Obama election signals change in stem cell fight

A commentary by friend and colleague Art Caplan in his MSNBC column:

'Change' was the horse that Barack Obama's presidential campaign rode to victory. Indeed the 2008 election will be remembered not only for Obama becoming the first African-American president, but also for its impact on core bioethical topics that have long dominated American domestic politics.

Divisive issues such as abortion bans failed to gain traction on state ballot initiatives, while newer bioethical concerns that are likely to dominate American politics for years to come, including physician-assisted suicide, emerged.

The past eight years of the Bush White House have seen stem cell research and the status of embryos at the center of the moral values debate. Obama's election has brought the fight over embryonic stem cell research in the U.S. to an end.

Loosening stem cell research
The state of Michigan passed Proposal 2, loosening restrictions on embryonic stem cell research. This means that in Michigan - whose universities such as Michigan State in East Lansing are major biomedical research powerhouses - scientists will be able to use the excess embryos created at in-vitro fertility clinics as a source of stem cells for research, as long as they have the written consent of the parents who sought treatment.

There are now 10 states that have laws permitting embryonic stem cell research. These 10 are likely to be the recipients of an executive order that the new president will undoubtedly sign shortly after taking office, freeing up federal funds for embryonic stem cell research while laying out new regulatory guidelines.

One of the main arguments against embryonic stem cell research is that all embryos are persons from the moment of conception. The voters of Colorado were given the chance to put that view into law with the proposed Amendment 48. The so-called "Personhood Amendment" sought to define fertilized eggs as human beings, extending them constitutional rights. Coloradoans defeated this amendment by a margin of three to one.

Many, including myself, would argue that the ongoing debate over the morality of stem cell research is really just a stalking horse for the abortion debate. But efforts to further restrict abortion did not fare well at the ballot box, either. California voters rejected a proposition that would have required doctors to notify parents before performing an abortion on a minor. The initiative also would have required a two-day waiting period before minors could get abortions.

In South Dakota a measure that would have banned abortions - except in cases of rape, incest and serious health threat to the mother - also lost. An even tougher version, without the rape and incest exceptions, was defeated two years ago. The 2008 initiative went down to a resounding defeat of 55 percent to 45 percent.

Taken all together this series of votes represents an important moment in public bioethics in America. Like it or not - and I am well aware that many are not ready to let go of these issues - the nation may be starting to move past the endless battles over stem cells, embryos and abortion. Stem cell research in all forms is proceeding. Embryos are not going to be given legal status as persons. Further restrictions on abortion are unlikely.

There will still be plenty to fight over! The most important topic to emerge from this election is how Americans die and treat painful medical conditions.

Michigan became the 13th state to enact an amendment legalizing marijuana use for medical purposes. Proposal 1 passed by a margin of 63 percent to 37 percent. It allows patients with "debilitating medical conditions" to register with the state and, with the permission of a physician, legally buy, grow and use small amounts of marijuana to relieve pain, nausea and appetite loss, among other symptoms. Massachusetts decriminalized possession of one ounce or less of marijuana, shifting the penalty to a $100 fine.

Help for terminally ill
Americans are clearly telling Washington that they want dying people to have access to whatever helps make that process less burdensome. It will be interesting to see how the new administration grapples with that message. If no one listens, then a much more controversial option may emerge - physician-assisted suicide.

Perhaps the most startling measure to pass at the state level was in Washington's Initiative 1000, offering terminally ill people the option of physician-assisted suicide. Washington voters decided that adults who are deemed competent and have been given less than six months to live by a physician can legally request and self-administer lethal prescription medicine. The measure passed by a margin of 59 percent to 41 percent.

This surely will not be the last state-level effort to legalize physician-assisted suicide if other policies aimed at minimizing the suffering of the dying are not enacted. While I have my doubts about the wisdom of offering help in ending one's life before offering them health insurance, I suspect it will become a political hot potato in a number of states in the next few years.
An aging population, the increasing cost of medical care and a lack of high-quality palliative and nursing-home care almost guarantee it.

The pundits will spend the next few months analyzing the election, pontificating on what led to the Obama victory and the Democrats taking greater control of Congress. They won't find the answers if they do not pay attention to the clear messages Americans sent concerning critical bioethical questions.

Original article here.

A New Day...

Now that the numbers are in, here are some of the election results that our readers might be interested in:

South Dakota's Measure 11, aimed at triggering a Supreme Court showdown on Roe vs. Wade, has been defeated.

The ban on gay marriage is leading.

Colorado 'Personhood' Amendment Defeated.

The next American President is an advocate and steward for the environment.

Michigan became the 13th state to legalize marijuana for medical purposes, with 63 percent of the vote.

Voters in Massachusetts approved an initiative to decriminalize possession of less than an ounce of marijuana.

More Monkey Business (Chimp Business, to be more accurate)

In a follow-up post to our post earlier today about primates, Brandon Keim of Wired Science asks, "Chimps: Not Human, But Are They People?":

"As a population of West African chimpanzees dwindles to critically endangered levels, scientists are calling for a definition of personhood that includes our close evolutionary cousins.

Just two decades ago, the Ivory Coast boasted a 10,000-strong chimpanzee population, accounting for half of the world's population. According to a new survey, that number has fallen to just a few thousand.

News of such a decline, published today in Current Biology, would be saddening in any species. But should we feel more concern for the chimpanzees than for another animal — as much concern, perhaps, as we might feel for other people?

'They are a people. Non-human, but definitely persons,' said Deborah Fouts, co-director of the Chimpanzee and Human Communication Institute. 'They haven't built a rocket ship to the moon. But we're not that different.'

Fouts is one of a growing number of scientists and ethicists who believe that chimpanzees — as well as orangutans, bonobos and gorillas, a group colloquially known as great apes — ought to be considered people.

It's a controversial position. If being a person requires being human, then chimpanzees, our closest primate relative, are still only 98 percent complete. But if personhood is defined more broadly, chimpanzees may well qualify. They have self-awareness, feelings and high-level cognitive powers. Hardly a month seems to pass without researchers finding evidence of behavior thought to belong solely to humans.

Some even suggest that chimpanzees and other great apes should be granted human rights. So argued advocates for Hiasl, a chimpanzee caught in an Austrian custody battle, and the framers of an ape rights resolution passed by the Spanish parliament. The question of rights is practically thorny — how could a chimp be held responsible for, say, attacking another chimp? — but the fundamental question isn't practical, but rather scientific and ethical."

For the rest of the story, click here.

The Question of Embryos and Legal Status

What constitutes 'a person' under the law? At first glance, this seems such a simple question; however, the more I think about this, and the more I investigate, I am realizing that there is not a clear answer. There clearly has not been a consensus amongst the legal and scientific communities.

Recently the Los Angeles Times examined the issues surrounding leftover frozen embryos. Many couples in the United States with frozen embryos leftover from fertility treatments are “finding themselves ensnared in a debate about when life begins”. These couples have three choices: discard them, donate them to research or donate them to another couple for potential pregnancy. There are initiatives in several states that seek to protect embryos. One of these initiatives defines a fertilized egg as a person in the state constitution (Colorado). Indiana lawmakers are proposing an allowance for leftover frozen embryos to be adopted for implantation by another couple. New Jersey legislators have proposed allowing unused embryos to become wards of the state, and Georgia and West Virginia are considering legislations that would grant embryos “personhood status”. This is a very slippery slope; for, if the Supreme Court allows these proposals, one would be in a position to say all abortions must stop.

Roe v. Wade is the historic Supreme Court decision overturning a Texas interpretation of abortion law and making abortion legal in the United States. The Roe v. Wade decision held that a woman, with her doctor, could choose abortion in earlier months of pregnancy without restriction based on the right to privacy. At the time of this decision, it was clear that an embryo was not a “person”, or abortion would have been “murder”; thus illegal. In Davis v. Davis the lower court found that “human embryos are not property, and human life begins at conception”. However, the Supreme Court of Tennessee overruled this by saying something quite different, that embryos occupied a special status of “quasi-property”. Most recently, the Oregon Court of Appeals has ordered six frozen embryos be destroyed after ruling they can be treated as personal property in a divorce.

So, in essence, it remains unclear in the scientific world “when life begins”, but in the “legal world” it is quite clear that embryos are not “persons under the law” (yet). In fact, at this time it appears embryos are simply “property”! Did I answer my own question? Embryos are life forms, but not persons?

Pain and personhood

Yesterday's NYT Magazine ran a long article about whether fetuses feel pain. The author, Annie Murphy Paul, is working on a book about how our early experiences shape development, and she asks some interesting questions about what effects pain and stress might have on fetuses. The pain question is an interesting one, and experts disagree about whether, to what degree, and at what point in time fetuses can experience pain.

If fetuses can experience pain, it seems not only reasonable but morally necessary that they receive sufficient anesthesia when they undergo painful procedures (such as blood transfusions or surgical interventions--which, believe it or not, can actually be done in utero in certain specialized centers in the U.S.). Such a claim doesn't rest on assertions of personhood, only of sentience. I would never let a veterinarian do surgery on my dog without anesthesia, but that doesn't make him a person.

As Paul notes, some anti-abortion activists have seized on research that shows fetuses displaying a physiological response to painful stimuli. They want to use this information as an emotional weapon, making sure that women know that if they have an abortion, the fetus will feel pain. Therefore, the argument goes, they should not abort. But while such a statement might make a woman feel worse, I have a hard time imagining that it would really change the mind of a person who'd made a firm decision to abort. It might cause her to ask that anesthesia be provided, though, which seems like a good thing.

Setting aside the abortion debate, pain is awfully tricky. We tend to understand pain as a subjective phenomenon: two people exposed to the same painful stimulus might well have different responses. So what does it mean to talk about pain for the fetus, who can't rate pain on a scale from 1 to 10, or even point at a frowny face? What do measures of cortisol or other stress hormones, or changes in blood flow, tell us about what the fetus is experiencing?

If we say that increases in certain metrics or decreases in others correlate with pain, what would it mean if we saw similar indications in a person in a persistent vegetative state? Paul comments that it might cause one to reconsider active euthanasia in such a situation, as a means of sparing suffering. But the connection between pain and suffering, between objective physiological measures and life as experienced, forces us to think about consciousness, about personhood, about respect for living beings (human and not), and about mercy. I can't do the article justice here, but it's definitely worth a read.

Bark, Bark, Woof, Woof -- Lassie Speaks

It was thought for the longest time that humans were the only species that could 'speak' -- then came along Washoe and Koko and Alex, and now, Hungarian researchers have written a promising program that could translate the meaning of dogs' barks, and it could applied to other species as well.

Yet another indication to revisit and enlarge our moral universe.

Birds Do It.... so do Chimps and Dolphins

Display remarkable intelligence, that is...after spending all of yesterday discussing various aspects of personhood (from embryos to animals to artificial intelligence) at the Terasem conference, this article is timely in illustrating the evidence accumulating on animal intelligence:

'The chimp who outwits humans; the dolphin who says it with seaweed; the existential dog... An elephant that never forgets its extended family, a chimp that can outperform humans in a sophisticated test of visual memory and an amorous male dolphin that likes to say it with flowers -- well, a clump of river weeds to be more precise. These are just some of the recent observations from the field of animal behaviour. They appear to show that there is no limit to the intelligence of animals, but what do we really know about the true cognitive powers of the non-human brain?"

To read the rest of the article, click here. And to see a remarkable demonstration, click here.

Dame Warnock weighs in again

As some of you may know, the 2007 Amendments to the highly successful HFEA (Human Fertilisation and Embryology Act) of 1990 are now before Parliament for approval. The recent announcement that pluripotent stem cells could be derived from human skin cells (thus obviating the need for embryonic stem cell research) injected some side issues into the House of Lords Debate on the passage of the 2007 Amendments. On November 21, 2007, more than one member of the House of Lords voiced concerns that the 'moral status' of embryos needed to be revisited in light of the new research by Yamanaka and Thomson. See, http://www.theyworkforyou.com/lords/?id=2007-11-19a.704.4 19.

Dame Warnock, chair of the 1984 Warnock Committee of Enquiry into Human Fertilisation and Embryology which spearheaded the 1990 HFEA - perhaps fearing the injection of old arguments into the debate on the 2007 amendments - wrote a powerful essay for the November 29 issue of Nature reminding us that "there was little possibility of moral consensus" about research using live embryos when her committee recommended the 14 day rule to criminalize keeping an embryo alive in the laboratory more than 14 days after fertilization. [During her Committee's deliberations, she noted that] "the Church claimed a right to regulate science in this area, because of its superior knowledge of morality. In sharp contrast, the committee's entitlement to issue moral advice to ministers derived from its having been set up to do so and from its having a wide and non-partisan membership."

"The moral decisions that such committees have to make are essentially matters of public not private morality. We had to consider our own moral or religious scruples alongside what the consequences might be of the decisions for society as a whole. This was the reason we could not allow ourselves to be swayed by arguments derived from a particular religious dogma." "The legislation [we crafted] would govern everyone - believers and atheists - and had to take into account wider considerations such as the relief of suffering ... [Remember] that it is permissive. No one would be compelled to seek a form of infertility treatment or engage in a form of research..."

"It is essential that ignorance and prejudice should not be allowed to dictate the outcome. Everyone should be educated so as to have a broad understanding of science, and an appreciation of its potential for good. Without this, we cannot responsibly erect barriers to scientific advance." "This must be done by weighing up possible goods against possible harms. These harms do not include only the offending of religious sensibilities of a particular group."

More on the Ballot Initiative to give Personhood to Embryos

Judith Graham and Judy Peres of the The Chicago Tribune have done a follow-up article on ballot initiative we had blogged about before -- the proposed referendum to grant the legal status of personhood to embryos from the moment of fertilization. The strategy of the groups proposing the ballot and the response from all different viewpoint is revealed, including the thoughts of some ethicists -- a major concern being that "many people won't understand the potentially profound consequences." Check out the full article here.

The Perfect Spouse

We had an earlier post about Sex and Marriage with Robots, the AJOB blog has followed up on the theme and Hollywood dreamed this all up in The Stepford Wives long before scholars were writing about the possibility. But for the first time, that I can think of, that someone (namely Wired's Regina Lynn) has named a top 10 reasons list to marry a robot -- here are just a few of the reasons she gave:

- Artificial intelligence is still intelligence.

- Robots have off switches.

- A robot is forever -- at least until the warranty runs out.

I could think of few other reasons -- like, no complaints about who does the housework -- after all, doesn't the perfect robot spouse dust, vacuum, and do laundry while you're off at work all day, and then greets you at home with a healthy, gourmet dinner? Or balances your checking account without criticizing your spending habits? Or is never too tired at night to tango? The list could be quite lengthy...

Good for a chuckle -- you can access the rest of Regina's article here.

Colorado Supreme Court OKs Ballot Initiative to give Personhood to Embryos

[Hat tip to Terry Tomsick for this story]

From the Denver Post:

The Colorado Supreme Court on Tuesday gave the go-ahead to proponents of a ballot initiative seeking to amend the state constitution in 2008 to define personhood as a fertilized egg.

Opponents to the measure, which would lay the foundation to make abortion illegal in the state, challenged the ballot title as misleading to voters.

The court ruled in a 7-0 decision that it is clear and meets the state requirement for a single-subject ballot question.

"Proponents of this initiative have publicly stated that the goal is to make all abortion illegal, but nothing in the language of the initiative or its title even mentions abortion," said Kathryn Wittenben, executive director of NARAL Pro-Choice Colorado.

"If that's not misleading, I don't know what is," Wittenben said.

The amendment, if approved by voters, would extend constitutional protections from the moment of conception, guaranteeing every fertilized egg the right to life, liberty, equality of justice and due process of law.

The initiative's 20-year-old proponent, Kristi Burton, founder of Colorado for Equal Rights, announced the court's decision Tuesday afternoon to loud applause at the Pro-Life Leaders Summit at the Timbers Hotel in Denver.

"This is a very simple petition. That's all we need," Burton said. "The people of Colorado will support protecting human life at every stage. More than that, we have God. And he is enough."

The rest of the article can be found here.

Sex and Marriage with Robots?

One of my students sent me a link to this article on a grad student doing a thesis on "Intimate Relationships with Artificial Partners" -- David Levy, a grad student in artificial intelligence at University of Maastricht in the Netherlands, speculates that robots will become so human-like in appearance, function and personality that many people will fall in love with them, have sex with them and even marry them. He predicts that Massachusetts will be the first jurisdiction to legalize marriages with robots, circa 2050.

Several things come to mind:

First, AI has to attain the status of legal personhood before any such thing as marriage (or any other contractual relationship for that matter) is recognized.

Secondly, as Glenn McGee wrote in an article in the Scientist and on blog.bioethics.net earlier: "As humans build robots that learn what their owners desire, the dilemma of the robots of Blade Runner emerges: What do humans owe “purpose-built” machines who begin to reach awareness, or to so resemble awareness that it becomes a selling point? Should laws be written to protect robots from us, by requiring robot makers to stop short of, say, robosexual devices that learn to be incredibly intimate with humans and yet are owed nothing? If so, do we create such laws in the interest of robots, or to preserve our own human dignity by choosing not to create a new kind of slave, whether or not that slave is fully aware?"

Thirdly, would these robots be sentient -- capable of experience pleasure and pain? Because the act of creating potentially sentient beings carries with it the corresponding responsibility for their actions and for the impact on the human community, the biosphere of the earth and the universe as a whole.

Fourthly, will it ever be possible to 'upload' your thoughts and memories to create a robot version of you? Some organizations are striving to do this -- and if they succeed, it will certainly have an impact on the previous questions.

[Added Oct 24, 2007, 9:14am EST - Editor's note: Our blogger extraordinaire, Kelly Hills, had some really interesting things to say about this, as we covered in a previous post.]

The gene/neurochemical that may separate human/ape brains: Neuropsin II

From Physorg.com this morning: Gene mutation linked to cognition is found [so far] only in humans

The human and chimpanzee genomes vary by just 1.2 percent, yet there is a considerable difference in the mental and linguistic capabilities between the two species. A new study showed that a certain form of neuropsin, a protein that plays a role in learning and memory, is
expressed only in the central nervous systems of humans and that it originated less than 5 million years ago. The study, which also demonstrated the molecular mechanism that creates this novel protein, will be published online in Human Mutation, the official journal of the
Human Genome Variation Society.

Led by Dr. Bing Su of the Chinese Academy of Sciences in Kunming, China, researchers analyzed the DNA of humans and several species of apes and monkeys. Their previous work had shown that type II neuropsin, a longer form of the protein, is not expressed in the prefrontal cortex (PFC) of lesser apes and Old World monkeys. In the current study, they tested the expression of type II in the PFC of two great ape species, chimpanzees and orangutans, and found that it was not present. Since these two species diverged most recently from human ancestors (about 5 and 14 million years ago respectively), this finding demonstrates that type II is a human-specific form that originated relatively recently, less than 5 million years ago.

Jay Hughes of the IEET comments "Just wait my hairy friends - soon you will be blogging and working with the rest of us."