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January 29, 2008

Questioning the Allure of Putting Cells in the Bank

There are companies that offer to extract and store stem cells from adult blood, from fat removed by liposuction, from children’s baby teeth after they fall out and from leftover embryos at fertility clinics.

But some experts say consumers should think twice before spending hundreds or thousands of dollars on such services, because it is not clear how useful such cells will be. (New York Times)

Cancer drug activates adult stem cells

The use of a drug used in cancer treatment activates stem cells that differentiate into bone appears to cause regeneration of bone tissue and be may be a potential treatment strategy for osteoporosis, according to a report in the February 2008 Journal of Clinical Investigation. (Physorg.com)

New lease on life? The ethics of offshoring clinical trials

When several patients with Aids died after an experimental drug trial at Ditan Hospital in Beijing in 2003, human rights activists and local media turned on the pharmaceutical group involved. (Financial Times)

Bush backs more funds for ‘ethical’ stem cell research

President George W. Bush said Monday the US is increasing funds for “ethical” stem cell research that does not involve destroying human embryos. (AFP)

January 28, 2008

The High Price of Biological Colonialism

India is searching for a monster who convinced the destitute to sell their kidneys at bargain basement prices and sold them for a huge profit. But the real empowerers of this atrocity are the foreigners who wanted new kidneys and didn’t care who got hurt in the process. From the story:

India has launched an international hunt for a doctor accused of running an illegal clinic that duped between 500 and 600 poor labourers into selling their kidneys and then peddled them to foreign clients…

Police alleged that Dr Kumar used middlemen to entice poor labourers with the promise of jobs worth 150 rupees (about £2) a day, plus food and accommodation, and then offer them money for their kidneys. Those who refused were often drugged and had their kidneys removed without their permission, according to several former “donors”…

India banned the trade in human organs in 1994 but non-governmental organisations estimate that 2,000 human kidneys are still sold in India every year.

If organs can be bought and sold, the rich will buy and the destitute will sell. It’s that simple. And there will be horrible people to take advantage of their need. We are entering an era of biological colonialism and it must be stopped.

The only way to effectively stop this is to stifle demand. The time has come to make such purchases illegal and punishable internationally. Desperation over one’s own illness does not justify such exploitive depredations. Stop the demand and the supply issue will resolve itself.

The Need for Uniform Criteria to Declare Death by Neurological Criteria

I have written several posts about the need to develop uniform standards of declaring death by neurological criteria–popularly known as “brain death.” Now, there’s some more information out about that problem. From the story:

Guidelines for determining brain death differ substantially between major U.S. hospitals, a national survey shows, and few stick to parameters established by the American Academy of Neurology.

“There are substantial differences in practice that may have consequences for the determination of death and initiation of transplant procedures,” Dr. David M. Greer, at Massachusetts General Hospital in Boston, and colleagues report in the medical journal Neurology.

Greer’s team requested guidelines from hospitals named as having the top 50 neurology programs in the nation in 2006 by US News and World Report. Only 42 percent of the hospitals required that a neurologist or neurosurgeon perform the examination for brain death, results showed. Among the 71 percent that stipulated multiple examinations, the time required between examinations varied from 1 to 24 hours. Furthermore, the authors point out, “It was surprising to find that the cause of brain death was not stipulated in a large number (37 percent) of guidelines.”

This is a very serious matter. The trust of the American people depends on getting this most fundamental matter right.

Supprting the Murderer of a Disabled Girl

The most robust opponents of assisted suicide–and the most effective in my view–are disability rights advocates. They understand well that legalizing assisted suicide is a gun aimed at their hearts. An opinion column by one Ian Mulgrew of the Vancouver Sun underscores the threat. He urges that the child murderer Robert Latimer be freed. Latimer killed his daughter Traci, because she had cerebral palsy. From the column:

Born with a severe form of cerebral palsy, his daughter Tracy was a 12-year-old who weighed barely 40 pounds, had no mobility, suffered unrelenting pain and endured five to six epileptic seizures a day. She had little more than a newborn’s consciousness. Doctors at the time of her death were preparing to install a permanent feeding tube in her stomach and to remove her thigh-bone to relieve the pressure on her hip, dislocated because of the metal rods already implanted in her spine to correct the damage done by her bedridden condition…

It was in the face of such circumstances that while his wife and other children went to church, Latimer carried Tracy to a pickup truck and ran a hose from the exhaust pipe into the cab. She died from carbon monoxide poisoning.

Latimer was charged with first-degree murder and convicted of second-degree murder… In 1997, a second jury again convicted Latimer, but it recommended he be eligible for parole after a year. Juries at both of his trials were conflicted over what had happened and racked because of the empathy they felt for this man.

But our system got in the way of their humanism.

So, winking at the murder of a helpless disabled girl is “humanism?” (By the way, Traci’s condition was not as depicted here, but I don’t want to get into that debate because it might imply that disability is a legitimate reason to kill a child. For those interested in a more accurate description of Traci’s condition, read Mark Pickup’s blog entry here, in which he notes:

Monday-Friday Tracey traveled to school on a regular school bus and returned home at the end of each school day on the same bus as her siblings and other children — right up to the Friday before she was killed.)

What is amazing to me as I read columns like this and stories that are sympathetic to killing disabled children and/or support eugenic infanticide, is that we once understood such acts of murder to be an unequivocal evil. Doctors were hanged after Nuremberg for killing disabled infants, children, and adults.

Some comfort themselves with the false notion that the earlier slaughter was evil because it was Nazism, while the new support for killing people with serious disabilities is rooted in compassion. Wrong. Nazis did not force doctors into killing. Indeed, it was considered a compassionate “healing treatment.”

Some then say, well the parents didn’t consent to those killings, and that made it wrong. But since when do parents have the right to consent to the murder of their children? Besides, Baby Knauer, the first official infanticide sanctioned by Hitler in 1939, was killed precisely because his father requested the killing. And in the Netherlands, where studies in the Netherlands show that 8% of all infants who die each year in that country are killed by doctors–and of those, more than 20% of parents had not consented.

We are moving into an era of a new eugenics where it is considered humanism to murder helpless disabled children. Mulgrew may think he’s a compassionate and liberal. But it is a denial of the equal worth of all people and a profound violation of human rights–which is the antithesis of “humanism” properly understood.

America’s Broken Healthcare System

The 2008 International Bioethics Conference, “America’s Broken Healthcare System” is coming up on February 21-22, 2008 at the Hilton Hawaiian Village Beach Resort & Spa in Honolulu, Hawaii. Hawaii Medical Association (HMA) members have a discounted rate of $300 for 2 days and $175 for 1 day. Nursing CEs have also been approved.

If you would like more information, go to www.stfrancishawaii.org, click on The St. Francis International Center for Healthcare Ethics 2008 International Bioethics Conference (located on left column). View photos from the 2006 Medical Malpractice Conference and 2007 “Becoming an Ethics Consultant” Training Course.

A Pandora’s Box of DNA

Specifically, the accuracy of some tests now on the market is under question, as is their usefulness when the results are supplied direct to consumers, rather than with professional medical advice. (Cyprus Mail)

Huge Lawsuit Could Change Handling of the Dead

The suit argues that the next of kin, not the state, should make decisions on how to dispose of organs no longer needed for testing, and that denial of such a right violates the Constitution’s promise of due process. The federal lawsuit names 87 of Ohio’s 88 counties; the other, Hamilton County, which encompasses Cincinnati, has already settled with families for $6 million. (Washington Post)

Gene Therapy for Chronic Pain

A new kind of gene therapy could bring relief to patients suffering from chronic pain while bypassing many of the debilitating side effects associated with traditional painkillers. (Technology Review)

Op-Ed: CIRM’s stance after pluripotency

The swiftly changing scientific landscape has seen the rise and fall of many favoured stem cell types and technologies. Some of what is de rigueur today will be dé classé tomorrow. Inducing pluripotency currently requires randomly inserting genes for transcription factors using engineered viruses1, 2, 3, 4, whereas creating ES cells from primates using somatic cell nuclear transfer (SCNT) requires hundreds of mature oocytes5. These issues are but the tip of the iceberg; many complex problems remain unsolved. Numerous challenges and opportunities lie ahead in stem cell science, and the rapidly moving field requires continued funding by CIRM to meet them. (Nature)

Flawed embryos seen as source for stem cells

From what is now considered medical waste might be fashioned bio-treasure: stem cells able to form into any of the body’s 220 cell types, including blood, nerves, bone, and skin tissue, new research suggests. (The Boston Globe)

Nitschke’s suicide films may air in NZ

Euthanasia advocate Dr Philip Nitschke said he had been warned by Australian authorities not to screen the films, The Single Shot and Doing it with Betty, but believed he could show them in New Zealand.

Nitschke wants to play the films at meetings of his group Exit International, a lobby group for voluntary euthanasia. (News.com.au)

Taking Part in Drug Trials

Thousands of people, healthy and sick, participate each year in clinical studies. The experience can provide medical, financial and emotional benefits, but there are also potential risks. (Wall Street Journal)

January 27, 2008

A Living Art, Part 2

Stelarc shows a model ear on his forearmThis is the second posting on the bioarts, a relatively new field in which artists are using living tissue and organisms to create their works. I offered a glimpse into the world of bioart in my previous article, and will now look at some of the ethical issues at stake before turning to my own vision for bioaesthetics.

The Ethics of Bioart

Art, like any aspect of society, must continually change or risk becoming stagnant and irrelevant to its culture. This is true of all art forms, whether bioarts or more “conventional” ones like film, sculpture, and literature. These days, though, it seems that artists particularly enjoy pushing out the frontiers of their mediums in order to arrest their audiences (and to make a name for themselves in the art world).

Along these lines, the mantra that I think describes bioartists best is “the sky is the limit.” Mouse cells employed to create a tiny jacket? Sure! Graft a living ear onto a person’s forearm? Why not? It seems that bioartists at this point are more interested in the novelty of their experiments than in conveying any meaningful content – or ascribing to any ethical standards in their practices.

While the various grotesques that are emerging from bioartists’ workshops may be created and destroyed at will, the artists themselves declare that they are against the abuse of our environment and its living species for the sake of profit. Carol Gigliotti, an art educator and media theorist, has done an excellent job of highlighting the contradictions in this approach, which she summarized in a phone interview with NPR:

I feel like [bio]artists at this point are mirroring what’s happening. I don’t feel they are encouraging shifts to new levels of consciousness.

Furthermore, significant ethical boundaries are crossed when artists start turning animals and even humans into works of art. Like using people’s foreheads to advertise products, these bioartists treat their subjects like living billboards for their ideas. And bioartists go well beyond the skin-deep transformations of tattoo artists: many create their works by invoking dramatic surgical and genetic changes in their subjects. It is not only presumptuous but also ethically repugnant for bioartists to consider their legacy and “right to expression” so important that they feel free to conscript other living creatures for their art experiments.

So, what should characterize good bioart, and what does artistic and ethical integrity look like in a world where there are few practical limits to the ways that life can be altered through biotechnology? These important questions are at the start of bioaesthetics, which I will discuss further in my next posting.

January 25, 2008

How to Build a Bionic Eye

People don’t think twice about wearing a Bluetooth headset to have conversations on their cell phones. Well, one day it might not be unusual to wear a contact lens that projects the phone’s display directly onto the eye. Researchers at the University of Washington have taken an important first step toward building contact lenses that could do just that. By incorporating metal circuitry and light-emitting diodes (LEDs) into a polymer-based lens, they have created a functional circuit that is biologically compatible with the eye. (Technology Review)

Swedes Ponder Whether Killer Can Be a Doctor

The Karolinska Institute here is famed for choosing the winners of the Nobel Prize in Medicine each year, and as one of the world’s most prestigious medical schools it rejects many students with the highest grades. (New York Times)

Doctors Review End-of-Life Care Guidelines

Dying patients need to be regularly monitored for pain, shortness of breath, and depression, say new American College of Physicians (ACP) guidelines to improve end-of-life care. (U.S. News & World Report)

Scientists Create First Synthetic Bacterial Genome — Largest Chemically Defined Structure Synthesized In The Lab

A team of 17 researchers at the J. Craig Venter Institute (JCVI) has created the largest man-made DNA structure by synthesizing and assembling the 582,970 base pair genome of a bacterium, Mycoplasma genitalium JCVI-1.0. This work, published online today in the journal Science by Dan Gibson, Ph.D., et al, is the second of three key steps toward the team’s goal of creating a fully synthetic organism. In the next step, which is ongoing at the JCVI, the team will attempt to create a living bacterial cell based entirely on the synthetically made genome. (Science Daily)

New Stem Cell Discovery for Diabetes

Scientists today announced that they have found pancreatic stem cells in mice.

That discovery may lead to stem cell treatments for diabetes patients, if pancreatic stem cells can be found in people. (WebMD)

 

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