He also complains that IVF is becoming a manufacturing process. "In some places IVF is almost becoming a production line whereby diagnosis is ignored merely to get a patient into the IVF process and thereby produce a baby. With this, couples are happy to have a healthy baby but a diagnosis is never made and no research investment occurs to improve our knowledge."
Professor Norman's complaint echoes stinging comments made by Lord Robert Winston, a leading fertility researcher in the UK. "Amazing sums of money are being made through IVF," he said in May. "... money is corrupting this whole technology."
But commercialisation is not Professor Norman's only concern. Because patients receive subsidies from the Australian government for an unlimited number of IVF cycles, there is less incentive for doctors to investigate simpler treatments, such as "ovulation induction, intrauterine insemination and lifestyle modification". And this happens even though IVF babies have a higher risk of significant health problems. ~ ABC News, Sept 3
The British fertility watchdog has approved the creation of human- animal embryos. After having lobbied long and hard for permission, stem cell scientists were relieved. Dr Stephen Minger, of King's College, London, said: "These techniques provide the only ethically justifiable option given the large numbers of eggs required to derive cloned human stem cell lines from individuals with incurable and highly progressive neurological disorders."
Approval was almost certain after the Human Fertilisation and Embryology Authority released a long-awaited public consultation this week. The HFEA claimed that a majority -- 61% --of Britons are "at ease" with the controversial procedure. However, this cheery interpretation involved some creative fudging on the HFEA's part. True, 61% were in favour when told that the hybrids would help to understand diseases, but 22% had never even heard that such a thing was possible. And, to pick one amongst many figures, only 32% were unconcerned about what scientists might do next if they were allowed to create hybrids. Those who were most concerned, in fact, were those who were best informed.
The consultation, a three-month process of opinion polls, public meetings and debates, found that people were initially wary of merging animal and human material. However, after they were given more information, they began to see the light. There is more support for inserting human genetic material into hollowed-out animal eggs (cytoplasmic hybrids) than there is for combining human and animal gametes (true hybrids).
"It does seem a little abhorrent at first analysis, but you have to understand we are using very, very little information from the cow in order to do this reprogramming idea," says Dr Lyle Armstrong, of Newcastle University. "It's not our intention to create any bizarre cow-human hybrid; we want to use those cells to understand how to make human stem cells better."
Hybrid embryos are strongly opposed by some groups. Dr Helen Watt, of the Linacre Centre for Healthcare Ethics, said the technique was a violation of the rights of the embryo. "The embryo is deprived not only of its life in the course of the experiment, but of any human parents," she told the BBC. "It is further dehumanised by the very method of its creation." ~ BBC, Sept 5; Guardian, Sept 4; London Telegraph, Sept 6
BOTCHED ABORTION OF DOWN CHILD SPARKS DEBATE IN ITALY
The tragic case of a botched selective termination has thrown more petrol on to the smouldering abortion debate in Italy. A 38-year-old woman who was pregnant with twins discovered after a prenatal test that one of them had Down's syndrome. Her gynaecologist performed a "foetal reduction" -- but killed the healthy one by mistake. The two had changed position in the womb -- "an act of fate that could not have been foreseen", according to the gynaecologist. She was backed by the hospital. Later on, the Down's syndrome child was also aborted. The woman and her husband, who already have a son, say that they are heartbroken.
The case was seized upon by opponents of abortion. "What happened in this hospital was not a medical abortion but an abortion done for the purposes of eugenics," Senator Paola Binetti, a medical doctor and member of the national bioethics committee, wrote in the newspaper Corriere della Sera. ~ AFP/New York Times, Aug 28; London Times, Aug 29
RUSSIAN PSYCHIATRISTS REVERT TO BAD HABITS
Russian psychiatrists are falling back into bad habits of the Soviet era by drugging and hospitalising critics of the government -- or even of mental hospitals. According to the Independent Psychiatric Association, a Moscow watchdog, they can even arrange a zombie-like existence for the victims of unscrupulous relatives or criminals. "We see cases of psychiatrists taking bribes and faking diagnoses all the time," says Gennady Gudkov, a member of the Russian Duma (parliament). Two doctors, in Nizhniy Novgorod and Ulyanovsk, are currently on trial for having committed old people and sold their apartments for personal profit.
An even more sinister development is using mental hospitals for political critics. According to Newsweek, Andrey Novikov, a journalist in central Russia, was jailed earlier this year on charges of "extremism" after criticising policies in Chechnya. Not long afterwards Novikov was sent for involuntary psychiatric treatment for what his doctors say in court papers would be "as long as it takes to have his mental health fully restored." Another journalist, Pavel Kuznetsov, was declared "mentally unsound" in February after criticising local authorities' inefficiency in the newspaper.
Journalist and activist Larisa Arap was hospitalised and drugged in July after she published an article on child abuse in local psychiatric wards. An independent commission agreed that she showed some signs of mental instability, but that hospitalisation was unnecessary. Pressure from international media led to her release in August.
"We're returning to this Soviet scenario when psychiatric institutions are used as punitive instruments," says the president of the Independent Psychiatric Association, Yuri Savenko. "I call this not even punitive psychiatry, but police psychiatry, when the main aim is to protect the state rather than to treat sick people." ~ Chicago Tribune, Aug 7; Radio Free Europe, Aug 22; Newsweek, Sept 3
US PSYCHIATRISTS AN IRRELIGIOUS LOT
A nationwide survey has found that the least religious of all medical specialties in the US is psychiatry. "Something about psychiatry, perhaps its historical ties to psychoanalysis and the anti-religious views of the early analysts such as Sigmund Freud, seems to dissuade religious medical students from choosing to specialise in this field," said study author Farr Curlin, assistant professor of medicine at the University of Chicago. "It also seems to discourage religious physicians from referring their patients to psychiatrists."
"Because psychiatrists take care of patients struggling with emotional, personal and relational problems," Curlin says, "the gap between the religiousness of the average psychiatrist and her average patient may make it difficult for them to connect on a human level."
Although 61% of all American doctors were either Protestant (39%) or Catholic (22%), only 37% of psychiatrists were Protestant (27%) or Catholic (10%). However, 29% were Jewish, compared to 13% of all doctors. About 17% of psychiatrists listed their religion as "none," compared to only 10% of all doctors.
Although Protestant physicians were only half as likely to send a patient to a psychiatrist, Jewish physicians were more likely to do so. Least likely were highly religious Protestants who attended church at least twice a month and looked to God for guidance "a great deal or quite a lot." ~ University of Chicago, Sept 3
PARENTHOOD 2.0
It's time to abandon out-moded notions which restrict parenthood to biological mothers and fathers, argue two Australian researchers in a forthcoming issue of the international journal Human Reproduction. The development of technology, say bioethicist Guiliana Fuscaldo and sociologist Sarah Russell, has created a new spectrum of possible parents.
"Perhaps it is time to accept that there is more to parenting than just biology and to abandon the idea that different "parents" (genetic, gestational, social and legal) are in competition. We could simply accept that a child can have more than two parents [and] that all of them can play roles in raising that child. After all, we have known for a long time that 'it takes a village'," they write in the Age newspaper. They do not propose any limit on the number of individuals who could be nominated as parents of a child. ~ Age, Sept 3
KITCHEN EUTHANASIA
At an age when most old people are content to potter about their kitchen and make cups of tea, a group of Australian seniors are cooking up lethal doses of the barbiturate Nembutal. The drug has been banned in Australia since 1998 but is the suicide drug of choice for members of Exit International, a group founded by Dr Philip Nitschke, a prominent Australian euthanasia activist. They have now made a YouTube video which shows unnamed members concocting the lethal drug with a pressurised pot on a kitchen stove-top. The result is a thick, creamy substance which looks a bit like margarine. The makers of the video claim that it is Nembutal, although they have not tested it yet.
Dr Nitschke says that the kitchen chemists want to have a peaceful, pain-free death if they become weakened by illness or age. The video can be seen on YouTube. ~ Courier Mail, Aug 28
PROTECTING PRIVACY OF EXECUTIONERS
A doctor attends executions by lethal injection in Florida to confirm deaths -- but for the past year he has been wearing a purple moon suit and goggles to ensure his anonymity. With 318 men on death row, there is a steady flow of work.
The moon suit is meant to conceal the doctor's identity not only from the prisoner's family and friends, but from the American Medical Association, which strongly opposes the participation of its members. "We are a profession dedicated to healing," says Dr Mark Levine, chairman of the AMA's Council of Ethical and Judicial Affairs. "Participation in an execution is an image of a physician with a dark hood."
Capital punishment is legal in 38 states, most of which protect the privacy of doctors who attend executions. In July a Missouri newspaper revealed that a doctor who has supervised 54 executions has been sued for malpractice more than 20 times and has a history of making medical mistakes. The legislature responded by passing a law which will allow doctors to sue anyone who discloses their identity. Otherwise, said government officials, it will be difficult to find a cooperative doctor. ~ AP/MSNBC.com, Aug 28; Washington Post, July 31
ILLINOIS JUMPS ON STEM CELL BANDWAGON
The state of Illinois has passed a law allowing human embryonic stem cell research, but banning human cloning. "Stem cell research has limitless potential to help cure devastating diseases, from Parkinson's to diabetes and even many forms of cancer," said Governor Rod Blagojevich. The law formalised an executive order which the governor issued two years ago. With that, he established an Illinois stem cell institute authorised to use embryonic stem cells. ~ Chicago Tribune, Aug 29
SHUFFLING OFF THE MORTAL COIL
Occasionally an amateur ethicist like the editor of BioEdge discovers an article so cogent and consistent that it sheds more light than shelves of textbooks. Whether or not it is correct, or even sane, is quite another matter. Such is the case with "The body as unwarranted life support: a new perspective on euthanasia", in the latest issue of the Journal of Medical Ethics, a British publication.
David Shaw, of the University of St Andrews, cuts the Gordian knot of the euthanasia debate. Teasing out the distinction between "letting die" and actively ending life has filled many volumes. Here is his solution: the patient is not his body; he is his mind. Since the body is merely the instrument of the mind, when it becomes an encumbrance, it can ethically be turned off, like any other machine. QED.
In fact, contends Dr Shaw, denying a patient's request for voluntary active euthanasia or assisted suicide is wrong: "it is almost as if doctors are obeying the 'wish' of the patient's body rather than the patient's mind, as keeping bodies functioning is what doctors are habituated to. This attitude is understandable, but it is not ethical."
To the amateur ethicist, this appears to be a logical consequence of the mind/body distinction on which the textbooks expatiate in mind- numbing detail. The body is not an integral part of the person, but merely an instrument yoked to the mind, which is the real self ("fastened to a dying animal", as Yeats said). Deep waters, these, and the implications for medicine are immense and uncharted. ~ Journal of Medical Ethics, September
How to support BioEdge
BioEdge and ABI's other services rely completely upon the generosity of private benefactors and volunteer workers. ABI has no institutional backing. If you would like to support the best bioethics news service on the Web, you can do it painlessly through Paymate, a thoroughly reliable payment service which is affiliated with the internet auction site eBay.
Just access the Paymate website and follow the instructions. You will need to fill in our email address, which is bioedge@australasianbioethics.org. You will also have to give your credit card details and an amount in Australian or US dollars. Thanks!
|
To subscribe to our weekly email newsletter,
click here for the HTML version.
click here for the text version.
To cancel your newsletter subscription, click here.
Australasian Bioethics Information
ISSN 1446-2117
Website:www.australasianbioethics.org
BioEdge editor: Michael Cook
New Zealand Contributing Editor: Carolyn Moynihan
The BioEdge privacy policy
Your subscription information will be kept private and is not publicly accessible.
Your email address and other information will never be sold to a third party or given out
without your consent. You may cancel your subscription at any time.
|
An Australian IVF expert has joined the doyen of British fertility studies in criticising the increasing commercialisation of his industry. According to Professor Robert Norman, of Adelaide University, "We are seeing the rise of IVF mega businesses whereby some of the people running IVF units are more interested in the financial aspects than the medical components of IVF."