More info on British experience with OTC EC

More on the lack of effect on the abortion rates in the UK after emergency contraception went over the counter in that nation. (And a rare chance to post the word, "whilst.")

From the responses (reader's letters) to that British Medical Journal Article posted earlier:

Whilst Marston et al make interesting observations , it only comments in passing on the failure of OTC emergency contraception to reduce unwanted pregnancy. OTC emergency contraception was introduced to try and reduce unwanted pregnancies by improving access. However the latest abortion statistics from the DoH sadly show a further increase in abortions for 2004 (up to 184,000), and in this respect the introduction of OTC emergency contraception can be said to have failed in its purpose.

Plan B Not Abortifacient, But Doesn't Change Much, Either

As the news that the FDA may soon make Plan B , the progesterone only protocol that is often called "Emergency Contraception" or the "morning after pill," available without prescription, we'll probably hear all sorts of opinions about whether or not it is an abortifacient or will lower the abortion rate.

The answer is probably "no" for both.

There is good news about the Plan B protocols, the progesterone-only formulations. The evidence is not conclusive, but I am fairly convinced that the protocols only work before ovulation and any effect after ovulation would serve to slow the sperm so that it's less likely to get to the oocyte in the fallopian tube, where fertilization takes place and to actually *encourage* implantation if there is fertilization.

This latter makes sense when we remember that one of the reasons for miscarriage is low progesterone and fertility docs often give
progesterone to women early in pregnancy.

It is very important to spread the news that if the pill only works by blocking ovulation, it will only work - and is only useful- during the 5 days or so before ovulation. (Fortunately, that's the most fertile period of the cycle, too.)


The most significant information about the mechanism by which the Levonorgestrel-only medicines function are the studies from Brazil by Croxatto and his group (H.B. Croxatto et al. Contraception 70 (2004) 442–450), which was a blind study, cycling women who were otherwise unable to get pregnant (sterilized or with - what I consider unethical and potentially abortifacient - IUD's) through 3 courses - placebo, and two forms of progesterone-only pills. The researchers followed the women with serial ultrasound and hormonal blood essays of hormone levels. The levonorgestrel interupted ovulation, so there could be no fertilization and no lost pregnancies.

There is a supporting study by Durand, et.al. (M. Durand et al. Contraception 71 (2005) 451– 457), from 2001 which tested surgically sterilized women given 2 doses of Levonorgestrel, 12 hours apart. These women were studied by serial ultrasounds and women who ovulated also underwent endometrial biopsy. There was no difference in their uterine lining function or anatomy although there was a difference in the expression ofglycodelin-A. This protein prevents binding of the sperm to the zona pellucida of the oocyte and so, prevents fertilization. (There is some speculation that the protein acts to help implantation, too.)

The conclusions from the data are still controversial. I am not one to risk causing death until I am certain, so I hope that Croxatto and Durand will continue their research and that others will replicate it.

On the other hand, results from other countries indicate that the abortion rate will not come down with increased access to Plan B. In fact, women and girls who were provided with the morning after pill in advance were no more likely to use the medication than before and were no more and no less likely to have unprotected sex.

From the British Medical Journal:

After emergency hormonal contraception was made available over the counter, levels of use of different types of contraception by women aged 16-49 remained similar. No significant change occurred in the proportion of women using emergency hormonal contraception (8.4% in 2000, 7.9% in 2001, 7.2% in 2002) or having unprotected sex. A change did, however, occur in where women obtained emergency hormonal contraception; a smaller proportion of women obtained emergency hormonal contraception from physicians and a greater proportion bought it over the counter. No significant change occurred in the proportion of women using more reliable methods of contraception, such as the oral contraceptive pill, or in the proportion of women using emergency hormonal contraception more than once during a year.

From Medical News Today, a fairly reliable source for medicine news, is this story from December 2004;

Morning after pill fails to reduce abortion rates
04 Dec 2004

The decision to provide women with the morning after pill over the counter has failed to reduce the UK's abortion rate, new figures reveal.

Researchers from Dundee, Edinburgh and Oxford universities found that a 28-month scheme by Lothian Health Board had no effect on women who were not already using family planning services.

Nearly 18,000 women aged from 16 to 29 were given packs of the morning-after pill to keep at home under the scheme.

However, the study concluded that many people were "too embarrassed" to ask for the advance emergency contraception.

More than 4,500 of the women gave at least one course to a friend and 45 per cent of the women used at least one of the courses themselves during the study, but admitted that they rarely asked for advance supplies of emergency contraception due to embarrassment and concern about being judged by health professionals as morally inadequate.

(Please note the fact that women gave these pills to other women and girls.)

What will change is that there will be less of a chance for a woman or a girl to have personalized medical advice or any sort of examination for the other problems that come from unprotected sex.

Imagine! Editorial On President's Veto

This is one of the best editorials I've read about the veto of HR 810, thanks to a Mr. Don Ehler and the Fort Worth Star Telegram (Free registration required for some content):

Posted on Tue, Jul. 25, 2006


Imagine all the aspects

By Don Erler
Special to the Star-Telegram

Imagine there's no heaven

It's easy if you try

No hell below us

Above us only sky

Imagine all the people

Living for today ...

-- John Lennon, Sept. 9, 1971

Add to the former Beatle's (perhaps drug-enhanced) imagination a pair of soberly unimaginative laws of life: All slopes get slippery when wet, and we traverse slopes daily. Preventing our slide into oblivion are the legal (therefore, political and moral) footholds that we establish on the hillsides of our collective life.

Maybe you know that last Wednesday, President Bush directed the National Institutes of Health to proceed with stem cell research that would not require the destruction of human embryos.

You didn't know that?

Oh, that's probably because most of the news stories touching on this controversial subject mentioned only Bush's first veto of his presidency.

He stopped federal funding for research using "spare embryos" from fertility clinics, which would otherwise be destroyed. White House press secretary Tony Snow said the president is one of those who abhor public funding of "something many people consider murder."

You might have seen pictures of Bush hoisting 15-month-old Trey Jones, once a frozen embryo who was adopted. Said the president of Trey and similar children: "These boys and girls are not spare parts."

At least seven points need to be made:

First: Even if Lennon's imagination happens to be correct, the embryos in question are human life (not "potential" or "building blocks"). Each contains unique DNA, making each a unique member of the human species. There is nothing religious about this biological fact.

Second: Our constitutional system protects "persons," not necessarily all human life. For example, the Fifth Amendment states that "No person shall ... be deprived of life ... without due process of law." Article II requires the president to be a "natural born" citizen. And the 14th Amendment confers citizenship only on "persons born or naturalized in the United States."

In short, embryos (and, for that matter, even late-term fetuses) cannot be citizens here. But they can, if we choose, be treated as "persons," just as fetuses should be protected when they begin to resemble "normal" people.

Third: Although the fact that embryos constitute early human life is biologically incontestable, the moral status of such life remains problematical. Columnist Chuck Colson has claimed that the "supporters of embryo-destructive research ... are seeking not only to destroy human life made in God's image but also to manufacture life made in man's image."

Fourth: Some loonies have referred to Bush's veto as politically inspired. If so, given opinion polling depicting a substantial majority opposing his veto, he is an inept politician. But Democrats have vowed to make this a political issue in the fall elections.

Fifth: In 2001, Bush approved research using 78 embryonic-stem-cell lines already in existence. Those stem cells had already been removed from the embryos and, therefore, could never develop into fetuses, toddlers or adults.

Yet at least one state (California) permits the kind of embryonic stem cell research that Bush vetoed. The president has not called for abolition of privately funded research or for laws requiring criminal proceedings against researchers who extract stem cells from -- thereby killing -- embryos.

Sixth: Not "everybody" does embryonic stem cell research. Colson noted that "Germany and France have embraced the same position President Bush has."

Seventh: Adult stem cell research has generated treatment for at least nine (possibly as many as 80) human diseases or conditions. According to National Review Online commentator Michael Fumento, "there are 1,175 clinical trials for ASCs" (adult stem cells) vs. "zero for ESCs" (embryonic stem cells).

In other words, promising research using adult stem cells is well advanced. But research requiring the destruction of very early human life has, at least thus far, proved fruitless.

Where, on this morally and politically slippery slope, we establish footholds depends largely on whether we believe in Colson's faith or Lennon's imagination.

Life, death, lawyers and ethics

LifeSite and Wesley Smith's "SecondHand Smoke" are covering the very public grief of a family facing the death of their father due to asbestos-related lung cancer.

There are accusations of euthanasia and "precipitating" death. In fact, the story does not support any of these.

From the Wall Street Journal Opinion by Pamela Winnick:

A medical resident--we called her "Dr. Death"--at the Intensive Care Unit at Long Island's North Shore Hospital chased us down the hallway.

"Your husband wants to die," she told my mother, again. Just minutes before I had asked her to leave us alone.

"He can't even talk," I reminded her.

"He motioned with his hands when we tried to put in the feeding tube," she said.

Not exactly informed consent, I pointed out as we turned our backs on her and walked down the hallway, trying to avert our eyes from the other patients in the ICU that night, each of them at various points in the so-called "twilight zone" between life and death.

Afflicted with asbestos-related lung cancer, my father, Louis Winnick, was rushed into the ICU in late May after a blood clot nearly killed him. The next day, my husband and I raced to New York from Pittsburgh. I packed enough work and knitting for what might be an extended stay, but I also put in a suit for what I was certain would be my father's imminent funeral. Still, he wasn't dead yet. And we had no intention of precipitating the inevitable.

"Dr. Death" was just one of several. A new resident appeared the next day, this one a bit more diplomatic but again urging us to allow my father to "die with dignity." And the next day came yet another, who opened with the words, "We're getting mixed messages from your family," before I shut him up. I've written extensively about practice of bioethics--which, for the most part, I do not find especially ethical--but never did I dream that our moral compass had gone this far askew. My father, 85, was heading ineluctably toward death. Though unconscious, his brain, as far as anyone could tell, had not been touched by either the cancer or the blood clot. He was not in a "persistent vegetative state" (itself a phrase subject to broad interpretation), that magic point at which family members are required to pull the plug--or risk the accusation that they are right-wing Christians.

I complained about all the death-with-dignity pressure to my father's doctor, an Orthodox Jew, who said that his religion forbids the termination of care but that he would be perfectly willing to "look the other way" if we wanted my father to die. We didn't. Then a light bulb went off in my head. We could devise a strategy to fend off the death-happy residents: We would tell them we were Orthodox Jews.

My little ruse worked. During the few days after I announced this faux fact, it was as though an invisible fence had been drawn around my mother, my sister and me. No one dared mutter that hateful phrase "death with dignity."

Though my father was born to an Orthodox Jewish family, he is an avowed atheist who long ago had rejected his parents' ways. As I sat in the ICU, blips on the various screens the only proof that my father was alive, the irony struck me: My father, who had long ago rejected Orthodox Judaism, was now under its protection.

As though to confirm this, there came a series of miracles. Just a week after he was rushed to ICU, my father was pronounced well enough to be moved out of the unit into North Shore's long-term respiratory care unit. A day later he was off the respirator, able to breathe on his own. He still mostly slept, but then he began to awaken for minutes at a time, at first groggy, but soon he was as alert (and funny) as ever. A day later, we walked in to find him sitting upright in a chair, reading the New York Times.

(Emphasis is mine)

From a link on Euthanasia at the bottom of the LifeSite article concerning Ms. Winnick's article:

"Euthanasia is the deliberate act of putting an end to a patient’s life for the purpose of ending the patient’s suffering."

I suspect a local - meaning the treatment team including residents, fellows, and the attending - influence with a prejudice toward low/no interference in patients with a terminal condition. The upper level residents and fellows would be the place I'd look. Someone taught the resident to use the phrase, "Your father wants to die." There's also the possibility that she's had a bad experience in her professional or private life and that she's projecting or assuming too much from Mr. Winnick's fighting when the feeding tube was placed (probably a nasogastric tube - through the nose to the stomach - at this point in the story.)

However, please note the timeline in the original essay and that the doctors were not suggesting "precipitating" anyone's death. The disease is/was killing Mr. Winnick. The blood clot was symptomatic of changes due to the cancer. It is absolutely true that it was a miracle that Mr. Winnick was able to come off the ventilator and that he had no heart or brain damage due to the blood clot.

The original article told us that these conversations were in the ICU, while the author's father was still unconscious. (Later reports on LifeSite and SecondHand Smoke were not as clear cut. This one seems to contradict the description of Mr. Winnick's condition described above and to be a later report.)

If there was no advance directive, how could the treating team know how far to go with intervention in the face of a patient with terminal cancer and a blood clot (I assume in the lungs) who has very little chance of being weaned from the ventilator due to the damage from the cancer, aggravated by the clot, before the patient has regained consciousness, without asking the family?

Many people would consider death during the unconsciousness due to a pulmonary embolism or pneumonia preferable to pain and air hunger or liver failure, kidney failure, bleeding disorders as the clotting factors are used up, and the other problems that I can imagine down the line.

Especially in these days of autonomy and accusations that doctors are patronizing and have all sorts of bad motivations and worse actions, it is/was appropriate to hold a family meeting in the ICU to discuss the attitude toward accelerated treatment, if needed. The treatments to be anticipated are interventional, possibly painful and require multiple departments and people: surgical intervention for a tracheostomy tube for the ventilator, permanent placement of a gastric feeding tube, cardiac compression and/or shocking in the event of heart attack or arrhythmia, addition of pacemaker, dialysis, or parenteral feedings [high-tech IV solutions that require constant monitoring and adjusting and which cause liver damage in the long-term]. If there were recurrent admissions for emergent conditions due to more clots or infections, I would discuss the risk vs. benefit of repeated painful interventions and manipulations in the face of new complications.

The discussion just happens to be the right thing to do, as well as good risk (lawsuit risk, that is) management.

After all, if lawyers have taught us anything, it's that if we don't document, we didn't do it and that anyone can be sued for anything, right?

Now, I agree with Ms. Winnick that bioethics doesn't seem to be all that ethical, far too often. (In fact, I call it the "formalized study of who we can kill.")

On the other hand, medical Clinical Ethics, a much older discipline that is too often considered a sub-division of bioethics, does tend to be more ”ethical.”


Unfortunately, ethics training in medical school focuses more on how to avoid lawyers than on clinical ethics. We are taught to avoid malpractice, to obtain informed consent, to code properly so the Federal government won't come in with their fines and guns, and to avoid crossing personal barriers. (The latter usually means sexual barriers.)

I’ll admit that clinical ethics has come to focus more on autonomy and justice (as in fair distribution) more than on beneficence guided by non-maleficence. Rather than “Heal when possible, but First, do no harm,” medical students learn that physicians should consider all world views as equal. Lord forbid that we mention Him (the subject of the last half of that original editorial by Ms. Winnick) or that we imply that some actions are flatly wrong and others are “the right thing to do.” Some ethicists teach that doctors have no right to let their consciences influence their practice of medicine, at the risk of being "idiosyncratic," "bigoted," and "discriminatory."

I haven’t figured out where “rights” and “should” come in to play if I have no conscience. Perhaps, doctors should just follow orders.

Greenberg's Frankenstein Syndrome

I'd call it the Dred Scott Syndrome.

Paul Greenberg has written an editorial arguing against destructive and manipulative embryonic stem cell research and in favor of the veto by President George Bush of HR 810.

The next ethical ridge to be crossed would then loom ahead: If it's permissible to experiment on embryos destined to be destroyed, why not on terminally ill patients, or prisoners on Death Row, or, well, the list would surely grow.


The case for embryonic experimentation isn't dubious just ethically but scientifically. To quote Robert P. George, a law professor at Princeton who served on the President's Council on Bioethics:


"Researchers know that stem cells derived from blastocyst-stage embryos are currently of no therapeutic value and may never actually be used in the treatment of diseases. . . . In fact, there is not a single embryonic stem cell therapy even in clinical trials. (By contrast, adult and umbilical cord stem cells are already being used in the treatment of 65 diseases.) All informed commentators know that embryonic stem cells cannot be used in therapies because of their tendency to generate dangerous tumors."


All of which leads Professor George to suspect that the clamor for embryonic stem cell research isn't really about using these early-stage blastocysts but exploiting more fully developed embryos, say those 16 to 18 weeks old, when the stem cells would be less likely to grow out of control.


Slate magazine's resident bioethicist, Will Saletan, outlined just such a program not long ago in his five-part series "The Organ Factory: The Case for Harvesting Older Human Embryos."

Why harvest? Why not go on to manipulate and create post-natal children of humans who are not "persons"? Why not go forward toward a C. S. Lewis' Abolition of Man in which, since we are enslaving our children of the future without their consent anyway, we create stunted, yet useful, growing and self-replicating non-person humans?

How much consciousness is necessary, and how do I measure your consciousness on my scale, Peter Singer's scale, or Genentec's scale? Where's the arbiter when we divide humans into persons and non-persons, and why should I let any creature live free if I'm smart enough to enslave them? The person begins at fertilization - any tech in any in vitro lab can discern whether or not fertilization has occured within hours. (In fact, the axes of the embryo are set at penetration of the oocyte by the sperm, and those axes are persistent throughout development.)

That same tech can tell you that if the first cell division is poisoned or if there is contamination of the blastocyst, that the embryo's functions stop and implantation will fail. Or, perhaps the embryo can be humanly modified to follow a pre-determined tack.

Why not train children to be our slaves, or use technology to grow slaves who can accept nothing more than training?

If there is action based on immediate emotional responses to empathy, I can understand that a person without time and full knowledge will make decisions that favor the more developed human over the less developed human.

However, in the case of legislation about the deliberate creation of extracorporeal human embryos, destructive or manipulative embryonic cell research, and elective abortion, the empathy should be guided by knowledge and planning.

Very soon, as this article shows, we will have to make laws to deal with whether or not our children of the future who are not Homo sapiens are actually "human." We will have to determine whether they can ever be "persons," just as Justice Taney had to decide about Dred Scott - after all those responsible for his being in the US had never intended him or his children to be persons, either.

What about the children of the children of the future? Will they be human, objects of empathy or not-human-enough? How much self-interest will there be, then? How many horrors are we to allow? Low IQ infertile sex slaves, specialized and fertile harvest models, or chattel designed for mining on earth or for life in space stations

Lois McMaster Bujold's Falling Free is a story about similar genetically modified humans. There's the old standby, Brave New World - why not Deltas and Epsilons? Or the cloned "students" in Never Let Me Go? (Also available in e-book form here.)

How, rather than human parentage will these decisions be made? Will these children of the future need to pass some test for consciousness? Will they need to be within 2 standard deviations of "person" genes, phenotype, ability to hire a lawyer?

Still no coverage of (ethical) spinal cord stem cells

Dr. Carlos Lima published his paper in the Journal of Spinal Cord Medicine last month on the treatment of patients with their own stem cells, derived from olfactory stem cells found in the nasal mucosa. These stem cells are easily obtained with minimal risk and reproduce readily, both in the body and in culture. In this case, intact mucosa was used, rather than isolated nerves and nerve progenitor or stem cells.


The patients are 7 of the over 60 patients that Dr. Lima has treated in his Lisbon, Portugal pilot trial. All of the patients in this report had chronic spinal cord traumatic lesions (over 6 months up to 78 months past injury, so that little if any spontaneous improvement could be expected), were followed for 18 months in 2001 to 2003. Each had surgery in which tissue containing the olfactory (or smelling) sensory nerve cells and the stem cells that allow the life-long regeneration of those sensory nerves.

6 of 7 patients had improved sensory function and all had some improvement in their motor function. 2 of the patients regained the ability to control their bladders and one, the control of his bowels. The levels of function were tested by a standardized scale before and after surgery.

This means that the transplanted cells either grew to function in the patients or stimulated the patient's spinal cord cells to grow and replace or bridge the gap made by the injury and the scar.


But where is the news coverage?

As reported earlier, the veterinarian from South Korea got at least 63 news articles yesterday covering the latest phase of his testimony on charges of embezzlement and misappropriation of funds that were meant to clone human embryos. Instead, the money was used to buy women's oocytes, clone a puppy, and in attempts to clone a tiger and a mammoth.


However, the formal report of the research with real results in humans, using their own stem cells as published in a peer-reviewed journal has received very little notice.



The Public Broadcasting System did cover the research and success in patients in a documentary in 2004.

"Miracle Cell" travels to Portugal to document on film, for the first time ever, the harvest and transplant operation. The film also tracks the progress of several of Dr. Lima's patients in the ensuing months. For some, improvement has been dramatic. As Dr. Hinderer assesses 19-year-old quadriplegic Laura Dominguez six months after her surgery, he concludes: "I've never seen recovery like this in 25 years of practice ... I can tell my patients they may walk again, rather than saying life from a wheel chair can be good." Two months later, Laura is able stand up on her toes and move her foot on command. Another of Dr. Lima's patients, paraplegic Joy Veron, is seen on the road to recovery after undergoing the treatment last August. Joy's injury is the result of a tragic accident in which she was run over by her SUV in an attempt to stop it from rolling off a cliff with her children inside. She began to experience some sensation in her leg almost immediately after surgery, and through intensive rehabilitation and fierce determination, Joy continues to make dramatic gains

News@nature.com (subscription only) included a short report on the study last December, in an article entitled, "Stem cell therapy or snake oil?"

"Whether you agree with it or not, it's happening," says Stephen Hinderer, a physiatrist at Detroit Medical Center. "To not learn from that doesn't make sense." For him, the solution is to identify good researchers abroad, and work with them to collect the safety data necessary to run a rigorous clinical trial in the US. One such pioneer is Carlos Lima based at the Hospital Egas Moniz in Lisbon (Box 1). Though Lima hasn't published, he has been perfecting his treatment for patients with spinal cord injuries, in which he implants a slice of autologous olfactory mucosa, which presumably contains a mixture of olfactory stem cells, a procedure approved by European regulatory authorities. Lima has operated on over 60 patients already, 16 from the Detroit Medical Center. Hinderer is seeking FDA approval to bring Lima's therapy to the US, and hopes the data will be convincing enough to skip straight to phase 2 trials in Detroit.

More on Patient Navigator (US tax money)

The Patient Navigator program (mentioned earlier today) sounds like a good idea, but like many such an idea when government funding is involved, it appears that holding meetings and publishing research on those meetings will account for too much of the expenditure. This article mentions $25 Million, but that's over 5 years:

Despite the disagreement on the conceptualization of patient navigation, researching its effectiveness within the cancer care system is a focus of NCI's Patient Navigator Research Program. The program describes patient navigation as supporting and guiding the patient with cancer and/or the patient's family from the time of abnormal finding to the completion of cancer treatment [10]. The roles and responsibilities of patient navigators extend beyond scheduling appointments and coordinating insurance to include community education and outreach, forming partnerships, and encouraging clinical trials participation. Research focused on evaluating the effectiveness of patient navigation will provide data to determine if patient navigator programs can reduce cancer health disparities.

(More at this press briefing on the "first Patient Navigator Academy," where navigators were able to "communicate and build networks.")

Private and community funds are being donated for the ctual patient navigator programs in hospitals and cancer screening and treatment programs.

Athens, Ohio is supporting the local hospital's American Cancer Society's navigator program through a "Relay for Life."

Avon (Cosmetics) Foundation has donated $250,000 to the Southern Illinois Healthcare breast cancer screening and treatment program to upgrade the mammography equipment (good!) for patient navigators and babysitters for the clients.

The United Way in Springfield, Illinois has donated $28,000 to that city's American Cancer Society's patient navigator program.

The Patient Navigator system may help prevent some medical errors that result from patients who get lost to follow up because they misunderstand or cannot follow doctors' advice due to money problems or other barriers such as transportation and childcare.

Wouldn't the money be better spent training nurses and doctors and/or paying us for the time that we and our staffs spend doing this work?

Patient Navigator funding

The "Texas Insider" email newsletter gives us a "scoop" about funding for the Patient Navigator,

Navigators are specially trained individuals who answer patients’ questions and allay their fears about diagnosis, treatment and insurance coverage. The program is modeled after successful initiatives such as the Harlem Navigator Program in New York City and the Washington Hospital Center's Cancer Preventorium. Implementation of the Harlem program has improved early diagnosis of breast cancer. In 1989, only one out of 20 breast cancer diagnoses made were at an early stage. Through the navigator program, four out of 10 diagnoses are made at an early stage.

I agree that navigation of the medical system can be difficult to nearly impossible - even for doctors and nurses. I'm concerned about the actual use of this $5 Million, though.

Bears watching.

Media and "clone" researcher

The Korean veterinarian, Hwang Wu Suk, who was the first author in the human cloning scheme that became a scandal, testified this week in his embezzlement trial. The headlines and focus that various news outlets chose is almost a story in itself.

After seeing a LifeNews report that Hwang admits that he diverted research money into failed experiments to clone mammoths as well as humans, I went searching for other coverage. A Google News search tonight on "Hwang mammoths" yeilded 63 news articles, half(whose original author was Bo Mi Lim) titled "scientist denies embezzling," and half (authored by Jack Kim) titled, "scientist says tried to clone mammoths." Only about half of each group designated "the scientist" as "disgraced."

Oh, and he tried to clone tigers, too.

"I am also a victim who was deceived. I am the biggest victim," he said.

Claiming that he did not know that the results in the articles were faked - although in the past he has admitted to ordering his staff to fake results from 2 stem cell lines that he (really, truly) believed existed to make them look like 11 lines - and that he spent all the money in the efforts to further cloning of humans as well as dogs and mammoths, Hwang testified that he is the biggest victim of all.

I would not agree with him. The women who donated the more than 2000 human oocytes and all the people who were fooled into backing unethical research by an unethical man are "bigger" victims.

But come on, cloning mammoths? We definitely need more information. What was the origin of the oocytes used in these experiments?

Is this a story in hubris, or what?

Judge stops forced treatment

16 yo Starchild Abraham Cherrix will not have to report for chemotherapy today for his Hodgkin's lymphoma. (Earlier, I called the disease "Non-Hodgkin's," which is a different disease, with a worse prognosis that Hodgkin's, which is actually several types of lymphoma (cancers of the lymph nodes and lymphatic system). Some types of Hodkin's have up to 80% cure rate.)

I hope that the family and doctors can come to an agreement about treatment.

I'm convinced that everyone involved has the best interests of the child in mind. It's just that there are different views about what those "best interests" are.

The act of forcing a treatment on an unwilling and non-consenting
year old seems the worst of the possible options, second only to the death of the boy due to his cancer. The risks of side effects and even death due to some unforseen reaction would prevent me from pushing this treatment. However, I'd want to check back often and make sure that Starchild and his parents know that they can change their mind.

Autonomy - how far?

The case of the 16 year old boy with Non-Hodgkin's lymphoma in Virginia is one of the hard cases in medical ethics.

The court has ruled that Starchild Abraham Cherrix must undergo chemotherapy against his wishes and the wishes of his parents.

This is the second round of chemotherapy for the boy. He says that the first round made him sick and that he would rather die feeling healthy at home than in a hospital bed.

The doctors are faced with forcing Starchild to submit to medication against his will.

I am afraid that there are no winners in this case.

A 16 year old child, while a minor, has the right of refusal of treatment. The fact that his parents - who are his legal guardians and who would rightly be his surrogates if he were not competent to make decisions - agree with him puts more ethical weight behind his own decision. Even if the parents and the child disagreed, we would have to give strong consideration to a 16 year old's decisions.

On the other hand, the child has cancer and will most likely die if he is not treated. I understand the wishes of medical caregivers to ensure the best treatment possible.

I'm hoping for better communication between the two sides. Perhaps Starchild can be persuaded to consider a short trial of chemo.

However, from an interview that I saw on television, I'm afraid that both sides are set on disagreeing.

The Physician's Role in Crisis

Reading the stories in the New York Times (for example, these forwarded by Nancy Valko, here and here) about the arrests of two nurses and one doctor in New Orleans on charges of homicide during the aftermath of Katrina has me concerned that I have never read about a formal medical review of the case.

I can't imagine the heart-wrenching pain of watching my patients as they become more and more uncomfortable. Of not being able to transport them because I can't move them through what has been described as a 3 foot by 3 foot hole to get them to the roof. Watching the ventilators fail. Watching my staff fatique as they try to hand ventilate all the patients. Knowing that there are no medicines to make patients breathe, only medicines that can make them comfortable and make them unaware as their diseases cause them to smother and suffocate.

I, too, would give medicine to relieve the respiratory distress, while being aware of the risk of depressing the breathing drive. And I would discuss my thought processes with my staff and pray that rescue would come before the drive to breathe was suppressed enough to cause the patient to die. I'm not sure how much solace I would feel in knowing that those who have no drive to breathe will at least be sedated enough to never feel smothered.

I'm concerned that the State Attorney General has pressed homicide charges against these women before there was a formal medical review or evaluation.

I'm concerned that one report says that medicines found in the patients at autopsy were medicines that "they were not supposed to have in their bodies." If the physician prescribed them for legitimate purposes, then this statement is patently false. The medical review should come first, in order to evaluate medical decisions.

I have not heard an accurate account of the numbers of patients on ventilators and other machines dependent on electricity. No one has listed the medications that were available to the doctors and nurses. Even though the papers report conversations about "lethal doses" (from anonymous sources), none of them say the witnesses claim the doses were given with the intention of causing death.

The doctrine of double effect allows risk while relieving pain and suffering as long as the intent is not to cause the death of those suffering.

The heat alone would have put patients with mild lung disease, diabetes, and those who are underweight at risk of dehydration leading to respiratory distress which could not be relieved in the heat without sedation and ventilation. The humidity would have actually increased the respiratory distress.



Without the means to cool the patients, administer IV fluids, and/or put the patients on ventilators, it was appropriate to sedate the patients to relieve their pain.

For that matter, sedation can be used to slow the progression of respiratory distress. Morphine can be given as a mist in these cases. Regardless, sedation is usually needed in order to ventilate patients.

So what would the Attorney General have done with no resources other than sedatives? Would he have let these men and women die in pain?

The doctor and nurses in question did not abandon their patients. Instead, the reports are that they fought to care for all the patients and help as many survive as possible.

Why would any doctor or nurse remain in such conditions at the time? Will any be willing in the future? The answer to this last is, "Yes, even at risk of being arrested for caring for our patients."

Creative Bookkeeping at Medicare

One more reason I do not want government-only healthcare.

According to the "Medicare Learning News," (a pdf document) no payments will be made to Medicare "providers" (doctors, hospitals, pharmacies, and the intermediate insurance companies with which the government contracts to "manage" Medicare) for the last 9 days of the fiscal year, September 22 to September 30, 2006. The payments will go out in a batch on October 2, 2006.

This planned "hold" will not affect Social Security or your Senators' and Representatives' health plans. I do plan to watch the pork barrel giveaways more closely between now and the election.

This means that the insurance companies who manage payments from Medicare as they filter back to your doctors, pharmacies, hospitals and all sorts of groups "downstream" will wait longer to be paid for work and supplies that they have already provided to Medicare, Medicaid and TriCare patients during those 9 days. They will have to plan ahead to cover their own bills during the lull.

The first day of the fiscal year for government funded agencies and grants is October 1st. September tends to be an "interesting" month for the bookkeepers of recipients of government money: some have run out of their Federal funds, and others have money that they must spend or lose. The conventional wisdom that I've heard is that if you don't spend it, you won't get your full grant next time -- and someone may come around to ask why the grant was inflated in the first place.

(Shouldn't there be some sort of award, rather than penalty? I never knew of anyone who actually tested this out.)

Many of the stories that I've heard about grants and budgets concern shopping sprees in September in order to spend every last dime, within the limits of the charter or grant. No one wants to risk next year's grant or an audit, so purchases of office supplies, computers and peripheral office machines increase and store rooms fill.

However, some agencies run out of money or never seem to have enough money allocated in the first place. And then there are those with planned shortages. Medicare is one of those agencies this year.

Medicare, along with Social Securty, is funded by specific taxes taken from payroll -- that "FICA" on your check stub -- before those checks are written to employees. The employer matches the employee's portion, so that employers send off checks equal to about 13% of the salary of each employee to Washington each payday. (Larger employers are required to file electronically, so that money is automatically withdrawn from their bank accounts and sent to Washington. Smaller businesses send checks each payday, through their banks.)

The trouble, I think, is that the Medicare and Social Security money is dumped into and re-distributed through the general Federal budget each year. Maybe you've heard about the "lock box" that doesn't exist: All that money that should be earmarked for healthcare and Social Security payments - for work already done and promises already kept on one side - is used just like the income tax money - for "pork barrel" projects as well as legitimate promise-keeping. No penalties, no interest will be paid.

There's also the problem that the money is redistributed through companies like Blue Cross, United Health Group, and Cigna, companies which must make a profit and pay high-salaried CEO's. United Health Group, for instance, paid its CEO, William McGuire, MD, $124 Million last year, not including his stock options that total as high as $1 to $2 Billion, depending on the date Dr. McGuire is able to put on those options.

Report on Olfactory Stem Cell Spinal Cord Repair

Wesley Smith's "Secondhand Smoke" has a link to and short note on a report in the Journal of Spinal Cord Repair on Carlos Limos' treatment of patients with their own olfactory mucosa stem cells.

Looks legitimate and well documented.

It's late, but will get back to y'all when I've read it. In the meantime, let's spread the word.

Art Caplan: lies and projection

Best title ever from the editors and pseudoeditors over at the blog.bioethics.net: "President to Stem Cell Community: Drop Dead."

In fact, the President demonstrated the "checks and balances" guaranteed in the Constitution by vetoing a bill that did not allocate new funds and that would have encouraged the unethical destruction of embryos without a clear source of payment.

I'll bet they laid this strategy out at the Progressive lunch last week. As I said, if you want to know what the "progressives" are doing, just listen to what they're accusing others of doing.

While accusing the President of beginning his embryonic stem cell policy with a lie, saying that Karl Rove knows something about rats, and blurring the line between ethical and unethical "stem cells," Glen McGee quotes Caplan as he reminds us that death is the subject for the embryo destroyers.

Caplan asks why the President hasn't shut down IVF clinics if he's so concerned about human embryos.

Nothing was shut down. US taxes have never payed for in vitro fertilization and have never been used to destroy embryos even before August, 2001, although it was legal with non-tax money then and it's legal now.

More on "Science" mag "Pseudoscience"

Note: edited to correct the authors to George and Lee, not George and Cohen.

Earlier today, I reported on Michael Fumento's rebuttal to the letter in Pseudoscience Science magazine that attacked Dr. David Prentice on his support for Adult Stem Cells. Another blogger, LTI, pointed me to an op-ed by two of my favorite ethicists, Robert P. George and Patrick Lee of the Franciscan University of Steubenville, which also points out the fraudulent use of the reputation of Science in pursuit of an unethical, political and financial agenda that has nothing to do with true science.

The George/Cohen essay points out the use of the euphemism "early stem cell research." This was the term used by Myra Christopher of the Center for Practical Bioethics (a strong proponent for the right to die and the right to kill) at last week's Bioethics and Politics conference and reported, here. Ms. Christopher did not take my suggestion that she was giving us a perfect example of Dr. Alt's discussion of changing the name to influence opinion and law.

Good veto, Mr. President!

As a proud member of organizations that PP calls “Terrorists and Extremists,” it seems fitting that President George Bush’s first veto should concern a life issue: the ethical use of science and in protection of all humans, no matter where or how they originated. After all, his first televised speech as President, in August 2001, was also in defense of the smallest and newest members of our species.

In fact, the President had anticipated the need to veto HB/HR 810. Wesley Smith reported on his blog, Secondhand Smoke, that he had been invited to the veto-speech days ago.

Thank you, Mr. President.

More Lies: Stem Cell "Experts" For Sale?

Michael Fumento, in the National Review Online, writes a rebuttal to the lies that have been spread concerning David Prentice, Ph.D. and the current use of non-embryonic stem cell therapies vs. trick language and out and out lies.

There are wonderful resource links and references in the article to prove Dr. Prentice is much more correct than his critics, including the journal, Science, are willing to compromise their own integrity in pursuit of trash-science. Remember, Science magazine is the publisher of the "alleged" Korean veterinarian, embezzler, and abuser of women, Hwang Wu Suk.

Fumento cuts to the chase:

How can Science not know all this? Simple; it does. I’ve written repeatedly of how the publication has made itself a propaganda sheet for ESC research, as well as other political causes. At the least, it should change its name to Pseudoscience. Sometimes it prints easily falsifiable studies, such as this, attacking the usefulness of ASCs. Other times it falsely promotes ESCs. That culminated in January when the journal was forced to retract two groundbreaking ESC studies that proved frauds.

The journal wants to flood unpromising ESC research with taxpayer dollars because private investors know just how very unpromising it is. Now yet again Science has showcased the scientific and moral bankruptcy of the entire ESC-advocacy movement.

PP and terrorism

What an absolute joke - the minds aren't there if Planned Parenthood seriously considers Feminists for Life, Eagle Forum and Americans United for Life among the "Anti-choice" organizations that are listed under the Heading "Terrorists and Extremists."

Okay Feminists for Life (mottos: "Refuse to Choose," "Question Abortion" and "A Woman Deserves Better") goes around to colleges and teaches that abortion is anti-woman and that a woman shouldn't have to choose between her own child and an education, that an unplanned pregnancy should be unplanned joy. Yeah, terrrorism.

Uh,oh. I wore my Feminists for Life pin to the Politics and Bioethics conference last week - identifying myself as a member of one of the terrorist groups!

All three organizations could be terrorists if terrorism includes teaching non-violence and using education to change the hearts and minds of voters, boyfriends and best friends and pregnant women themselves and use the courts, the legislature and the public forum to protect women and their children.


On the other hand, if attempting to use RICO laws (including triple fines and confiscation of assets so there is no money for defense lawyers), separating children from the protection of their families, and directly killing a large proportion of the children conceived in this Nation isn't terrorism, what is?

Follow the Money (embryos)

I can't find any mention of actual funds allocated for the destruction of embryos in HB 810. However, the bill says that the Secretary of Health "shall conduct and support," and "Human embryonic stem cells shall be eligible for use in any research" that meet the criteria of prior informed consent, being "in excess," and no one is paid for the donation. However, there's no money allocated by the bill.

I'm not a lawyer, but this is either a demand for the Secretary to go into the lab and do the research himself without any funds earmarked for that research and/or the bill creates a mandate to the Department of Health and Human service to provide automatic funding for any research that involves embryonic stem cells, even if it's not specifically related to the development of therapies or the study of the research itself.

But, where is the money to come from?
Will only that money already earmarked for research on the previously eligible (pre-August, 2001) embryonic stem cell lines be used?
Can embryos rejected for implantation because they are diagnosed as having a genetic disease or the susceptibility to a disease be legitimately called "excess"?


From searching HB 810 Thomas.gov:

SEC. 498D. HUMAN EMBRYONIC STEM CELL RESEARCH.

`(a) In General- Notwithstanding any other provision of law (including any regulation or guidance), the Secretary shall conduct and support research that utilizes human embryonic stem cells in accordance with this section (regardless of the date on which the stem cells were derived from a human embryo).

`(b) Ethical Requirements- Human embryonic stem cells shall be eligible for use in any research conducted or supported by the Secretary if the cells meet each of the following:

`(1) The stem cells were derived from human embryos that have been donated from in vitro fertilization clinics, were created for the purposes of fertility treatment, and were in excess of the clinical need of the individuals seeking such treatment.

`(2) Prior to the consideration of embryo donation and through consultation with the individuals seeking fertility treatment, it was determined that the embryos would never be implanted in a woman and would otherwise be discarded.

`(3) The individuals seeking fertility treatment donated the embryos with written informed consent and without receiving any financial or other inducements to make the donation.

`(c) Guidelines- Not later than 60 days after the date of the enactment of this section, the Secretary, in consultation with the Director of NIH, shall issue final guidelines to carry out this section.

`(d) Reporting Requirements- The Secretary shall annually prepare and submit to the appropriate committees of the Congress a report describing the activities carried out under this section during the preceding fiscal year, and including a description of whether and to what extent research under subsection (a) has been conducted in accordance with this section.'.

Passed the House of Representatives May 24, 2005.

Next: funding for creation of embryos

Next will come the call for the purposeful creation of funding for disease-specific embryos.

These embryonic humans are not dead. They were chosen and frozen because they looked promising for future attempts to fill the empty arms of their mothers and fathers. SB 810 authorizes the use of tax money to pay to thaw, nurture, evaluate and kill for harvest.

Very, very few of the currently frozen embryos are eligible to be harvested:

1. Informed consent was not obtained at the time of fertilization.

2. They are mostly the children of white, healthy (other than infertility) parents and so will not be the models for the diseases supposedly to be studied or treated.

3. A survey by Art Caplan a couple of years ago showed that few parents want to donate in the first place.

What a waste of money, the lives of researchers and -- the lives of the humans to be harvested, themselves.

When all else fails, change the language

The blog.bioethics.net links to several online reports about the Bioethics and Politics conference, including LifeEthics and this one from the Scientist, covering one of the paper sessions. ( Covered by LifeEthics last week.)

It seems that Missouri legislators would not vote to approve embryonic stem cell research if the bill had the word "embryo" in it. The subject of research was changed to "left over material," and "unused material."

As I commented on the Scientist,

The use of alternate language to obscure the meaning of law does not sound ethical to me.

Are the lawmakers too dumb to learn the science or do they believe that the voters are too dumb to be educated on the facts?

Or is it just that the elitists know better than we do what is good for us?

As I pointed out to the panel, the new International Stem Cell Research Guidelines has an excellent glossary. If there is truly contention about the definition of embryo, perhaps a good reference would help.

From comments that were made in several of the forums, the purpose of the Progressive Bioethics Institute [luncheon] - an invitation only political meeting just prior to the opening of Thursday's session - was to discuss strategy that included just this sort of redefining and renaming in order to influence the public and legislators.

Endarkenment and humans

Wesley Smith has had a bit of time to consider and reconsider the way he was called out and singled out at lunch by Alta Chara on Friday, July 14th at the Bioethics and Politics Summer Conference of the American Society of Bioethics and Humanities.

I am unabashedly human-centric and a human species-ist. Any other species that enters the conversation will earn/receive my due respect. And I will do my best not to harm or stress any members of other species.

But, I will not equate animals with humans or humans as animals.

What was interesting was that Professor Chara not only pushed for science as an expression of free speech, but for science as being able to prove that there is no Creator, no special status for human beings, other than being lucky enough to tax and support scientists and lawyers-turned-bioethicists.

Good grief, just because scientists can create artificial chromosomes and create clones of human beings in the lab (or Frankenstein can reanimate the monster?) does not mean that there is no God. It doesn't even mean that humans are not a species that deserves special consideration from other humans.

And, I'm sorry, but hasn't the test for freedom and freedom of speech (and a lot of pre-penumbra events and ethics) always been that you can have what you want, I won't aggress against you, but your rights stop at the point when you infringe on the rights of another.

If you and your grand-kids are not special, then ok. But me and mine are special. In the meantime, don't swing that fist far enough to hit my nose and don't shout "Fire" in a theater.

(Remember the story about God and the scientist? When the scientist challenged God on being God because He is able to create life and now, scientists claim to be able to do the same. The researcher scooped up some dust off the floor and began to try to show the Lord that He is not the only One. God said, "Whoa! Hold on there, son! First, make your own dirt!)

Ethical correctness is not extreme

Besides abortion, destructive embryo research, and complete sexual freedom for teens, I wonder how many other moral issues are judged, "Regardless of its ethical correctness . . ."? As it is, I wouldn’t want someone that goes around acting "regardless of ethical correctness" for my doctor or even an employee.

The ethical correctness is the point.

Human life should not be intentionally and electively ended by humans. There are no "human non-persons." There are all sorts of classifications of humans who can be put in harm's way due to poor judgment or the intentional actions of other humans. (human females, human Jews, human Negros, human Chinese, human non-citizens, human minors, human felons and . . .)

It isn't necessary to use the term "sacred." All societies prohibit the killing of some humans. They all act as though human life is sacred. It's just that some have different definitions of "human." Females aren't fully human in some Islamic countries. Black men and women were not considered fully human - or were at least "non-person" humans, in the UK and the US in the past.

However, with what we know empirically about embryology, taxonomy and causation, there are no criteria for the limiting of personhood among living human organisms that cannot be used against currently legally protected human persons - to redefine them as "human non-persons" available for killing, harvesting and/or enslaving.

In fact, insisting that one human is more equal when it comes to the right not to be killed than another is simply a matter of personal opinion. Unless there's some verifiable, repeatable, consistent evidence I'm not aware of.

That is why the same people are in favor of stem cell research that is not destructive and against destruction of embryos created extracorporeally. That's why so many married evangelicals feel comfortable using non-abortifacient contraceptives, but would never abort the results of "contraceptive failure." Because to cause fertilization by intention or even to risk conception by the act that is known to enable fertilization is to engage in actions that can put your own children in harm’s way. (Look up the old law on digging holes and the responsibility of the digger to cover it and to pay restitution if anyone falls in)

All humans are created with the right not to be killed and the right not to be enslaved. It doesn't matter whether she is frozen in Albany, New York, USA or whether she wears a headscarf in Bangladesh. She has the right not to be killed and society should protect her equally with others.

As to abstinence – how many societies do you know that encourage early onset of sexual activity, outside of marriage? And what is the result in teen pregnancies, unplanned pregnancies, and STD’s? I hear the UK's numbers are worsening despite not being plaqued with abstinence-only sex ed. Who's happy?

Human enough, no matter where or how

If I wanted to study disease through embryonic stem cell research, I'd imagine that I would want to study only those with the disease or susceptible to the development of the disease. How many of the chosen, frozen embryos are likely to be diseased?

This is just one of the questions you need to ask your Senators today.



The debate on increasing tax funding for destructive embryonic research will begin today in the US Senate, with votes planned for tomorrow. I'm afraid that (except this vote will be the result of the representative democratic legislative process rather than a judicial fiat, which is a huge difference, I know) we will all look back at 2006 as the same sort of turning point that 1973 was.

Our Senators appear to be poised to pass all three bills, including the one that will allow government funding for research that depends on the destruction of the embryonic brothers and sisters of babies who have been born to and fill the arms of parents that desired children so much that they used the highest technology and complicated medical procedures to create them. These children were purposefully created, they passed the first tests of viability, but were "excess" or not as robust as their siblings who were implanted, and so they were abandoned to a freezer.

Nevertheless, these are human organisms. They were organized enough in the process of development that they were frozen rather than deemed defective or dead and flushed as waste. They deserve our protection and our affirmation that they, too, have the right not to be purposefully killed to harvest their parts.

This year, the researchers ask for funding for "left over" embryos. What is the ethical difference between newly and specifically created embryos or cloned embryos and these?



Call your Senators today and urge them to vote against the funding of destructive embryonic research. Again, you can access your Senator's information at Thomas.gov.

Podcast Interviews from Bioethics and Politics

Linda Glenn of the Women's Bioethics Project and the A Marsh Bioethics Institute in Albany interviewed several of the key speakers and has posted the interviews, free for the listening. It played from the website, without additional software.

Unfortunately (there's that word, again), there's Dr. Pelligrino and Nigel Cameron to represent the conservative, prolife side and many times that number from the "progressive," pro-destructive research and abortion side.

I've only been able to listen to one, so far, but I still recommend them for a taste of the conference and so you can make up your own mind about the viewpoints of the speakers as well as the reality of the assertion that all the money and power is in the hands of conservatives.

Letter to the Houston Chronicle

My letter to the editor is in today's Houston Chronicle.

I wish I had thought to be more "precise and clear," myself.

I wanted to praise the reporter for his question on adult stem cells and point out the hope Dr. Simmons has for them - even if the researcher still wants to get his hands on embryonic stem cells. It just didn't seem the time to chide Mr. Ackerman and Dr. Simmons about destructive embryonic research. I was wrong.

Sending the letter to the "viewpoints" editors was an after thought. I was not expecting it to be published.

It's time to call our Senators, today, since the vote is scheduled for Tuesday. You can find your Senator and a link for "Contacts" at Thomas.gov.

Politics and Bioethics Conference Wrap-up

In sessions titled “The States and Bioethics: Stem Cells” and “The Endarkenment: Bioethics in a Time of NeoConservatism,” I spent the last few days surrounded by self-proclaimed "liberals," “progressives,” “leftists,” and “women.” (I know, I'm a woman, but evidently not their kind of woman.)

Seriously: it seemed very important to most of the speakers to reaffirm that they came from the left, were progressive, and/or were active in defending women’s reproductive rights. Some of the comments were meant to be funny, such as the time that the side of the room chosen to go to the buffet first was determined because the announcer said he prefers the left. (The guy didn’t get it right, though: he chose those to his left, as opposed to those sitting on the left of the room. Okay, that was open to interpretation.)

But some of the comments were not funny.

Too often, the comments made by the self-labeled liberal about the “conservatives,” “religious,” “neo-cons,” and “right” were attacks directed at a person rather than a rebuttal of ideas. Reportedly, one of the paper sessions included a presentation with a picture of the “Unibomber,” labeled with the name of Nigel Cameron, Ph.D. Wesley Smith was criticized at lunch by a keynote speaker for being human centric. One paper was focused on exposing Americans United for Life and the bulk of another presentation dealt with the religious beliefs of former Attorney General John Ashcroft.

The “liberals” also repeatedly noted that they were surprised that so many of the conservatives showed up. Besides Glenn McGee and Art Caplan, who seemed to be genuinely enjoying the give and take and the result of their brainchild, I don’t think the liberals wanted us there. I would like to assure those who seemed more concerned than delighted that I and, as far as I could tell, the others, we conservatives were there because we wanted to learn and discuss, and because some of “our” guys were actually invited speakers. We recognize that the bioethics debate permeates every aspect of education, law, medicine and economics and we really do believe what we say: each human is human enough for our protection of their right not to be killed or enslaved.

As is often the case when I listen to or read the “pro-choice,” “leftist,” or “progressive” bioethicists, I had the urge to shout “Boo!” as one boogey-man after another was brought out to frighten the listeners. They actually tried to frighten us about the risks of using fear-tactics to influence public opinion. (But, some seemed to think fear is just a tool that needed to be wielded by the proper – not “right” – hands. Watch for the follow up on this.)

One speaker urged us all to respect the authority of local laws and conditions as they influence regional attitudes toward bioethics issues, while praising Justice Kennedy's ruling that history, tradition and public opinion concerning morals shouldn't affect laws concerning private matters.

We were reassured that Preimplantation Genetic Diagnosis and other techniques of prenatal diagnosis with selective abortion would not lead to eugenics. I pointed out that we have contemporary laboratory evidence of a sort in India and China, on the eugenic effects of acting to select children whoare more desirable than others according to the local attitude toward moral issues. There are 120 or more boys for each 100 girls in India and China. I was told not to worry: that's in India and China, not the US or China where families tend to want one boy and one girl.

“Yes,” I asked, “but what’s the difference between killing your children because you want to make sure to have one of each or killing them because you only want males?” Can there be good and bad, if it’s somehow wrong to be human centric in the first place?

What are laws in a democracy, except the expression of the traditions and will of the people, through direct referendum or representative legislation? How do we respond to those societies that practice jihad, slavery and the non-personhood of women?

One after another, the leftist, progressive, women’s bioethicists warned about the conservatives’ efforts at redefining and honing the language, that we were getting together to work against the left, and far too many of us are against abortion, belong to the Republican party, go to church and belong to, support, or are supported by right wing think tanks and organizations. (Of course, only the conservatives called abortion, “abortion.” The “liberals” consistently called “abortion” “a woman’s right to choose,” “choice,” and “reproductive rights,” as in, “John Ashcroft is anti-choice.”)

None of the self-declared liberals seemed to count the support the left receives from, and their formal and informal service to, humanists, PP, NOW, and all those “death with dignity” organizations that received seed money from the Robert Wood Johnson Foundation and George Soros or by the organizers of the "Progressive Bioethics Initiative.”

(I think a couple of women looked guilty when a third woman happened to mention that means of redefining and using words in order to influence the public had been brought up at the “Progressive lunch.” Or maybe they were just worried about the leak. I became increasingly cynical the 2 days, deciding that there is no secret about what the left is up to: just listen to what they’re accusing the conservatives of doing, and expect them to do the same.)

One conservative speaker challenged us to name even one prominent Conservative in a tenured position in a university. Whispers broke out behind me, and over the course of the day, several people mentioned echoed the whisperers: we've got Robert P. George!

Okay, there's one. Name another.

In the end, though, my final impression is that the group is – so far – a closed and insular one. There was little acceptance that the conservatives had a place in the discussion, except as a caricatured opposition - a caricature drawn with curly black mustache, blackened teeth and horns.

Will Texas seek death penalty for illegal abortions?

Well, we all know that actions have consequences. And District Attorneys are the ones we have charged with initiating prosecution of people who break the law. However, I think we're seeing headline-seeking more than we're seeing true concern on the part of these lawyers. And . . . there could be a secondary agenda of some "pro-choice" activists.

In 2003, Texas passed the Prenatal Protection Act which, like the Federal law nicknamed "Lacy and Connor's Law," enabled the prosecution of anyone who kills a child due to an "unlawful" act. Abusive husbands and drunk drivers can now be tried for the death of unborn children. The law specifically excluded any acts of the mother or any medical professional she hired. (I know, it still allows abortion and the destruction of embryos in in vitro fertilization clinics, but it was a small step forward.)

A benefit of that law was the definition of a human "individual" as beginning at fertilization.

In 2005, we passed a new Medical Code that included several restrictions on those doctors who perform abortion. The doctors now have a requirement to get parental consent or a court order before performing abortions on minors and all abortions done after the 16th week must be done in a facility that is equiped like an ambulatory surgical center and there are stronger prohibitions on abortions in the 3rd trimester.

For a while now, some of the lawyers in Texas have been saying that , because the combination of the existing homicide laws and the Prenatal Protection Act includes the possiblity of the death penalty for those convicted of killing an unborn child with the newer illegality of performing an abortion on a minor without parental consent, that doctors are now at risk of the death penalty.

The whole idea is an exageration of the scope of the laws. And, to affirm that the docs are not really in danger of the death penalty when and if they perform an illegal abortion, Representative Swinford, the Republican Chair of the House State Affairs Committee has officially asked State Attorney General Abbott to give a ruling on the interpretation of the law.

(of course, if the doc kills a child any time after he or she has a birth certificate, he could be at risk of the death penalty, too.)

More on "Not Dead Yet" protest at Bioethics and Politics

Yesterday, I posted a real-time report on the half hour delay of the Bioethics and Politics Conference in Albany by Stephen Drake and members of "Not Dead Yet." I held off on publishing an extended report, hoping that there would be more coverage. Unfortunately, a search on Google News shows that none of the mainstream media picked up the story. There's not even a note on the Not Dead Yet website. (Okay, I'll admit it: The lazy side of me was hoping that the press release would be online for ease of copy-and-paste. I would also like to read more about the communications between the organization and Glenn McGee, et. al.)The Scientist has a report on the incident at their blog.

Just before the (planned) 1:30 start time (as Richard Doerflinger, who was to be the first speaker, was setting up his PowerPoint presentation) a large group of wheel-chair bound and obviously disabled people walked in the front of the room. Then, they all started shouting "Nothing about us, without us." A few held hand-lettered posters with the slogan and some handed out two flyers. The chanting went on and on, as the registered conference attendees began to figure out that we were being picketted because there were no invited speakers who were identified as disabled or advocates for the disabled! (That was when I started typing my report.)

Finally, everyone around me began to question why the program leaders didn't come into the room and interfer.

After nearly half an hour, the powers that be announced that Mr. Drake would be allowed to address us. I was ready to give a standing ovation to the man who had won a forum to make a stand for those whom I agree are too often used and abused in the political and policy wings as well as in research.

Until Mr. Drake offended even me.

Unfortunately, Mr. Drake "cussed" (as we say in Texas) a couple of times, used the "F" word, and attacked doctors, caregivers, as well as the bioethicists. He accused us all of pushing the disabled out of the way in favor of our culture war. The flyer even attacked Wesley Smith for his review of "The Party of Death," because Mr. Smith hasn't protested against cuts in Medicaid.

He talked about the slant of conversation on disability issues and cases such as the recent killing of a 3 year old who had severe autism. There was a discussion about the Terri Schiavo case and his belief that the advocates for the disabled were shoved aside in favor of the more "sexy" polar debates and debators. However, there are many of us who feel that we are trying to restrain those who would harm our brothers and sisters.

One man in the back of the room shouted that we didn't need "that" (the language and attacks on individuals.)

He talked about the Terri Schiavo case and his belief that the advocates for the disabled were shoved aside in favor of the more "sexy" polar debates and debators. However, there are many of us who feel that we are trying to restrain those who would harm our brothers and sisters.

There was no mention of any - if any - efforts to work with the Conference administration. No acknowledgement of the 3 or 4 papers to be presented on the activism of the disabled community and/or Terri Schiavo's death and the events that led up to it.


I agree that the discussion of bioethics policy seems too often to be a bunch of people "making a living at it." Even Dr. Edmund Pelligrino commented (in his speech at dinner, last night) that too many bioethicists have become "personalities." However, while demanding respect, we must show respect.

Today's actions were not in the urgent defense of any life or against clear dangers - they were a "sexy" bid for attention that has not paid off in public attention and probably won few advocates, and turned off a few of us. Mr. Drake won, but he did not show grace in victory.

Any of the protesters could have registered and attended as I did. They could have asked questions and made comments at the sessions, as many did (although our time was shortened by the time taken up by the protesters.) I'm not sure whether any of the protestors submitted papers at all, but I would have liked to hear from Mr. Drake whether he had a paper that was rejected, rather than hearing that he wasn't invited to speak.

In the end, (again, unfortunately) the protesters actually gave us a mini-lesson of the politics that too often permeate bioethics discussions: the appeal to emotion and varied weight given to those who can wield power by force, public opinion, or claims to being more equal than others.

Day one of Bioethics and Politics

The day was short, with a panel discussion followed by 5 separate groups of submitted papers and the dinner lecture by Dr. Edmund Pelligrino.

First, we heard from a Catholic, a Protestant, and a Rabbi (Richard Doerflinger, William May and Gerald Wolpe) about where religion is in bioethics today. All agreed that the division of "left" and "right," "conservative" and "liberal" along religious lines are not appropriate. Not all religious people believe it should be illegal to kill an embryo are religious and not all who believe that it's okay to kill an embryo are without religion.

Wishing I could be in five places at once, I attended the session on "The States and Bioethics 1: Stem Cells."

The first speaker, Susan Berke Fogel, J.D. of the Pro-Choice Alliance for Responsible Research, talked about her group's efforts to protect women and ensure transparency and responsibility after the passage of the $3 Billion embryonic stem cell research initiative in California. She noted that the public discussions about embryonic stem cell research, including IVF and cloning, begin with the oocyte, not with the woman. Her group wants to put the woman back in stem cell research policy. She pointed out a fact that I'd never thought of: when recruiting women to donate eggs for in vitro fertilization to treat infertility, the recruiters want the women's DNA, so they appeal to women (usually white, educated, attractive women) who have proven that they have been successful in some way. But in cloning, the DNA will not matter, so there is more risk of a focus on paying less to women who need the money because they are in a weaker socio-economic situation.

The second speaker, also a woman, Patricia M. Alt, Ph.D., discussed the history of embryonic stem cell research in Maryland as "The Legislative Politics of Medical and Bioethical Language." She has discovered how vital the words and terms used in debate are to the influence on legislation. Maryland's embryonic stem cell research bill, HB1/SB144, refers to the embryos in question as "certain material" and "unused material" in IVF clinics. Also, the oversight has been moved from the State's Health Department to the Maryland Technology Development Corporation -- as a business, rather than healthcare matter.

The third speaker was also a woman (the moderator was a man). Myra J. Christopher of the Center for Practical Bioethics, spoke of the difficulties in Missouri that the pro-abortion and pro-destructive embryo research forces have had, largely due to religious opposition. She spent quite a bit of time detailing the religious actions of former Attorney General John Ashcroft, and listing words and phrases in Missouri law and ethics debates that she indicated were religious, such as "human life begins at conception." And, she invariably called embryonic stem cell research "early" stem cell research.

I wasn't too popular when I pointed out that the International Society for Stem Cell Research had just published a good glossary of terms that could be used in these debates.

Not Dead Yet shuts down Bioethics and Politics

The opening of the Politics and Bioethics Conference is delayed due to a large, loud group of protesters from "Not Dead Yet."

To quote the press release from the organization:

. . . [I}t's clear that many of the players in this conference are working to keep our democracy a "divided" one. Organizer Glenn McGee takes a blatantly partisan approach in his bioethics advocacy.

We are about to hear from Stephen Drake.

Politics and Bioethics - a divided democracy

Today's the first day of the Politics and Bioethics conference in Albany. Since my plane was delayed and we didn't get in 'till 2 AM, I'm glad I don't have to be anywhere until 1 PM.

Evidently even NPR noticed - at least the emotional attraction.

It's a shame that so many of these discussions do devolve into political divisions. Stephen Myers is reporting that there's a "move on to get MoveOn.org" involved in pushing for Senate passage of funding for destructive embryonic stem cell research. He's also posted some of the comments at Dvorak's blog, where explanations about the nature of embryonic stem cell research is dismissed as "superstition" and parroting leaders.

I find it preferable and reasonable to assume that those who enter the conversation have done at least a little thinking about the issues, even if they don't know the most up-to-date facts or draw different conclusions from those facts. Working from that assumption and what you learn that they know may yield more consensus and eventual results than resorting to labeling, name calling and ridicule.

And be the solution to the Future of Bioethics.

A Father? A Father's Choice?

Here's an article about the failure of one UK facility to follow the informed consent preferences of a sperm donor. I wasn't aware that donors could specify the type of families would receive their sperm.

Some of the comments in the article and the responses are heart-breaking revelations about the effect of finding out that Dad was an anonymous donor. But, I wonder if there are just as many devastating stories from children whose parent or parents abandoned them and/or refused to acknowledge them.


However, it seems to be a part of human nature to want to know where we came from and why we're here. The recurrent reports about several children - siblings - who inherited a genetic disease from an anonymous donor points out the health risks.(here and here, for instance)

The desire to be a parent can lead to tough choices and even tougher consequences. This is one of those hard questions. In the case of purposefully created children, how much regulation is necessary? Is it ethically permissable to help start children when you never intend to be a true father?

Texas imports Australian stem cell researcher

The Houston Chronicle (free registration required) has an excellent "Q & A" interview by Todd Ackerman with Paul Simmons, Ph.D, until recently, one of the most prominent researchers in adult hematopoietic stem cell from Melbourne, Australia.

Mr. Ackerman's questions and Dr. Simmon's answers were much more clear and concise than those we normally see in the popular press. Although Dr. Simmon is a strong proponent of "relaxed" destructive human embryonic stem cell research, he is very enthusiastic about adult stem cell research potential.

Q: What do you think is the future of embryonic stem cell research in the aftermath of the Korean scandal (in which a researcher admitted to falsifying breakthrough results)?

A: I think it's extremely bright. It's sad to say, but the field of stem cell biology is hardly the only one in which there's been evidence of wrongdoing on the part of scientists. It's a speed bump on the way, but progress in the field is really undiminished. And it really challenges me to maintain high standards in my own research and those of my colleagues.

Q: How much promise is there for adult stem cells? You keep hearing how embryonic stem cells have all the potential, but it seems there are lots of breakthroughs with adult stem cells these days.

A: I could talk about that for a half-hour. I think adult stem cells' potential as therapeutic application is huge. I'm frequently at pains trying to explain to people that the concept of stem cells could use stem cells from adult tissue as a way to repair and regenerate those tissues was really an obvious step forward.

Q: From where do you plan to recruit stem cell scientists to UT-Houston? A lot from
outside the United States?

A: I'll be recruiting from outside the U.S., that's for sure, but I'll also be recruiting heavily within the U.S. Having had the good fortune to train and work in the UK, Canada, the U.S. and Australia, I have extensive contacts here and internationally.

Q: Do top-flight stem cell scientists still want to come to the United States, given the current constraints on research?

A: Absolutely. While the current U.S. policy on embryonic stem cell research may be problematic to them, it certainly wouldn't deter those interested in adult stem cell biology. The U.S. has been and always will be the No. 1 draw for biomedical research.

Q: What are your realistic goals for UT-Houston's center? Can it compete with better-known Baylor College of Medicine?

A: My major intention for the center is to establish it as a major center of excellence, not just for the Houston area but within the U.S. and internationally. ... I also hope to collaborate extensively with some of the experts from Baylor. ... In the end, I'd like the center to be seen not only as a center of excellence but as a reference center for people interested in questions of stem cell biology, a place where they can come and get objective insights and information about stem cells.

The Center for Stem Cell Research is part of the the Brown Foundation Institute of Molecular Medicine for the Prevention of Human Disease at UTHSCHouston. It is the result of a $230 Million private fund-raising effort in Houston. Evidently, State and Federal funds aren't all that necessary. Or, if like the founders of the IMM, if there's enough desire to do research that is not eligible for tax funding, there will be enough private money to do so.


I do hope that Dr. Simmons will make it a point to focus on hiring Texas physicians and researchers for the new Center for Stem Cell Research at . It seems that we keep hearing about the "brain drain" if Federal and State funding are not adequate, but here is an example of Texas research money (even if most is from private donations) used to import professionals from other countries.

International Stem Cell Research Guidelines

The International Society for Stem Cell Research has published (.pdf file, here) the proposed guidelines for stem cell research. Unfortunately, like the National Academies guidelines (available, here. You may have to do a search on "stem cell guidelines" if the link doesn't work), they assume that cloning and embryonic stem cell research is a given. Fortunately, the guidelines do recommend a moratorium on "reproductive cloning," although defining "reproductive cloning" as implantation for the production of a baby. In reality, of course, all cloning is asexual reproduction of the donor of the nuclear DNA.

The Scope of the Guidelines are given as:

4.1) Well-established guidelines and regulations governing the use of human subjects are already in place throughout the world. These principles have been articulated in internationally recognized research ethics guidelines including, but not limited to, the Nuremburg Code of 1947, the Declaration of Helsinki of 1964 and 1975, the Belmont Report of 1979, the Council for International Organizations of Medical Sciences (CIOMS), the International Ethical Guidelines for Biomedical Research Involving Human Subjects of 2002, and the UNESCO Universal Declaration on Bioethics and Human Rights of 2005. Regulations for use of animals and hazardous materials in research have also well established and in wide use. This Guidelines document focuses on issues unique to stem cell research that involve pre-implantation stages of human development, and
research on the derivation or use of human pluripotent stem cell lines, and on the range of experiments whereby such cells might be incorporated into animal hosts.

4.2) These Guidelines pertain to the procurement, derivation, banking,distribution, and use of cells and tissues taken from pre-implantation stages of human development; to procurements of gametes and somatic tissues for research; and to the use of human totipotent cells or human pluripotent stem cell lines.

4.3) These Guidelines assign criteria for defining categories of research that arenon-permissible, that are permissible under currently mandated review processes, and research that is permissible yet should be subjected to an added level of oversight. These Guidelines prescribe the nature of regulatory review and
oversight for each of the permissible research categories.

I was right about the overlap of the two committees, btw. The International Committee is much larger, but the two committees have several members in common. More importantly, Appendix C of the National Academies' document is the "Workshop Agenda and Speakers' Biographies." The agenda reveals that, as the International guidelines acknowledge, the same set of men and women were called on to inform one another and to draw up both sets of guidelines. I wish there were some inclusion of scientists and ethicists who are not proponents of cloning and destructive embryo research, perhaps someone like Dr. James Sherley of MIT.

The glossary at the end of the ISSC document defines the embryo as beginning with the first cleavage of the "fertilized ovum," while noting that some sources define the embryo as beginning at the implantation stage. There are definitions of "parthenogenic embryos," "nuclear transfer embryos," "altered nucleus embryos," "chimeras," and "hybrids." The definitions of "totipotent" and "pleuripotent" are:

Terminology relating to developmental potential
Totipotent: capacity to support full organismal development in utero
Pluripotent: capacity to support development of all tissue of an organism,not alone capable of sustaining full organismal development in utero.