What should be done with patients deemed to be in a "permanent vegetative state"? A discussion in the current Journal of Medical Ethics shows that there is a growing interest in using their bodies for medical experiments. They would be especially useful in studying the long-term effects of transplanting animal organs. The patients often survive for years, and if a virus affected their brains or other vital organs, very little harm would be done.
Some bioethicists have even contended that PVS patients are actually dead and can be treated as cadavers. But Dr Steven Curry, of the University of Melbourne, disagrees, partly because they aren't dead and partly because it would be too difficult to persuade the public that they are.
PVS patients are alive, he contends, but they have nothing to lose and they can contribute to the common good:
"Those who are in a PVS will not ever wake up, they feel no pain or discomfort and have no continuing interest in their own survival... these patients must also have a right to risk that life for the common good... The patients will not be able to have children and have no capacity for movement, so that their possible confinement does not violate the interest that underpins the right to free movement... Also, no risk of withdrawal of consent exists."
Ideally, of course, people should agree in advance to such experiments by enrolling in a register. But it is unlikely that many people will, as few people anticipate living in a comatose state for several years. Hence, says Dr Curry, it ought to be possible to get others to consent on their behalf "with reference to the person's values and stated preferences". ~ Journal of Medical Ethics, Oct
Although IVF clinics are beginning to screen embryos so that children will not carry genes for diseases which appear late in life, their clients could be buying a pig in a poke. An article in the New York Times by Gina Kolata points out the link between genes and life expectancy and many diseases is very small, so small that it is nearly impossible to predict. "Recent studies find that genes may not be so important in determining how long someone will live and whether a person will get some diseases -- except, perhaps, in some exceptionally long-lived families. That means it is generally impossible to predict how long a person will live based on how long the person's relatives lived."
This has been confirmed by research on fraternal and identical twins. A 2000 study of 44,788 pairs of Scandinavian twins in the New England Journal of Medicine found that only a few cancers had a genetic component -- and that was very small. Dr Robert Hoover, of the National Cancer Institute, wrote in an accompanying editorial: There is a low absolute probability that a cancer will develop in a person whose identical twin -- a person with an identical genome and many similar exposures -- has the same type of cancer. This should also be instructive to some scientists and others interested in individual risk assessment who believe that with enough information, it will be possible to predict accurately who will contract a disease and who will not."
Despite this, many people are prepared to sift through embryos until they find one which will have a long life. Twenty-eight per cent of American IVF clinics which test embryos have done it to avoid an adult-onset condition such as Huntington disease, hereditary breast cancer, or Alzheimer's. ~ New York Times, Aug 31; Fertility and Sterility, Sept
A survey of American IVF clinics has found that almost half of them offer sex selection. Overall, sex selection of embryos accounted for 9% of all embryo screenings in 2005. These embryo screenings happen in about 1 in 20 IVF pregnancy attempts.
This surprised bioethicists. "That's really startling," said Arthur Caplan, of the University of Pennsylvania. "Family balancing seems like a morally persuasive reason to some people," but doing gender selection just because a couple doesn't want any girls, or any boys, is troubling, he said.
The US is one of the few countries in the world in which sex selection is not banned. Even China -- officially -- has banned sex selection. forty-two per cent of American clinics offering pre- implantation genetic diagnosis have provided PGD for "non-medical sex selection". About half will do whatever the parents wish, but the other half set conditions: 41% will only provide such a service for a second or subsequent child. ~ Fertility and Sterility, Sept; AP, Sept 20
Chinese prisoners are still a source of organs for foreigners with bundles of cash, according to this dramatic BBC TV report. Reporter Rupert Wingfield-Hayes used a hidden camera to film his interviews with hospital authorities in Tianjin.
The risks of egg donation for cloning research are real, but not large enough to worry about, according to a panel of experts who spoke at a seminar in San Francisco recently. Apparently it was the first medical meeting in the US convened to discuss potential health risks for women. "They're finally focusing on women," said Susan Berke Fogel, coordinator of a group called the Pro-Choice Alliance for Responsible Research. "Every other slide show until this showed us the eggs as if they just magically appeared."
The experts agreed that there was little risk of infection, infertility or cancer, but that there is a significant risk of ovarian hyperstimulation syndrome, which occurs in about 100 to 200 cases in 100,000. In rare instances, women have died. But, according to Dr Marcelle Cedars, of the University of California, San Francisco, the worst cases occur when an embryo is implanted immediately after egg retrieval. This would not happen if women were donating eggs for therapeutic cloning.
California has just passed a law banning payment, other than for reasonable expenses, of egg donors. The panel felt that it would be impossible to eliminate all potential dangers, and that these donors should be carefully screened and given elaborate informed consent forms. ~ San Francisco Chronicle, Sept 29
In the wake of overblown claims by the company Advanced Cell Technology that it had found an ethical way of deriving embryonic stem cells, journalists should be more cautious about broadcasting news of "breakthroughs", according to a writer for Scientific American. Sally Lehman says that "Scientists in many fields have sometimes exaggerated the importance of their work. But stem cell researchers seem uniquely inclined toward dramatic claims."
Their enthusiasm is understandable, she says, "but pumping up the science to overcome moral and ethical objections is the wrong sales strategy". Some prominent researchers now feel that clinical applications of embryonic stem cells may be as far away as 15 to 20 years and that they may never even be used as therapies. Rather, they might be useful largely as a path to cheaper, more efficient methods. Most Americans support this research, writes Ms Lehman. But by telling tall tales about imminent cures, embryonic stem cell researchers squander their credibility. Why risk losing the public trust? The basic science is thrilling enough." ~ Boston Globe, Oct 1
Two prominent supporters of embryonic stem research have hit upon the same argument for demolishing US President George Bush's refusal to fund it. Writing on his website, evolution activist and Oxford don Richard Dawkins says that Mr Bush is illogical and hypocritical because he is willing to allow Iraqi and Lebanese civilians to die as collateral damage. "It is an inconsistency that you could find only in a mind massively infected with the disease of religion," he asserts.
And Michael Kinsley, former editor of Slate and the New Republic, now a columnist, says that it is impossible "to reconcile Bush's absolutism over allegedly human life when it is a clump of unknowing, unfeeling cells with his sophisticated, if not cavalier, attitude towards the loss of innocent human life when it is children and adults in Iraq".
Of the two, Dawkins is more hostile to the notion of protecting embryos. It is a fundamentally un-evolutionary concept, he complains. "It is partly [due to] a mystical reverence for humanness, as though all cells of Homo sapiens are suffused with a divine essence, some sort of sacred juice called Homsap, which no other species possesses." But Kinsley has a firmer grasp of the Bush psyche, which, he says, attempts to combine the high-mindedness of Gandhi's respect for insect life with the utilitarian pragmatism of Harry Truman's decision to bomb Hiroshima. At least Truman achieved democracy and peace, he says, while Bush's strategy has disintegrated into a bloody civil war. "You can't be Gandhi and Truman at the same time," he concludes. ~ Washington Post, Sept 29; Dawkins website, Aug 1
Unless Australia legalises therapeutic cloning, it will lose billions of dollars and fall behind in science, according to Victorian Premier Steve Bracks. In an interview with The Australian newspaper, Mr Bracks said that his country's standard of living was at stake, and that his state would lose economic ground to the resource-rich states of Queensland and Western Australia. Victoria is home to half of Australia' s biotech industry and receives 45% of research funding for the sector.
The Premier used a report from two eminent Australian scientists to support his contentions. Sir Gustav Nossal and Professor Geoff Mitchell say that Australian medical research must allow therapeutic cloning. "The amount of progress that has been made in a scant eight years with human embryonic stem cells is breathtaking," the report says. "Australian scientists have been prominent in this global endeavour, and should not be excluded from the next exciting step." The report has not yet been released for public scrutiny of its glowing forecasts.
In November the Australian Parliament will probably vote on a private member's bill which would authorise therapeutic cloning, but debate is heating up, with intense lobbying on both sides. Mr Bracks is keen to persuade wavering Federal MPs of cloning's potential. However, he and his allies face stiff opposition. Tasmanian Senator Guy Barnett has attacked supporters as peddlers of "false hope that compounds misery". ~ Australian, Oct 2
Although scientists regularly swear that reproductive cloning is unethical because it is unsafe, almost none of them grasp the nettle of whether it would be ethical if it were safe. Fortunately there are bioethicists who can do the hard yards for them. Writing in the current issue of the Journal of Medical Ethics, D. Elsner, of the University of Melbourne, argues that the right to reproductive freedom outweighs the possible harm done to cloned childen. "People wishing to reproduce by cloning should be able to do so, provided that there is no reasonable alternative, and trials of HRC [human reproductive cloning] as an experimental medical procedure should not be prohibited." However, Elsner baulks at declaring that cloning should attract government funding -- for the time being, at least.
But what about the possible harm to a child? Most cloned animals suffer from poor health and, like Dolly the sheep, die early. Having seen the deformities which afflict cloned animals, scientists feel that it would be cruel to create a cloned human.
Elsner responds that existence is better than non-existence. Furthermore, parents and doctors know that children created through IVF face a substantially higher risk of bad health and birth defects and yet no one is calling for IVF clinics to be closed down. "Few people would seriously suggest that IVF, with all the benefits it has brought to infertile people, should be banned on the basis of these findings." IVF, too, had its early failures and seemed terribly unsafe in the 1970s. One popular IVF technique, intracytoplasmic sperm injection, was hardly tested on animals, and introduced without an experimental phase.
As one of a portfolio of techniques for artificial reproduction, reproductive cloning could be useful in at least two circumstances. First, a demand for genetic relatedness. Although at first blush it might sound grotesque and egocentric to create a child with the same genetic make-up as oneself, this is already one of the main reasons why people use IVF to conceive a child. Otherwise they would adopt children instead of making them in a Petri dish. Second, for spare parts. Children could be created as a source of healthy tissue for adopted siblings who have no genetic match. Since this is already an accepted practice at many IVF clinics, it is difficult to argue that children should not be cloned for the same purpose. ~ Journal of Medical Ethics, Oct
BACK AGAIN: Advanced Cell Technology, the US company which was pilloried recently for misrepresenting its discovery that stem cell lines can be created from 8-cell blastocysts, is back in the news. A team headed by Dr Robert Lanza claims in the journal Cloning and Stem Cells that embryonic stem cells have restored the sight of blind rats. Researchers grew embryonic stem cells, differentiated them into retinal cells, and transplanted them into the rats without side effects. Dr Lanza believes that 50 million people around the world suffer from a similar visual defect and could benefit from embryonic stem cell treatment. ~ London Telegraph, Sept 25; Cloning and Stem Cells, Sept
SCIENTISTS TO OPPOSE BUSH: A group of scientists and engineers have founded a new group to elect science-friendly politicians. Scientists and Engineers for America says that they have an obligation "to enter the political debate when the nation's leaders systematically ignore scientific evidence and analysis, put ideological interest ahead of scientific truths, suppress valid scientific evidence and harass and threaten scientists for speaking honestly about their research." ~ New York Times, Sept 28
TONY BLAIR: In a farewell speech to his party's annual conference, UK Prime Minister Tony Blair gave an unqualified endorsement of embryonic stem cell research. "America doe not want stem cell research. We do, we welcome it here," he said. ~ Los Angeles Times, Sept 27
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What should be done with patients deemed to be in a "permanent vegetative state"? A discussion in the current Journal of Medical Ethics shows that there is a growing interest in using their bodies for medical experiments. They would be especially useful in studying the long-term effects of transplanting animal organs. The patients often survive for years, and if a virus affected their brains or other vital organs, very little harm would be done.
Although IVF clinics are beginning to screen embryos so that children will not carry genes for diseases which appear late in life, their clients could be buying a pig in a poke. An article in the New York Times by Gina Kolata points out the link between genes and life expectancy and many diseases is very small, so small that it is nearly impossible to predict. "Recent studies find that genes may not be so important in determining how long someone will live and whether a person will get some diseases -- except, perhaps, in some exceptionally long-lived families. That means it is generally impossible to predict how long a person will live based on how long the person's relatives lived."
Although scientists regularly swear that reproductive cloning is unethical because it is unsafe, almost none of them grasp the nettle of whether it would be ethical if it were safe. Fortunately there are bioethicists who can do the hard yards for them. Writing in the current issue of the Journal of Medical Ethics, D. Elsner, of the University of Melbourne, argues that the right to reproductive freedom outweighs the possible harm done to cloned childen. "People wishing to reproduce by cloning should be able to do so, provided that there is no reasonable alternative, and trials of HRC [human reproductive cloning] as an experimental medical procedure should not be prohibited." However, Elsner baulks at declaring that cloning should attract government funding -- for the time being, at least.