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December 28, 2007

The Year in Review: Science

Two of the most significant science events of 2007 occurred within the space of a fortnight. The first was when scientists announced that they had been able to clone dozens of embryos from an adult monkey – a technical feat that had eluded researchers since the announcement on cloning Dolly the sheep back in 1997. The second breakthrough happened when researchers showed that it was possible to convert human skin cells into the equivalent of embryonic stem cells, which could then be used to make beating heart-muscle and brain cells in the test tube. (The Independent)

The Year in Biotech: Stem cells from skin, myriad microbes, and a $350,000 personal genome

Genomics Gets Really Personal
This year may be remembered as the turning point for personal genomics, when broad gene testing for individuals finally came within reach. Two genomic pioneers–James Watson, codiscover of the structure of DNA, and Craig Venter, leader of the private effort to sequence the genome–published the sequence of their own genomes, revealing personal disease risks. (MIT Technology Review)

December 27, 2007

OP-ED: Reprogramming human stem cells could replace using embryonic cells

Recent stem cell research advances, heralded as great news by a number of people, have not included the terms “clones” or “embryos.”

The primary goal for stem cell research, aside from Nobel prizes, patents and off-the-scale profits, has been therapeutic advances to treat the infirmities of an aging and/or infirm population. . . . (The Tennessean)

December 26, 2007

Diving into the world of genetic engineering

We sit on the cusp of a new world in which the ability to genetically engineer our children, as well as reupholster our own organs, promises to become routine rather than exotic. Just as old definitions of life proved ethically problematic once medicine understood pregnancy better (would people fight over abortion if everyone agreed a child before birth is not conscious?), our traditional ideas of how we should control our bodies and those of our children look increasingly fragile in the face of “reprogenetics,” the new medical field that unites reproductive and genetic technology. (Portland Press Herald)

Court curbs insurers’ ability to rescind medical policies

A ruling restricts the ability of California health plans to cancel coverage after patients run up medical bills. (Los Angeles Times)

Artificial blood vessels ‘closer’

Scientists are a step nearer the creation of tiny artificial blood vessels after growing miniscule tubes out of stem cells in the laboratory. (BBC)

Feds block health plan

The Bush administration has thwarted Gov. Ted Strickland’s plan to expand Ohio’s popular children’s health insurance program to cover middle-class youngsters. (The Columbus Dispatch)

Deaf demand right to designer deaf children

DEAF parents should be allowed to screen their embryos so they can pick a deaf child over one that has all its senses intact, according to the chief executive of the Royal National Institute for Deaf and Hard of Hearing People (RNID). (Times Online)

Researchers get embryonic stem cells from skin

A third team of researchers has found a way to convert an ordinary skin cell into valued embryonic-like stem cells, with the potential to grow batches of cells that can be directed to form any kind of tissue. (Washington Post)

December 25, 2007

Eugenics is Eugenics in Whatever Direction it is Aimed

We’ve heard stories like this before: In the UK, deaf parents want the right to ensure having deaf children through embryo selection. From the story:

DEAF parents should be allowed to screen their embryos so they can pick a deaf child over one that has all its senses intact, according to the chief executive of the Royal National Institute for Deaf and Hard of Hearing People (RNID). Jackie Ballard, a former Liberal Democrat MP, says that although the vast majority of deaf parents would want a child who has normal hearing, a small minority of couples would prefer to create a child who is effectively disabled, to fit in better with the family lifestyle.

Ballard’s stance is likely to be welcomed by other deaf organisations, including the British Deaf Association (BDA), which is campaigning to amend government legislation to allow the creation of babies with disabilities.

Some might say that the wrong here is producing children intentionally to have a disability. But the real wrong here is that children are becoming mere products ordered out of a catalogue–only worth bringing to birth if they suit parental desires and satisfy parental ‘lifestyles.” It marks the end of loving our children unconditionally.

Defenders of the proposal seem to be playing tit-for-tat:

A clause in the Human Tissue and Embryos Bill, which is passing through the House of Lords, would make it illegal for parents undergoing embryo screening to choose an embryo with an abnormality if healthy embryos exist. In America a deaf couple deliberately created a baby with hearing difficulties by choosing a sperm donor with generations of deafness in his family. This would be impossible under the bill in its present form in the UK. Disability charities say this makes the proposed legislation discriminatory, because it gives parents the right to create “designer babies” free from genetic conditions while banning couples from deliberately creating a baby with a disability.

Two wrongs do not make a right. Designing children to be deaf is just as morally wrong as selecting embryos out because they will be hearing impaired. The proper course is to block the eugenic provision now in the bill, not add more such pernicious ingredients into an already noxious stew.

December 21, 2007

U.S. Fertility Rate Hits 35-Year High, Stabilizing Population

For the first time in 35 years, the U.S. fertility rate has climbed high enough to sustain a stable population, solidifying the nation’s unique status among industrialized countries.

The overall fertility rate increased 2 percent between 2005 and 2006, nudging the average number of babies being born to each woman to 2.1, according to the latest federal statistics. That marks the first time since 1971 that the rate has reached a crucial benchmark of population growth: the ability of each generation to replace itself. (Washington Post)

Human Embryonic Stem Cell Lines Created That Avoid Immune Rejection

In a groundbreaking experiment scientists from International Stem Cell (ISC) Corp. derived four unique embryonic stem cell lines that open the door for the creation of therapeutic cells that will not provoke an immune reaction in large segments of the population. The stem cell lines are “HLA-homozygous,” meaning that they have a simple genetic profile in the critical areas of the DNA that code for immune rejection. The lines could serve to create a stem cell bank as a renewable source of transplantable cells for use in cell therapy to replace damaged tissues or to treat genetic and degenerative diseases. (ScienceDaily)

Govt to fund iPS cell study

The Education, Science and Technology Ministry announced Thursday it will subsidize research into induced pluripotent stem (iPS) cells, which show promise for regenerative medicine while sidestepping the ethical issues involved in producing embryonic stem (ES) cells, and open a facility for the research at Kyoto University. (The Daily Yomiuri)

Scientists Weigh Stem Cells’ Role as Cancer Cause

Within the next few months, researchers at three medical centers expect to start the first test in patients of one of the most promising — and contentious — ideas about the cause and treatment of cancer.

The idea is to take aim at what some scientists say are cancerous stem cells — aberrant cells that maintain and propagate malignant tumors. (New York Times)

December 20, 2007

The Hospitalist Movement is Here to Stay

Once, when patients were hospitalized, their own doctors would follow and coordinate the care provided by whatever specialist was needed. But economics, the desire to reduce the length of hospital stays, and the unique challenges of providing hospitalized care led to the development of the “hospitalist,” that is physicians who specialize in treating patients in the hospital.

I have nothing intrinsically against the concept, except that in today’s health care system increasingly challenged by utilitarian pressures, I have worried that hospitalists– being employees or contractors with the hospitals rather than specifically the patient’s own physician–could come to unconsciously represent the hospital’s bottom line and culture rather than the needs and values of the sickest patients. I am especially concerned about this potential paradigm in futile care theory cases in which hospitalists who want to terminate wanted care could unduly sway ethics committees. And, not being a patient’s usual doctor and with no history with the patient or family, I have also been concerned that communication with families in catastrophic situations could be difficult or become hostile. On the other hand, I have seen the work of hospitalists in my local hospital and have, so far, been quite impressed.

My concerns aside, it is pretty clear that the hospitalist movement has succeeded and is moving quickly from the experimental stage to becoming the norm. This is clear from the conclusion of an article in the current New England Journal of Medicine (no link) entitled, “The Hospitalist Movement–Time to Move On,” by Laurence F. McMahon, Jr., M.D., M.P.H.. He concludes:

The hospitalist movement has arrived, and it has transformed the care of hospitalized patients. Investigations similar to the early studies of hospitalist practice, which were focused on cost and comparing outcomes with those of other providers, should begin to wane. New investigations should focus on quality improvement, comparative effectiveness, clinical informatics, the safety of patients, and the translation of new medical advances to clinical practice. Academic medical centers must make strategic investments to provide opportunities in research training for hospitalist physicians and to support the research infrastructure. The academic focus and role models in the training environment will enhance the pipeline for hospitalists, but the underlying payment structure for evaluation and management needs to be dramatically enhanced if this field is to be sustained. Hospitalists are now an integral component of our delivery system; we must take advantage of these skilled physicians and take the next steps to enhance the care of hospitalized patients. It is time to move on.

Like it or not, this is clearly the future of medicine.

Drugs to build up that mental muscle

As Major League Baseball struggles to rid itself of performance-enhancing drugs, people in a range of other fields are reaching for a variety of prescription pills to enhance what counts most in modern life.

Despite the potential side effects, academics, classical musicians, corporate executives, students and even professional poker players have embraced the drugs to clarify their minds, improve their concentration or control their emotions. (Los Angeles Times)

Addicted Doctors Are Allowed to Practice

Troubling cases in which doctors were accused of botching operations while undergoing treatment for drugs or alcohol have led to criticism of rehab programs that allow thousands of U.S. physicians to keep their addictions hidden from their patients. (Wired)

U.S. House passes extension of child health program

Ending months of deadlock with the White House, the U.S. House of Representatives on Wednesday gave final bipartisan approval to legislation that would temporarily extend the state health insurance program that covers about 6.6 million poor children.

The bill, approved by a 411-3 vote, extends the program until March 2009. It also delays a scheduled 10 percent pay cut for Medicare doctors for six months and provides a 0.5 percent increase instead. (Reuters)

Virgin birth stem cells may offer tissue bank

Human egg cells can be tweaked to give rise to valued stem cells that match the tissue types of many different groups of people, U.S. and Russian researchers reported on Wednesday.

They said the stem cells they have created from unfertilized human eggs look and act like embryonic stem cells. (Reuters)

Gene therapy ‘corrects fragile X

Gene therapy has been used to alleviate symptoms of a condition which is a leading cause of inherited learning difficulties and autism. (BBC)

Cancer Docs’ Bedside Manner Often Lacks Empathy

Most cancer specialists do not respond to the emotional concerns of their patients with verbal expressions of empathy and support, a new study reveals. (HealthDay)

 

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