BioEdge 245 -- Wednesday, 18 April 2007

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BioEdge 245: Potential organ donor wrongly declared brain-dead

THIS WEEK


bullet 
Potential organ donor wrongly declared brain-dead
      But it doesn't happen often, say experts
bullet 
Indiana apologises for compulsory sterilisation
      hundredth anniversary of law for "imbeciles"
bullet 
Belgium's baby euthanasia
      Half of deaths of children under 12 months
bullet 
British to screen embryos for Alzheimer's
      A first for British IVF
bullet 
Abortion "crisis" in Britain
      Fewer doctors want to do them
bullet 
Bereaved mothers clash with abortion supporters
      Fight over definition of "stillborn"
bullet 
Another South Korean cloner in hot water
      Wolf clones could be fakes
bullet 
Is there a right to a child?
      British woman loses court battle
bullet 
Adult stem cells may have cured diabetes
      Brazilian trial supports hope of cure
bullet 
Homebrew sperm on horizon
      Women could produce their own sperm

POTENTIAL ORGAN DONOR WRONGLY DECLARED BRAIN-DEAD

It doesn't happen often, say the experts, but it does happen. A 47- year-old California man, John Foster, had a massive brain haemorrhage and was unconscious in hospital. His daughter, Melanie Sanchez, agreed to donate his organs. She was pestered "at least twice a day" by the California Transplant Donor Network. "It kind of blew my mind," says Ms Sanchez. "Like they were waiting like vultures, waiting for someone to die so they could scoop them up."

Finally two doctors examined Mr Foster and found that he was brain- dead. The second doctor, Ms Sanchez recalled, threw a document on her father's legs and said "We've got two signatures. We're pulling the plug. That's hospital policy." However, a nurse performed her own examination shortly afterwards and had some reservations. Then a neurosurgeon examined the patient. He declared that Foster was not brain-dead and should not be removed from life support. Foster died 11 days later; by that time his organs were unusable.

Experts told the Los Angeles Times, a newspaper with a history of highlighting medical errors, that the incident could deter people from donating organs. "It is one of those things that is pretty spooky when it happens," said Dr. Michael A. Williams, chairman of the ethics committee of the American Academy of Neurology. "It's a rare, but high-stakes, error." ~ Los Angeles Times, Apr 12   

INDIANA APOLOGISES FOR COMPULSORY STERILISATION

One hundred years ago, back in 1907, the American state of Indiana passed the world's first compulsory sterilisation law. In 1909 the law was suspended and was later declared unconstitutional. But eugenics enthusiasts persisted and a new law was passed in 1927 which remained on the books until 1974. About 2,500 people from Indiana were sterilised in an attempt to improve the gene pool. Indiana was the first of 30 states which, all told, authorised about 65,000 sterilisations. The Nazi policy of compulsory sterilisation proudly cited US precedents. (See accompanying 1936 propaganda poster, "we are not alone" which displays the flags of countries which had already legalised sterilisation or were about to. The Stars and Stripes is in the top left-hand corner.)

Earlier this month Indiana formally expressed its regret for this misguided policy. An historic marker was unveiled opposite the Statehouse to commemorate the sterilisation of "imbeciles" and paupers. Present was Jamie Renae Coleman, a woman who was sterilised in 1971. Two years later she sued her mother, her doctor and the authorising judge. It was an historic case which went all the way to the Supreme Court, but the outcome was not a vindication of her plea. Instead it became the leading Supreme Court decision on judicial immunity.

In a seminar at Indiana University-Purdue University Indianapolis, Dr Peter Marcus, of Indiana University School of Medicine said that "Eugenics is still around, it just takes a different way." He observed that Virginia was currently considering early release for sexually violent predators who agreed to castration. And on the medical front, ultrasound and other tests allow women to abort children with medical defects. ~ Indianapolis Star, Apr 13   

BELGIUM'S BABY EUTHANASIA

About half of the 300 deaths of infants under 12 months in Belgium are involuntary euthanasia, according to a study by Veerle Provoost, of the University of Ghent. Dr Provoost examined the medical files and found that in about 150 cases the baby's life had been actively terminated. The cause of death varied. In most cases, treatment for a sick infant was withdrawn or it was terminally sedated. In 9% of cases, products were explicitly administered to end the baby's life. In 84% of cases, the decision to terminate was taken after consultation with parents. Most of the babies were said to have no chance of survival or little hope of an acceptable quality of life. ~ Expatica, Apr 11   

BRITISH TO SCREEN EMBRYOS FOR ALZHEIMER'S

A group of British IVF experts has announced that it is about to begin screening embryos for genes which predispose people for early- onset Alzheimer's. This was first done in the US about five years ago. Writing in the newsletter BioNews, three experts from the London Bridge Fertility, Gynaecology and Genetics Centre defiantly anticipate "the usual controversy" about designer babies.

The man who has requested the clinic to screen his embryos has several relatives who died from the condition in their 40s. If he himself is a carrier, half of his children are likely to be affected as well.

The distinctive ethical issue with screening for early-onset Alzheimer's disease is that the person will not develop symptoms for more than four decades, if ever. However, these experts suggest that 40-plus years of a disease-free life is not the only factor to be considered. First of all, screening gives couples a choice between childlessness and risk. "PGD is all about choice for individual patients at risk of transmitting genetic disease to help prevent suffering for their families," they argue.

Furthermore, if couples choose pre-implantation genetic diagnosis, they will be able to avoid the expenditure of "vast physical, emotional and financial resources" in caring for a "middle-aged 'child'" when they are in their 70s or 80s. ~ BioNews, Apr 17   

ABORTION "CRISIS" IN BRITAIN

Britain is staring down the barrel of an abortion crisis, because fewer and fewer doctors are willing to do the procedure. According to the Royal College of Obstetricians and Gynaecologists, distaste with performing abortions combined with a growing number of doctors who refuse on ethical and religious grounds means that many young doctors are opting out of abortions.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, which carries out a quarter of all abortions performed in England, says: "There is a real crisis looming. Unless we can address the problem and motivate doctors to train in abortion, we may well face a situation in five years' time in which women's access to abortion is severely restricted. It is our biggest headache."

According to the Independent newspaper, a key factor is "the dinner party test": " gynaecologists who specialise in fertility treatment creating babies for childless couples are almost universally revered -- but no one boasts of being an abortionist." The RCOG is very worried about the situation. Although it recognises a right to conscientious objection, it says that "careful workforce planning" will be needed to enable on-going abortion services.

Abortion in Britain is far less politicised than in the US, where the culture wars are said to produce cadres of committed abortionists. However, across the Atlantic, despite widespread public support for abortion and increasing demand, being an abortion doctor is a low-status and unglamorous job. ~ Independent, Apr 16   

BEREAVED MOTHERS CLASH WITH ABORTION SUPPORTERS

The grief of mothers of stillborn babies is set to clash with abortion rights in California. Legislators there are preparing to debate a bill which would authorise the state to issue a "certificate of birth resulting in stillbirth", a measure which already exists in 18 states. Currently mothers of stillborn babies leave hospital with a death certificate, but not with a birth certificate. For many of them this is a sorrow and an injustice.

Although everyone sympathises with the bereaved mothers, abortion supporters worry that the bill might lend support to the contention that the foetus is an unborn person. "Any time we deal with any legislation, we have to think big and think about unintended consequences," says Yali Bair, of Planned Parenthood. She feels that it is important not to define a stillbirth in a way which might include terminations. ~ San Francisco Chronicle, Apr 10   

ANOTHER SOUTH KOREAN CLONER IN HOT WATER

The South Korean government has done a lot of huffing and puffing about restoring the ethics and credibility of Korean stem cell science after the Hwang debacle broke in 2005. But just weeks after a plagiarism scandal in California involving the director of a Korean stem cell institute, suspicions have arisen about a paper on wolf cloning at Seoul National University by a former associate of Hwang.

Professor Lee Byeong-chun claimed in the international journal Cloning and Stem Cells that he had cloned two wolves. Now a group of Korean scientists has expressed their scepticism and his University has announced a probe into his results.

In the wake of revelations of Hwang's fraudulent research, Professor Lee was suspended for three months. However he returned to his job after it was shown that he had succeeded in cloning dogs. ~ Korea Times, Apr 9   

IS THERE A RIGHT TO A CHILD?

The issue of whether there is a right to bear children surfaced again in Britain after a woman lost an epic fight in the courts to have her frozen embryos implanted. "I am distraught at the court's decision today. It is very hard for me to accept that the embryos will now be destroyed and I will never become a mother," said Natallie Evans.

Ms Evans and her boyfriend Howard Johnston had six embryos frozen in 2001 before she underwent chemotherapy which left her infertile. But afterwards the couple broke up and her boyfriend adamantly refused to consent to using the embryos. He does not want to have his child raised by a woman with whom he is no longer connected. The law in the UK clearly requires that both partners consent to a pregnancy.

Now, after exhausting her options in the British system, Ms Evans has been told by the European Court of Human Rights that her right to become a parent in a genetic sense did not deserve greater respect than her former fiance's right not to have a child with her.

The case has been widely followed in Britain. Columnist Mary Kenny declared that giving Ms Evans a chance to try for a child was both pro-choice and pro-life: "the woman's choice should take precedence". And former Marxist Mick Hume, of Spiked, used the case to inveigh against a "human rights culture": "The harsh fact is that nobody can be granted the human right to have a baby or a family life. Nobody can be guaranteed the human right not to be unhappy." ~ Spiked, Apr 13; Guardian, Apr 11; CommentIsFree, Apr 10   

ADULT STEM CELLS MAY HAVE CURED DIABETES

Dr Voltarelli (left) and Dr Burt with unidentified diabetes patient. Adult stem cells may have cured young Brazilian diabetics of their ailment. "It's the first time in the history of type 1 diabetes where people have gone with no treatment whatsoever," says Dr Richard Burt, of Northwestern University. An accompanying editorial in the Journal of the American Medical Association says that the results will stimulate more research which could prevent or reverse type 1 diabetes.

Dr Burt and his colleagues received some criticism for the ethics of the study, which involved only 15 patients, one as young as 14. He says that he needed to go to Brazil as US doctors were not interested in his approach. He worked there with Dr Julio Voltarelli. The treatment involved stimulating the body to produce new stem cells and harvesting them from amongst blood cells. Several days of high-dose chemotherapy shut down the immune system, stopping the destruction of the few remaining insulin-producing cells in the body. Then the harvested stem cells were reinjected to help build a healthier immune system.

The study was small and preliminary, but suggests that the devastation of type 1 diabetes may be curbed by adult stem cells. "It's the threshold of a very promising time for the field," says Dr Jay Skyler, author of the JAMA editorial. ~ JAMA, Apr 11; AP, Apr 10   

HOMEBREW SPERM ON HORIZON

British researchers have turned human bone marrow tissue into primitive sperm cells, raising hopes that it may be possible for women to produce their own sperm. Biologist Karim Nayernia, of the University of Newcastle-upon-Tyne, obtained mesenchymal stem cells from four adult men about to undergo bone marrow transplants. His team managed to morph these into spermatogonium cells, from which mature sperm capable of fertilising eggs originate.

This work is quite preliminary, as no functioning sperm have been created yet. Furthermore, other biologists warned that manipulating the stem cells could lead to permanent genetic changes and abnormalities. However, Dr Nayernia is optimistic that infertile men could use the technique to conceive naturally. And lesbians could also use the technique to produce their own biological daughters. No time line was reported. ~ New Scientist, Apr 13   

 

  

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Australasian Bioethics Information
ISSN 1446-2117
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BioEdge editor: Michael Cook
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