BioEdge 230 -- Tuesday, 5 December 2006

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BioEdge 230: New IVF hazard comes to light

THIS WEEK


bullet 
New IVF hazard comes to light
      Fertility drugs may damage chromosomes
bullet 
Leading journal eats humble pie over Hwang
      Resolves to scrutinise papers more carefully
bullet 
Australian MPs debate therapeutic cloning
      But bill will probably pass
bullet 
Patients care about cures, not conflict of interest
      Survey in NEJM
bullet 
Peter Singer explains support for vivisection
      I am following a consistent line, he says
bullet 
Private funding enough for stem cell research, says libertarian think tank
      No need for funding, just liberal laws
bullet 
Biotech jobs lost to offshoring trend
      China and India are beneficiaries
bullet 
Turf wars in cosmetic surgery
      Non-specialist doctors move in
bullet 
Spanish woman asks for euthanasia
      Could become cause celebre
bullet 
IN BRIEF: Animal rights; sperm donors

NEW IVF HAZARD COMES TO LIGHT

Another IVF health hazard unknown to patients but widely discussed amongst fertility experts has been dragged from the shadows. According to British specialists, the powerful drugs used to stimulate egg production can actually make women less fertile and keep them from getting pregnant.

The doyen of British IVF, Lord Robert Winston, told the Sunday Telegraph: "The trend is to get as many eggs as possible, but that may be counterproductive. From the research we've done, the main risk is that doing this produces chromosomal damage in at least half, if not 70 per cent, of eggs. New studies are needed to prove the drugs are causing the damage, but it is my strong suspicion that this is the case."

The first meeting of the International Society of Natural Cycle Assisted Reproduction will call upon the IVF industry to rethink its dependence upon high doses of drugs. This is a high-profile gathering, with the CEO of the UK's fertility regulator attending, along with a number of well-known figures from the IVF industry.

Although experts mentioned this danger as if it were common knowledge, it is largely unknown outside of professional meetings and medical journals. A page on the British Fertility Society website, for example, is devoted to the "risks and complications of assisted conception". It is a long and growing list, but chromosomal damage to eggs is not one of the items. ~ London Sunday Telegraph, Dec 2   

LEADING JOURNAL EATS HUMBLE PIE OVER HWANG

Hwang Woo-suk After eating humble pie over the publication of fraudulent research by disgraced South Korean stem cell researcher Hwang Woo-suk, the journal Science has made some New Year's resolutions. An independent panel of three senior editors at Science, a former editor at Science now working at its rival Nature, and two stem cell biologists investigated the debacle and gave Science a mark of "above average but needs to try harder".

From now on, the chastened journal will give high-risk papers special scrutiny, perhaps requiring higher standards for primary data, a clearer description of the roles of authors, and a more thorough evaluation of digital images.

The editor of Science, Donald Kennedy, said that more robust safeguards were needed because scientific fraud was only going to grow worse: "the environment for science now presents increased incentives for the production of work that is intentionally misleading or distorted by self-interest". The reviewers pointed out that special care needed to be taken with papers dealing with climate change, human health, and particular issues in commercial biomedicine and nanotechnology because they could influence public policy or "contribute to personal or institutional financial gain".

Dr Kennedy's upbeat editorial said that his journal had been vindicated by the review -- it had followed normal protocols and had made "a substantially greater effort than for most papers to ensure that the science was sound". However, when read carefully, the carefully phrased letter from the reviewers gives a different impression. The Hwang fraud was not the first time that Science had been duped. The reviewers described its current procedures as "inadequate to deal with the problems of intentionally misleading work".

Furthermore, it appears that Science was an easy mark for the Koreans. Its editors were aware of a "a major potential flaw " in both of Hwang's faked papers. They asked for better data but accepted Hwang's explanations when it was not supplied. Furthermore, the whole paper had a fishy feel to it, giving "a general sense of unease to many editors", in the words of the reviewers. Yet Science charged ahead anyway. The question left unanswered by the reviewers is what might account for its reckless disregard of these nagging doubts. ~ Science, Dec 1   

AUSTRALIAN MPS DEBATE THERAPEUTIC CLONING

Parliament House in Canberra The Australian Parliament is creeping towards closure on the contentious issue of therapeutic cloning. A private member's bill authorising it passed the Senate last month, and it is now being debated in the House of Representatives. Insiders expect the bill to pass comfortably, but the issue has provoked some interesting observations from MPs. Nearly 50 plan to speak.

Teresa Gambaro told the House that she was a Catholic, but plans to support the bill because of her father, a victim of Parkinson's. "He pleads with me to help him," Ms Gambaro said tearily. "I can't look him in the eyes and say I won't be supporting this bill."

Sophie Mirabella, on the other hand, condemned the bill. Therapeutic cloning is a step in the wrong direction, a depraved practice reflecting nothing more than the turpitudes of modern scientific egos in their race to the bottom of the ethics ladder," she said.

And Lindsay Tanner, reputedly one of the few intellectuals in the Australian Parliament, said that the possibility of consumer eugenics "sent a chill down my spine". "Because of scientific and technological advances we are gradually getting into a position where we can recreate ourselves as a species, and the implications of that are absolutely profound," he said. "At some point we may cross a moral boundary where we will in effect re-engineer what human life is... I fear that we are getting close to that point." Despite his misgivings, Mr Tanner will vote for the bill. ~ Sydney Morning Herald, Dec 4; Australian, Dec 5   

PATIENTS CARE ABOUT CURES, NOT CONFLICT OF INTEREST

More than a third of doctors who sit on review boards overseeing the integrity of clinical trials do not bother to disclose a financial stake in the outcome, a study in the New England Journal of Medicine has shown. However this does not shock cancer patients. In the same journal another study found that 80% were "not worried at all" if a doctor profited from a tested drug. In fact, most patients said that they opposed bans on such relationships. The author of the study said that this was quite understandable since participants in clinical trials "are very vulnerable, have a serious problem and want someone to care for it." ~ Washington Post, Nov 30; HealthDayNews, Nov 29   

PETER SINGER EXPLAINS SUPPORT FOR VIVISECTION

Animal rights activists are aghast at the news that their intellectual godfather, Australian philosopher Peter Singer, is prepared to support animal experimentation in some cases. The British website Arkangel for Animal Liberation said that he had fallen for vivisectionist lies: "the man talks rubbish and the sooner the notion that he has any place in the modern animal rights movement is dispelled the better".

Singer responded to the growing controversy amongst his erstwhile admirers with letters of clarification to British publications. In these he attempts to correct the mistaken impression that he believes that experimentation can never be justified. As a utilitarian, he contends that actions are justified by their consequences. Hence, if animal experiments could lead to immense benefits, they could be defensible, at least in theory.

However, he does not accept that humans are more worthy than animals, so the bar has to be set very high. His letter says: "a test for whether a proposed experiment on animals is justifiable is whether the experimenter would be prepared to carry out the experiment on human beings at a similar mental level - say, those born with irreversible brain damage."

The controversy is thinning the ranks of Singer's friends. One of his critics, Gary Francione, an American animal rights activist and legal expert at Rutgers University, points out in his blog that Singer has never believed in animal rights -- or in any rights for that matter. Both humans and animals can, in his system, be used as means to another's ends. ~ Inside Higher Ed, Dec 4; Gary Francione blog   

PRIVATE FUNDING ENOUGH FOR STEM CELL RESEARCH,
    SAYS LIBERTARIAN THINK TANK

Governments should get out of the stem cell research business, argues the bioethics expert at the Cato Institute, an American libertarian think tank. Writing in the Los Angeles Times, Sigrid Fry-Revere contends that stem cells do "hold the promise of incredible medical progress". But government funding for them is "bureaucratic, wasteful, fickle and divisive". Where philanthropists and investors step in, however, money flows into labs. Geron has invested twice as much as the US Federal Government and Harvard University has received more money than the National Institutes for Health. Governments should legalise embryo research, but should not fund it, she says.

Ms Fry-Revere holds up Missouri as a regulatory model. Last month voters gave embryo researchers a guarantee that their work could continue without political interference. A private foundation was able to commence work immediately with US$2 billion in funding from philanthropists Jim and Virginia Stowers. She also describes American IVF as a case study in the libertarian model of medical research. Because the field was so controversial, the federal government contributed nothing. Today, fertility treatment is, she claims, a $16 billion industry.

And the story of a stricken millionaire appears to confirm her point. Augie Nieto, an entrepreneur who made hundreds of millions from a chain of fitness clubs, has ALS, or Lou Gehrig's disease. He has pushed knowledge of the disease forward rapidly and plans a cutting-edge research institute. "The business of ALS is a blast," he says. "The disease sucks." ~ LA Times, Nov 28; Pittsburgh Post Gazette, Nov 30   

BIOTECH JOBS LOST TO OFFSHORING TREND

One of the most potent political arguments for legalising stem cell research is the threat of job losses. In Australia's recent debate over therapeutic cloning, for instance, its supporters harped on the departure for the US and Singapore of talented researchers. But is this biotech brain drain a result of hostile laws or part of a natural movement towards offshoring? A recent feature in the Union Tribune, of San Diego, home to a thriving biotech industry, highlights the giant sucking sound of jobs flowing east to China and India.

Recent studies have shown that drug companies are farming out jobs to American contract research groups or cheaper offshore companies. A survey of 186 top global companies with a combined R&D budget of US$76 billion found that by the end of 2007 China and India will account for 31% of global R&D staff, up from 19% in 2004. "Companies are increasingly looking abroad to spur innovation and build new markets. In today's competitive environment, business can't be held hostage by the 'not invented here' syndrome," says a spokesman for consulting firm Booz Allen Hamilton.

In the American biotech industry, the trend is for the creation of virtual companies with a small staff which handle late-stage products or revamping existing drugs with offshore workers. "Using the labour market in China, you can multiply by 10 the number of products you can put on the market," says one biotech executive. ~ San Diego Union Tribune, Nov 26   

TURF WARS IN COSMETIC SURGERY

A turf war is building up in the US over the lucrative field of cosmetic surgery. Lured by a better lifestyle and higher pay for less work, doctors are deserting conventional specialties and hanging up shingles as "cosmetic surgeons", "aesthetic surgeons" and laser surgeons". Established doctors are upset by the newcomers. Dentists are doing Botox, and urologists are doing hair transplants and vein removal," says New York dermatologist Ellen Gendler. Everyone wants to be a plasticologist [sic]."

Established doctors claim that the field requires specialist training, but squatters say that beauty treatment is far less complicated than Caesareans or appendicectomies and that professional development classes can quickly bring them up to speed. One obstetrician and gynaecologist told the New York Times that she and her business partner refer difficult procedures to a dermatologist. Specialists, however, tell horror stories of patients who received botched treatments from doctors practicing out of their scope. The root of the conflict appears to be money. Americans are spending US$12 billion a year on cosmetic medicine and many doctors want a piece of the action. ~ New York Times, Nov 30   

SPANISH WOMAN ASKS FOR EUTHANASIA

A 51-year-old woman with advanced muscular dystrophy is trying to get the Spanish government to legalise euthanasia. Inmaculada Echevarria has been in a hospital bed for 20 years and says that she wants to die. Euthanasia supporters are hoping that her case will spark a debate in parliament. The present government appears to be broadly in favour of euthanasia, but legalising it would provoke huge opposition. The health minister, Elena Salgado, says that Ms Echevarria's case is a matter for the courts.

In an October press conference, Ms Echevarria said that "the loneliness is worse than the physical pain. People treat me well, with kind words, but in the end no one helps me." Her partner died in a car accident and she gave her son up for adoption. She has a brother in the northern city of Logrono, but he has not contacted her for years. ~ Newsday, Nov 29   

IN BRIEF: animal rights; sperm donors

  • Buoyed up by the news that a Dutch animal rights party won two seats in parliament last month, activists in the UK have launched a party of their own, Animals Count. Their Dutch colleagues' success was made possible by a proportional representation system, so they will contest elections first in Wales, where this is used to elect the Welsh Assembly. Party leader Jasmijn de Boo refused to rule out standing against Greens candidates. ~ BBC, Dec 3

  • The rights of sperm donors are at stake in a landmark case being decided by the Supreme Court of Kansas. A donor wants parenting rights to a child born with his sperm. He claims that a Kansas law which denies parental rights to donors unless there is a written agreement is unconstitutional. The case pits a supposed constitutional right to be a parent against a child's right to a stable upbringing. The 1994 law was meant to protect children and parents against custody disputes and child support lawsuits. Family lawyers are following the case closely, as it could affect sperm donors across the US. ~ Kansas City Star, Dec 3   

      

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    Australasian Bioethics Information
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    BioEdge editor: Michael Cook
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