Fri, 3 Oct 2008

A dispute over conscientious objection making headlines in the Australian state of Victoria. The issue is the Abortion Law Reform Bill, which has already passed the Victorian lower house and will be debated in the upper house next week. Apart from decriminalising abortion, it also stipulates that a doctor who objects must make an effective referral to a doctor who does abortions. And in an emergency, a doctor must perform an abortion, whatever his beliefs.

After a slow start, healthcare professionals have marshalled forces to oppose what they feel is effectively a ban on conscientious objection. Obstetric anaesthetist Eamonn Mathieson, of the Doctors in Conscience Against Abortion Bill group, described the proposed law as an "extreme and unprecedented" attack on human rights. He claimed that it breached the code of ethics of the Australian Medical Association (AMA), as well as Victoria's own human rights charter.

Even more pressure was applied when the Catholic Archbishop of Melbourne, Denis Hart, declared that Catholic hospitals would close their maternity and emergency departments if the bill passes.

"In the worst-case scenario, if a government is determined to enforce such laws, we have no option. We might get out of hospitals altogether," Archbishop Hart told The Age. "Catholic hospitals cannot be part of any abortion. That has to be respected in the community. Even providing a referral is a co-operation in evil, and that impacts very strongly on us as Catholics." Victoria has 15 Catholic hospitals and they account for about a third of all births in the state.

The AMA is also troubled by the proposals. "Respect for a conscientious objection is a fundamental principle in our democratic country, and doctors expect that their rights in this regard will be respected, as for any other citizen," it told the Victorian Premier, John Brumby, in a letter. ~ The Age, Sept 22; ABC, Oct 2

 

Fri, 3 Oct 2008

In consultations about lung cancer, physicians rarely respond empathetically to the concerns of patients about mortality, symptoms or treatment options, according to a University of Rochester Medical Center study. After examining 20 transcripts of conversations, researchers identified a 384 "empathetic opportunities" -- but doctors responded to a dismaying 10% of them. Sometimes doctors simply changed the topic.

In one typical example, the conversation with a lung cancer patient went like this:

Patient: No, sir, I've never had a heart attack; supposedly, I worked very hard when I was a young man, a young boy. I was doing a man's labour and I was always told I had a good strong heart and lungs. But the lungs couldn't withstand all that cigarettes...

Physician: Yeah.

Patient: Asbestos and pollution and second-hand smoke and all these other things, I guess.

Physician: Do you have glaucoma?

"When patients are struggling and bring up important issues, doctors don't have to take a lot of time to address them, but they do need to respond," says one of the researchers, Diane Morse. "Showing that they understand and giving their patients more of what they need is not that difficult." ~ Science Daily, Sept 23

Fri, 3 Oct 2008

Disney has released a new batch of genetically engineered teenagers for its new season television shows. It’s just like putting the pieces of a jigsaw puzzle together, resident Disney IVF engineer Andrew Roark told The Onion News Network. Teen heartthrob Mitchel Musso, for example, is model 6831-A, a standard male base with Type 3 skin pigmentation. To save costs, engineers normally use the same DNA base with minor variations in the hair and skin colour. New techniques allow unprecedented ethnic blends and future models could even be capable of nuance and subtlety, The Onion reports.

Well, if you buy any of that, we have a bridge to sell you at a once-only discount. But at least this clever spoof from “America’s finest news network” shows one possible avenue of commercial development if genetic engineering were ever to take off.

Fri, 3 Oct 2008

With conscientious objection emerging as a surprise bioethical headline over the past month, it turns out that the President's Council on Bioethics is preparing for a white paper on this very topic. Council chair Edmund Pellegrino prefaced testimony from some prominent ethicists on September 11 and 12 wtih an explanation of the scope of the Council's study: "In light of the growth and emergence and almost absolutization of patient autonomy, how are the two to be balanced? And what is the present status, both legally and morally, of the sanctity of the human conscience? Should the health professional be morally neutral...?"

The first to speak was Father John Paris, a bioethicist from Boston College. His speech outlined the notion of conscience as a fallible but generally reliable interpreter of immutable moral truth in Catholic thought from the New Testament to Thomas Aquinas to the Second Vatican Council. Exasperated by Father Paris's theological emphasis, Council member Alfonso Gomez-Lobo interjected that conscience can be defended "can be defended on purely rational grounds". To which, without any apparent irony, Father Paris replied that Yes, Thomas Aquinas would agree with that.

The next speaker was Anne Drapkin Lyerly, a bioethicist with the American College of Obstetrics and Gynecology. She was critical of doctors who refuse to do abortions or supply emergency contraceptives, and refuse to refer as well. She was roasted by Council member Robert P. George, a professor at Princeton, for promoting a "my way or the highway" view medical ethics.

The next speaker was Howard Brody, of the University of Texas Medical Branch, who sternly criticised the Catholic view of conscience. He preferred to see conscience as keeping faith with special moral mentors – with colleagues, in the case of healthcare workers. The rights of conscience should never trump the needs of patients, in his opinion.

Finally, Farr Curlin, of the University of Chicago, criticised what he termed the "patient sovereignty model" promoted by the previous two speakers. In his view, if doctors always acceded to patients' requests without reference to their consciences, the outcome will be less than ideal. "Patients gain technicians, it seems to me — technicians who are committed to cooperation, and they lose healers committed to health. They gain control over physicians, but thereby divest physicians of responsibility. As a result, physicians can wash their hands of patients' decisions so long as the physician gives accurate information and provides technically proficient health care services."

Fri, 3 Oct 2008

Britain's leading bioethicist, 84-year-old Baroness Mary Warnock, recently shocked the nation by declaring that the elderly ought to volunteer for euthanasia if they become a burden on society. Her utilitarian outburst was widely criticised, so widely that it may have seemed as if her musings had been a "senior moment". Not so. Blogging at the American Journal of Bioethics website, Dr Summer Johnson supported the idea.

"Not exactly warm fuzzies from the Baroness. Yet, in a socialized health care system every dollar spent on one person is a dollar not spent on another. Thus, years spent in a demented state means that tens to hundreds of thousands of dollars spent on a demented patient are not spent on essential preventive and life-saving services for children, young adults, and the middle-aged who have a chance of leading longer, healthy, fulfilling lives. Thought about that way Warnock's argument doesn't seem so harsh. Is Baroness Warnock's position cold-hearted? No. It's practical." ~ blog.bioethics.net, Sept 24

Fri, 3 Oct 2008

Pessimism about cures from human embryonic stem cells was one of the main messages from the 2008 "World Stem Cell Summit," in Madison, Wisconsin, last week. In the words of science writer Rick Weiss, "This was a gathering of hundreds of scientists, pharmaceutical company reps, patient advocates and policy folks united in their evidence-based faith that stem cells are going to revolutionize biology and medicine."

However, the revolution still seems stuck in the future. Commercialisation of discoveries is "excruciatingly slow," one biotech CEO told the Minneapolis Star-Tribune. "I'm not aware of a successful stem-cell company. If you thought gene therapy was difficult, then [stem cells] are astronomically difficult." Even Weiss, who has long been a supporter of embryo research, observed that the stunning progress made with reprogrammed cells suggests "the scientifically and politically tantalizing possibility that embryonic stem cells themselves — controversial in some circles because their derivation requires that five-day-old embryos be destroyed — may before long become irrelevant. And Monya Baker, a journalist with Nature, also discovered that most stem cell scientists were worried about whether patients would be able to afford the cures if and when they arrived.

Despite these very public qualms about the viability, profitability and affordability of embryo research, the latest news still has not reached the ears of many politicians. California's governor Arnold Schwarzenegger recently vetoed a bill which would have made it easier for grant money from the California Institute for Regenerative Medicine to flow to other kinds of stem cells -- because voters clearly wanted cures from human embryonic stem cells. And a fierce battle is being fought in Michigan over a proposal in the November ballot to allow scientists to use spare embryos from fertility clinics.

Fri, 3 Oct 2008

Gusts from Hurricane Katrina, the 2006 storm which laid New Orleans waste are still whistling through Louisiana. The latest is a proposal by a member of the state legislature to pay poor women US$1,000 to be sterilised to limit the numbers on welfare rolls. After seeing hurricane-devastated residents queuing up for food stamp assistance, Representative John. LaBruzzo had a eugenic epiphany. "I realized that all these people were in Louisiana's care and what a massive financial responsibility that is to the state. I wonder if it might be a good idea to pay some of these people to get sterilized."

LaBruzzo says that participation in his plan would be voluntary and incentives would be extended to men, too, to avoid allegations of gender discrimination. It would also include incentives for college-educated, higher-income people to have more children. "What I'm really studying is any and all possibilities that we can reduce the number of people that are going from generational welfare to generational welfare, " he said. LaBruzzo's brainwave has yet to be formalised in a bill, but it have succeeded in drawing the wrath of blacks and religious leaders for being eugenicist and racist. ~ Times-Picayune, Setp 23

Fri, 3 Oct 2008

Australia has granted a patent for cloning to the disgraced South Korean scientist Hwang Woo-suk. This will protect the technique he used in experiments in which he had claimed to have cloned human embryos. Although Hwang had faked his results, he and his supporters have always insisted that his technique for cloning was workable. He applied for patents in 10 countries, but so far only Australia has granted one.

Although Hwang’s friends see this as a step towards vindication of his controversial work, Australian patent laws are less rigorous than many other countries. Australia only requires that an invention be new, inventive, fully described and adequately defined. It does not have to work and its supporting data need not be true. ~ Nature News, Oct 1

Fri, 3 Oct 2008

The Australian government has issued its first license for cloning human embryos to obtain embryonic stem cells. Sydney IVF, one of Australia's largest fertility clinics, was granted the license. It reportedly has access to 7,200 human eggs for its research. If the firm is successful it would be a world first, the Australian government's National Health and Medical Research Council, which granted the license, said on Wednesday.

An Australian ban on therapeutic cloning was lifted in December 2006 after a long debate in Federal parliament.

The director of the lobby group Australians for Ethical Stem Cell Research, David van Gend, criticised the issuing of the licence. He said cloning research was no longer necessary because of recent advances in stem cell science. "It is unspeakable that we should continue this project of creating living human embryos with the sole purpose of destroying them when the compelling justification for such experiments has gone," Dr van Gend said.

Fri, 3 Oct 2008 The US government has declared that all female immigrants must be treated with Gardasil, a controversial vaccine against the human papillomavirus which causes most cervical cancers. According to a report in the Wall Street Journal, immigration advocates are upset because this adds to the already hefty cost of migrating. The ruling flows from a 1996 law which stipulates that any vaccination recommended by the government for citizens is mandatory for green-card applicants.

"We don't want someone coming into the US who hasn't been vaccinated against measles or chickenpox," said Dr Jon Abramson, a member of the board of a Centers for Disease Control and Prevention panel which recommended the vaccine last year. "[But] HPV can only be communicated by sexual contact... This is not something that endangers kids in a school setting or puts your population at risk."

The vaccine sparked controversy because many parents felt that it might remove a barrier to sexual promiscuity. It has generated more than US$1 billion in sales for its manufacturer, Merck. However the company denied that it had lobbied to include Gardasil on the list of vaccines for immigrants. ~ Wall Street Journal, Oct 1

Wed, 24 Sep 2008 One of Britain’s leading moral philosophers and the architect of its fertility laws has suggested that people with dementia may have a duty to die because they are a burden on society.

Baroness Mary Warnock told the magazine Life and Work that "If you're demented, you're wasting people's lives – your family's lives – and you're wasting the resources of the National Health Service. I'm absolutely, fully in agreement with the argument that if pain is insufferable, then someone should be given help to die, but I feel there's a wider argument that if somebody absolutely, desperately wants to die because they're a burden to their family, or the state, then I think they too should be allowed to die.

"Actually I've just written an article called 'A Duty to Die?' for a Norwegian periodical. I wrote it really suggesting that there's nothing wrong with feeling you ought to do so for the sake of others as well as yourself."

She also said that there should be a license to kill people who wanted to die. "If you've an advance directive, appointing someone else to act on your behalf, if you become incapacitated, then I think there is a hope that your advocate may say that you would not wish to live in this condition so please try to help her die. I think that's the way the future will go, putting it rather brutally, you'd be licensing people to put others down."

The interview provoked a storm of controversy in the UK. One MP, Nadine Dorries, said that her comments were highly irresponsible. "Because of her previous experiences and well-known standing on contentious moral issues, Baroness Warnock automatically gives moral authority to what are entirely immoral view points." ~ Telegraph, Sept 19

Wed, 24 Sep 2008 Legalised assisted suicide is on the horizon, says Spain’s health minister, Dr Bernat Soria. In an interview with the newspaper El Pais, Dr Soria says that changes in the law are needed to ensure that no one undergoes unnecessary suffering. "The change will ensure that the patient’s right to a dignified death becomes a real right. We know that people die suffering. This cannot be. We are not going to win the battle against death, but we can win the battle against pain."

Before becoming health minister last year, Dr Soria’s day job was in human embryonic stem cell research. He was the first president of the European Stem Cell Network, and was the director of CABIMER, a stem cell institute.

For him, this is not just a medical issue, but a fundamental political issue. "The Socialist Party say: you are the owner of your body. You are the one who takes decisions... That is the socialist ideology. We respect the choice of a citizen who can say that he does not want to be submitted to the torture that therapeutic treatment can often represent, sometimes against his will."

However, since assisted suicide requires a change in the criminal code, it may be as long as 18 months before legislation is ready. "It’s not absurd to say that Spain may end up with legislation similar to that in Switzerland or the Netherlands, but we just can’t do everything in one day... Our society has demonstrated already on several occasions that it is a modern society, that it is mature, and that it is ready for any kind of debate." ~ BMJ, Sept 20; El Pais, Sept 7;

Wed, 24 Sep 2008 "The right to life is universal and does not depend on ethnic background." This seems hardly controversial in today's world. However, a new documentary highlights a clash between cultural relativism and universal human rights in Brazil which raises unsettling questions for Western bioethics. "Hakani" deals with the controversial practice of some Indian tribes who kill new-born infants who are born to single mothers, are deformed or are twins. Infanticide is said to be practiced by 20 of Brazil's 200 "ethnicities". Normally the children are buried alive.

A bill under study by the Brazilian Congress would ban infanticide as inconsistent with the universal right to life, but it has many opponents. Many regard it as an unjust imposition of Western values upon the Indians. In a feature in USA Today, Antenor Vaz of the Department of Indian Affairs says that it would be dangerous to "criminalise indigenous actions." The state, he says, should not use the moral judgements of modern culture "to regulate the indigenous cultures who have survived in this land a lot longer than us whites."

Some NGOs also support this position. "I'm not going to defend infanticide," Fiona Watson of Survival International, a group that defends the right of native tribes all over the world, told USA Today. "But I think you have to understand that in the context of Indian culture, "it's not considered murder."

"In fact," she says, "it's often considered something which is a kind thing to do. If you have somebody who is born into your community who is not going to survive, who is very badly deformed and you are an indigenous people who are living deep in the jungle, you don't have access to medical care, that is the kindest thing to do."

Another anthropologist offered another explanation which is relevant to Western bioethics debates. For the tribes, anthropologist >Mércio Pereira Gomes explains, the Indian only considers a human being as a person when he is received by the community. "When infanticide is practiced, from the cultural and not biological point of view, the human being is not considered as complete.

The film is backed by an evangelical Christian NGO and relates the story of a girl, Hakani, rescued by two missionaries, Marcia and Edson Suzuki. They claim that her tribe buried her alive because she was disabled. She was rescued by her older brother. Eight years later, after being treated for a thyroid condition, Hakani walks and talks normally. Ms Watson and Mr Vaz told USA Today that the missionaries are the real villains of the story. They have been exaggerating the number of infanticides and destroying ancient cultures.

Because many Indian settlements are so isolated, estimates of the number of infanticides vary wildly. The Suzukis claim that there are 200 every year; others say that there are only 5 or 10.

Wed, 24 Sep 2008 A common criticism of the sanctity-of-life of human embryos is that so many of them perish spontaneously, especially before implantation, that it is absurd to treat them as precious. Michael Kinsley, formerly editor of The New Republic and Slate, now a columnist for Time magazine, often deployed this argument. "An embryo feels nothing, thinks nothing, cannot suffer, is not aware of its own existence. Embryos are destroyed routinely by the millions in the natural process of human reproduction. Yet opponents of stem-cell research would allow real people, who can suffer, to do so in service of the abstract principle that embryos are people too. If faith takes you there, fine. Reason can't," he wrote in one of his Slate articles.

This argument is highlighted in a recent issue of the American Journal of Bioethics, where an Oxford academic claims that the notion that embryos have the same moral status as adults leads to absurdly unpalatable conclusions. Toby Ord contends that 200 innocent million people must be dying each year through spontaneous abortion -- if this is taken seriously -– far more than from cancer or any other disease. It is, he says, "one of the world’s greatest problems, if not the greatest problem."

And what are pro-lifers doing about this tragedy? Almost nothing. This inconsistency, he maintains, shows that no one really believes in equal moral status of embryos. Otherwise a movement equal in fervour to animal liberation would exist to save embryos. "With 200 million lives per year at stake, it would surely be a matter for heated discussion in the journals or in the Church."

AJOB did its best to highlight this ingeniously simple argument by recruiting several academics to comment on it. In summary, most of them highlighted utilitarian themes in Ord’s approach: that everyone counts as one, that the greatest good of the greatest number is the measure of ethics, and so on. He also deploys a staple theme of euthanasia debates: collapsing the distinction between doing evil and failing to do good. But none of the responses shook Ord from his conviction that a consistently pro-life view means that "the badness of embryo death [must] be at least roughly comparable to the badness of adult death." ~ AJOB, July 2008

Wed, 24 Sep 2008 Evolutionary morality seems to be getting traction in the media. A recent issue of Newsweek included a feature on neuroscience and moral life. In one, Professor Marc Hauser, of Harvard, explains how people make moral decisions. "A new science of morality," he says, "suggest[s] that nature provides a universal moral grammar, designed to generate fast, intuitive and universally held judgements of right and wrong". He has found that this is basically a kind of utilitarianism which assesses moral actions by calculating the outcomes. Emotions do not affect our perceptions of what is right, but they do influence our actions. "We generally do not commit wrong acts because we recognize that they are wrong and because we do not want to pay the emotional price of doing something we perceive as wrong."

And in another article, Michael Craig Miller, editor of the Harvard Mental Health Letter, >declares that "The brain is the mind is the brain." All mental operations, from fear to happiness to religious belief are all essentially material. A life worth living is one which fully engages the sensory cortex, the prefrontal cortex, the amygdala, the hippocampus, and the nucleus accumbens.

It must be rather unsettling for champions of traditional morality. Why bother about morality if you’ve got neuroscience?

Wed, 24 Sep 2008 One of the more bizarre products of the cosmetic surgery industry is cosmetic genital procedures for women, including restoration of the hymen to restore virginity. These are being vigorously marketed in the UK and the US. However an article in the journal Obstetrics, Gynaecology and Reproductive Medicine says that there is little evidence of the safety or psychosocial benefits of these procedures. "In the absence of clear evidence, surgeons must tread cautiously, choosing to operate only as a last resort."

They also make the controversial claim that there is little essential difference between the practice of female circumcision and some of these commercially-driven practices. "A comparison can also be made with female genital mutilation. There are clear distinctions, most notably that female genital mutilation is typically performed without adequate consent upon a minor, and has clearly established physical harms.

"However, the similarities with procedures not being performed in Western nations for cosmetic reasons have led to the suggestion that any distinction is only a Eurocentrist fallacy. There is a genuine concern that female genital cosmetic procedures are not justified on medical grounds, and are being performed without adequate evidence of either safety or psychosocial benefit." ~ Obstetrics, Gynaecology and Reproductive Medicine, Sept 9

Fri, 19 Sep 2008 The risk of terminating healthy babies after a positive test for Down Syndrome is far higher than previously claimed, according to a British study. For every three unborn Down's syndrome babies aborted, two healthy babies will be miscarried because of the invasive methods used to confirm a diagnosis.

A report in the Down's Syndrome Research and Practice journal claims that for every 660 Down Syndrome foetuses which are detected and terminated in the UK each year, 400 normal children perish as well. The problem is that invasive tests are needed to confirm a diagnosis of Down Syndrome in an unborn child. These involve a small risk of miscarriage. According to the authors, Frank Buckley and Sue Buckley, of Down Syndrome Education International, the vast majority of positive blood tests for Down’s are actually false. But to confirm the diagnosis, worried mothers have an amniocentesis, a test in which amniotic fluid is extracted with a long needle. Or, earlier in the pregnancy, they can have chorionic villus sampling, in which a sample of placental tissue is taken.

The best available evidence, say the authors, suggests that the risk of pregnancy loss due to amniocentesis is 1% and that loss due to first-trimester chorionic villus sampling is 2%. Erring on the conservative side, they used a 1% loss figure for CVS in their calculations. If the more generally accepted figure of 2% is used, about 600 normal children are being unnecessarily terminated – a ratio of about 1 to 1.

The Guardian says that because the authors are Down Syndrome experts, they could be "accused of pursuing their own agenda". However, journalists seem to have cross-checked with other doctors and found no one who denied the findings. Professor Kypros Nicolaides, of King's College Hospital in London, says that it is "completely unacceptable" to lose this number of normal babies.

The Guardian also says that "The research casts doubt on the advice and risk assessment given to women when they are deciding whether to undergo the screening and subsequent testing to assess the health of an unborn baby." However, at the moment, the American College of Obstetricians and Gynecologists is recommending that all pregnant women be offered prenatal screening at least before 20 weeks. In the UK, the National Institute for Health and Clinical Excellence (NICE) has recommended that all women be offered a first trimester test. ~ Guardian, Sept 14

Fri, 19 Sep 2008 The regulatory body for doctors in the Canadian province of Ontario has retreated from a policy of low tolerance for conscientious objection and non-referral. A draft policy for the College of Physicians and Surgeons of Ontario advised doctors that they could expect to be deregistered if they appeared to discriminate in the judgement of the Ontario Human Rights Commission. "There will be times when it may be necessary for physicians to set aside their personal beliefs in order to ensure that patients or potential patients are provided with the medical treatment and services they require," they stated.

Furthermore, doctors could not rely upon support from the College if they refused to provide services such as IVF for same-sex couples, contraceptives or abortion or refused to refer patients to other doctors. "Irrespective of whether a physician’s actions are found to have violated the Code, the physician’s conduct could constitute an act of professional misconduct," the draft said.

The draft code was opposed by religious groups and by the Ontario Medical Association. "Referring is just a way of sloughing off your responsibility," Rabbi Reuven Bulka commented. "If you're opposed to these things, referring is the same as taking part in the evil." ~ National Post, Sept 17

Fri, 19 Sep 2008 More adventures in the "My genes made me do it" department, this time, marital infidelity. Researchers at the Karolinska Institute, in Stockholm, have concluded that men with that men with two copies of a particular gene variant are less likely than men without it to be engaged in happy monogamous relationships. Just over one-third of the men with two copies of the gene variant had marital difficulties, but only 15% of the men with no copies exhibited such difficulties. The gene in question regulates levels of the hormone vasopressin. Studies have shown that this turns highly promiscuous male meadow voles into model monogamous husbands.

The researchers reached the cautious conclusion that "previous studies on the influence of the gene coding for the vasopressin receptor on pair-bonding in voles are probably of relevance also for humans."

The media always find news of an "infidelity gene" exciting. In 2004, a British researcher claimed that some women may be genetically programmed to stray in their relationships. In a study of twins, he found that if one had a history of infidelity, the chances her sister would also stray were about 55%.

However, Erik Parens, of The Hastings Center, an American bioethics institute poured cold water on these suggestions. "First, it's possible to have the gene variant but to have no marital difficulties. (66 percent of the men with two copies of the variant had no marital trouble.) Second, it's possible to have marital difficulties but not have the gene variant. (Again, 15 percent of the men with no copies of the variant did have trouble.)" The weak results of this study, he argues, show that the One-Gene-One-Disorder (or O GOD) model of human behavior has been discredited. ~ San Francisco Chronicle, Sept 10; London Times, Sept 2

Fri, 19 Sep 2008 US Army psychiatrists may be participating in the interrogation of detainees in the war-on-terror, ignoring recommendations to the contrary from professional medical associations, according to a Penn State bioethicist and a Georgetown University law professor.

"The American Psychiatric Association (APA) and the American Medical Association (AMA) adopted positions in 2006 that basically said physicians should not be directly involved in any interrogation of any individual," says bioethicist Jonathan Marks. "According to them this is not what physicians should be doing, whether the interrogation is aggressive or not, or legal or not."

Yet documents provided under the US Freedom of Information Act reveal that the Department of Defense still wants physicians to be involved in interrogations and continues to resist the positions taken by the professional medical associations. An article in the New England Journal of Medicine points out that an October 2006 Army document, known as the Behavioral Science Consultation Memo, seeks to undermine the positions of the two associations and tries to carve out a role for psychiatrists advising interrogators on individual interrogations.

The authors contend that the Army is trying to provide rationales to justify the participation of physicians in interrogation. As of October 2007, at least five psychiatrists had undergone training as behavioral science consultants even after the AMA and APA adopted their restrictive policies. One of the techniques they studied was "learned helplessness". This is suspected of being "the paradigm for some of the most aggressive interrogations in the war on terror", say the authors. ~ NEJM, Sept 11

Fri, 19 Sep 2008 Australia’s flagship stem cell research centre is in danger of complete disintegration. Several weeks ago CEO Stephen Livesey was sacked while he was on holidays by a seven-member board. Shortly afterwards they resigned en masse. The federal minister for science is studying a damning report which describes a fragmented, fractious and frustrated organisation which has been unable to meet the scientific milestones it needed to get ongoing funding from the federal government and the state of Victoria. "The centre is demonstrably unsuccessful," says the federal minister, Kim Carr.

According to The Australian, the rock on which the ASCC foundered was commercialisation. Dr Livesey wanted to push the commercial benefits of stem cell science, while the board favoured research. There is talk of transforming the dysfunctional organisation into something like the California Institute for Regenerative Medicine (now led by a founder of the ASCC, Professor Alan Trounson). Under this model, it would not do research itself, but channel funding to scientists and promote stem cell research in the community. ~ Australian, Sept 13; The Age, Sept 11