FROM THE EDITOR
We goofed and we're eating humble pie. Wednesday, October 19, was World Bioethics Day. I'm afraid that it passed unnoticed at BioEdge, perhaps because every day is World Bioethics Day here. But was also the first time it was celebrated, so we shall be better prepared next year.
However, it appears that very few people were popping champagne bottles in the UK and US even though they must have the larges number of bioethicists. No events were planned in the United Kingdom, only one in the US, and 29 in India. World-wide, there were events in 55 countries, most on the theme of the Day, "human dignity and human rights".Click Here to Comment on this letter
|This week in BioEdge|
Same-sex couples are currently unable to have children with genetic material from both parents. Yet research conducted by scientists in Japan appears to suggest that we might one day be able to overcome these limits imposed by nature.
Reproductive biologist Katsuhiko Hayashi and his team of researchers from Kyushu University in Japan have managed to create eggs from the skin cells of mice, and have used the eggs to produce several new mice.
The procedure involves reprogramming the skin cells into to embryonic-like stem cells and then into primordial germ cells (PGCs). These PGCs -- cells which give rise to gametes -- are used to form mature eggs, which can then be inseminated with sperm and brought to term.
While researchers have previously managed to turn skin cells into PGCs, Hayashi and his team are the first to complete the cycle in vitro -- from skin cells to functional eggs in a dish.
“Parts of this work were done before — here they are put together in completeness. It’s impressive that they got pups that way,” Dieter Egli, a stem cell biologist at the New York Stem Cell Foundation Research Institute, told Nature.
While scientists say it will be several years before anyone creates “oocyte-like” human eggs, bioethicists are calling upon the broader scientific community to consider the ethics of the matter.
“This is the right time to involve the wider public in these discussions, long before and in case the procedure becomes feasible in humans,” reproductive biologist Azim Surani from the University of Cambridge told Nature.
Hillary Clinton and Donald Trump clashed over abortion in their third and final debate of the presidential election on Wednesday evening. In one of the first questions, Trump was asked if he would seek to overturn Roe v. Wade, a landmark 1973 Supreme Court decision which protects a woman’s right to abortion.
Trump replied that he would appoint pro-life judges who redefine abortion as a matter to be settled on a state-by-state basis. He went on to pillory Clinton for her support of late term abortions: “If you go with what Hillary is saying, in the ninth month, you can take the baby and rip the baby out of the womb of the mother just prior to the birth of the baby.”
Clinton strongly backed abortion rights, saying that the government should not interfere in women’s “intimate” and “personal” decisions about their reproductive health: “I will defend Planned Parenthood. I will defend Roe v. Wade, and I will defend women's rights to make their own health care decisions.”
She defended her vote in the Senate against a ban on late-term partial-birth abortions, saying that “The kinds of cases that fall at the end of pregnancy are often the most heartbreaking, painful decisions for families to make.”
Do-it-yourself genetic testing with 23andMe.com can be useful for discovering susceptibilities to genetic diseases and for research into ancestry. What no one anticipated was that it would be popular amongst white supremacists in the United States.
A Vice journalist, Elspeth Reeve, spoke to a number of white supremacists and alt-right trolls who are conducting conversations on the internet about their ancestry. People are posting screenshots of the results of their tests to prove how white they are. As she points out, “if you believe in the superiority of European culture and white people, then it follows that one of the most important facts you should establish is that you are white yourself.”
As one poster said, “We alt-right types may have more at stake in our genetic results than the average deracinated Western white.”
What they value as “white genes”, however, can be a bit puzzling. There are disputes over whether Finns or Russians are “white”. And when 23andMe started to release the percentage of Neanderthal genes, the reaction was “counterintuitive”:
In an article for GeneWatch, published by the Council on Responsible Genetics, Keel noted “Just days after the discovery of the Neanderthal genome,” Stormfront commenters “claimed Neanderthal DNA was responsible for the ‘intellectual supremacy’ and ‘physical prowess’ of Europeans.”
It’s hard to distinguish between what the trolls really think and what is mere trolling. But the existence of unexpected genetic backgrounds has sparked theories that 23andMe is rigging the results. The entry for 23andMe on the racist conspiracy site Rightpedia claims, “This company likes to give people of European descent about a 1% nonwhite mongrelization, usually Subsaharan African. They’re really just finding DNA common amongst all races of humans and assigning it as black.” 23andMe’s response? “We can unequivocally deny that. 100 percent.”
Another euthanasia lobby group has rebranded itself. SOARS, The Society for Old Age Rational Suicide, a lobby group based in the United Kingdom, has renamed itself My Death, My Decision. “Suicide” is a word that nearly all campaigners avoid as it carries negative connotations.
In 2009 SOARS split from another UK group, Dignity in Dying, which is currently the largest UK assisted dying lobby group. The issue was at what point it should be legal to request assisted suicide. Dignity in Dying settled for the voter-friendly time of six months’ life expectancy for a terminally ill person.
SOARS, however, insisted that there should be no time limit, as many people are left incurably suffering for longer than six months. It wants to make it possible for people to request death when they feel that their lives are complete.
Dignity in Dying has also rebranded itself – several times. Founded in 1935 as The Voluntary Euthanasia Legalisation Society, it became the Euthanasia Society in 1960, the Voluntary Euthanasia Society in 1969, Exit in 1979, reverting to the Voluntary Euthanasia Society in 1982, and evolving into Dignity in Dying in 2005.
The most prominent American group has followed a similar trajectory. The Hemlock Society was founded in 1980; in 2003 it became End of Life Choices; and in 2004 Compassion & Choices.
Indonesian President Joko Widodo has told the BBC that his new policy of chemical castration could “wipe out” paedophilia in his country. He said that "our constitution respects human rights, but when it comes to sexual crimes there is no compromise. We are strong and we will be very firm. We will hand out the maximum penalty for sexual crimes."
The new law follows a number of high-profile sex crimes. He told the BBC that: "In my opinion… chemical castration, if we enforce it consistently, will reduce sex crimes and wipe them out over time."
Chemical castration, which involves the use of drugs to reduce libido, was approved over strong resistance from the Indonesian Doctors Association. They declared that it was unethical and against human rights. Dr Prijo Sidipratomo, chairman of the Association’s medical ethics committee, published a fierce denunciation of the penalty in the BBC:
You cannot cure paedophilia by chemical castration. How long can it last? Let's say the patient has it for three years while in jail. But after his release he can go to a doctor and reverse it with hormone therapy. Chemical castration is not completely irreversible, so it is not effective.
Furthermore, the punishment cannot be done as long as the executor is a medical doctor, because we have to uphold medical ethics. When you become a doctor, you have to swear that you won't do anything harmful to any human being. My message to all doctors across Indonesia is that as long as you're a doctor, you cannot do it, even if the government says it is to punish a rapist.
The President's response is that if doctors refuse, he will use military doctors. "There are lots of people who want to do it. That's not a problem."
Norwegian health officials have ruled that not only is foetal reduction legal for residents, but that women from foreign countries can seek it as well. The controversial procedure involves aborting one or more healthy babies in a multiple pregnancy.
In February the Department of Justice found that aborting a health twin should be treated no differently than any other abortion. (Abortion is legal until the end of the 12th week in Norway.) Now the Department of Health has opened the doors to foreign women as well. Since neighbouring Sweden and Denmark have banned selective abortions, some Norwegians fear that the development of “abortion tourism”.
IVF has increased the demand for foetal reduction, as multiple pregnancies are more common with this form of fertility treatment.
“We have not found any medical benefit from this,” Dr Birgitte Heiberg Kahrs, a specialist in fetal medicine in Oslo told The Local. “On the contrary, it exposes the second child in the womb to danger as the abortion risk increases.”
“Our recommendation was that this should only be allowed for twins if one fetus showed developmental abnormalities, and that it should be done between weeks 12 and 14 to reduce the abortion risk.”
More and more couples are resorting to internet crowd-funding sites to finance their IVF treatments in the United States. According to a report in Bloomberg, an important element is the lack of government IVF funding and lack of insurance coverage. Only about a quarter of companies offer IVF as part of their health cover.
Funding for IVF has become a robust category at GoFundMe.com, where more than $3.6 million has been raised across more than 1,700 IVF campaigns, with almost 37,000 individual donations. Total IVF gifts and campaigns have increased every year since the company’s launch in 2010. On Giveforward.com … the category that includes both IVF and adoptions is the fastest growing, up 429 percent over the first eight months of this year compared with the same period in 2015
Desperate for a pregnancy, couples also cover the cost of IVF cycles with credit card debt and by raiding their 401(k) retirement savings accounts.
China's recently introduced universal two-child policy is predicted to have a relatively small effect on population growth, with a likely peak of 1.45 billion in 2029, compared to 1.4 billion in 2023 if the one-child policy had continued, according to academics writing in The Lancet. By 2050, the population is predicted to be 1.42 billion under the two-child policy, compared to 1.27 billion under the one-child policy.
The authors say that two-child policy will likely to lead to a reduction in the number of abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more balanced sex ratio, but warn that the effect on the shrinking workforce and rapid population ageing may not be felt for two decades. As a result, they say that policies, including increasing the retirement age, strengthening the state pension system, and encouraging three generation living should be strongly considered.
China's one-child policy was introduced in 1979 to curb population growth and promote economic development. Difficult to implement in rural areas, from 1984 rural couples were allowed a second child if their first child was a girl (the so-called 1.5 child policy). Fertility rates dropped from an estimated 5.9 births per woman in 1970 to between 1.5 and 1.7 in the late 1990s. Amid fears that universally lifting the one-child policy would lead to a baby boom, the Chinese government has introduced gradual changes - for instance, by allowing parents who were only-children to have two children. But, by May 2015, only 1.45 million (13.2%) of 11 million eligible couples applied for permission to have a second child. In October 2015, the two-child policy was introduced country-wide.
Although ageing populations are increasing worldwide, the one-child policy has rapidly accelerated the process in China. Other negative effects of the one-child policy include the highly skewed sex ratio, with a predicted excess of 30 million unmarriageable men by 2020 under current trends, and the decline in the working age population which could threaten economic growth.
The European Medicines Agency (EMA) is currently implementing a policy of publishing all the clinical data it receives from pharmaceutical companies, in a bid to promote transparency in clinical trials.
The EMA, which acts as the European Union’s regulator for drugs and medical products, says that it intends to release all Clinical Study Reports in applications that have been submitted since 1 January 2015, whether or not the applications were approved, rejected or withdrawn.
Earlier this week the agency published published some 100 clinical reports about two EMA-approved medicines (carfilzomib, a cancer drug, and lesinurad, a gout treatment).
The EMA’s CSR policy — which it adopted in 2014 — “will benefit academic research and the practice of medicine as a whole", says EMA executive director Guido Rasi.
The policy shift comes in the wake of an ongoing campaign by lobbyists to have all trials registered and results reported.
Some 700 medical and patient organizations had lobbied for the data release under the auspices of the AllTrials campaign.
The US branch of AllTrials is actively lobbying the Food and Drug Administration to adopt a similar policy to the EMA.
Critics of the IVF industry in the US have attacked “misleading” marketing strategies that encourage older women to use IVF.
In an interview published by the New York Times this week, Miriam Zoll -- a vocal opponent of the IVF industry -- criticised the “deceptive” marketing of IVF to women over the age of 40. Zoll, who herself unsuccessfully tried to conceive via IVF at age 39, says that the industry takes advantage of the naive women who eager to conceive:
“The industry [avoids] saying that the technology hasn’t worked for an estimated 20 million women globally during the last 40 years”.
The article also quotes Dr. Mark V. Sauer, former director of the I.V.F. clinic at Columbia Presbyterian Medical Center, who says that “there’s hardly any age that the [IVF] clinics now turn away”.
It is generally accepted, Sauer says, that IVF has little promise for women over the age of 40. Yet Oxford bioethicist and neonatologist Dominic Wilkinson believes this should be clarified. In an article in The Conversation this week, Wilkinson states that success rates for older women increase dramatically when donor eggs are used:
“...these “success” rates are based on IVF treatment with the woman’s own eggs. For women who receive donor eggs or embryos, the chances of a live birth are based on the donor’s age, not on that of the recipient. Where the egg donor is young, older women have the same sort of chances of “success” with IVF as younger women.”