Human embryonic stem cells could "revolutionise" drug discovery and testing, according to an article in the latest issue of the journal Nature Reviews Drug Discovery. There are significant problems to be overcome before the cells can be commercially useful, but their potential is enormous, contend Colin Pouton and John Haynes, of the Department of Pharmaceutical Biology, at Monash University in Melbourne. ESCs can be used for primary screens, secondary pharmacology, safety pharmacology, metabolic profiling and toxicity evaluation. Drug discovery will be more efficient and fewer experiments on animals and people will be needed.

Admittedly, it is still proving difficult to make embryonic stem cells differentiate into other cell types properly, an essential requirement for reliable testing. However, when this hurdle is overcome, they will "certainly provide commercial opportunities for innovative small and medium-sized enterprises."

Indeed, this may already be happening, the article hints. "Advances in stem-cell technology have considerable commercial potential, which means that it is possible that the published [academic] literature lags behind commercial activity and the patent literature," it says. Since 2001, 246 patent applications with the words "embryonic stem cells" in their abstract have been published in the US. ~ Nature Reviews Drug Discovery, August   

LONDON IVF DOCTOR TANGLES WITH REGULATOR

The livelihood of Britain's most successful IVF doctor is at risk after he was found guilty of treating patients without a correct licence.

The UK fertility regulator said last month "that the clinic is a successful one, much appreciated by patients, and Mr Taranissi is a dedicated physician". However, he "had not been fully mindful" of the regulations and "had not displayed the necessary understanding of the important duties and responsibilities" required by the person responsible for running a clinic.

A last-minute extension has given Dr Taranissi a month's reprieve to appeal. He said that he was going to celebrate by making "three new babies" on the day.

Dr Taranissi and the Human Fertility and Embryology Authority have long been at loggerheads. In January the HFEA raided his clinic to retrieve records. He sued and the raid was found to be illegal. But the HFEA stripped him of his licence anyway.

The maverick doctor is also suing the BBC over a program broadcast in January which alleged that one of his clinics had offered "unnecessary and unproven" fertility treatment to an undercover journalist. If it loses, the BBC could face over £1 million in damages and legal costs. ~ Daily Mail, Aug 9   

GENETIC ANGER MANAGEMENT IN AUSTRALIA

A campaign to encourage parents to tell donor-conceived children about their origins has prompted a lively discussion in the opinion pages of one of Australia's leading newspapers. The Infertility Treatment Authority of the state of Victoria recently launched phase two of a three-year campaign, along with the world's first evidence- based "telling" guide. Only about a third of donor-conceived children are told, surveys suggest, and the ITA says that parents should steel themselves for negative reactions from teenage children.

This prompted a letter in The Age from a bioethicist at Monash University, Dr Giuliana Fuscaldo, a former IVF clinic employee. She argued that there was little evidence to support the need for such a campaign. Anonymous sperm or egg donation was unlikely to harm children. "There is more to families and our identity than genetics," she concluded. An egg donor also wrote an op-ed column saying that she had no interest in knowing anything about her offspring.

Dr Fuscaldo's comments infuriated advocates of candour with donor- conceived children. A spokeswoman for the Australian lobby group Tangled Webs wrote "here we have a bioethicist supporting a system of genetic deception that can only be described as morally corrupt and discriminatory." Professor Eric Blyth, of the University of Huddersfield, wrote from the UK that "deceiving children about their origins is a matter of ethics and not one that needs to be justified by empirical evidence". And the author of a Canadian government report on surrogate motherhood, Juliet Guichon, weighed in, as well: "Adults have been looking after their own interest at the expense of the more vulnerable, the children".   

PRIVATE ENTERPRISE FILLS SPERM DONOR INFORMATION GAP

Apart from screening semen for infectious diseases, there is no central monitoring of sperm donors in the US. This means, says the founder of DSA, Kirk Maxey, that sperm banks do not verify all the information given to them. They do not routinely test for many genetic diseases. They do not even confirm that the sperm requested by a woman is the sperm which she receives. They do not track donors.

Because there is so little information, there have been few complaints so far, but some irregularities have emerged. For example, the record of a registry which enables children to meet their half-siblings united several women who had received sperm from a single donor. But DNA testing showed that one of the children had a different father. In another case, an unidentified man who donated to a clinic in Michigan has passed on a rare congenital disease to at least five children. The sperm bank has no idea how many children he has fathered.

Mr Maxey was once a sperm donor himself. But he quit when he discovered that a lab technician had stolen a vial of his sperm and inseminated herself. "I'm convinced that every conceivable misstep and perversion has happened," he says.

Some bioethicists have reservations about DSA's plans. Arthur Caplan, of the University of Pennsylvania, says that it violates the principle of informed consent. "Surreptitiously keeping samples in a biobank without explicit consent is unethical," he says. ~ New Scientist, Aug 9   

IS SEX SELECTION MIGRATING TO CANADA?

SHOULD PATIENTS BE PAID TO TAKE THEIR MEDICINE?

Representing the affirmative was psychiatrist Tom Burns, of Warneford Hospital. How can it be considered ethical to lock a psychotic patient up and force him to take medicines, yet unethical to pay him to take them, he asks. There is some evidence that payment works, he writes. One US survey found that half of all mental patients had been offered some form of reward or coercion to cooperate in their treatment. In fact, payment is an acknowledgment of fairness and respect.

Rerpesenting the negative was Joanne Shaw, a UK health bureaucrat. Non- adherence to drug regimes can be very costly, she acknowledges. Transplant patients who neglect to take their anti-rejection drugs lose their organs or their lives, for instance. However, payment for adherence creates perverse incentives because even people who do not need it would ask for payment. "After all, why should patients agree to take medicines for nothing if they can be paid?" In the end, everyone might be pauid, at an enormous cost. Furthermore, it raises serious questions about informed consent. Payment sends a signal that patients are being asked to do something which is not really in their own interest. ~ BMJ, Aug 4   

ELECTRODES ROUSE MAN FROM SIX-YEAR SLUMBER

A man who received a "pacemaker for the brain" has partially recovered from a minimally conscious state. After six years of almost complete inability to communicate or even swallow, the unnamed 38-year-old can eat without the help of a feeding tube and follow a conversationt, scientists have reported in the journal Nature. "He has regained his personhood, his personal agency," said Dr. Joseph J. Fins, chief of medical ethics at Cornell University, and a co-author of the study. The patient has amnesia and cannot yet fully represent his interests, Dr. Fins added, "but now he's got interests to represent."

The man sustained severe brain injuries after being mugged and kicked in the head in 1999. At one stage his mother signed a "do not resuscitate" order. But after the pacemaker was installed, she says, "I cry every time I see my son, but now it's tears of joy."

The deep brain stimulator which transformed the man's life has already been approved for treating Parkinson's disease. However scientists caution that they do not know how many other patients could benefit. "We really see this as a first step, but it should open doors that have not been open before for patients like this," said Dr Giacino. ~ New York Times, Aug 1   

SCOTTISH DOCTORS LOBBY FOR PRESUMED CONSENT
    IN ORGAN DONATION

The BMA says that waiting lists in Scotland are rising and says "we need to ask the public its view again so we can move forward on this issue." The number of Scottish patients on the waiting list for an organ rose from 702 in July 2005 to 818 last month. But in the same time, the number of transplants actually fell, from 229 to 222. ~ Scotland on Sunday, Aug 5   

AUSTRALIAN PRIZE FOR HUMAN CLONING

CLONED UNTO FOURTH GENERATION AND STILL HEALTHY