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.

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!"