BioEdge

China’s Octomom highlights a booming surrogacy business

2012-02-11T12:15:17Z

There is an extraordinary story behind the photo above. These babies are allegedly the children of one wealthy couple in Guangzhou. The wife had twins and two surrogate mothers each had triplets. Although the story made national headlines in China late last year, the couple has not been identified – with good reason, for gestational surrogacy is illegal there.

However, the "eight baby scandal" has highlighted the increasing popularity of the black market surrogacy in China. This is the lunar year of the Dragon, which is said to be an auspicious year for births, as the mythical being is associated with power and intelligence.

According to a feature in the UK Guardian, the Guangzhou-based newspaper Southern Metropolis Weekly estimated last year 25,000 surrogate children have been born in China in the past 30 years. There are more than 100 online surrogacy agencies. In the year of the Dragon, they are very busy.

Matching up wealthy parents who want to evade the one-child policy with poor women who need money is a good business for the brokers. Some see it as a disturbing sign of rising inequality. "It's unfair to poor citizens to whom it seems the rich can have as many children as they want,” Zhai Zhenwu, director of Renmin University's school of sociology and population told the Guardian.“ It's another negative signal to society that money can buy anything, when we should be teaching people that the golden key can't open every door."

A columnist for the semi-official China Daily was incensed by China’s Octomom. He wrote that surrogacy would inevitably give rise to "a breeder class" of poor women who end up "renting their wombs to wealthy people."

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The danger of being a doctor in a war zone

2012-02-11T05:22:17Z

Dr Abd-al-Razzaq Jbeiro, secretary-general of the Syrian Arab Red Crescent, was shot and killed two weeks ago on a highway near Damascus. Although the Red Crescent emblem was clearly visible on his vehicle. Dr Jbeiro’s death shocked the organisation, as well as the International Committee of the Red Cross (ICRC) and the International Federation of Red Cross and Red Crescent Societies. They have pleaded with those involved in the violence to spare Red Crescent and Red Cross staff and volunteers so they can perform their humanitarian work. The ICRC wrote in a press release: “The exclusively humanitarian aim of the Red Crescent and Red Cross is to bring aid in a fully impartial and neutral manner to people in need.”

Dr Jbeiro’s death is only one example of violence against humanitarian healthcare workers. Médecins Sans Frontières (MSF) recently declared that its workers in conflict zones have increasingly found themselves and their clinics under attack. NPR reported two weeks ago that the organisation decided to stop treating patients from detention centres in Misrata, Libya because: “torture was so rampant that some detainees were brought for care only to make them fit for further interrogation.”

It was noted in the Hastings Center Bioethics Forum that over 1800 people have been injured or killed in over 600 cases of violent attacks on healthcare professionals, clinics, patients or patients’ families across 16 countries in under 3 years – but that these numbers are “clearly not comprehensive”. It was also reported that the World Health Organisation’s (WHO’s) executive board passed a resolution last month calling the WHO director general for leadership in documenting such attacks. ~ Hastings Center Bioethics Forum, Feb 3; NPR, Jan 26; International Committee of the Red Cross, Jan 25

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Georgia Supreme Court strikes quashes assisted-suicide law

2012-02-11T05:15:17Z

The Georgia Supreme Court has struck down a central provision of a state law that criminalised some assisted suicides because it breaches free speech rights. The ruling means that 4 members of the advocacy group Final Exit Network will not have to stand trial on charges related to the 2008 suicide of 58-year-old John Celmer, who killed himself 2 years after he was diagnosed with cancer.

Georgia’s state legislature passed the law in 1994 to prosecute people such as the late Jack Kevorkian. But the law only criminalised some assisted suicides -- those in which a person advertises or offers to assist in a suicide and moves to carry it out.

Consequently, the Court ruled that “The State has failed to provide any explanation or evidence as to why a public advertisement or offer to assist in an otherwise legal activity is sufficiently problematic to justify an intrusion on protected speech rights”. Alex Schadenberg, of the Euthanasia Prevention Coalition, noted that John Celmer was suffering from “significant depression” when he committed suicide. He wrote:

“The story of John Celmer reinforces how a person who is living with depression can be influenced by others and die by assisted suicide. He was in remission from cancer and was awaiting reconstructive surgery on his face. Celmer's wife stated soon after the arrest of the four Final Exit Network members that: ‘His physical condition was curable. Any depression he had was treatable, and death is not.’”

~ Atlanta Journal-Constitution, Feb 6; Market Watch, Feb 7; Euthanasia Prevention Coalition, Feb 6

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Lesbian couple “betrayed” by gay father who wants to see his son

2012-02-11T05:07:17Z

A lesbian couple in the UK say they feel “bitter and betrayed” because their gay sperm donor is demanding weekend and holiday contact with his biological son. The aggrieved woman says they agreed at a restaurant meeting before the boy was conceived that she and her partner would be “primary parents” in a “nuclear family” and that he would not assert his paternal rights. However, the man, a former close friend who was present at the birth and cradled the newborn in his arms, has now demanded overnight and holiday contact with his biological son. Three Appeal Court judges are being asked to rule on whether the boy should have “three parents and two homes”.

All three parents are high-income professionals who live in central London. The father was previously in a “marriage of convenience” with the mother, but they are now divorced. The lesbian couple’s lawyer told the court that his clients wanted to raise their child in “an intact, two-parent, family” because that would be the best environment. “To this particular couple,” he said, “the concept of 'three parents, two homes', repeated so often by the father, is very alien and it has never been something they would consider.” Nonetheless, they did want the father to participate in the boy’s upbringing in some way. ~ London Telegraph, Feb 8

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An Obama misstep?

2012-02-10T14:01:17Z

Has President Obama made a major political miscalculation at the beginning of an election year? He has announced that his administration will force employer-provided private health-care plans to cover contraception -- even if they are conscientiously opposed to contraception.

It seemed impossible to make American politics even more bitter and polarised, but this decision has done so. Late last year Obama’s secretary of Health and Human Services, Kathleen Sebelius, told a pro-choice gathering, “We are in a war.” Obama’s foes were trying to “roll back the last 50 years in progress women have made in comprehensive health care in America.”

Now his foes feel exactly the same way. “The religious truce is officially over,” writes Dr Jennifer Roback Morse in MercatorNet. “The Established Church of Secular Hedonism has declared war on the rest of us, enlisting the might of the United States government on their side.”

How should the debate be framed? Bioethicist Art Caplan says that it is simply a matter of providing access to an essential health service. He believes that it is bizarre that “Somehow making birth control affordable violates some unfathomable view of government-church-employer relations.”

Since most opponents of providing ready access to contraception are Catholics, Obama’s supporters believe that Catholic moral intransigence is the problem. In Caplan’s words, the Catholic “Bishops have declared war – on everyone else’s moral and religious views who happen to work for them.”

However, a number of Jewish and Evangelical groups, along with liberal Catholics who support abortion and contraception are framing it as a First Amendment, freedom of conscience issue. Writing in The Atlantic, Amy Sullivan says that “The question is whether the federal government should be able to require a religious institution to use its own funds to pay for something it finds morally objectionable.”

Many Catholics feel betrayed. Douglas Kmiec, a law professor at Pepperdine University, supported Obama vigorously in the 2008 election because of his health care policy and was rewarded with an ambassadorship. He told the New York Times, ““For people attracted to him for those reasons, who applaud the very passage of the health care law, we are just sort of baffled by this. Especially when the train wreck was foreseen, and we kept saying, ‘Not this track, not this track.’ And here came the train and ran us all over.” ~ New York Times, Feb 9

UPDATE, FEB 11 -- President Obama made a concession to opponents on Friday. In a new version of the rule the cost would be shifted to health insurance companies instead of requiring religiously affiliated institutions to pay for contraceptives for their employees. This is basically the scheme which is in place in Hawaii.

The compromise – whose details are still unclear -- is unlikely to quench the controversy. For one thing, thousands of religious organizations self-insure, so it changes nothing. Nor are the insurance companies happy at having to cover the full cost of contraceptives. The White House claims that the additional cost will be offset by a decline in the costs associated with unintended pregnancies.

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Mobile euthanasia squads launched in the Netherlands

2012-02-10T12:50:17Z

Six euthanasia flying squads of a doctor and a nurse will begin making house calls in the Netherlands on March 1. The teams will visit people who want to end their lives but whose wishes have been thwarted by another doctor who refuses to take their request seriously or who is simply unwilling to do it.

The local right-to-die association, the NVVE, will also open an “end-of-life clinic” in the Hague on March 1 for people who cannot be euthanased at home. The clinic should be fully operational from the middle of the year.

The latest development in the controversial history of euthanasia comes almost exactly 10 years after it became legal in the Netherlands on April 1, 2002. The NVVE is also sponsoring a film festival to celebrate the occasion.

According to Radio Netherlands, with these new arrangements, the NVVE expects to add another 1,000 euthanasia deaths a year to the nearly 3,000 deaths which are officially reported each year. The NVVE stresses that the clients for its home delivery euthanasia service will not be allowed to make hasty or rash decisions and that the euthanasia team will follow Dutch guidelines carefully.

In the past, most euthanasia cases in the Netherlands have involved cancer patients who are suffering unbearably. However, the NVVE is currently welcoming people in the early stages of dementia and people who are suffering from chronic psychiatric problems. This is allowed under current legislation.

An FAQ in the end-of-life clinic’s website explains how the system works. Apart from the seriously ill, the demented, and psychiatric patients, it also caters for people who desire appropriate comfort care while they are being terminally sedated because they feel that their life is “complete”. Donations to the clinic are tax-deductible. The NVVE stresses that the funds will not be wasted on lavish expenses and cars. ~ Radio Netherlands, Feb 6; London Telegraph, Feb 10

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Neuroscience as the military’s new weapon

2012-02-09T13:12:17Z

Doctors are not the only professionals excited about rapid advances in neuroscience. The military and the police are following advances closely, creating the possibility of ethical conflicts, according to a report released this week by the UK’s Royal Society.

Some of these are performance-enhancing applications – plugging brains into weapons systems to make soldiers more alert and perceptive; culling unsuitable prospects during recruitment; detecting targets; overcoming sleep deprivation and rehabilition.

Others are performance-degrading applications to harm opponents like chemical weapons, heat guns and brain scrambling. The Royal Society points out that “Neuroscientists have a responsibility to be aware from an early stage of their training that knowledge and technologies used for beneficial purposes can also be misused for harmful purposes.”

"As a scientist I dislike that someone might be hurt by my work. I want to reduce suffering, to make the world a better place, but there are people in the world with different intentions, and I don't know how to deal with that,” Vince Clark, a cognitive neuroscientist at the University of New Mexico told The Guardian. "If I stop my work, the people who might be helped won't be helped. Almost any technology has a defence application."

Check out the full report here.

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Single-embryo transfers? Fugedaboudit, says NY IVF doctor

2012-02-09T12:32:17Z

Single-embryo transfer should be the gold standard in IVF, argue many European fertility specialists. The risk of multiple pregnancies is too high, with dangers for the babies and for the mother. At the worst, the consequence is the scandal of an OctoMom – the California woman who gave birth to eight children in a single pregnancy.

But the outspoken Norbert Gleicher, Medical Director of the Center for Human Reproduction (CHR) in New York City, argues that this is daft. Doctors should heed market demand and respect customer choice.

European IVF pregnancy rates have levelled off, he says. The most recent European data show delivery rates of 26.6%. During the same time period, the US delivery rate was 40.7%.

"A part of the reason is the recent propagation of single-embryo transfer (sET) in Europe," explains Dr. Gleicher. "In Europe, fertility experts and governments alike consider the reduced risk of multiple pregnancies through sET a good enough reason to offset lower pregnancy chances caused by sET. Thus, many European countries mandate sET despite irrefutable evidence that patients value nothing more than better chances of pregnancy in choosing their infertility treatments.

"This is a good example for the fundamental difference in the socio-medical philosophy between Europe and the US," points out Dr Gleicher: "Europe values what they perceive as the 'common good' over individual rights of patients. What they fail to recognize, however, are the unintended consequences affecting the patient-physician relationship and, most importantly, IVF outcomes."

"If there is a lesson to be learned here," says Dr Gleicher, "it is that IVF pregnancy rates in the US will continue to improve, as long as IVF research and clinical care remain largely unaffected by government interference, and primarily driven by success in the marketplace, as they have over the last few decades." ~ PRWEB, Feb 6

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Dutch celebrate a decade of euthanasia with a film festival

2012-02-06T13:25:17Z

The world’s first euthanasia film festival is being held in Amsterdam, sponsored by the Dutch Right to Die lobby (NVVE). This week, from February 6 to 12 is a "Week of Euthanasia" in the Netherlands, a celebration of a decade of euthanasia and assisted suicide. They were legalised on April 1, 2002.

More than 35 old and new films and documentaries, from all over the world, from Hollywood to Bollywood are to be screened. They include Million Dollar Baby, Mar Adentro, The Barabarian Invasions, Las Buenas Hierbas, Igby goes down, Whose Life is it Anyway? and The Suicide Tourist. There will be five world premieres, including one about the work of the NVVE called Compassion. (For a complete list, click here.) Oddly enough, the program does not include one of the first and most famous euthanasia films, the tear-jerker Ich Klage An – perhaps because it was made by Nazis during World War II to promote voluntary euthanasia as a cover-up for the involuntary sort.

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No conscience exemption for contraceptive coverage, says Obama Administration

2012-01-28T03:38:33Z

Church-affiliated institutions must cover free contraception for their employees, the Obama administration has announced. As a concession to outraged religious groups, Health and Human Services Secretary Kathleen Sebelius said their hospitals, colleges and social service agencies will have an additional year to comply with regulations under President Barack Obama’s health care overhaul. The plan takes effect on August 1, but institutions who have sought an exemption will not have to comply until August 1, 2013 – after the election in November.

Ms Sebelius said that access to contraception was a fundamental part of healthcare: “Scientists have abundant evidence that birth control has significant health benefits for women and their families, it is documented to significantly reduce health costs, and is the most commonly taken drug in America by young and middle-aged women.”

Despite protests, the Obama Administration seems confident that this will not become a religious liberty issue. “This decision was made after very careful consideration, including the important concerns some have raised about religious liberty. I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services,” Sebelius said in a statement.

A number of important religious groups disagree strongly. A spokesman for an Orthodox Jewish group, Nathan Diament, complained about the “underlying rationale for its decision, which appears to be a view that if a religious entity is not insular, but engaged with broader society, it loses its 'religious' character and liberties.”

The National Association of Evangelicals said that employers with religious objections to contraception will be forced to pay for services and procedures they believe are morally wrong. “No government has the right to compel its citizens to violate their conscience. The HHS rules trample on our most cherished freedoms and set a dangerous precedent.”

"In effect, the president is saying we have a year to figure out how to violate our consciences," said Archbishop Timothy M. Dolan, president of the US Conference of Catholic Bishops. "To force American citizens to choose between violating their consciences and forgoing their health care is literally unconscionable. It is as much an attack on access to health care as on religious freedom. Historically this represents a challenge and a compromise of our religious liberty."

Politically, the move is puzzling. America, a leading Catholic magazine, observed that “the exemption will surely prove an election year headache for the Obama administration as it adds powerful fuel to the fire for those alleging that the administration's policies and practices often trample religious liberty… Clearly a lose-lose proposition in an election year.”

On the other hand, supporters of the measure insist that it is a women's rights issue. Louise Melling, deputy legal director of the American Civil Liberties Union, pointed out in the Washington Post that nearly all women, including many Catholics, use contraceptives at some stage. Furthermore, religious institutions employ many who do not share their faith and many states already require contraceptive coverage. Religious freedom “does not give religious groups the right to impose their beliefs on others,” she said.

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At last, some good news for embryonic stem cells

2012-01-28T03:37:33Z

In the first published results from a clinical trial using human embryonic stem cells (hESCs), 2 legally blind patients with macular degeneration who had been given an injection in one eye have suffered no harmful side effects and appear to have slightly better vision. The trial was sponsored by a Massachusetts biotech, Advanced Cell Technology.

This is a rare piece of good news for the stagnating hESC field and ACT’s share price rose 23%. Two months ago another company, Geron, aborted the only other human trial with hESCs – a potential cure for spinal cord trauma – and announced that it was abandoning the field entirely. ACT is now the only company working with hESCs.

The results were widely reported, based on a study published in The Lancet. However, the author of the paper, Steven D. Schwartz, a retina specialist at UCLA, conceded that it was “extremely unusual” to publish a paper with data based on only 2 patients --without a control group. He said that it was justified by public’s huge interest in stem cells.

Since they were discovered 13 years ago, hESCs have shown promise for treating diseases, but they have also been shadowed by safety issues and ethical concerns, as the process destroys human embryos. ~ New York Times, Jan 23

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UK to consider three-parent IVF

2012-01-28T03:14:33Z

The controversial practice known as “three-parent IVF” has drawn one step closer in the UK with the government’s announcement of public consultation into its acceptability. The Wellcome Trust has also announced that it would allocate extra funds to expand research into the technique, which uses genetic material from 3 parents – 2 women and a man – to build a baby. The procedure, which currently banned, is a response to mitochondrial disease – defects in the small frameworks called mitochondria which surround the cell nucleus.

Mitochondrial diseases are inherited from the mother. They are rare – only about 100 affected children are born each year in the UK – but often very disabling. The proposed procedure involves extracting the nucleus from an affected woman’s egg, transferring it to the shell of an egg supplied by a donor with healthy mitochondria, then fertilising it with the sperm of the affected woman’s partner.

The ensuing baby would have genetic characteristics mainly from its mother and father, and some from the third parent – the donor. In another method, the woman’s egg is fertilised with her partner’s sperm and then transferred into the donor egg.

Strictly speaking, the procedure does not cure the disease at all and it will be of no help to current sufferers. Instead, it creates an embryo which lacks the disease. It is not clear whether the procedure itself is safe.

The Society for the Protection of Unborn Children said: “These macabre experiments are both destructive and dangerous and therefore unethical. Scientists should abandon the spurious field of destructive embryo experimentation and instead promote the ethical alternative of adult stem-cell research, which is already providing cures and treatments for the same conditions.” ~ Independent, Jan 20

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Leading UK surgeons call for ban on cosmetic surgery advertising

2012-01-28T02:50:33Z

Leading plastic surgeons in the UK have responded to the current crisis in cosmetic surgery by calling for a ban on advertisements for all types of cosmetic surgery, including breast enlargements and tummy tucks. They say the industry is an under-regulated “wild west”.

The surgeons are members of the British Association of Aesthetic and Plastic Surgeons (BAAPS), who work on reconstruction in the National Health Service and regularly perform cosmetic surgery in private hospitals. The group, based at the Royal College of Surgeons, has been concerned in recent years about standards in private cosmetic chains, which advertise aggressively in tabloids and women’s magazines.

They have called for a ban as part of a six-point-plan with proposals for tighter regulation of the industry, including registration and audit of surgeons. “Over the last decade the BAAPS has worked tirelessly to educate the public on the many aggressive marketing gimmicks that not only trivialise surgery but endanger the patient,” said the organisation's president Fazal Fatah.

“We have warned against the unrealistic expectations set by reality 'makeover' shows and against crass competition prizes promising 'mummy makeovers' and body overhauls. In no other area of surgery would one encounter Christmas vouchers and 2-for-1 offers – the pendulum has swung too far, and it is time for change.”

According to the BAAPS, nose straightening and breast enlargement are medical procedures, and advertising should be banned as for prescription medicines. BAAPS says there should be a register for all types of implants, not simply those used to enlarge breasts but also those inserted into the buttocks, calves, pectoral muscles and other areas. Widespread calls for a breast implant register followed the scandal of the PIP implants, which were made with industrial-grade silicone designed for mattresses. ~ Guardian, Jan 22; BioEdge, Jan 21

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Hacking scandal executive has daughter via surrogate

2012-01-28T02:41:33Z

Former News International CEO Rebekah Brooks and her husband have become parents through surrogacy. Once the editor of the now-defunct tabloid News of the World, the 43-year-old Ms Brooks was in the business of headlining celebrities’ private lives. Now her own 5-year battle with infertility is fodder for her colleagues, along with her arrest on charges of alleged phone hacking and corruption. The surrogate mother of Scarlett Anne Mary Brooks, whose name has not been released, was pregnant with twins, but one of them died early in the pregnancy. The story is likely to boost the profile of surrogacy in the UK. ~ BBC, Jan 26; BioEdge, Nov 19

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Research fraud troubles UK scientists

2012-01-27T06:50:33Z

“Dishonesty is common and institutionalized in medicine and medical research,” says a UK cardiologist, Peter Wilsmhurst, who has spent years trying to expose research misconduct and has reported more than 20 doctors to the General Medical Council.

Apparently the UK scientific establishment agrees with him. Earlier this month the British Medical Journal and the international Committee on Publication Ethics organised a meeting with representatives from universities, funding groups, journals and lobby groups to discuss the problem.

According to Nature News, Elizabeth Wager, of the international Committee on Publication Ethics, said that one American editor had told her that UK institutions were the worst to deal with if misconduct were suspected. “Our reputation in the world is not looking good.”

A number of factors are at work. The UK government, unlike the US, does not have an effective watchdog for research fraud. There can be conflicts of interest if a university detects fraud by one of its employees. It is much easier to dismiss an erring academic than to publicise his misdeeds. Whistleblowers can be sued for defamation.

The issue is serious enough for Nature to devote an editorial to it. It proposed more government oversight, collaboration between funders and universities, and reform of the English libel laws. “Sounds ambitious? If the solutions were easy, there wouldn't be a problem to discuss,” says Nature. “But there is, so we must face it.” ~ Nature, Jan 13

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