The website of the Missouri Coalition for Life-Saving Cures shows what most voters, and not just in Missouri, expect from embryonic stem cell (ESC) research. The Coalition is battling for a referendum which will legalise therapeutic cloning. Gathered in the website's "Stories of Hope" are two dozen heart-rending accounts of children who are dying young of chronic diseases and adults whose lives have been consumed by disease and spinal cord injuries. They all conclude with a desperate plea to voters for support.
Unfortunately, according to the New York Times, embryonic stem cell therapies will be long a-coming. "Many [scientists] no longer see [embryonic] cell therapy as the first goal of the research, parting company with those whose near-term expectations for cell therapy remain high. Instead, these researchers envisage a longer-term program in which human embryonic cells would be a research tool to study the mechanisms of disease. From this, they say, many therapeutic benefits may emerge, like new drugs, which would probably be available at least as soon as any cell therapy treatment."
Work on embryonic stem cells since 2001 "has produced no significant advances", says the Times, although it has allowed scientists to gauge just how daunting the task of working with ESCs will be. The horizon for cell therapies is now at least "5 or 10 years off". Many of us feel that for the next few years the most rational way forward is not to try to push cell therapies," says Thomas M. Jessell, of Columbia University Medical Center, in New York.
And John D. Gearhart, of Johns Hopkins University, one of the best-known experts in the field, told the Times, "I personally feel that the beauty of these cells is that we'll learn a lot about human biology and disease processes, and that that information will be more important than the cells themselves."
Although researchers complain that restrictions imposed by President Bush have hampered their work, the real issue is that it has proved unexpectedly difficult to differentiate the embryonic cells into specific types of tissue, such as heart cells, or liver cells or brain cells. Furthermore, scientists are not sure whether cells grown in a Petri dish will have all the information they need to flourish when introduced into a patient's body. "We initially hoped we could leapfrog over certain developmental steps," says Dr Evan Snyder, of the Burnham Institute in San Diego. "We are starting to learn that doesn't always work." ~
New York Times, Aug 14
SINGAPORE RACES FOR STEM CELL SUPREMACY
Singapore is jockeying for a position as a world leader in stem cell research. Researchers disgruntled with meagre funding or restrictive regulation in their home countries are moving to the island state. Faced with declining returns in electronics, the Singaporean government declared a few years ago that biotechnology would become one of the pillars of its economy. It has invested S$500 million into a "biopolis", a huge biomedical complex with the latest equipment (including an underground facility for 250,000 mice). A stem cell bank is under way.
Giving Singapore a competitive edge in this field are extremely liberal regulations. Back in 2002, its Bioethics Advisory Council declared that "a human embryo has a special status as a potential human being, but is not of the same status as a living child or adult. Such respect is however, not absolute and may be weighed against the recognised benefits arising from the proposed research." The utilitarian stance of the government's position would have provoked intense controversy elsewhere, but in Singapore there was little opposition.
Singapore offers many carrots to draw foreign expertise. Drug companies are attracted by a 30% subsidy of building costs. Talented stem cell researchers from the US, UK, Japan and Australia buzz over the honey pot of generous salaries and tiptop facilities. In return, however, Singapore demands results. It recently severed a link with prestigious Johns Hopkins because the US university had failed to achieve its agreed staff recruitment goals.
Singapore is also aiming to become a world leader in medical tourism. It recently engaged US consulting firm McKinsey to map out a plan for attracting 1 million medical tourists by 2012. Last year the figure was 374,000. Some patients will no doubt visit the two immense casinos which are also under way to strengthen another pillar of the economy, tourism. ~ New York Times, Aug 17;
AFP, Aug 18;
Inside HigherEd, July 27
STEM CELL SCIENTISTS AND THE LAW
What should stem cell scientists do when their moral views clash with society's? First, set up an eminent persons committee and call for consultation and communication. This is what is being proposed by the so-called Hinxton Group of about 50 scientists, ethicists, journal editors, lawyers and policy makers, in an article in the leading journal Science. These include John Harris, of Manchester University, and Julian Savulescu, of Oxford University, both regarded as radical utilitarians.
Without too much optimism, the group calls for uniform international standards in the regulation of stem cell research. More achievable, however, is stopping "extraterritorial jurisdiction" over researchers, the ability of a government to prosecute citizens for crimes" which may be legal in another country. They insist that scientists who do work which is banned at home should not be punished if they do it abroad. This is a real issue for German scientists, because the extraterritorial reach of the law is written into Germany's constitution.
In a thoughtful commentary, one of the authors, bioethicist Ruth Faden, of Johns Hopkins University, comments that scientists should welcome societal oversight of their research. On the other hand, they "should continuously make their case to society by appealing to public moral reasons that are accessible to all." This, she says, is hard work for which few scientists are prepared. ~
Science, Aug 18
POLLS SEND CONFLICTING MESSAGES TO AUSTRALIAN POLITICIANS
Australian politicians are gearing up for a conscience vote on therapeutic cloning. Health minister Tony Abbott is doing his best to demonise it by raising the spectre of "human-animal hybrids" and condemning its supporters as "peddling hope". However, it is votes, not words, which will carry the day. The trouble is, what voters feel about this complex issue is itself a matter of debate. Opinion polls in Australia's public debate over therapeutic cloning have yielded very different results.
Back in June the respected Morgan poll claimed that 82% of Australians back the use of embryonic stem cells to treat diseases like heart failure and Alzheimer's. Eighty per cent favoured therapeutic cloning. However, the poll tended to overstate the possibility for cures -- especially Alzheimer's, which nearly all scientists acknowledge will not be licked with stem cells. Nor did it use the words "therapeutic cloning". Instead, the pollster described the procedure as "merging an unfertilised egg with a skin cell" without fertilisation.
From a poll commissioned by the Southern Cross Bioethics Institute, which opposes therapeutic cloning, very different results emerged. About 51% of the people surveyed were opposed to "the cloning of human embryos as a source of stem cells". When people were informed that "extracting stem cells from an embryo causes the embryo to be destroyed in the process", support dropped from 29% to 14%.
Hence, it appears that the side which can frame the debate in its own terms will win the legislative battle. If the Australian public -- which knows little about the science of embryonic stem cells -- is persuaded that miracle cures are the only issue, therapeutic cloning will be legalised. If it realises that human embryos will be destroyed in the process, the outcome is far from certain. ~
Age, Aug 22;
Morgan poll 4036;
Australian, Aug 19
BROWNBACK SETS SIGHTS ON OREGON'S ASSISTED SUICIDE
Conservative US Senator Sam Brownback has introduced a bill which would bar doctors from prescribing federally controlled drugs to be used in assisted suicide. This is aimed directly at Oregon, where 37 patients died legally with the help of their doctor in 2004. "When the law permits killing as a medical 'treatment', society's moral guidelines are blurred, and killing could gain acceptance as a solution for the chronically ill or vulnerable," said Brownback. He does not expect the bill to become law this year, but he wants to use it as "a rallying point for those opposed to assisted suicide." (It might also rally conservatives to his presidential ambitions.)
Predictably, the prospect of a Washington do-gooder trampling Oregon law underfoot nettled the Seattle Times. It sputtered in an editorial that the senator from Kansas was not the third senator for Oregon and should not try to lead it down "the yellow brick road of righteousness". ~
Seattle Times, Aug 15; AP, Aug 15
TEEN WINS BATTLE TO TREAT HIS CANCER
A 16-year-old cancer patient in Virginia has reached an agreement with a court about how to treat his Hodgkin's disease. Abraham Cherrix and his parents were so distressed by his discomfort after one round of chemotherapy that they opted for the Hoxsey method, a type of Mexican natural medicine which most doctors regard as outright quackery. A court decided that they were being negligent -- despite Abraham's protestations that he did not want chemotherapy -- and ordered him to be treated. Now, after an appeal, a compromise has been reached: he can continue with the alternative treatment, so long as he sees a recognised cancer specialist. He will not have to have chemotherapy, but he might get radiation.
Although the case ended harmoniously, it raised thorny questions about patient autonomy, in much the same way that teenage abortions do. Does an intelligent teenager have the right to determine his own treatment and does the state or his parents have the right to determine what is best for him? Bioethicist Arthur Caplan observed that this was "absolutely the right resolution for this difficult case". He felt that it showed that it proved the value of government intervention. ~
AP, Aug 16;
MSNBC.com, Aug 16
IN BRIEF: lessons, Hwang, New Orleans
Lessons: Investigators into the botched UK drug trial which left six men desperately ill have released an in-depth report. The drug, TGN1412, a monoclonal antibody, caused a massive immune response which flooded the volunteers' blood with inflammatory agents and triggered organ failure. The doctors say that the drug should have been used more cautiously and that the men should have been tested at least two hours apart, rather than at 10-minute intervals. ~
Science, Aug 18
Hwang: Disgraced Korean stem cell researcher Hwang Woo-suk has made a silent return to the lab bench and his cloning research, even though he is still facing charges of embezzlement, misuse of funds, and violation of bioethics laws. Dr Hwang is working with 30 colleagues on animal cloning, and still hopes to return to human cloning at some stage. ~
Korea Times, Aug 17
New Orleans: Neither murder nor mercy killing may have been intended by the doctor and two nurses who killed four critically ill patients in the aftermath of Hurricane Katrina. US bioethicists contend that the distress of the patients could have been so great that higher- than-usual doses of narcotics were used which indirectly hastened their deaths. Dr Steven Miles, of the University of Minnesota, believes that it might also have been a case of terminal sedation -- although the legal status of this procedure is uncertain. ~
New York Times, Aug 13
