The rumours about non-voluntary euthanasia in the chaotic conditions of Hurricane Katrina last year were all too true, the Attorney-General of Louisiana has claimed. A New Orleans ear, nose and throat specialist and two nurses have been arrested over the deaths of four patients, ranging in age from 61 to 90. If convicted of second-degree murder -- which is far from certain, as none of the three women has actually been charged under Louisiana law -- they face life in prison without parole.
Attorney-General Charles Foti Jr explained that "we feel they abused their rights as medical professionals. We're talking about people that were maybe pretending they were God." According to Foti's affidavit, Dr Anna Maria Pou, Lori Budo and Cheri Landry deliberately injected four acute-care patients with lethal doses of painkillers. At the time, conditions at the Memorial Medical Center were atrocious, with communications and electricity cut, sweltering heat, lack of medical supplies, and an apparent breakdown in law and order. To the staff, it may have seemed impossible to give patients adequate care under these trying conditions.
At least one of the patients who was allegedly killed was "aware, conscious and alert", although he was badly obese and paralysed. According to one witness, Dr Pou told staff "I want y'all to know I take full responsibility and y'all did a great job taking care of the patients". Dr Pou's lawyer denied the allegations. "They're victims of the storm," he said. "They're not victims of homicide." ~ New Orleans Times-Picayune, July 19
BUSH ATTACKED OVER EMBRYO DECISION
Supporters of embryonic stem cell research are regrouping after setbacks in the US and Australia. In the US, President George W. Bush has been lambasted for vetoing a bill -- the first veto of his administration -- which would have authorised funding for research on "spare" IVF embryos. The leading journal Nature described this as a monumental error". It points out that the issue is now dead in the water, until 2009, after the next election, although some states, notably California, plan to provide funding. "The scientific opportunities squandered in that time are irretrievable; the years of human life and health lost, unknowable," it laments. It advocates, instead, a funding model like "America's uneasy but workable abortion policy": grants for stem cells, but none for destroying embryos.
With the US heading towards mid-term elections, Bush's critics hope that his decision will hurt him at the polls. It is already an issue in a few tight races for the November polls for the House of Representatives and the Senate. The White House does not appear to be using the issue as wedge politics. In fact, on the day before the veto Bush's press secretary, Tony Snow, described the destruction of embryos as "murder", but quickly backpedalled, saying afterwards that his boss "would not use that term". (What Bush did say was that he opposed "the taking of innocent human life in the hope of finding medical benefits for others".)
Many commentators were heated in their criticism and hyperbolic in their prose. Sean Tipton, the Director of Public Affairs for the American Society for Reproductive Medicine, the American IVF industry group, is also the president of the Coalition for the Advancement of Medical Research. He declared that "this veto should strike fear into the hearts of anyone in America who has a desire to innovate". Writing in the Guardian, in the UK, Karen Armstrong linked Bush's religiously motivated" veto to the woeful health of existing American children and the deaths of hundreds of Lebanese civilians recently "with the tacit approval of the US".
A similar stoush is taking place in Australia after its Prime Minister, John Howard, declared that his government would not lift a ban on therapeutic cloning. As in the US, however, the states are free to forge their own regulations about stem cell research and two premiers, Victoria and Queensland, are strong supporters of embryo research. However, the new premier of the largest state, New South Wales, Morris Iemma, sided with the Federal government. This outraged the man who bequeathed him the job, Bob Carr. The former premier was reportedly fuming that his state was now "in the hands of Calabrian choirboys" who had capitulated to Catholic prejudice against medical research.
There seems to be a danger in both the US and Australia of the issue turning into ideological trench warfare instead of informed debate. At its heart is whether embryos in Petri dishes are human beings with human rights. But the merits of this claim are seldom debated in the media. Instead, opponents bicker over the respective merits of embryonic stem cells and adult stem cells and the accuracy of scientific claims. Even leading scientific journals are taking sides. Science published an express letter which was bitter attack on the scientific and personal integrity of Dr David A. Prentice, an adviser to opponents of embryo research. It was timed to appear just before the US Senate voted.
BLAIR NO STEM CELL LAP DOG
Although UK Prime Minister Tony Blair has been accused of being George Bush's poodle in his Middle East policy, this certainly does not hold true for stem cells. Shortly after the Bush veto, Blair was touting Britain as an ideal place for embryo research. On a four-day visit to California, he met several bioscience companies in the San Francisco area and unveiled plans for a joint UK-Californian conference on stem cell technology in Britain in November. "This is an area that I think is of fundamental importance for my country and its economic development in the future," Blair told the businessmen. ~ Mercury July 31
ARE STEM CELL SCIENTISTS MIGRATING?
One of the most persuasive weapons in the arsenal of supporters of embryonic stem cell research is fear of losing highly qualified scientists to countries or states with more liberal regulations. It is often claimed that the US will experience a brain drain because of its policies are, in the main, more restrictive than in the UK or Europe. Similarly, Australians fret about a brain drain to the US, and UK scientists have been lured to Singapore.
An article in Nature Biotechnology has attempted to turn anecdotal evidence of this into hard statistics. The researchers found that US stem cell scientists are significantly more likely than biomedical colleagues in less contentious fields to have received job offers, especially from overseas institutions. However, "too few international offers were reported to draw firm conclusions". In any case, the mere offer of a job does not necessarily result in a job change. Surprisingly, despite some high-profile moves, the fear is still not a fact. ~ Nature Biotechnology, July
EUROPE APPROVES EMBRYO RESEARCH
The climate for embryonic stem cell research is also favourable in Europe after an agreement reached in Brussels this week. The EU has agreed to fund research on the stem cells, but not for "projects which include research activities which destroy human embryos". This compromise was opposed by Poland, Austria, Slovakia, Lithuania and Malta, but they did not have the numbers to block the measure. The EU meeting did decide, however, that no funding would be available for reproductive cloning, human gene line modification or creating embryos solely for research.
A Vatican spokesman, Bishop Elio Sgreccia, said that "Europe has committed itself appropriately and collegially to halt acts of violence and war in the nearby Mediterranean region. But it is seriously incoherent in not opposing destructive research. This, too, is violence, even if it is happening at the beginning of life." ~ Zenit, Jul7 26; BMJ, July 29
HWANG'S MAMMOTH MISTAKE
The activities of disgraced Korean stem cell scientist Hwang Woo-suk are looking stranger and stranger. More details are emerging as his trial proceeds on charges of misappropriating public funds, embezzlement and illegally purchasing human eggs. It turns out that some of these funds were diverted into a project for cloning extinct mammoths. His team tried three times and failed. However, he says, Not a single penny was spent for personal use." Hwang still insists that he did not realise that his cloned human embryos were fakes. "I am also a victim who was deceived," he told the hearing. "I am the biggest victim." ~ AP, July 25
PUBLIC-PRIVATE DEBATE IN ETHICAL REVIEWS
Should research ethics boards be run for profit? Known as institutional review boards in the US, these have traditionally been staffed by volunteer committees of scientists and clinicians who are working in an institution. More and more, however, for-profit IRBs are being hired to conduct efficient, high-quality ethical reviews. The oldest of these, the Western Institutional Review Board, has been in business since 1968. Nonetheless, not everyone is happy with the idea. Critics say that for-profit IRBs have an inherent conflict of interest because they derive their income from clients who have a direct financial stake in obtaining approval.
A debate in the journal Public Library of Science between Ezekiel J. Emanuel, of the National Institutes of Health, and Trudo Lemmens, of the University of Toronto, and Carl Elliot, of the University of Minnesota, suggests that the issue will not be settled soon. Dr Emanuel complains that critics are blindly prejudiced against private enterprise. He says that outcomes -- in terms of high quality reviews of protocols and monitoring of the safety of research participants -- is what matters. A number of private IRBs have outstanding records while several scandals, including deaths, have occurred under the supervision of academic IRBs.
Trudo and Elliot oppose the trend towards commercialisation of ethics, especially for large pharmaceutical companies: "They are in a client-provider relationship with the commercial entities whose studies they review." Delays in approvals by IRBs may affect profit margins. Furthermore, companies are free to shop around for an IRB which will give them an easy run. Recently, they point out, several commercial IRBs have been involved in controversial research practices. They agree with Emanuel that academic IRBs are also flawed, but insist that the way to fix the problem is "to clean up the conflicts of interest, not to institute a replacement in which such conflicts are built into the system." ~ PloS, July
BRITISH SCIENTISTS ACCESS EGGS WITH CUT-PRICE IVF
British women will soon be offered half-price IVF and in return half of the eggs they produce during the treatment will be used to create cloned embryos. The scheme is highly controversial, not least because the UK's fertility regulator issued a licence to the North East England Stem Cell Institute before launching a public consultation about egg-sharing for research. Professor Alison Murdoch, of Newcastle University, feels that women will be eager to take part. "All patients involved in egg-sharing need IVF to help them have a baby," she says. "We are helping them to have treatment they may not otherwise be able to afford."
Josephine Quintavalle, of Comment on Reproductive Ethics, was flabbergasted. "This is just coercion," she said. "Women who can't afford IVF but are desperate for a baby will see this is the only way they will be able to have children. They may not want to give their eggs to researchers but it is a choice between that or not being able to have IVF." ~ Scotsman, July 28
SPERM DONOR SHORTAGE HITS UK
It's being described as a "crisis" for would-be British mothers: a sperm donor shortage. The lobby group Infertility Network UK is calling for a campaign to recruit more donors. The UK recently abolished donor anonymity, so donors can expect a knock on their door after their biological child turns 18. For most of them, this is not a welcome prospect and as a result, apparently, suppliers have vanished. The Network wants to educate possible donors about the extent of their obligations towards their inconvenient offspring -- there are none, either financial or moral, it says.
The shortage follows the change, but even network spokeswoman Susan Seenan was reluctant to pin all of the blame on the new legislation. In fact, the UK's fertility regulator, the Human Fertilisation and Embryology Authority, says that it is a "myth" that the change caused the shortage. "What we see is a patchy provision across the country," says HFEA spokesman John Paul Maytum. "Some areas are struggling but other areas have plenty. We'd like to see clinics in areas where there is a shortage talking to other clinics where there is a good supply." ~ BBC, June 8; Guardian, July 30
