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BioEdge 232 -- Tuesday, 19 December 2006 | |||
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THIS WEEK Will probably never lead to cures Poverty can push people over the edge Stem cells in follicles Single women and lesbians to access IVF Donation after cardiac death needed, say doctors Closer to humans Hwang quietly toiling away with his research I'll behave myself, says euthanasia doctor HAPPY CHRISTMAS AND NEW YEAR TO ALL OUR READERS! The next issue of BioEdge will appear on January 9. THERAPEUTIC CLONING OVERSOLD, SAYS UK EXPERT Cloning research has been oversold to the public and has gained an unreasonably high profile. In fact, says Professor Smith, it has limited potential for treating disease and adds little to scientific understanding. In theory, it may be possible to treat people with cloned embryonic stem cells, but the technical barriers would be insurmountable in practice, he told the London Times. Professor Smith is an unlikely sceptic, as he is one of the first scientists in the UK to be granted a licence to work on human embryonic stem cells. He is the new director of the Wellcome Trust Centre for Stem Cell Research at Cambridge and expressed his opinions at a function sponsored by Cambridge and the journal Nature to celebrate the 25th anniversary of stem cell research. He says that research on embryonic stem cells from "surplus" IVF embryos and on adult stem cells is less controversial and more likely to yield medical benefits. ~ London Times, Dec 18
DOLLARS AND CENTS OF VOLUNTARY EUTHANASIA Bioethics "has been largely silent about [economic] pressures, when in fact it has been willing to legitimize individual and social end- of-life decisions even if they reflected such pressures," he says. Two reasons which are often cited in cases of assisted suicide, fear of becoming a burden on others and fear of loss of control and independence, may often be, fundamentally, economic considerations. Contemporary families are so busy and pressured by the "rat race" that they cannot afford the quality of care that the elderly deserve. And in fact, he says, 63% of the people who died in Oregon in 2000 under its assisted suicide law feared being a burden on their families. Although Dr Epstein describes himself as a supporter of voluntary euthanasia, he admits that it is possible that "the meaning and the social role of a right to die with dignity depend foremost on the absence or presence of a positive right to live with dignity." Dame Mary Warnock, the UK's doyenne of bioethics, illustrates his point. She argued in 1994 that "if a patient herself argued that keeping her alive was also too expensive for society... and that this was at least part of what caused her to wish to die, then that reasoning must be accepted... Cost-benefit must be the criterion here; and we should not be ashamed to use it." ~ Bioethics, vol 21, no. 1, 2007
The lead scientist, Dr. Maya Sieber-Blum, says: "We see the potential for cell replacement therapy in which patients can be their own donors, which would avoid ethical issues and reduce the possibility of tissue incompatibility." Her colleagues have done some preliminary research on mice with spinal cord injuries. These cells, called epidermal neural crest stem cells, grafted into the spine and survived. ~ physorg.com
DADS NOT NEEDED, SAYS UK GOVERNMENT Outspoken Liberal Democrat MP Evan Harris welcomed the proposal. He said the existing act was "unjustifiable, discriminatory and vindictive. It was also unsustainable in human rights and equality terms. The evidence suggests children do very well brought up by lesbian couples and solo parents, so good riddance." Dr Calum MacKellar, of the Scottish Council on Human Bioethics disputed this: "It is possible that these children may only become aware of any psychological problems when they become adults or consider having children of their own." Doing away with Dad is only one of 25 proposals to be presented to Parliament. Public health minister Caroline Flint has suggested a raft of changes. Some of these are designed to deal with awkward cases which have arisen over the past few years. These include: a one-year cooling off period after one of the partners wants embryos destroyed; extending the mandatory period for storing embryos from five to ten years; allowing screening of embryos for medical conditions and saviour siblings; gamete donor access to some information about their children; allowing donor-conceived children to find their siblings; and the creation of some hybrid embryos. "A greater range of persons" will be able become legal parents of IVF children. Presumably this will allow homosexual couples to become parents without having to adopt a child. It is not clear from the information released by the government whether the range will be extended numerically as well to allow 3 or 4 people to become legal parents. Although the tone of the recommendations is generally permissive, the Government does plan to ban sex selection for family balancing. This provoked an angry response from Guardian journalist Sarah Ebner: "I know of numerous families with two or three sons or daughters who would like to have another child, but only if they know it will be of the other sex... We're facing a demographic disaster in this country and need all the children we can produce." ~ Guardian, Dec 14; London Times, Dec 15
EXPANDING THE POOL OF ORGAN DONORS "The propriety of donation after cardiac death is so well established and its potential to ease organ shortages is so great that the Health Resources and Services Administration has deemed it an important goal for the nation," writes Dr Francis L. Delmonico, the medical director of the New England Organ Bank. Since it is a fundamental ethical rule that patients must be dead before their organs are transplanted, the problem is defining when they actually die. The normal criterion is strict: brain death, even in the brain stem. In other words, no brain function at all. This is less common than cardiac death which occurs when a person's heart stops beating. Lungs, livers and kidneys remain viable after cardiac death. Normally brain-dead patients have been on a ventilator, with their hearts still beating, until the moment of transplant. This gives the organs a better chance of survival. But many patients die without being on a ventilator. When their heart stops, their organs begin to deteriorate immediately. The contentious issue is how long doctors should wait before removing organs. The standard interval is five minutes. Apparently there has never been a documented case of heart resuming after two minutes. In the US, the Joint Commission on Accreditation of Healthcare Organizations will require hospitals to enable the practice from next year. However, some doctors are uneasy about removing organs too soon after the heart stops and many hospitals will take advantage of an opt-out clause. Dr Delmonico worries that their scruples could cause lives to be lost unnecessarily. ~ New York Times, Dec 15
PRIMATES NEEDED FOR RESEARCH, SAYS UK RESEARCHER He led an independent working group that carried out an 18-month study of how non-human primates such as marmosets, tamarins and macaques are used in research. "We are not calling for an expansion in non-human primate research," Sir David said. "Focusing research at specialised centres would have huge scientific and welfare benefits. There is a scientific case for careful, meticulously- regulated non-human primate research, at least for the foreseeable future, provided it is the only way of solving important scientific or medical questions and high standards of welfare are maintained." Although animal welfare groups immediately slammed the report, Sir David insisted that non-human primates are the only way to ensure that medications are safe and effective before they are tested on people. Rodents and other animals are too different to human beings to provide relevant information. The journal Nature urged scientists to take a nuanced view of the use of animals in medical research. According to an anonymous poll it conducted, about three-quarters of scientists felt that animal research was essential to progress. However, some expressed misgivings about their work. ~ London Telegraph, Dec 14; Nature, Dec 14
Koreans are split over Hwang. Some feel that he is a victim and that the real culprit is his former associate Kim Sun-jong. Others think that he was brought down by American researchers who were jealous of his success. Professor Park Se-pill, of Cheju National University, does not agree with either theory, but admires his competence and want to see him back in the lab. "Hwang and his men have unrivalled technologies for cloning," he told the Korea Times. "Korea should not scrap that know-how for the benefit of the country and the world." ~ Korea Times, Dec 12
"You can put any conditions you want on me," he told the parole board. "I'm not going to do it again. Anything that will bring me back to prison I will avoid. Prison is not a place to live." However, he will continue to press for the legalisation of assisted suicide. Kevorkian has served 8 years of a 10 to 25-year sentence; his parole begins in June. ~ Detroit Free Press, Dec 14
IN BRIEF: serial killers; another fake; blood substitute Another fake: An important paper in the respected journal Cell has been challenged over image manipulation. A group at National Chung Hsing University, in Taiwan, published the paper in the October 20 issue. However, anonymous sleuths have alleged that certain images had been manipulated. The lead author, Ban-Yang Chang, has denied it, but his university has advised him to retract the article. Now the sleuths have challenged another of his papers in the Journal of Biological Chemistry. ~ Science, Dec 15 Blood substitute: The US Food and Drug Administration has failed to approve a blood substitute, Hemopure, which the Navy says could save many lives. The Navy wants to test it on 1,100 trauma victims in emergency situations without obtaining informed consent. However the FDA says that such trials must give victims some benefit, not just minimise the harm done to them. In this case, it says, the benefits do not outweigh the risks. While a blood substitute which will maintain blood pressure and is compatible with all blood types is a good idea, it has a chequered history. Twenty patients tested with a similar product in 1998 died. ~ AP, Dec 14
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