BioEdge 267 -- Wednesday, 26 September 2007

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BioEdge 267: Was John Paul II euthanased?

THIS WEEK


bullet 
Was John Paul II euthanased?
      Sensational allegations in Italian media
bullet 
German politician backs euthanasia
      Recruits Swiss activist in campaign
bullet 
Californian euthanasia supporters find loophole
      Advice only
bullet 
Nature backs drugs in sport
      We're all grown-ups here
bullet 
Screening leads to unnecessary abortions, says Israeli study
      Mildly affected children terminated
bullet 
UK clinic to screen for Alzheimer's
      Only 35 years of worthwhile life possible
bullet 
Enthusiasm for hybrid embryos spreads
      Even Hwang climbs on board
bullet 
Sex-change operations leave patients satisfied
      But there are complications
bullet 
Death in gene therapy trial raises questions
      Factoring in financial pressure for informed consent

Was John Paul II euthanased?

coffin of John Paul II The deaths of popes offer rich pickings for scandal-mongers and conspiracy theorists. David Yallop sold 6 million copies of In God's Name, which argued that John Paul I was murdered in 1979 by corrupt officials who feared exposure of their shady deals, changes in Catholic teachings on contraception, cosying up to the Soviets, and so forth.

Now it is John Paul II's turn. Time magazine reports that he may have been euthanased in 2005. It bases these "grave accusations" on an article in the high-brow magazine Micromega, an offshoot of the left-wing Italian newspaper Repubblica. In "The Sweet Death of Karol Wojtyla", an anaesthetist at the University of Ferrara, Lina Pavanelli, says that the Pope refused to have a feeding tube until a few days before his death and this ultimately killed him. Time journalist Jeff Israely suggests that if Dr Pavanelli's surmises are true, the Pope or his minders may have been guilty of euthanasia.

Dr Renato Buzzonetti, doctor to both John Paul II and his successor, waved away the sensational allegations. "His treatment was never interrupted. Anyone who says otherwise is mistaken". He said that a feeding tube was inserted three days before the Pope's death when he could finally no longer ingest food or liquids.

This story has to be placed in its context, which is the malarial swamp of Italian politics. Bioethical issues like euthanasia, stem cell research and abortion are hot button issues in Italy, where Catholics have been bitterly resisting progressive trends. Micromega is known for being critical of Catholic bioethics and Dr Pavanelli's speculations leave the Vatican looking mendacious and hypocritical. The article may have been timed to coincide with a Vatican reaffirmation of the need to provide food and water even to patients who will never regain consciousness. ~ Time, Sept 21

German politician backs euthanasia

Assisted suicide in English-speaking countries is generally associated with progressive politics. However, in Germany a right- wing politician has created a stir by offering to manufacture and distribute a suicide machine. Roger Kusch, a former justice minister in Hamburg who is standing as a candidate for his own party, Heimat Hamburg, in elections in October, is no shrinking violet. He displayed a prototype of his apparatus as a nursing home in the town of Lokstedt. Assisted suicide is illegal in Germany, but Kusch maintains that the law does not cover his machine because the patients themselves will activate the lethal injection.

Kusch also wants Hamburg to create a help centre which will offer advice to citizens who are interested in euthanasia. He argues that euthanasia is a fundamental right and has enlisted Switzerland's most prominent figure in the euthanasia movement, Ludwig Minelli, of the assisted suicide association Dignitas, in his campaign. (German speakers can listen to Kusch's spiel on YouTube.

Left-wing media scored points by pointing out the danger of encouraging the elderly to take an early exit because they are "unproductive, useless and an unacceptable burden on the welfare state". ~ Hamburg Express, Sept 11; World Socialist web site, Sept 15; Heimat Hamburg website

Californian euthanasia supporters find loophole

In California, supporters of assisted suicide have adopted a similar strategy. Having failed to persuade the State Legislature to legalise it, as in neighbouring Oregon, they have resorted to setting up an advisory service. "Volunteers will neither provide nor administer the means for aid in dying," said Rev. John Brooke, a United Church of Christ minister who is an organiser of the new End of Life Consultation Service. "We will not break or defy the law."

His group will advise the terminally ill on how to find better end- of-life care and will remain present to comfort people as they commit suicide. A spokesman for an opposition lobby group, the Campaign for Children and Families riposted that it sounded like the formation of "California death squads". ~ San Jose Mercury, Sept 18

Nature backs drugs in sport

The world's leading science journal, Nature, has endorsed performance-enhancing drugs in sport. Its argument is based on the growing acceptance of drugs by ordinary people to help them cope with everyday life. "By the end of the century," says Nature's editorial, "the unenhanced body or mind may well be vanishingly rare." To me sure, drugs are risky, but adults have to take responsibility for their own lives.

"If spectators are seeking to reset their body mass index through pharmacology, or taking pills that enhance their memory, is it really reasonable that athletes should make do with bodies that have not seen such benefits?" Nature asks. "The more the public comes to live with the mixed and risk-related benefits of enhancement, the more it will appreciate that allowing such changes need not rob sport of its drama, nor athletes of their need for skill, training, character and dedication."

The editorial sparked a couple of indignant letters. Pharmacologist Piero Dolara, of the University of Florence, responded that increased physical performance because of drugs is often associated with serious side effects. He also worries that it could lead to "wild drug experimentation". "To my knowledge," he writes, "the rule primum non nocere -- first, do no harm -- has not yet been abolished for the medical profession". ~ Nature, August 2; September 20

Screening leads to unnecessary abortions, says Israeli study

With fresh discoveries of disease genes announced almost weekly, more and more doctors are offering parents the possibility of having an abortion to prevent affected children from being born. However, an article in the Journal of the American Medical Association questions whether screening is appropriate for treatable or non-fatal diseases. Researchers in Israel who studied Gaucher disease, a condition whose symptoms range from severe to unnoticeable, found that 25% of couples aborted babies with the bad gene even though the abnormality would not have resulted in a serious health problem.

"Not until clinicians and researchers better understand the factors that determine whether a patient... will develop severe disease or none at all will screening for Gaucher disease become useful," said Dr Ernest Beutler, an expert on the condition. Until then, he said, such screening "will likely do more harm than good."

And ethicist Dr Lainie Friedman Ross, of the University of Chicago, said that the purpose of screening was not to test for minor diseases. "We want testing to help us diagnose a serious disease, to find the right treatments for those diseases -- treatments we'll respond to -- and some want it for making decisions about serious genetic abnormalities in their potential children," she said. "Gaucher doesn't fit into any of those models." ~ Chicago Tribune, Sept 18

UK clinic to screen for Alzheimer's

A couple who fear that they will pass on a gene for early-onset Alzheimer's disease have been given permission to screen their embryos to keep any with it from being born. The Bridge Centre, an IVF clinic with a history of pushing the envelope on ethical issues, will screen embryos for Charl and Danielle de Beer. Mr de Beer's mother, grandmother and two uncles died prematurely from the condition.

The scientific director of Bridge, Dr Alan Thornhill, says that because early-onset Alzheimer's strikes in the late 30s and early 40s, it can mean that the person "has only half a life worth living". However, he noted that people had to be very serious about the screening, as it is a very difficult process emotionally and physically. Screening for early-onset Alzheimer's is news only in the UK. Dr Yuri Verlinsky, of the Reproductive Genetics Institute of Chicago, did this as long ago as 2001. ~ London Telegraph, Sept 21

Enthusiasm for hybrid embryos spreads

Hybrid embryos are clearly the Next Big Thing in stem cell research. Hard on the heels of a decision by the UK's fertility authority to allow approved research groups to create them, the idea is popping up everywhere. And, as usual, the more controversial the research, the more dramatic the alleged benefits.

In Scotland, the creator of Dolly the clone sheep has predicted that therapies resulting from stem cells will one day be as common as antibiotics. Professor Ian Wilmut says that hybrid embryos, created using cow eggs and human DNA, are essential to study genetic diseases and test drugs. "If we could have nerves in the dish which show that change, then people with the right sort of technology would be able to literally test thousands of compounds every year," he said. "That is probably 1000 times faster than anything that can be done in any other way at the present time." Professor Wilmut is thinking of applying for permission to create hybrid embryos.

In the US, the New York Times has given the "valuable alternative" of hybrid embryos its tentative backing. The main reason for this radical step, it notes, is that "there are distressingly few women willing to donate their eggs for experiments at the frontier of this promising science." According to the Times, stem cell researchers at Harvard spent US$100,000 in advertising to encourage women to donate their eggs -- but after hearing how difficult it would be, not one volunteered.

Even the disgraced Korean researcher Hwang Woo-suk is climbing onto the band wagon, although he apparently prefers the more neutral term "inter-species nucleus transplant". He and ten colleagues have moved to an unnamed university in Thailand to conduct research on hybrid embryos. According to a colleague at Cheju National University, Park Se-Pill, Hwang wants to avoid provoking further protests from civic and religious groups in Korea, even though he would not be breaking any laws there. "These days the ethical yardstick is more important than judicial judgements," Dr Park commented glumly.

Hwang is still fighting fraud charges in Korea over faked experiments which purported to show that his team had created human embryonic stem cell lines. ~ Sunday Herald, Sept 22: New York Times, Sept 24; Wired/AP

Sex-change operations leave patients satisfied

Despite significant complication rates, most sex-change surgery patients in Britain assert that they are happy with the outcome. According to a survey of 220 men who became women conducted by University Hospitals of Leicester shortly after the operation, 88% were "content" and only 7% were unhappy. However, in a survey of 70 patients a few years after the surgery, 29% reported major complications which could require further surgery. Still, three- quarters of these said that they were happy. ~ BBC, Sept 23

Death in gene therapy trial raises questions

The mysterious death of an Illinois woman in a gene therapy clinical trial has raised questions about informed consent and the future of novel therapies like embryonic stem cells. Jolee Mohr was a 36-year- old mother who suffered from rheumatoid arthritis. Her symptoms were already being managed with a new anti-inflammatory drug, but her doctor signed her up for an experiment run by a Seattle biotech, Targeted Genetics. Three weeks after an injection of genetically altered viruses, she was dead.

There has been no convincing evidence so far that her death was caused by the gene treatment, but the news is disquieting for potential investors in gene therapy. The final results of an autopsy are expected in December.

In the meantime, there has been much discussion of the informed consent process. Mrs Mohr was recruited by her doctor, but she was not told that he was being paid for every patient he signed up. He also secured her consent on the spot, rather than letting her study the 15-page form at home. Recruitment by doctors has always been a controversial practice, because patients routinely believe that experimental treatments recommended by their own doctor are likely to help them.

Bioethicist Arthur Caplan, of the University of Pennsylvania, says that the tragedy underscores the high risk of participating in clinical trials for novel therapies. He suggests that there should be a national insurance program for people injured in early-stage research studies, so that their bereaved families do not have to engage in lengthy litigation to pay their bills. He also questions whether there is enough protection for patients when drug companies are sponsoring much of the research, when for-profit ethics committees are reviewing trials, and when doctors are paid for recruiting patients. ~ Washington Post, Sept 18; MSNBC.com, Sept 17

 

  

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