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.

Argument against government health care

Should your access to medical care depend on your political or religious viewpoints, or even your criminal record?

The UK healthcare system is used as an example by members of both sides of the government-payor medicine debate in the US. These discussions prove that - like the meaning of the universe and when life begins - the definitions of justice and rationing are in the eye of the beholder(s). Some of us look at the history in the UK and the US and worry about the potential for abuse when medical access is regulated with government funds, prisons, and guns.


Kathryn Jean Lopez of the National Review Online reports (free registration required) that a 74 year-old man was sentenced to a prison term for sending pictures of the results of abortion in the mail to employees at a hospital that performs abortions.

On top of the 28 days prison time, the man in question was informed that he would be denied all but emergency, life-saving care at the (government, tax funded) hospital in question. Despite that under the National Health Service trust this hospital is his only choice, his scheduled eye exam appointment was cancelled and he has been dropped from the (government, tax funded) waiting list for evaluation (the waiting list before the waiting list) for hip replacement surgery.


I can't think of any intimate, personal matters that are managed well by committee, much less by the process of government and law making. Medical care is very intimate and personal, and my experience with the Social Security and Medicaid disability process, TriCare, Workman's Compensation, Medicaid and Medicare do not lead me to believe that the Federal government is qualified to hire me as a family doctor or to manage hospitals or other health care "providers."

(I've covered this subject before here Or, see this newspaper report about "fraud" rallies held by Secretary of Health Shalala, Attorney General Reno and FBI Director Freeh in 2000.)

Because of changes to the Social Security Act and various "Omnibus" budget bills over the last 20 years (including the newspeak-named "Health Insurance Portability and Privacy Act), the Federal government and anyone who can claim to be functioning in the name of the (Federal) Secretary of Health has a right to copy anything in your doctor's office, to open every door and drawer, and even to write their own subpoenas. Any physician or "provider" who refuses or interferes with such an action risks "exclusion" (losing the ability to bill any government medical insurance and possibly all insurances that receive payment from those government insurances.)

What may be worse, the risk of Medicare audit hangs over the head of all those who see patients who qualify for Medicare funding. The person or entity audited pays for the audit, and there have been rumors that "deals" are offered: pay $10,000 or so, and the audit will go away. In light of the fact that compliance with rules is probably impossible, can cost even small practices hundreds of thousands of dollars and carry the risk of charges of Medicare fraud and abuse with its threat of triple fines and prison time, that $10,000 can begin to look like a bargain.

In the US, we have difficulty refusing anyone virtually any medical care - far too often on the tax payers' bill. I do wish that there could be more personal responsibility and an expectation that some payment, in some form will be paid.

However, in Mr. Atkinson's case, he has paid in the form of taxes through the years. His healthcare should not be restricted, however he has offended in the past.

For more information, see the website of the Association of American Physicians and Surgeons. You can start with this article or this review from the American College of Physicians, which represents Internal Medicine docs)

One more adult stem cell therapy (and another hero)

Patients' own stem cells are being used, every day, to treat more and more diseases. The July 11th New York Times reports on one of the heroes in the effort to treat patients using their own stem cells. Urologist Dr. Anthony Atala is pursuing research in ethical regenerative medicine at Wake Forest in North Carolina, including the use of urinary bladder stem cells to grow new bladders for children.

By 1999, he was ready to report that his bladders had functioned in dogs for a full year. That same year he inserted his bladder scaffolds into the first of seven children with spina bifida. The outcome was reported in Lancet.

All seven continue to do well, Dr. Atala said. The oldest of the new bladders has functioned for more than six years.

Working from the knowledge he had gained from bladder tissue, Dr. Atala continued to improve on a basic strategy: grow a tissue’s “committed” progenitor cells, attach the cells to a scaffold made of degradable polymers or natural substances, like collagen or keratin, and implant the structure. He first applied this strategy to the urinary and genital tracts, the territory he knows best.

“Then, once we finally got it, we thought, boy, let’s try some other tissue,” Dr. Atala recalled.

So far, his research team at Wake Forest can make only a few human parts, including bladders, urethras, patches of skeletal muscle, blood vessels and cartilage.

But in other animals, Dr. Atala has reported successes that include vaginal tissue, penile implants, kidney tissue that processes urine, pancreatic insulin-producing tissue and heart patches.

“The only changes each time are the type of cell and the biodegradable scaffolds,” he said.

To make a windpipe, for instance, the engineers seed a rigid scaffold with cartilage cells outside and respiratory cells inside. For an esophagus, a softer scaffold substance is used, its exterior coated with muscle cells, its interior with gastrointestinal cells.

Bioethics Book Club

(Edited for typos - I guess I can't listen to audiobooks and blog at the same time.)

The Women's Bioethics Project has begun a Bioethics Book Club on their website. The Club pages include "kits" on the selected books, with thoughtful and thought-provoking questions. There are even links to sample letters (in Word Files - .doc ) for readers to send to their legislators to "ban," "encourage," and/or "regulate" research in Human Germline Genetic Modification.


Three books are listed: My Sister's Keeper, Never Let Me Go, and Oryx and Crake.

I've already read Never Let Me Go and I'm currently reading My Sister's Keeper("listening" to the latter, actually - the book is available at Audible, as well as in the form of an "ebook", conventional hardcover and paperback versions on Amazon). Oryx and Crake is by Margaret Atwood, the same author who wrote The Handmaid's Tale.

I believe that the selections are a pretty good start, but I have a preference for my own, wider, list of stories and novels with bioethics subjects. Most of my list is science fiction. (And the lessons are much more subtle, in most cases - although my comments may not be.)

Warning: spoilers follow!!!

Kazuo Ishiguro's Never Let Me Go is an incredible novel that seems to be the diary of a shallow young woman. The story slowly draws you into a world where children are created, nurtured until adulthood, and finally harvested for their parts. None of them seem to understand why they are donors and rebellion, on the rare occasion that it is expressed, is incredibly (there's that word, again) understated. But, knowing the range of human nature, it's credible.

I'm enjoying My Sister's Keeper, as much as I can enjoy an excellent telling of the story of a family which has become absorbed in the sickness of one child which causes them to create another to use for the benefit of the second. The fire metaphors are great.

I haven't started the 3rd novel, and probably wouldn't have considered it if it hadn't been on the list. I read The Handmaid's Tale back when it first came out. There was a bit of truth in the story, but the agenda was as obvious as that in any hell and brimstone sermon. The Scarlet Letter is much better written, and The Crucible is subtle in comparison.

I'm a fan of science fiction stories and novels that deal with bioethics. Not all SF does - some are just horror stories, westerns or swashbucklers set in space or some technological setting. It seems that these are the ones that become Hollywood movies.

SF that explores the interaction of science, medicine, research ethics and human nature can inform us about what I believe are lessons we don't have to learn the hard way.

Nancy Kress, Kate Smith, Elizabeth Moon, Anne McCaffery, and Lois McMaster Bujold are women who tell good stories, that just happen to be about people (both human and non-human) who know that their lives are the result of manipulations by other people, using science and medicine.

Nancy Kress has written many insightful stories, told with out preaching or stereotyping, about genetically modified "designer babies" and their families.

From the introduction to a collection of short stories entitled Trinity:

A friend pointed out to me that nearly all my fiction contains the same theme: absence of God. More specifically, I write about what people use to make sense of the world when they do not believe in the concept of a Supreme Being.

Her remark annoyed me, mostly because it was true and I had not, until then, realized it. My characters embraced -- sometimes desperately -- mysticism, art, reincarnation, even an anguished desire for UFO’s in valiant or pathetic attempts to feel connected to the larger universe.

It's not surprising that people will cling to what appears to be a miraculous or technological answer to all our fears or our secret desires. We all want to live longer, to be stronger, to achieve, or at least to be in control and "connected."

I don't believe that there's anything necessarily or essentially wrong with even the most ridiculous attempts at gaining this control. Although I have a strong "yuk" factor myself, I require a better reason to restrain someone else from their pursuits.

Except, as in all human pursuits, we must stop at the point when any human is redefined as a tool to use for our own purposes.

Common Ground Possible?

As the header states, LifeEthics is an attempt at finding and working from common ground.

A reader asks why I would respond to an invitation to a bioethics conference and round table discussion from the Center for American Progress and the Women's Bioethics Project.

The question should be why wouldn't I be welcome, in light of the PBI's goal of "Moving beyond the narrow concerns and ideological conflicts that have plagued contemporary bioethics"?

It never surprises me that people and organizations with common goals may have different ideas about how to achieve those goals.

Division is destructive. Conversation rather than labeling and exclusion is the best practice in medicine, science, and ethics.

If the meeting is only for a small clique of true believers and like-minded, then I don't need or want to attend. If it is an educational discussion of the issues (even if only one viewpoint is presented) and an opportunity to share ideas and get to know others interested in protecting human dignity and help each other "understand the direct and profound affect emerging biotechnologies will have on your life," then I'd like to meet these people and hear what they have to say.

There's probably plenty of time at the regular conference. No worries!

New Calendar of Events

I'm trying out the (free) on-line Trumba Calendar, in order to publish dates and details on meetings that might be of interest to readers of Bioethics blogs. Click here, or see the link at the side bar, right.

Please let me know about meetings in your location and I will try to keep up with posting them to the Calendar.

Be sure and let me know any information you have about membership qualifications, dues and fees, and participation in business meetings for the organization hosting the meeting.One of the goals of LifeEthics is to involve readers' participation and influence in their local and professional communities, in order to affect public policy.

Closed meeting of "Feminist" "Progressive" "Women" Bioethicists

Proving the timeliness of next week's American Society of Bioethics and Humanities' June 13-14th summer conference, entitled "Bioethics & Politics - The Future of Bioethics in a Divided Democracy," I have been denied admission to a "pre-conference briefing and round-table discussion."

It looks like they're ensuring that everyone at the pre-conference will be closed- like-minded.

The invitations were on several blogs and email lists.

From the Womens Bioethics Blog

"Do you consider yourself a progressive bioethics scholar? Are you interested in getting more politically involved? Will you be attending the ASBH Summer conference in Albany, NY entitled “Bioethics & Politics - The Future of Bioethics in a Divided Democracy”? If so, you should email info@womensbioethics.org to get an invitation to a pre-conference (July 13th 11-1pm – lunch included) private, invitation only briefing and round table discussion hosted by Jonathan Moreno, Center for American Progress and Kathryn Hinsch, Women's Bioethics Project. The briefing is not open to the press."

Ms. Hinch also sent an invitation by email to all the members of Feminist Approaches to Bioethics list serve:

Please join the
Women's Bioethics Project and the Center for American Progress
for a Summer ASBH pre-conference, invitation-only, private briefing on the “Progressive Bioethics Initiative” and how you can get involved.

However, I received the following response:

We received your request to attend the pre-conference lunch meeting sponsored by the Women's Bioethics Project and the Center for American Progress. Unfortunately, we are unable to grant your request. If you are still interested in learning more about the Women's Bioethics Project, I will be happy to meet with you at another time during the ASBH conference in Albany or arrange a phone conversation at a later date.
Thanks for your interest in our efforts.
Sincerely,
Kathryn Hinsch

I am an advocate for the right of association and will admit that I am probably not their kind of progressive, feminist, woman. However, I am surprised at the exclusion of any interested party by so-called "progressive," "feminist," men and women.

These are the same people (both the Women's Bioethics Blog and the ASBH editors' Blog.Bioethics.net)who noted a prediction of a "rumble" at the ASBH conference on the Pro-life Blogs and Wesley Smith's "Secondhand Smoke."

Truly ethical (adult to embryonic) stem cells (But . . .)

Last month I reported that International Society for Stem Cell Research meeting in Toronto was to be the site for a report about research from Texas research firm, Pharmafronteirs. The July 6th issue of Nature has a News article on an announcement of the discovery of one way to cause adult cells to become embryo-like stem cells, in a "Simple recipe gives adult cells embyro powers."

Now, Shinya Yamanaka and his colleagues at Kyoto University, Japan, have developed what looks like a good first draft for this recipe, at least in mice. They say it takes only four chemicals. For their experiment, the researchers chose fibroblasts, adult cells that divide quickly and can already give rise to some other types of cell. When they added the four factors to fibroblasts, the team says the cells looked and behaved a lot like mouse embryonic stem cells. "Potentially, if we use these four factors with human cells, we could avoid the ethical issues and make pluripotent cells," says Yamanaka.

The reprogrammed cells pass many of the crucial tests of 'stem-ness'. They express some of the key genes that embryonic stem cells do, can be coaxed to make the three main cell types of the body, and can divide to give more cells like themselves. Yamanaka calls them "embryonic-stem-cell-like cells".
Luck and skill

Yamanaka unveiled his research on 30 June at the International Society for Stem Cell Research in Toronto, Canada, revealing that success involved patience, ingenuity and luck. Over five years, his researchers compiled a list of 24 candidate factors that help stem cells stay flexible. They engineered adult mouse cells so that they would be killed by a drug unless they turned on a gene active only in stem cells. Then the team added genes for the 24 candidate factors to the engineered mouse cells, and dosed them with the drug. Only the stem-cell-like cells survived.

The researchers repeated this experiment, removing one or a few genes at a time, until they arrived at four essential chemicals. Three of the factors — Oct4, Sox2 and c-Myc — were already known to be important for stem-ness. But the fourth was a surprise, says Yamanaka. Stem-cell research is so competitive that he refuses to name this fourth factor until he can publish his work in a scientific journal.

His research adds to work on which factors are key to reprogramming. Ihor Lemischka of Princeton University, New Jersey, and his colleagues have studied 70 genes in mouse embryonic stem cells (J. Silva et al. Nature doi:10.1038/nature04914; 2006). And Austin Smith's team at the University of Edinburgh, UK, is investigating a protein called Nanog (N. Ivanova et al. Nature doi:10.1038/nature04915; 2006). "Several researchers had shown factors that were necessary for programming, but nobody had shown which factors were sufficient," says Yamanaka.

Researchers are impressed and surprised at Yamanaka's achievement, mainly because he gambled everything on the key factors being included within his pool of 24 candidates. "He seems to have hit a home run," says Lemischka.

That meeting also yeilded new international guidelines for embryonic stem cell research, and "standards for obtaining sperm, eggs, embryos, or other cells from human donors." I haven't seen the list of participants on the panel drawing up these guidelines, but I'd bet there's very little variance from the same group that worked up the National Academies of Science.

My conviction that the same little incestuous group, "The Powers That Be" in Bioethics, is making these rules based on their own ideology, I keep remembering the warning, "Don't look behind the curtain. Pay no attention to that little man."

Just to add to the impression that the PTB do not want us to doubt the dogma that embryos must be created and destroyed, the Nature article goes on and on about just that "fact":

But scientists caution that Yamanaka's report has not eliminated the need for work on embryonic stem cells. Researchers must test the same four factors in human cells. And it is not entirely clear whether the reprogrammed cells can do everything that embryonic cells can. Although many of the genes they express are the same, many are not.

Yamanaka's report came just a day after the US Senate said it would vote on relaxing rules on embryonic research later this year. Some have argued that progress in reprogramming has made work on embryonic stem cells unnecessary, and they may seize on Yamanaka's work to bolster this position. But scientists at the Toronto meeting said that would be a mistake.

"There will be people who say that, and they will be wrong," says Lemischka. "There's a lot more work to do to understand these cells. The science is really solid, but it is by no means true that reprogramming has now been solved."

"Virgin Birth Stem Cells" are not ethical

With the sexy title, "Virgin Birth Stem Cells Bypass Ethical Objections," today's on-line New Scientist is hyping the possibility of producing embryonic stem cells from induced parthenogenesis, the stimulation of an oocyte (or "egg") to begin dividing to produce an embryo. The flawed reasoning is that, since these embryos are short lived and do not involve sperm or fertilization, they will overcome ethical objections to the destruction of human embryos.

Parthenogenesis in humans has been difficult in the laboratory because human embryos (unlike the amphibians and insects who are known to be able to reproduce by parthenogensis) depend on genes in the sperm for the development of the trophoblast, which becomes the placenta. Human embryonic parthenotes usually die after a few divisions, and do not form blastocysts.

Linda Geddes, the author of the New Scientist blurb, doesn't seem to be aware that the single embryonic stem cell line produced from thousands of human oocytes that the Korean veterinarian, Hwang Wu Suk, produced was determined to be the result of parthenogenis.

The excuses that "there's no sperm involved, so it's not human" ("male chauvenism" in its latest, high-tech, incarnation) and "it can never develop into a baby" (". . . because we intend to kill her for our own purposes before a birth certificate is issued") are used to overcome objections to human cloning, too.

However, if an embryo is produced by any technique using human chromosomes, it does not matter who her immediate parents are: she is an embryonic human.

To the male chauvenists: the embryo's grandfather did donate sperm.

To the utilitarians: the intentional creation of a handicapped human increases, rather than decreases, the ethical responsibility to that human.

Oh, and by the way: "Hands off our ovaries!"

MIT Scientist on Harvard's Cloning

Harvard alumnus James L. Sherley, M.D., Ph.D., a professor in the Biological Engineering department at Massachusetts Institute of Technology, has "come out" with his opposition to cloning and destructive embryonic stem cell research. In particular, Professor Sherley, a Pew scholar credited with research on the "assymetrical" division of adult stem cells, is quoted in Australia's MercatorNet,

When the errant biological properties of human embryonic stem cells are considered, it is difficult to foresee them ever being used directly as cures in children or adults. This promise was the earliest misleading misinformation from proponents of human embryo research. Because many factors that guide the normal development of embryonic cells are absent in mature tissues, embryonic stem cells placed in adult tissues produce malformed tissues that are cancerous. So, figuring out how to use human embryonic stem cells directly by transplantation into patients is tantamount to solving the cancer problem.

Human embryonic stem cell scientists, who lacked sufficient knowledge of the cell biology of mature tissues, naively promised to develop new therapies with mature cells produced from embryonic stem cells. These scientists overlooked the fact that mature cells, which lack the renewal capability of stem cells, cannot be used for long-term treatment in mature tissues, which require continuous renewal.

There is one strategy by which embryonic stem cells might be used to develop therapies for the tissues of adults and children. If embryonic stem cells could be used to produce tissue-specific adult stem cells, the adult stem cells could be tried for mature tissue therapies. However, since natural adult stem cells are available from informed consenting adult donors, this possible embryonic stem cell-dependent strategy is not absolute, as has been suggested by proponents of human embryo cloning.

Moreover, if derivation of specific adult stem cell types from embryonic stem cells is found to be possible, the derivation process will take longer than using natural adult stem cells and may still produce defective and possibly tumour-forming adult stem cells. However, more to the point, why pursue this uncertain path that requires destruction and exploitation of human embryos, when adult stem cells can be used instead?

Dr. Sherley wrote an editorial early in June, 2006 calling for Harvard to "revoke" plans to clone human embryos in the Boston Globe and is quoted extensively in another excellent review article, written by James P. Kelly, in the Seoul Times.

Considering the regulation of the use of human research subjects and the human embryo's protection under these regulations:

Human embryo scientists have tacitly agreed that cloned embryos should not be matured beyond an arbitrary early stage of embryo development. (This agreement highlights the deception of their feigned uncertainty on the question of whether human embryos are living human beings.)

However, it is very likely that diseases of adult life, if they show any manifestation in embryos at all, will do so well after this arbitrary stage of maturation. The public can be sure that Harvard's and other scientists, like camels in a tent, will keep inching this boundary forward with newly-crafted, misleading excuses for doing so.

MercatorNet: You seem pretty convinced that human embryos are human beings. Can you explain briefly why?

Sherley: My answer is, "What else could they be -- aliens?" Scientists who want to conduct experiments with human embryos are quick to say what human embryos are not. I challenge them to tell the public what human embryos are. There is only one answer to this question, "living human beings."

"Corrupted" Cells or Ethics?

The New Scientist is reporting the announcement (available by subscription here and the full, free version is here) by Pharmafrontiers (which is officially "Opexa Therapeutics.") that the company has successfully de-differentiated human blood cells into stem cells that are usually thought to be from other cell lineages. In other words, Pharmafrontiers,

"claims to have refined a way to produce stem cells from white blood cells called monocytes and develop them into many different tissue types including, crucially, insulin-producing cells."

This is exciting news. Pharmafrontiers is presenting a report at a scientific conference, where their research and results will presumably be subject to peer-review. The corporation is submitting a paper to a peer-reviewed journal and is applying for a patent on the technology to grow insulin-producing beta-islet cells from each patient's own white blood cells. The article notes several other labs in other parts of the world which have reported similar findings in peer-reviewed journals.

However, the bioethics story is the negative way in which The New Scientist has chosen to report the possibility that adult stem cells may provide therapies for diabetes and other diseases. There is an especially spurious comment about the amount of blood that would be needed from each patient - see the end of this post for more on that.


From the article:

Most mainstream stem cell researchers are sceptical, however, because the idea that specialised cells like monocytes can be "de-differentiated" back to more primitive stem cells remains heretical. "Let's see first how they perform functionally," says Stephen Minger of King's College London.

Pharmafrontiers, is to present its latest results at the end of this month in Toronto at the International Society for Stem Cell Research meeting. Deriving "stem cells" from monocytes was originally reported in 2003 in Proceedings of the National Academy of Sciences (vol 100, p 2426) by a team at Argonne National Laboratory in Illinois, but Pharmafrontiers bought up and refined the technology.

The company says it can de-differentiate monocytes into "multipotent" stem cells by exposing them to certain nutrients and growth factors. Such stem cells can give rise to many but not all tissue types like "pluripotent" embryonic stem cells (ESCs). Different combinations of growth factors can then turn the stem cells into a range of cell types.

Moreover, Pharmafrontiers says it is about to submit a patent application on a brew that turns the monocytes into pancreatic islet-like cells that produce insulin in response to high levels of glucose. "We now want to transplant these cultures into a diabetic mouse model," says Winnier, adding their results are being prepared for publication in a peer-reviewed journal.

Alan Colman of ES International, a company developing insulin-producing cells from human ESCs in Singapore, is also sceptical. He says it would take huge amounts of blood to produce enough islet cells for individual patients.

Chris Major of University College London says most stem cell researchers have neglected the idea of de-differentiating adult cells in favour of using embryonic stem cells. However, he warned there could be problems with using adult cells, because they have suffered years of genetic damage. "With embryonic cells, they're fresh, and not corrupted," he says.

Other teams are also experimenting with stem cells from blood. A team led by Bernat Soria of the Institute of Bioengineering at Miguel Hernández University in Alicante, Spain, last year reported reversing a mouse form of diabetes with insulin-producing cells developed from blood cells (Gastroenterology, vol 128, p 1774). And researchers at the University of Kiel in Germany led by Fred Fandrich report producing liver cells.

(emphases are mine)

The bug-a-boo about the volume of cells that would be necessary to treat any one patient is one of the arguments against the possiblity of using (destructive) embryonic stem cells. In the case of adult stem cells, however, we know the objection is falsified by the currently accepted procedure for collecting stem cells for complete bone marrow transplants. The donor is given a stimulating factor to cause him or her to produce larger than normal amounts of bone marrow-producing stem cells which are released into the circulating blood. The donor then undergoes a procedure called apheresis to collect the stem cells without loss of red blood cells, plasma, or platelets. Apheresis is a technique that allows the removal of specific cells or proteins from the patient's whole blood, with immediate return of most of the blood to the circulation. We've collected platelets and removed harmful antibodies from patients with this technology for decades. Here's a pdf from the University of Utah, explaining the procedure in more detail.

Perhaps The New Scientist should look at its own editorial staff to see whether they belong to the religion that "neglects" research on adult stem cells as "heretical." And why.

Bioethics, politics and projection

The National Review Online (please note today's DBD cartoon) features correspondence between Eric Cohen, Jonathan Moreno, and Sam Berger, concerning Mr. Cohen's article from May on the Castle-DeGette bill and the loosening the funding restrictions on destructive embryonic research.

I am surprised that Moreno/Berger warn,

". . . politicized discussions of scientific issues are likely to end in hyperbole."

Moreno and Berger are associated with the Center for American Progress. In fact, Moreno is Director of the Progressive Bioethics Initiative, a sort of subsidiary of the CAP, founded to counter the Progressive's perception that current bioethics centers are dominated by conservatives. I disagree with that notion, since most of the University bioethics departments are in no way conservative.

Nevertheless, the point of the original argument was to answer political questions by opponents of the President's embryonic stem cell research policy. We are discussing Federal research funds. I have never seen a tax-funded program that was not influenced by and subject to political agendas.

If it's true that politics contaminates science, then its all the more reason to keep government money out of scientific research!

A Right to Life Movie

"Just Like Heaven," a romantic comedy starring Reese Witherspoon and Mark Ruffalo, did not get the attention that I think it should have received, last year. The movie is out on DVD (for more information, see Amazon.com and Netflix)

Warning: the following may contain "spoilers," and give away the surprises in the movie.

Talk about a timely movie! For most of the movie, the heroine is a disembodied spirit who is actually in a "persistent coma." We learn that she has filled out paperwork to the effect that she does not wish to be kept alive on machinery, and named her sister as her agent in the event that she cannot make health decisions for herself.

At one point in the movie, Elizabeth's spirit attempts to communicate with her sister and the doctor who is recommending withdrawal of life support. She argues that she has changed her mind about her wish to be on a ventilator. Unfortunately, only our hero can hear her.

Elizabeth, the hard working surgery "Senior Resident" in the story has sacrificed most of her life for her career. And she almost loses that life in an auto accident on the way to a blind date.

On the way to her sister's house, Elizabeth is driving while sleep-deprived in a hard rain in San Francisco, and has a head on crash after looking down to adjust her radio.

The movie is a romantic fantasy, with the spirit of a woman "haunting" her apartment, mediums and exorcists, as well as the notion that fate or some other force contrives to bring certain people together. With the implication that some of us are not real except with the one we love and a Sleeping Beauty/Cinderella ending.


There's not much science or medicine in the movie (the pneumothorax diagnosis is preposterous, for instance), but it does address the subjects of a balanced life, grief, the ethics of Advance Directives, prolonged life support, and the pressures on those named to make decisions for us. There's even an opportunity in the movie for parents to discuss sexual morality with their children (our hero turns down the overt seduction by a neighbor).

Why worry about science education?

This month's New Oxford Review contains a book review on From Darwin to Hitler: Evolutionary Ethics, Eugenics and Racism in Germany, which addresses the philosophical and religious changes that led to the eugenic crimes of doctors in Nazi Germany.

From the review:

Even so, Weikart concedes that these intellectuals who "built their worldview on science" may not have realized that at the foundation of their edifice were certain "philosophical presuppositions" that did not come "from empirical science and about which science could not arbitrate." In other words, as brilliant as they were, these German scholars and scientists could not quite manage to draw the line between the science of Darwin and Darwinian moral philosophy.

But, what have Darwin and a few rogue doctors in the history of Germany got to do with post-Holocaust Americans?

The review (as well as another available only to subscribers to the Journal of the American Medical Association on the book, Nazi Medicine and the Nuremberg Trials: From Medical War Crimes to Informed Consentby Paul Julian Weindling) reminded me of an earlier article "The Evolution of Genocide," by Rebecca Messall, in the Winter 1999 issue of the Human Life Review. Ms. Messall became interested in the evolution controversy played out over the last decade in Kansas, State-mandated "National Science Education Standards," and her discovery that "a Huxleyan eugenic vision forms the theoretical model of the National Science Education Standards."

According to the 1959 president of the American Eugenics Society, Harry L. Shapiro, three essentials of eugenics are Darwin's natural selection, Malthus' idea of scarcity, and Mendel's analysis of heredity. These are the elements of eugenics, whether or not it is re-named "unified concepts" or "evolutionary biology," or "synthesis." In fact the themes reinforced by the NSES' thirteen year long curriculum are population genetics, natural selection and Malthusian scarcity.

Ms. Messall lays out the connection between the sponsors and authors of Kansas' science standards and various "mainstream" (and government funded) science associations, academies and societies:

The leaders of the effort to "unify" biology and other sciences around natural selection were in fact, as revealed by (Kathryn) O'Keefe's research, some of the century's leading eugenicists.

and,

. . . Despite such a glaring historical lapse in a Harvard-published book purporting to be a history of biology, "Science as a Way of Knowing" is incorporated by reference into the NSES, at least twice for further reading, and the phrase is used and highlighted in the NSES text.
I was alarmed that the NSES relied heavily on Moore's book as a reference and even incorporated its title throughout the text. But it concerned me more that, on its dust jacket, his 1993 book bears official endorsements by, among others, the highest-ranking men in the groups overseeing the national standards and two other men with decidedly bio-philosophical points of view:
=>the President of the National Academy of Sciences, Bruce Alberts
=>F. James Rutherford, head of the AAAS Project 2061 education initiative
=>an elderly Harvard evolutionist, Ernst Mayr, who was a central figure in founding a post-war group to promote the idea of a "unity of the sciences," called the Society for the Study of Evolution (SSE) and its journal, Evolution
=>Paul Ehrlich, original population control advocate/author.

Out of seven endorsers listed on Moore's book cover, four are contributors to the NSES. Moore and at least four endorsers appear to have been colleagues in Huxley and Mayr's Society for the Study of Evolution, a group for which Moore is himself a past-president.

According to documentation in Smocovitis' Unifying Biology, it was Huxley and his contemporary, Ernst Mayr who formed the Society for the Study of Evolution as part of their move to "synthesize" or "unify" (some might say contaminate) all concepts of science with Darwin's doctrine of natural selection.

The book, Science as a Way of Knowing is excerpted at Amazon.com
Be sure and read the part about animism on page 13 - and the dismissive quote about souls and barbarians.

Prostitution is sex abuse and trafficking

Whatever we can think of, someone, somewhere has done it - or is doing it. Christianity Today reports that Germany has legalized prostitution and is setting up "sex huts" around stadiums during its World Cup (soccer or football) series.

Supposedly the sports fans cannot control themselves for a period of time, so the German government is providing a "relief valve."

There is no excuse for a Nation to subsidize and legalize the use of women's bodies for sex - whether for pay or not. No one in this day of hundreds of varieties of Sexually Transmitted Diseases, including HIV/AIDS and the long-overdue recognition that 99%+ of cervical cancer is caused by a "venereal disease," would consider prostitution a "victimless crime."


Countering claims that it is the woman's body and her "choice," the CT editorial cites these statistics:

Prostitution is anything but glamorous. The U.S. State Department's office to monitor and combat trafficking in persons points to prostitution's core problem: The "routine abuse and violence that form the prostitution experience and brutally victimize those caught in its netherworld. Prostitution leaves women and children physically, mentally, emotionally, and spiritually devastated."

The statistics are sickening. "Field research in nine countries concluded that 60 to 75 percent of women in prostitution were raped, 70 to 95 percent were physically assaulted, and 68 percent met the criteria for post-traumatic stress disorder in the same range as treatment-seeking combat veterans and victims of state-organized torture," the office reports. "Beyond this shocking abuse, the public health implications of prostitution are devastating and include a myriad of serious and fatal diseases, including HIV/AIDS." The study found that 89 percent of respondents wanted to leave prostitution.

Speaking of the "underground railroad."

I pointed out the irony of using this term for destructive embryonic stem cell research in my last post.

And I was reminded again, in Nat Henthoff's latest column, "The Devaluing of Life," in which he quotes Jesse Jackson:

The boy's spontaneous insistence on the primacy of life also reminded me of a powerful pro-life speaker and writer who, many years ago, helped me become a pro-lifer. He was a preacher, a black preacher. He said: "There are those who argue that the right to privacy is of a higher order than the right to life.

"That," he continued, "was the premise of slavery. You could not protest the existence or treatment of slaves on the plantation because that was private and therefore out of your right to be concerned." This passionate reverend used to warn: "Don't let the pro-choicers convince you that a fetus isn't a human being. That's how the whites dehumanized us... The first step was to distort the image of us as human beings in order to justify what they wanted to do and not even feel they'd done anything wrong."

Please, read Mr. Henthoff's column on the devaluing of human life crossing lines of politics and stages of life and the wisdom of children and a consistent life ethic.

Creating more embryos to kill

Several medical centers, including Harvard,the University of California at Irvine, and the University of Texas at Houston are bragging in the press that they are not stymied at all by the Bush Administration policy on funding embryonic stem cell research. Why there's even an "underground railroad" for stem cell research funded by two moms in New York. (How's that for irony - the act of rescuing those who weren't considered human enough to be protected 200 years ago is now compared to the deliberate, planned and technological destruction of humans not human enough, today.)

Harvard has been the site of the destruction of new embryos in the search for embryonic stem cells. However, Douglas Melton,Steven Hyman and Kevin Eggan aren't, unlike George Daley, are no longer satisfied with thawing and nurturing hundreds of "left over" embryos in order to derive new stem cell lines. (After all, that technique was inefficient and required 278 embryos to produce 17 cell lines. )

These researchers have moved on and are now attempting to get their hands on "fresh" oocytes in the quest to clone human embryos - after all, Korea's Hwang Wu Suk only had 2000 to 3000 or so oocytes to work with.

Of course, they aren't simply blindly following in the footsteps of the lying embezzling veterinarian's footsteps. If they manage to convince women to donate their oocytes, they hope to produce "disease specific," rather than "patient specific" embryonic stem cells.

"Doctors don't kill patients."

Len Doyal, Emeritus Professor of Medical Ethics, Barts and The London School of Medicine and Dentistry, is the British non-physician "ethicist" who claims that doctors should have the legal right to intentionally and purposefully act to kill their patients, even without consent. The paper, titled "Dignity in dying should include the legalization of non-voluntary euthanasia," was published as a "Guest Editorial" in the second issue of the Royal Society of Medicine's Clinical Ethics. It is available for free in pdf form, at the link "PDF" at the bottom of this page.

Doyal claims that the act of injecting a drug that is meant to kill is the same thing as withdrawing or withholding medical interventions. Unfortunately, many other people, both pro-life and not, believe the same thing.

However, the doctrine of double effect is a time honored way of determining whether or not a procedure that carries a risk of leading to death is ethical. There is, indeed, a difference between withholding the placement of an IV into a vein for artificial feedings while continuing to give ice chips and fluids as tolerated by mouth and using that IV to administer drugs that are intended to cause death. The latter is never a medical treatment and is always unethical. The former should only be done with consent or with the knowledge that the treatment will cause more harm than good.

Under the heading, "The Ethics of Euthanasia," the Times Guardian has published an excellent rebuttal by Professor Jeffrey Tobias,
Professor of cancer medicine, University College London Hospitals, to the UK "ethicist" who has called for legalized euthanasia - with or without consent - of patients by their doctors.

" To argue that there is no real distinction between "the disease that does the dirty work" and the clinician's active decision to terminate life by euthanasia is to profoundly miss the point.


"Doctors don't kill patients. It is exceptionally unusual for life to continue in an extended and distressing way once a medical decision has been made to discontinue support - a decision always taken with the patient's or family's consent. I would go further and argue that this is precisely the reason why clinicians become so irritated with so-called ethicists like Professor Doyal who, by and large, have no medical qualification and no direct experience of the burdens, challenges and privileges of clinical responsibility, but none the less adopt the moral high ground. Of course the euthanasia debate will continue, but to suggest that there are occasions where this could be done without consent speaks of breathtaking arrogance."

Bravo, Professor Tobias!

Informed consent waived for in vitro testing in emergencies.

The FDA has published a new rule which would allow investigational testing on samples "left over" from the usual testing in the event of a public health emergency, such as a terrorist attack.

The Seattle Post-Intelligencer is reporting the new rule as though it is controversial. I do not believe that there is any ethical difficulty - the samples are "left over," consent was already obtained to collect the samples and perform the usual tests. The new rule only concerns tests on these samples, using devices that are considered "investigational" or experimental.

The rule became effective June 7th and is published in the Federal Register:
"Guidance for Industry, Institutional Review Boards Clinical Investigators and Food and Drug Administration; Guidance on Informed Consent for In Vitro Diagnostic Device Studies using leftover Human Specimens;Availability."

SUMMARY: The Food and Drug Administration (FDA) is issuing this interim final rule to amend its regulations to establish a new exception from the general requirements for informed consent, to permit the use of investigational in vitro diagnostic devices to identify chemical,
biological, radiological, or nuclear agents without informed consent in certain circumstances. The agency is taking this action because it is concerned that, during a potential terrorism event or other potential public health emergency, delaying the testing of specimens to obtain informed consent may threaten the life of the subject. In many instances, there may also be others who have been exposed to, or who may be at risk of exposure to, a dangerous chemical, biological, radiological, or nuclear agent, thus necessitating identification of the agent as soon as possible. FDA is creating this exception to help ensure that individuals who may have been exposed to a chemical, biological, radiological, or nuclear agent are able to benefit from the timely use of the most appropriate diagnostic devices, including those that are investigational.

******

Consider the following possible scenario in which a terrorist event
is not suspected until a public health laboratory cultures an unusual or rare organism. When a patient presents to a health care facility with symptoms suggesting a systemic microbial infection, blood and other specimens are typically collected to determine the identity of the causative organism. The clinical laboratory would determine that the specimens contain an unusual organism that cannot be identified by the tests available in that laboratory. Because many clinical laboratories do not have the capability or resources to identify unusual organisms or those to which humans are rarely exposed naturally, the organism (culture isolate) or collected specimen would be referred to a public health laboratory. The public health laboratory would use in vitro diagnostic devices, including those that are investigational, to try to identify the cultured organism or detect its presence directly in the specimen.

In this scenario, the referring laboratory would not have obtained informed consent when the specimen was collected because the person directing that the specimen be collected would not have known at the time that the infecting organism could be reliably identified only by using an investigational device.

A way to end vacation

I'm back and happy to report that there was sun and sand left over. And that walking in the surf and sand is good for a broken toe.

But, what should I write about on my first post back? Art Caplan and the editors at blogbioethics.net were kind enough to help me out by publishing a plea for allowing gay men to donate blood!

HIV is a virus that attacks the immune system. There's not a "dormant" or true gestational period for the infection itself. Almost immediately on infection, the virus begins replicating itself. However, there is a period of up to 6 months when the virus can not be detected by any of the tests used by the blood banking system.

Caplan is wrong about the treatment of heterosexual donors and this statement of myth:

We don’t worry about heterosexuals who engage in risky behavior and might acquire HIV because we know the strict testing of today will screen out their blood if it is infected with the virus.

For at least the last two years, when I donate in South Texas, I am asked not only about IV drug abuse and sleeping with men who have sex with men, I'm asked whether I have sex with people who inject drugs and/or in exchange for money or drugs, or whether I have sex with people who have sex with other people in exchange for money or drugs. I am asked where I've traveled for the last 5 years. A friend was refused the opportunity to donate for 6 months because she traveled in Mexico where malaria is endemic.

I have taken care of patients who received false positive syphillus tests from the blood bank. I've cared for several who were turned away because they had high liver function tests, although the did not test positive for any known virus, including known hepatitis.

I also had one patient who received false positive results on HIV testing during an annual insurance physical at another doctor's office. The false results were confirmed by the back up antigen tests. But labs drawn a second time (and another day) in that doctor's office and a third time in my office were negative. We finally decided - in consultation with the other office and the testing lab - that someone in either the other office or the laboratory had mixed up the tubes of blood. So not only did my patient get a false positive, but someone some where received a false NEGATIVE.

It is vital that the blood supply for sick and traumatized patients - those who need blood transfusions and blood products - is screened as vigorously as possible.