BioEdge 235 -- Tuesday, 16 January 2007

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BioEdge 235: Ready-to-implant embryos available at budget prices

THIS WEEK


bullet 
Ready-to-implant embryos available at budget prices
      Texas broker uses mass production
bullet 
Disability activists protest "Ashley Treatment"
      Treatment is "unacceptable"
bullet 
Countdown to first womb transplant
      Even though unsuccessful in animals thus far
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Catholic hospitals in Australia under the gun
      Clash with abortion and IVF supporters
bullet 
Smokers told to butt out
      Debate in British Medical Journal
bullet 
House of Reps votes on US stem cell policy
      Margin not wide enough to override veto
bullet 
Another Korean stem cell expert trips up
      But caught before publication
bullet 
Death torment in Swiss suicide clinic
      Dignitas blots its copybook
bullet 
IN BRIEF: hybrid embryos; cosmetic surgery; liposuction
bullet 
BioEdge in the media

READY-TO-IMPLANT EMBRYOS AVAILABLE AT BUDGET PRICES

The US Federal Drug Administration says that it will not investigate a Texas woman who is running a embryo brokerage business. However, the controversy over Jennalee Ryan's company, the Abraham Center of Life, has highlighted the increasingly commercial nature of the American IVF industry. Ms Ryan, who used to be in the adoption business, says that selling embryos is far more convenient for prospective parents because they do not have to "kiss the butt" of alcohol and drug-addicted birth mothers or endure the humiliation of being screened by an adoption agency. Furthermore, it offers them choice. "Who wants an ugly, stupid kid?" she asks. "I mean, come on, if you choose yourself..."

Ms Ryan's business is based on the economies of scale of creating a large number of embryos from a few women. She charges US$2,500 for each implantable embryo -- far cheaper than a normal IVF procedure. She also guarantees high quality embryos: sperm donors must have PhDs and egg donors at least a college degree.

In a perceptive column in Slate, William Saletan predicts that the profit motive will extend the range of reproductive services that Ms Ryan and others like her will offer. "The logic of what Ryan is offering -- more control, more customisation, higher quality, fewer hassles, lower cost, and lower risk -- won't end here." He foresees higher prices for higher IQs and integrating surrogacy into the process. "PhD embryos will cost more than BA embryos," he says.

Bioethicist John Robertson took an optimistic view. "People are already choosing sperm and egg donors in separate transactions. Combining them doesn't pose any new major ethical problems." But Thomas Murray, of The Hastings Center, described it as a disturbing sign. He said that it privileged adults' preferences and ignored children's and established a "ludicrously inadequate standard for evaluating new reproductive technologies and practices -- that it is okay to create a child as long as that child would not have been better off never being born" ~ Slate, Jan 15; AP, Jan 12; Bioethics Forum, Jan 11   

DISABILITY ACTIVISTS PROTEST "ASHLEY TREATMENT"

Stunting the growth of a severely physically and intellectually disabled American girl has been denounced by disability activists. As reported in last week's BioEdge, doctors in Seattle limited the height of six-year-old Ashley, and removed her breast buds, her uterus and her appendix. Their aim was to help the girl's parents cope with caring for her.

Media coverage has provoked a storm of controversy. Complaints have been filed with the federal Office for Human Research Protections, although the agency says that it has no authority to investigate it. Steven Taylor, of Syracuse University, said that "it is unethical and unacceptable to perform intrusive and invasive medical procedures on a person or child with a disability simply to make the person easier to care for."

The fact that a hospital ethics committee had reviewed the case did not impress the Chicago group Not Dead Yet. It called for a total ban on the "Ashley Treatment". "Ethics committees are not a substitute for the constitutionally-guaranteed right of due process," it declared in a press release. "In fact, they often act an an end-run around those protections." ~ AP, Jan 11; Not Dead Yet, Jan 6   

COUNTDOWN TO FIRST WOMB TRANSPLANT

Despite unease amongst doctors and ethicists, a New York hospital is preparing to offer the first uterus transplant in the US. Dr Giuseppe Del Priore and Dr Jeanetta Stega, of the New York Downtown Hospital, have secured ethics committee approval and shown that it is possible to obtain wombs from deceased donors. They are confident that anti-rejection drugs will not harm the foetus. They are ready to roll.

However, other doctors said that the procedure is "not really ready for prime time". Doctors in Saudi Arabia attempted it in 2000 on a 20-year-old woman, but the womb survived for only 99 days. The technique is still unproven in animals, for instance. A similar operation with a Rhesus monkey failed recently. Bioethicist Arthur Caplan asked whether it is right to remove a womb without securing the consent of the donor. "It's got symbolic importance that's far different from a pancreas or a liver," he said. The operation would probably cost about US$500,000.

What sets a uterus transplant apart from other transplant operations is that it is driven not by concern for the patient's survival, but by her passionate desire for a child from her own body. It is quality of life surgery, not life-saving surgery. Furthermore, the child would probably not be conceived naturally, but with IVF. Once the woman has had her child, or if no child comes after two years, another operation would be needed to remove the uterus to minimise health risks from immunosuppressant drugs. ~ AP, Jan 15   

CATHOLIC HOSPITALS IN AUSTRALIA UNDER THE GUN

An expanding Catholic hospital system is colliding with the Australian abortion and IVF industries. The news that all 74 Catholic-run hospitals have been banned from referring rape victims from crisis centres unless the woman is probably not pregnant sparked an outcry. Two women Federal senators challenged the right of Catholic-run public hospitals to impose their moral views on patients while receiving public funding. And the president of the Australian Medical Association, Mukesh Haikerwal, declared that "the services offered by state hospitals should be the full gamut of services." Only "medical contra-indications" should be grounds for refusing a service, he declared.

Senator Lyn Allison called for a Senate inquiry, saying that she had long been concerned about growing Catholic influence in the health sector. Church control could influence the provision of many services, including abortion, sterilisation, fertility and genetic testing for severe foetal abnormalities.

The issue of Catholic involvement in health is particularly sensitive at the moment. Health Minister Tony Abbott recently enlisted two Catholic pregnancy support groups to help draft a pregnancy counselling manual. Abortion supporters have denounced this as a tragedy. This was followed by the news that a Canberra IVF clinic felt unwelcome in a private hospital after a Catholic hospital group bought it.

It seems likely that the Catholic hospital system will weather the storm, as it has strong support from state governments which rely upon their services. Queensland Acting Premier Anna Blight rejected Dr Haikerwal's criticism. "There is no one-size-fits-all arrangement for funding public hospital services," she said. ~ Australian, Jan 12; Jan 13   

SMOKERS TOLD TO BUTT OUT

Should smokers be refused elective surgery? The British Medical Journal features a vigorous debate on this burning issue. An Australian, Matthew J. Peters, of Concord Repatriation Hospital, in Sydney, says Yes. He contends that with finite resources, preferring non-smokers over smokers "will deliver greater clinical benefit to individuals and the community". He cites a plethora of statistics which indicate that smokers are far more prone to complications and require longer hospital stays. "Five non-smokers could be operated on for the cost and bed use of four smokers and the non-smokers' surgical outcomes would be better," he says.

However, Leonard Glantz, a bioethicist at Boston University School of Public Health, says No. He counters Dr Peters's statistics with jabs at the inconsistency of his principles. Doctors have always believed that they were obliged to treat pariahs with the same care as other patients, whether they were enemy troops, terrorists -- or smokers. Furthermore, the principle at issue seems to be that patients should be obliged to get healthy as a condition of receiving treatment. But many non-smokers cost society money because of sporting injuries -- 488 million days of productivity in 2002. "Indeed, if we treat a sports injury that person is likely to risk incurring future costly sports injuries. But we don't even think this, let alone suggest it." He concludes that "it is shameful for doctors to be willing to treat everybody but smokers in a society that is supposed to be pluralistic and tolerant." ~ BMJ, Jan 14   

HOUSE OF REPS VOTES ON US STEM CELL POLICY

In a gesture of solidarity with supporters of embryonic stem cells, the US House of Representatives has passed a bill which is intended to overturn restrictions imposed by President Bush The bill passed on a 253 to 174 vote, but the margin is probably not enough to override the President's veto.

The New York Times noted that some scientists actually view the politicians' inflated oratory about medical miracles with alarm. They "may generate public disenchantment with such research if its promise is not quickly fulfilled," it said.

Meanwhile the White House released a defence of the President's policy on stem cells which argued that "the dramatic advances in stem cell research since 2001 are evidence that the President's balanced policy is working."

The report restated the Administration's ethical stand on embryonic life: "The destruction of embryos for experimental purposes could also open the way to more general and profound manipulations and re- engineerings of human life. Without an understanding that life begins at conception, and that an embryo is a nascent human being, there will always be arguments that other uses, takeovers, and makeovers of embryos are justified by potential scientific and medical benefits. Crossing this line would needlessly encourage a conflict between science and ethics that can only do damage to both, and to our nation as a whole."

The report also highlighted very recent research from the US and Japan which seems to indicate that it will not be necessary to destroy embryos to obtain their touted benefits. Bioethicist Arthur Caplan remained sceptical: "The White House is playing politics with science in a highly deceptive way," he grizzled. ~ blog.bioethics.net, Jan 11; Advancing Stem Cell Science Without Destroying Human Life report; New York Times, Jan 12   

ANOTHER KOREAN STEM CELL EXPERT TRIPS UP

Another Korean has been found guilty of stem cell fraud -- but this time before his paper had been published. Jong-hyuk Park, a co- author of Hwang Woo-suk's cloning papers, deliberately falsified images in an unpublished manuscript which he was preparing for the journal Nature while working as a postdoc at the University of Pittsburgh. He also attempted to destroy evidence of his misconduct. His paper claimed that he had developed embryonic stem cell lines in Rhesus monkeys. Park has been barred from applying for or receiving federal grants, contracts or loans for three years. ~ The Scientist, Jan 12   

DEATH TORMENT IN SWISS SUICIDE CLINIC

The Swiss suicide agency Dignitas may not always deliver on its promise of a painless death. A Zurich newspaper has reported that a 43-year-old German woman with a brain tumour cried out in pain for four minutes after taking her lethal poison in November. She reportedly moaned "I'm burning; I'm burning" for four minutes before lapsing into a coma. And in 2004, another client spent three days in a coma before dying. The newspaper pointed out the contrast with the quick and dignified death promised by Dignitas. As recently as September, its head, Ludwig Minelli, told British parliamentarians that his organisation had helped more than 600 people to end their lives "without any complication". "We help our members to make a risk and pain-free suicide," he declared. ~ Deutsche Welle, Jan 14   

IN BRIEF: hybrid embryos; cosmetic surgery; liposuction

Hybrid embryos approved: The UK's fertility authority has given a green light to the creation of human-animal hybrid embryos. However, the Human Fertilisation and Embryology Authority says that it will not make decisions on individual applications until a "consultation exercise" is completed later in the year. ~ UPI, Jan 11

Cosmetic surgery: British cosmetic surgeons have denounced a company's plan to give cosmetic surgery as a prize in a lottery. A former president of the British Association of Aesthetic Plastic Surgeons, Dr Adam Searle, called it "an awful manifestation of the trivialisation of medical care in general, and aesthetic surgery in particular." However, Europa International co-founder John Babbage brushed the criticism aside. "I don't see what the difference is if somebody wins surgery in this competition or pays for it themselves." ~ BBC, Jan 9

Death from liposuction: A famous Egyptian actress has died after a routine liposuction operation. Comedienne Suad Nasr passed away after a year in a coma which may have been caused by anaesthetic. As elsewhere, Egypt is experiencing a craze for cosmetic surgery. ~ Gulf News, Jan 13   

BioEDGE IN THE MEDIA

"The Ashley experiment should never be repeated"
by Michael Cook, Sydney Morning Herald, 15 January 2007   

 

  

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Australasian Bioethics Information
ISSN 1446-2117
Website:www.australasianbioethics.org
BioEdge editor: Michael Cook
New Zealand Contributing Editor: Carolyn Moynihan


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