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Bioethics 101

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June 30, 2007

Dr. Maureen Condic Gets Her Say

Nearly two months ago, I posted an entry about the science journal Nature Neuroscience’s unfair editorial attack on Dr. Maureen Condic because she dared to question embryonic stem cell research dogma that ES cells offer the best hope for treatments, in the religious journal First Things. Making matters worse, after unfairly maligning her as “anti science,” the journal had refused to allow Condic to respond to its criticisms in the same forum in which they were made.

A lot of pressure was placed on the Nature Neuroscience and it relented. Condic’s letter to the editor published in the July 2007 issue is too long to print in full here, and there is no link. But here are a few choice excerpts:

Although the editors acknowledge that I am “correct in asserting that there are formidable hurdles to overcome before hESCs might serve therapeutic purposes”, they groundlessly assert that my article is “anti-scientific”, “polemical” and “disingenuous distortion of scientific arguments.” I will not attempt to refute this false characterization. I will simply restate what the editors do not–and cannot–deny: the scientific evidence overwhelmingly indicates that hESCs are unlikely to be useful for human therapies in the near future.

The issues of immune rejection, tumor formation and hESC differentiation raised in my article are not distortions or mere polemic; they are matters of scientific fact. These same concerns have been raised in the scientific literature.

Indeed. If there were polemics being thrown around, it was the editors of Nature Neuroscience who were doing the slinging.

Condic concludes on this powerful note:

Although serious scientific obstacles may not constitute sufficient reason to “abandon the search for stem cell therapies”, such obstacles can be addressed with far greater scientific power using animal models. For ethically controversial hESC research, we must engage in a frank, public discussion of the formidable hurdles preventing the development of stem cell therapies, if public policy is to be based on scientific fact, and not on science fiction. Rather than promoting such a rational civil discourse, the editors of Nature Neuroscience have sent the clear message that scientists who break ranks and publicly discuss the serious obstacles confronting hESC research will be groundlessly maligned in the editorial pages of a prestigious scientific journal.

Attempting to suppress public disclosure of the facts is, in the words of the editors, both a “disingenuous distortion” and an attempt “to spin science…to fit an anti-scientific purpose”.

Condic nails it again. Suppressing and punishing heterodox views is not only corrosive of science, it is disrespectful of democratic discourse.

June 29, 2007

Nano Laser Probes Cells

Researchers have developed a laser smaller than a red blood cell that can be tuned to emit different colors. They have incorporated the nanowire-based laser into a device that, by combining features from multiple microscopy techniques, could reveal new details about the structure and behavior of living cells. (Technology Review)

Scientists ‘swap’ bacteria’s DNA

A team led by maverick U.S. geneticist Craig Venter is reporting it has successfully transferred an entirely new set of genetic machinery into a tiny microbe and “booted” it up.

The feat, published online Thursday by the journal Science, is being greeted as both a landmark in bioengineering and evidence that Venter is racing into ethically troubling territory. (Vancouver Sun)

Injured man’s awakening called ‘miracle’

Eighteen days after his wife instructed doctors to disconnect food and water tubes, a Chandler, Ariz. man is sitting up in his hospice bed, giving the thumbs-up sign and communicating with visitors. (USA Today)

Pill to make dieters ‘feel full’

Italian scientists have developed a pill that expands in the stomach to make dieters feel full. They liken the effect to eating a bowl of spaghetti and say the pill can stop hunger for a few hours. (BBC)

Pup may be first to try ‘ingrown’ leg

A puppy found hobbling in the Kuwaiti desert has ended up at Colorado State University, where she might be a candidate for an experimental prosthesis that could one day help humans. (MSNBC)

New Regulations Needed For Patients Receiving Animal Tissue Donation – Study Recommends Patient Waivers That Provide Full Disclosure Of Risks

A new article in The Journal of Law, Medicine and Ethics calls for a change in the regulations surrounding xenotransplantation, the transplanting of animal cells, tissues or organs into humans. Although few xenotransplantation procedures have been done to this time, there appears to be a lack of awareness among potential xenotransplant patients about the risk of the procedures, and the required lifetime of infectious disease monitoring that come with it. (Medical News Today)

Op-Ed: Michael Moore and I Agree! (Sort Of)

First, Mike, I want to thank you for inviting me to the Washington, D.C., premiere of your new movie SiCKO. You invited me even though you knew I was likely to criticize the film’s prescription for health care reform. (TCS Daily)

June 28, 2007

Scientists Transform One Type of Organism Into Another

The creativity of biotechnologists sometimes astounds. In this instance, as reported in Scientific American, scientists transformed one type of bacteria into another by transferring the latter’s total genetic makeup into the former. Why transmute one species into another?

As radical as this transformation is…it represents only the first step toward man-made organisms. “Synthetic biology itself and the synthetic genome still remain to be proven but we are much closer to knowing that it is theoretically possible,” biologist J. Craig Venter says. “Just the naked DNA, just the chromosome itself without any accessory proteins, is all that is necessary to boot up this cell system. It really simplifies the task.”

The goal is ultimately to design new organisms that fulfill specified functions, such as manufacturing new fuels to replace oil and gas or capturing carbon dioxide, without evolving so that these capabilities are locked in over time. Venter hopes to create fuels from such an engineered organism within a decade or less.

Do we have the wisdom to become the creators of new and novel life forms? Is this safe? Such questions are beyond my pay grade. But boy…

Bone Marrow Stem Cells Significant Help With Spinal Cord Injury?

Keep in mind this isn’t peer reviewed, hasn’t been replicated, and was released as part of a PR move, but get this:

From May 2006 to January 2007, 25 patients with SCI were treated at Luis Vernaza Hospital in Guayaquil, Ecuador. They were treated with autologous bone marrow stem cells–meaning the cells were extracted from the patients’ own bone marrow.

Fifteen patients (60 percent) could stand up, ten patients (40 percent) could walk on the parallels with braces, seven (28 percent) could walk without braces, and four (16 percent) could walk with crutches. Patients demonstrated improvements in sensitivity, motility, bladder sensation, even controlling sphincters, erection and ejaculation. No adverse event was observed.

No one should tout this as a cure, or even yet a proven treatment. It is very preliminary human subject research. There is a very long way to go before this could be available, even if it pans out. But there is great hope out there.

Pushing for Assisted Suicide on Demand

The Hastings Center Report is probably the most prestigious bioethics journal in the world. Thus, when an opinion article appears in its pages, the ideas expressed are definitely in play among the bioethical elite. I bring this up because an article appeared in the May-June edition advocating assisted suicide for the mentally ill.

I have long maintained that the weight-bearing ideological pillars of assisted suicide advocacy–radical individualism that includes the right to choose the time, manner, and method of death, along with the view that killing is an acceptable answer to the problems of human suffering–preclude legalized assisted suicide from being limited to the terminally ill. The force of human logic–one of the most powerful forces in the universe–simply would not permit such a “restricted” approach, proved by the experiences of the Netherlands, Belgium, and Switzerland.

In “A Suicide Right for the Mentally Ill?” Brown University professor Jacob M. Appel echoes the above–with the exception that he approves of a broad assisted suicide license and I oppose all legalization. Subscription is required so I can’t link the whole article, but here are a few key quotes:

At the core of the argument supporting assisted suicide are the twin goals of maximizing individual autonomy and minimizing human suffering. Patients, advocates believe, should be able to control the decision of when to end their own lives, and they should be able to avoid unwanted distress, both physical and psychological.

Appel claims that assisted suicide would “empower” patients with mental illness:

Most likely, the taboo against assisted suicide for the mentally ill is a well-meaning yet misplaced response to the long history of mistreatment that those with psychiatric illness have endured in western societies. Psychiatrists and mental health advocates may fear that their patients will be coerced to “choose death” against their wishes, or that, once suicide is an acceptable option, the care for those who reject assisted suicide will be diminished. But as the plaintiff argued before the Swiss high court, in challenging “medical paternalism,” we are entering an era during which psychiatric patients do not need to be protected, but empowered. Our goal should be to maximize the options available to the mentally ill.

Of course, this was known all along, but political expediency (my term) prevented proponents from being, shall we say, candid with the people:

Since assisted suicide for the terminally ill was itself taboo fifteen years ago, it was unrealistic to expect that a mainstream debate would arise over the issue of suicide rights for psychiatric patients. Contemporary psychiatry aims to prevent suicide, yet the principles favoring legal assisted suicide lead logically to the extension of these rights to some mentally ill patients. But now that several Western nations and one U.S. state have liberalized their laws, it seems reasonable to question the policies that universally deny such basic opportunities to the mentally ill.

Ponder that last sentence; self destruction as a basic opportunity. Finally, the real agenda is coming into the open. Good. It is disrespectful of democracy to continue to play a game of hide the ball by pretending that assisted suicide would be permanently limited to the terminally ill for whom nothing else can be done to alleviate suffering.

So, let’s debate near death on demand. Let’s debate having euthanasia clinics widely available so the suicidal don’t have to kill themselves by jumping off bridges. Let’s have an open and honest debate about the limits, if any, that should be placed by society on destructive individual actions.

Doctors vote to cut delays and ease access for early abortions

Doctors voted yesterday for easier access to abortions for women in the first three months of pregnancy. But the British Medical Association’s annual representative meeting drew the line at allowing nurses and midwives to conduct abortions, or relaxing the rules on where they may be carried out. (Times Online)

Op-Ed: Human DNA, the Ultimate Spot for Secret Messages (Are Some There Now?)

In Douglas Adams’s science fiction classic, “The Hitchhiker’s Guide to the Galaxy,” there is a character by the name of Slartibartfast, who designed the fjords of Norway and left his signature in a glacier. I was reminded of Slartibartfast recently as I was trying to grasp the implications of the feat of a team of Japanese geneticists who announced that they had taught relativity to a bacterium, sort of. (New York Times)

Brain Boosters

Our reporter enters the new world of neuroenhancers by having his brain zapped with electricity and dosed with chemicals. (Technology Review)

Stem-cell research one step closer to Holy Grail

A British stem-cell discovery has brought scientists within sight of the medical revolution which could lead to spare body tissue being mass-produced in laboratories. The first clinical steps towards this goal could now be just five years away, according to one leading scientist. (The Herald)

High rate of misdiagnosis in patients in an acute vegetative state

New studies underline the importance of extreme caution in any decision to limit the life chances of patients during the acute phase of a vegetative state. (News-Medical)

AMA: Patents for Procedures Raise Ethical Hackles

The American Medical Association has decided not to soften its 1995 position that it is unethical to patent surgical procedures. (MedPage Today)

Scientists: Stem Cells Created From Eggs

Scientists say they’ve created embryonic stem cells by stimulating unfertilized eggs, a significant step toward producing transplant tissue that’s genetically matched to women. (Washington Post)

Book Review: New reproductive techniques require a new morality | Books | Arts | Telegraph

Emma Crichton-Miller reviews Everything Conceivable: How Assisted Reproduction Is Changing Men, Women, and the World by Liza Mundy. In the epilogue of this thought-provoking book, Liza Mundy writes of a friend seeing, on holiday on a New Jersey beach, a plane flying overhead. Stretched out behind trailed a banner reading: ‘WOMEN EARN $8000 AGE 20-30 888-968 EGGS’. With the same brash commercial energy that powers so much of the United States economy, breeding possibility from desire, the plane was soliciting human eggs. (Telegraph)

Op-Ed: A duty to the healthy and the sick

The multicountry odyssey of Andrew Speaker, infected with an ultra-rare type of tuberculosis that resists some of our best drugs – and the first person placed under a federal quarantine order in more than 40 years – has raised concerns about biosecurity, infection control, personal responsibility and public health powers. The incident set off an international uproar; accusations about right and wrong behavior are still flying back and forth across the oceans. (Baltimore Sun)

Op-Ed: Euthanasia and the Right to Die

Euthanasia, whether in a medical setting (hospital, clinic, hospice) or not (at home) is often erroneously described as “mercy killing”. Most forms of euthanasia are, indeed, motivated by (some say: misplaced) mercy. Not so others. In Greek, “eu” means both “well” and “easy” and “Thanatos” is death. (Associated Content)


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