International which also offered stem cell cures. Its founders are accused by US authorities of distributing untested stem cell treatments "without any basis in science" "This type of fraud victimises people in the most vulnerable situation," declared US state attorney David Nahmias. ~ Guardian, May 1
BRITISH KILLER FAILS TO GET IVF
A UK prisoner serving life for murder has failed in his latest attempt to get access to IVF treatment. Kirk Dickson, 34, married Lorraine in 2002, a pen pal who was also serving a sentence in another jail. Mrs Dickson is now 48 and will require IVF to become pregnant. After the Home Secretary turned down Mr Dickson's request for the facilities to allow this, he appealed to a British court and lost. Now his request has also been turned down by the European human rights court in a 4 to 3 decision.
The responses of the judges indicate the range of views about the ethics of IVF. Judge Bonello, of Malta, declared that "I am not particularly impressed by the argument that society regularly allows children to be born in similar or worse circumstances. The state in this case is being asked to become an active accomplice and participant in this future conception." However, in a dissenting opinion, Judge Borrego Borrego, of Spain, condemned the paternalism of the UK government which was hostile to conception in anything but ideal circumstances. ~ London Telegraph, Apr 19; London Times, May 2
PRESSURE GROWING FOR CHIMERAS
Although US President George Bush denounced human-animal hybrids as an "egregious abuse" in this year's State of the Union address, along with human cloning, pressure appears to be mounting to create them for medical research. A feature in this month's Nature Biotechnology contends that they will provide tantalising insights into fundamental scientific questions.
In a sense, hybrids, or chimeras, have already arrived. In 2003, Chinese researchers created nearly 100 human-rabbit blastocysts for their stem cells. UK researcher Ian Wilmut has applied to use the Chinese technique to study human disease. Douglas Melton, of Harvard University, is planning to use it as part of his investigations of diabetes, Parkinson's and Alzheimer's. "Laboratory chimeras may help unravel the mysteries of human disease without risky and unethical human experimentation," says the article.
According to Nature Biotechnology, most scientists feel that it is unlikely that human neural stem cell transplants would confer human consciousness upon animals. At least in the case of mice, the animal model used by most researchers, the structure of the brain is too different. "You can build a gas station and a cathedral using the same bricks; what makes them different is the architecture," says Stanford researcher Hank Greely. Although chimeras face stiff opposition from conservative politicians and some bioethicists like Dr Leon Kass, the mood amongst other bioethicists appears to be supportive. A panel of ethicists convened at John Hopkins last year declared that the line between what is natural and what is unnatural is impossible to measure, as most of modern medicine cannot be found in nature. ~ Nature Biotechnology, May
STEM CELLS COULD BYPASS ANIMAL EXPERIMENTATION
To avoid experimenting upon animals, German researchers want to use mouse stem cells when they examine whether drugs are toxic for unborn humans. These tests would offer "at least the same amount of information about the possible toxic effects on unborn human life as experiments on mice, rabbits, rats and guinea pigs," says Dr Heribert Bohlen, of Cologne, a co-developer of the new R.E.Tox method. The new method is also cheaper, he says.
The technique -- while not altogether novel -- will soon become more important, as a new EU regulation to be passed before the end of the year will require the testing of 30,000 chemicals already on the market for safety. As many as 6,000 substances will have to be analysed to see if they could harm fertility or affect an embryo's development. ~ Deutsche Welle, May 7
ABORTION CLINIC THRIFT
An autopsy has revealed that a 19-year-old Down Syndrome woman who died following a late-term abortion at a leading late-term abortion clinic was stripped of her corneas shortly after death. "The eyes are absent secondary to organ procurement (corneal donation)," says the document. The death of Christin Gilbert, a Texas resident whose family brought her to the Kansas clinic of Dr George Tiller, has become a cause célebre for the anti-abortion movement.
Although Tiller and his staff were originally cleared by the state medical authorities, activists have succeeded in convoking a grand jury investigation through a citizen petition. Apart from the inflammatory abortion issue, the Gilbert case raises thorny questions about the scope of informed consent for disabled adults. Christin was unable to consent to sex, unable to consent to the abortion and unable to consent to organ harvesting. But they still happened. ~ Off the Record, May 4, AP, May 3
