Living in the Biotech Century -- March 29, 2006

Shopping for a baby from an egg donor catalog—“A ‘morally troubling’ development akin to eugenics...”

Ads from The Daily Californian at UC Berkeley call for egg donors.

Photo by PhotoDisc; illustration by Karl Gelles, USA TODAY

Ads from The Daily Californian at UC Berkeley call for egg donors.

“Five years after a trade group tried reining them in, fertility clinics and brokers are bidding up prices for eggs sold by cash-strapped college women with top test scores and picture-perfect looks.

“Advertisements in campus newspapers and on websites plead daily. ‘Egg Donors Needed. $10,000,’ says one in The Daily Californian, the student newspaper at the University of California, Berkeley. The ad, from a San Diego broker called A Perfect Match, seeks women who are ‘attractive, under the age of 29’ and have SAT scores above 1,300.

“Eggs have been traded almost since the fertility industry started 30 years ago. But now, new technologies tied to the Internet have turned the business into a global bazaar of egg merchants, with little regulatory oversight.

“Classified-ad website Craigslist publishes 150 ads on a typical day. A Web search for ‘egg donor’ at Google produces dozens of links to advertisers. As other nations curtail the practice — Canada did so in 2004 — the USA is becoming the industry’s last bastion.

“‘We are selling children,’ Harvard Business School professor Debora Spar says in a new book, The Baby Business. Spar wants a national debate on bringing order and safety to an industry in which spending on everything from fertility drugs to eggs has mushroomed to an estimated $3 billion a year....”

Shopping for a baby from a sperm donor catalog—“A ‘morally troubling’ development akin to eugenics...”

Jessica Wynne for The New York Times

Daniela, a 38-year-old advertising executive, began by being inseminated with a known donor and is now trying anonymous ones.

“One day last October, Karyn, a 39-year-old executive, pulled her online dating profile off JDate and Match.com, two sites she had been using, along with an endless series of leads, tips and blind dates arranged by friends and colleagues, to search for a man she wanted to marry and raise a family with. At long last, after something like 100 dates in the past 10 years and several serious relationships, she had found the man she refers to, tongue only slightly in cheek, as ‘the one.’ It all began last summer, when she broke off a relationship with a younger man who wasn’t ready for children and got serious about the idea of conceiving on her own. She gathered information about fertility doctors and sperm banks. ‘Then a childhood friend of mine was over,’ she told me. ‘I pulled up the Web site of the only sperm bank that I know of that has adult photos. There happened to be one Jewish person. I pulled up the photo, and I looked at my friend, and I looked at his picture, and I said, “Oh, my God.” I can’t say love at first sight, because, you know. But he was the one....’

“Karyn said she hoped to join a population of women that everyone agrees is expanding, although by how much is hard to pin down because single mothers by choice (or choice mothers), as they are sometimes called, aren’t separated statistically from, say, babies born to unwed teenagers. Between 1999 and 2003 there was an almost 17 percent jump in the number of babies born to unmarried women between ages 30 and 44 in America, according to the National Center for Human Statistics....”

“Purifying the masses and eliminating people who might be considered ‘different’....”

“North Korea has no people with physical disabilities because they are killed almost as soon as they are born, a physician who defected from the communist state said on Wednesday.

“Ri Kwang-chol, who fled to the South last year, told a forum of rights activists that the practice of killing newborns was widespread but denied he himself took part in it.

“‘There are no people with physical defects in North Korea,’ Ri told members of the New Right Union, which groups local activists and North Korean refugees.

“He said babies born with physical disabilities were killed in infancy in hospitals or in homes and were quickly buried.

“The practice is encouraged by the state, Ri said, as a way of purifying the masses and eliminating people who might be considered ‘different....’”

Tennessee becomes the 13th state to offer ‘Choose Life’ license plates...

“A federal appeals court Friday allowed Tennessee to offer anti-abortion license plates bearing the message ‘Choose Life.’

“A three-judge panel of the 6th U.S. Circuit Court of Appeals in Cincinnati overturned a lower-court ruling that said the tag illegally promoted only one side of the abortion debate.

“‘Although this exercise of government one-sidedness with respect to a very contentious political issue may be ill-advised, we are unable to conclude that the Tennessee statute contravenes the First Amendment,’ Judge John M. Rogers said in a 2-1 ruling.

“‘It’s a validation of our position all along that the Legislature had the authority to authorize a plate that favors normal childbirth over the practice of abortion,’ said Brian Harris, the group’s president....”

“In 2005, cosmetic procedures—including surgery and minimally invasive treatments such as Botox injections and laser hair removal—were done more than 10 million times in the U.S.

“That’s an increase of 11 percent from 2004 and 38 percent from 2000, according to the American Society of Plastic Surgeons. Add in reconstructive plastic surgery—such as surgery to remove tumors or mend wounds—and the grand total tops 15 million procedures.

“Most cosmetic patients were women, whites, and middle-aged adults, the report shows. But more than a million men got cosmetic procedures. So did more than 300,000 youths aged 18 and younger....”

Before they go to market, they’ll be evaluated like a new drug by the FDA...

The genetically altered animals are rich in omega-3 fatty acids. But do they taste like pork?

Breeding bacon

A normal piglet (left) next to two piglets genetically engineered to have higher concentrations of beneficial omega-3 fatty acids in their fat. (University of Missouri)

“If a new kind of pork makes it to the dinner table, healthful eaters worried about fat and heart disease might finally be free to, well, pig out.

“Scientists using genetic engineering techniques have produced pigs rich in omega-3 fatty acids — a kind of healthful fat abundant in fish but not naturally found in meat.

“The omega-3 fatty acids are believed to offer some protection against heart attacks, and federal nutrition guidelines recommend adults include them in their daily diets....

“There is one little question looming over the potential feast of greasy bacon, succulent chorizo and juicy Chinese pork stew. Because the research is in its early stages, no one has yet sampled the pigs to see if they taste like pork....

“The team of scientists from Harvard, the University of Missouri and the University of Pittsburgh used a gene from an earthworm, which naturally produces omega-3 fatty acids, to genetically modify their pigs....”

Planned Parenthood has been recommending “off-label” use of this drug...do they have some liability in some of these cases?

“Two more women have died after using the so-called ‘abortion pill’ RU-486, regulators said Friday in a warning that brought renewed calls for pulling the drug combination from the market.

“The organization that provided the drugs to the two women said it would start following the approved instructions for their use.

“The Food and Drug Administration warned doctors to watch for a rare but deadly infection previously implicated in four deaths of women who had taken RU-486. The drug combination, also called Mifeprex or mifepristone, has not been proved to be the cause in any of those cases.

“Nor has the FDA confirmed the cause of the latest two deaths. However, in one of them, the woman’s symptoms appeared to resemble those in a cluster of four cases in California where the women died from an infection of the bloodstream, or sepsis. Those women did not follow FDA-approved instructions for a drug-induced abortion, which requires swallowing three tablets of one drug, followed two days later by two pills of another drug....

“...Planned Parenthood Federation of America Inc. said it would stop recommending vaginal insertion of the second course of pills. Four of the women who died, including the latest two, received the pills at Planned Parenthood-affiliated clinics....”

“Seoul National University on Monday decided to sack the disgraced cloning scientist Hwang Woo-suk without benefits. Four other faculty members involved in the fabrication of Hwang’s ostensibly groundbreaking research results will be suspended—medicine professor Moon Shin-yong and veterinary professor Kang Sung-geun for three months and veterinarian Lee Byung-chun and medicine professor Ahn Cu-rie for two. The committee also decided to dock the salaries of agriculture professor Lee Chang-kyu and medicine professor Baek Sun-ha for a month.

“Insiders say the measures are not as strict as SNU President Chung Un-chan originally promised and wonder why. Suspension, dismissal with benefits and dismissal without benefits are the three most serious disciplinary measures under SNU regulations.

“Meanwhile, prosecutors investigating the scandal said Monday the contamination of stem cell cultures at Hwang’s lab in January last year was an accident....”

Keeping kids calm by using drugs intended to treat schizophrenia and other psychotic illnesses...

“Soaring numbers of American children are being prescribed anti-psychotic drugs—in many cases, for attention deficit disorder or other behavioral problems for which these medications have not been proven to work, a study found.

“The annual number of children prescribed anti-psychotic drugs jumped fivefold between 1995 and 2002, to an estimated 2.5 million, the study said. That is an increase from 8.6 out of every 1,000 children in the mid-1990s to nearly 40 out of 1,000.

“But more than half of the prescriptions were for attention deficit and other non-psychotic conditions, the researchers said.

“The findings are worrisome ‘because it looks like these medications are being used for large numbers of children in a setting where we don’t know if they work,’ said lead author Dr. William Cooper, a pediatrician at Vanderbilt Children’s Hospital....”

“Use of attention deficit drugs rose nearly 19 percent among ages 20 to 44 in 2005 while falling 5 percent in children under 10, according to statistics released Tuesday amid a U.S. review of the drugs’ safety.

“An estimated 1.7 million U.S. adults aged 20 to 64 and nearly 3.3 million children 19 and younger took a prescription drug to treat attention deficit hyperactivity disorder (ADHD) in 2005, according to a report from pharmacy benefits manager Medco Health Solutions Inc.

“ADHD drugs include Novartis AG’s Ritalin and Focalin, Shire Plc’s Adderall and Johnson & Johnson’s Concerta.

“The biggest jump in use—a 19 percent rise from 2004—was among adults ages 20 to 44, the study said. The number of those aged 10 to 19 who took the drugs rose by 2 percent.

“Use fell 5 percent for children under 10. The findings were based on prescription data from 2.5 million U.S. patients....”

“A Food and Drug Administration panel is mulling Wednesday whether to place new warnings on popular drugs used to treat attention deficit hyperactivity disorder, or ADHD.

“The FDA is asking its pediatric advisory panel to weigh in with its views a month after its drug-safety advisory panel said the drugs should carry a strict ‘black-box’ warning about the possibility that the drugs increase the risk of heart attacks, strokes and sudden death.

“FDA officials, however, seemed to be reluctant to require all the drugs - which include Johnson & Johnson’s (JNJ) Concerta, Shire Pharmaceuticals Group PLC’s (SHPGY) Adderall, Eli Lilly & Co.’s (LLY) Strattera and Novartis AG’s (NVS) Ritalin, which is also available as a generic - to carry a black box.

“Dianne Murphy, the FDA’s director of the office of pediatric therapeutics, said the agency didn’t believe it had enough information to say whether ADHD drugs, most of which are stimulants, increase the risk of heart attacks and strokes. Black boxes are normally reserved for products in which there’s clear evidence that a particular product causes a problem. Strattera already carries a black box discussing suicidal risk, and Adderall has one discussing cardiac risks....”

“...Rearing children is work only for the brave. Children can be recalcitrant, outside influences can corrupt, and even the best of efforts may not bear good fruit. But even apart from the practical difficulties, the very aspiration of ‘producing better children’ is hardly trouble-free, even for parents and teachers with the best of intentions. For it is easier to wish whole-heartedly that our children be improved than it is to know what that would mean. For what, exactly, is a good or a better child?

“Is it a child who is more able and talented? If so, able in what and talented how? Is it a child with better character? If so, having which traits or virtues? More obedient or more independent? More sensitive or more enduring? More daring or more measured? Better behaved or more assertive? Is it a child with the right attitude and disposition toward the world? If so, should he or she tend more toward reverence or skepticism, high-mindedness or toleration, the love of justice or the love of mercy? As these questions make clear, human goods and good humans come in many forms, and the various goods and virtues are often in tension with one another. Should we therefore aim at balanced and ‘well-rounded’ children, or should we aim also or instead at genuine excellence in some one or a few dimensions? It is not easy to answer. Yet absent knowledge regarding these matters, acting on the laudable intention of producing better children can be a tricky, not to say dangerous, business.

“This is especially true because of a second difficulty, one derived not from the ambiguity of ‘good’ or ‘better’ but from the ambiguity that is at the heart of being a child. Children much more than adults are, so to speak, double creatures: they are both who they are here-and-now and, at the same time, they are also creatures on the way to maturity and adulthood. To be a child means ‘to-be-not-yet,’ means to be ‘on-the-way-up,’ growing up, maturing, reaching toward one’s prime. Yet to be a child is also to enjoy a special time of our lives, with special gifts, possibilities, and opportunities, and—in comparison with adulthood—with a relatively carefree existence. Childhood is that stage of life justly celebrated as most innocent, open, fresh, playful, wondering, unself-conscious, spontaneous, and honest: ‘out of the mouths of babes.’ This ‘doubleness’ of childhood is responsible for the notorious paradox of parenthood: we love our children unconditionally, just as they are, yet we are constantly doing everything in our power to get them to be different, to change for the better. Not content just to appreciate them in their childish glory, we labor to educate them, to lead them out of childhood, and to draw from them those latent but still largely dormant powers and virtues they do not as yet have or have not yet expressed. The task is made still more paradoxical once we remember the most important improvement we seek to promote: their ability to do without our educative meddling, to take the reins of their own chariots, and, in the best case, to repay the debt they owe us by doing the same for the next generation....”

“Better Children” is Chapter 2 of Beyond Therapy: Biotechnology and the Pursuit of Happiness, a report published by The President’s Council on Bioethics in October, 2003. The entire report is available online, and a free hard copy may be ordered at the same location.

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