Living in the Biotech Century -- October 27, 2005

The new eugenics—years ago our pediatrician had a “steady stream of patients with Down syndrome. Not anymore....”

The Abortion Debate No One Wants to Have

Prenatal testing is making your right to abort a disabled child more like ‘your duty’ to abort a disabled child.

Patricia Bauer with her husband, Edward Muller, and their children, Margaret and Johnny Muller, in June at Margaret’s high school graduation in Massachusetts. (Courtesy Christina Overland)

“If it’s unacceptable for William Bennett to link abortion even conversationally with a whole class of people (and, of course, it is), why then do we as a society view abortion as justified and unremarkable in the case of another class of people: children with disabilities?

“I have struggled with this question almost since our daughter Margaret was born, since she opened her big blue eyes and we got our first inkling that there was a full-fledged person behind them.

“Whenever I am out with Margaret, I’m conscious that she represents a group whose ranks are shrinking because of the wide availability of prenatal testing and abortion. I don’t know how many pregnancies are terminated because of prenatal diagnoses of Down syndrome, but some studies estimate 80 to 90 percent....”

Catholic Church Funds Adult Stem Cell Research

“South Korea’s Catholic church plans to donate 10 billion won ($9.61 million) for adult stem cell research to counter the burgeoning studies on embryonic stem cells.

“Toward that end, the Seoul Diocese yesterday set up a committee to allocate the funds and appointed Bishop Yeom Soo-jung to head it.

“‘We decided to establish this committee to boost adult stem cell research that will treat hard-to-cure diseases practically. We hope our efforts will mark a turning point to wash away a recent tendency of making light of life, as shown by embryonic stem cell experiments,’ Yeom said....

“Embryonic stem cells are derived from embryos and have the potential to become any cell or tissue of a human body such as bone, skin or blood.

“By contrast, adult stem cells are harvested from the fetus, child, adult and umbilical cord blood and typically create specific cell type similar to their tissue of origin.

“For example, muscle stem cells produce muscle cells. But recently, scientists have found adult stem cells that have the ability to change into other kinds of cells.”

Medical Hope in Umbilical Cord Blood

Researchers find its healing powers may provide cures for many deadly maladies

“When 5-year-old Gina Rugari started kindergarten in Cincinnati this fall she brought her own crayons, pencils, glue sticks and pink backpack, but the blood flowing through her arteries was not her own.

“Her red and white cells are the result of an umbilical cord blood transplant she had at 3 weeks of age. The transplant from an unrelated donor repopulated her bone marrow with stem cells, the wellspring of her new blood supply.

“Her blood does all the things blood is supposed to do, but in Gina’s case it does something much more: It prevents the swift destruction of her brain by a faulty gene she was born with.

“What is proving to be a lifesaver for Gina is also turning out to be a medical treasure trove for scientists. Cord blood is surprising researchers with previously unrecognized healing powers that go far beyond its known effectiveness against childhood leukemia and some other disorders....”

Scientific “smoke and mirrors”—creating embryonic stem cells without creating embryos?

Studies May Calm Stem-Cell Qualms

“Two new mouse experiments may show how to obtain human embryonic stem cells without ethical hurdles, a step that could allow federal funding for such research, scientists reported Sunday.

“Currently, scientists must sacrifice human embryos to harvest such cells, which can form any tissue type and are seen as valuable for studying and treating illnesses like diabetes and Parkinson’s disease. Objections to the embryo destruction have led to a ban on federal funding for such work, which scientists say hampers research.

“The new methods, detailed Sunday in the online edition of the journal Nature, seek to obtain the cells without destroying embryos.

“The Coalition for the Advancement of Medical Research, which advocates federal funding of stem-cell research, cautioned that despite the goal of avoiding ethical quandaries, the new approaches ‘will not sit well with many who oppose embryonic stem-cell research....’”

Contrary to the suggestion of the Associated Press article above, the two new studies in Nature will not “calm the qualms” in the embryonic stem cell debate. The reason is simple—neither proposal actually protects the human embryo. In fact, they both do the opposite.

First, the method used by researchers at the Whitehead Institute and MIT is a method of cloning (altered nuclear transfer, or ANT). It creates a handicapped embryo that is unable to develop a placenta. Without nourishment, the embryo will quickly die. Since this nonviable embryo cannot develop into a baby or an adult, the argument goes, destroying it to obtain its stem cells is not the same as destroying an embryo that could develop normally. True, it can’t develop normally. But this misses the point that the embryo was deliberately created with a fatal disability. And calling it an “abstract cluster of cells” or a “non-embryonic entity” is simply a rhetorical sleight of hand by the bioethics and scientific communities. Once we get beyond the “smoke and mirrors,” we realize that ANT is similar to removing most of a baby’s intestines and then permitting its other organs to be harvested because it will die for lack of nourishment, a point made by Dr. David Stevens, Director of the Christian Medical Association.

Additionally, the ANT procedure assumes that the critical gene, Cdx2, operates the same in humans as in mice, an assumption that is questioned by several scientists. However, testing this would require the creation and destruction of human embryos—unethical research on human subjects.

Second, the approach used by researchers at Advanced Cell Technology removes one cell from a developing eight-cell embryo. Supposedly, the now seven-cell embryo is left unharmed.

But what about the cell that was removed? It is claimed that the single cell is then “prompted” to develop into a “colony of embryonic stem cells.” However, this single cell is totipotent, unspecialized, just like the original fertilized egg. It has a built-in tendency to self-organization that directs it to develop as a new embryo—hence, the ability to produce a “colony of embryonic stem cells.” If allowed to develop, this new embryo would become a baby, an identical twin to the one that would develop from the seven-cell embryo.

The process used by Adanced Cell Technology is a variation of “twinning,” a naturally occurring phenomenon that produces identical twins when a developing embryo is somehow divided. And it does not get around the ethical issue of destroying human embryos. The only difference is that it destroys an embryo that was not produced by the direct union of an egg and a sperm.

Since neither method, on closer examination, passes ethical muster, neither has the potential to “calm the qualms” in the embryonic stem cell debate.

More Illnesses Reported in IVF Kids Early On

“Long-term rates of illness appear to be higher among children conceived after in vitro fertilization than for other children, Swedish researchers report. However, this might be influenced by parents of such children being more likely to seek medical advice.

“‘An increased morbidity in IVF children exists at least for the first few years of life,’ Dr. Bengt Kallen from the University of Lund told Reuters Health. This is partly due to singleton infants born prematurely but also to a large extent to multiple births, the researcher said.

“Kallen and colleagues analyzed hospitalizations and cancer occurrences in more than 16,000 children born after IVF during a follow-up period of 1 to 20 years.

“According to their report in the journal Fertility and Sterility, IVF children were nearly twice as likely as other children to require hospitalization during a median observation period of 5.5 years. The hospitalization risk was higher among children born in multiple births than in singleton children....”

“Even people who believe abortion should be legal are uncomfortable with the arguments in Roe....”

Experts See Legal Abortion Without Roe

“The two vacancies on the Supreme Court have abortion activists on either side sounding the death knell of Roe v. Wade, the landmark 1973 ruling overturning state laws that criminalized abortion.

“But some legal scholars who support abortion rights say that may not be such a bad thing.

“‘Roe was terribly reasoned,’ said Scott Powe, a professor at the University of Texas School of Law. ‘I think there’s some requirement under the Constitution that if you cannot explain a decision and its relationship with legal materials, it’s not a valid decision.’

“Powe, who describes himself as ‘100 percent pro-choice,’ is far from alone in his criticism of Roe. Justices Antonin Scalia and Clarence Thomas have made no secret of their revulsion toward Roe on legal grounds.

“But what may have been lost in the often shrill battle over abortion is that even people who believe abortion should be legal are uncomfortable with the arguments in Roe....”

The new international consortium—it’s as much about the politics as it is the science of stem cell research...

International Stem Cell Bank Opens

“A bank that will create and supply new lines of embryonic stem cells for research around the world has been opened in Seoul, South Korea.

“The project is being led by cloning expert Dr Woo Suk Hwang, who has pioneered the development of stem cells tailored to individual patients.

“It will serve as the main centre for an international consortium, including the US and the UK.

“But proponents argue that stem cells taken from embryos offer the best hope of new treatments for a range of diseases and injuries....

“The new bank is expected the help scientists from countries like the US get round government restrictions on stem cell research....”

The ethics of securing fresh human eggs: How many women? Will they be paid? What health risks? Will fresh human eggs become a commodity?

Clinic Searching for Egg Donors

“A San Francisco fertility clinic will recruit Bay Area women to provide eggs for stem cell research, helping build the world's first-ever bank of cloned embryos—which could supply new stem cell lines and perhaps replacement tissue for people with serious diseases.

“The Pacific Fertility Center hopes to offer eggs in January to a future Bay Area satellite clinic of the new South Korea-based World Stem Cell Foundation, according to center medical director Dr. Philip E. Chenette....

“The Pacific Fertility Center will seek eggs from healthy women in their 20s and early 30s, in good physical and emotional health. Women must be willing to give themselves hormone injections. The 30-minute surgical egg retrieval procedure is performed under sedation.”

Call for More, Earlier Use of Herceptin

“The cancer drug Herceptin, which has shown promise in battling the recurrence of breast cancer, gained renewed attention Wednesday, when an editorial in the New England Journal of Medicine called for an immediate expansion its use.

“At a spring cancer conference, San Francisco’s Genentech Inc. reported that Herceptin, which is already used in treatment of advanced cancer, also significantly delayed the progress of the disease when used at an earlier stage of treatment in women with an aggressive type of cancer.

“The full clinical trial results, published in today’s edition of the prestigious journal, show a significant drop in the rate of cancer recurrence four years after treatment.

“In an accompanying editorial, Dr. Gabriel Hortobagyi of the University of Texas M.D. Anderson Cancer Center in Houston said, ‘The results are simply stunning.’ He suggested that Herceptin might turn out to be a cancer cure.

“The glowing editorial and subsequent news coverage, however, raised concerns among health activists and doctors. They say the long-term effect on patient survival is still unknown, as are the risks.

“Kaiser Permanente breast cancer surgeon Dr. Susan Kutner cautioned that it will take years of follow-up studies to prove that the benefits are long-lasting. ‘In breast cancer, you never know for sure unless you are looking out 15 to 20 years,’ she said. ‘Before we can gush about a cure, we need to see really long-term studies.’”

Must a Patient Be a Person to Be a Patient? Or, My Uncle Charlie Is Not Much of a Person but He Is Still My Uncle Charlie

“As Paul Ramsey suggests, we may have arrived at a time when we have achieved an unspeakable thing: a medical profession without a moral philosophy in a society without one either. Medicine, of course, still seems to carry the marks of a profession inasmuch as it seems to be a guardian of certain values—that is, the unconditional commitment to preserve life and health; the responsibility for justifying the patient’s trust in the physician; and the autonomy of the physician in making judgments on others in the profession. But, as Alasdair MacIntyre has argued, these assumed virtues can quickly be turned to vices when they lack a scheme, or, in my language, a story that depends on further beliefs about the true nature of man and our true end. But such a scheme is exactly what we lack, and it will not be supplied by trying to determine who is and is not a ‘person.’

“The language of ‘person’ seems convenient to us, however, because we wish to assume that our medicine still rests on a consensus of moral beliefs. But I am suggesting that is exactly what is not the case and, in the absence of such a consensus, we will be much better off to simply admit that morally there are many different ways to practice medicine. We should, in other words, be willing to have our medicine as fragmented as our moral lives. I take this to be particularly important for Christians and Jews, as we have been under the illusion that we could morally expect medicine to embody our own standards, or, at least, standards that we could sympathize with. I suspect, however, that this may not be the case, for the story that determines how the virtues of medicine are to be displayed for us is quite different from the one claimed by the language of ‘person.’ It may be then, if we are to be honest, that we should again think of the possibility of what it might mean to practice medicine befitting our convictions as Christians or Jews. Yet, there is a heavy price to be paid for the development of such a medical practice, as it may well involve training and going to doctors whose technology is less able to cure and sustain us than current medicine provides. But, then, we must decide what is more valuable, our survival or how we choose to survive.”

“Must a Patient Be a Person to Be a Patient? Or, My Uncle Charlie Is Not Much of a Person but He Is Still My Uncle Charlie,” by Stanley Hauerwas, was originally published in Connecticut Medicine 39 (December 1975). It is reprinted in On Moral Medicine: Theological Perspectives in Medical Ethics (Second Edition), edited by Stephen E. Lammers and Allen Verhey (Eerdmans, 1998), pp. 387-390.

Living in the Biotech Century is produced, twice monthly, by The Humanitas Project. Please note that after a period of time, some web pages may no longer be available due to expiration or a change of address. Other pages may still be available, but only for a fee.

The views expressed in these resources are not necessarily those of The Humanitas Project. Our goal is to provide access to information from various sides of the debate. Ethically and morally, The Humanitas Project unapologetically defends both human dignity and the sanctity of human life in all contexts, from the vantage point of historic Christianity.

Feel free to forward this e-mail to anyone who might be interested in these issues. To subscribe or unsubscribe to Living in the Biotech Century, visit our website at www.humanitas.org, or e-mail . The Humanitas Project is a 501(c)3 nonprofit organization, and all gifts are tax deductible. For more information on The Humanitas Project, contact Michael Poore, Executive Director, at 931-528-2408 or .