Scientists as Creators (Shades of Frankenstein?)

Should scientists be acting as creators? A group of scientists is trying to form a living being from non-living chemicals reports a New Scientist blog by Bob Holmes. Though this opposes the religious beliefs of some, scientists believe that it will eventually provide immeasurable benefits including organisms that could clean fuel spills and heal injuries. Proto Life, a company based in Venice, is one of the few companies that has ventured to take on this controversial task in hopes of the next Nobel Prize. The company is run by CEO Norman Packard and his partner Rasmussen, a physicist at the Los Alamos National Laboratory in New Mexico. They have nicknamed this creature in creation the “Los Alamos Bug.”

To approach such a monumental task, Rasmussen and his co-workers questioned what base essentials were necessary for an organism to be considered alive. In simplified terms, containment, hereditary and metabolism was what was needed. These are the aspects that they are experimenting with to impart on the Los Alamos Bug.

[Thanks, Ana Lita]

Sex selection trial in China USA has been approved

This just in, a story in the Guardian referring to an article in the most recent issue of Nature:

A clinical trial into the effects of allowing couples to choose the sex of their babies has been given the go-ahead at a US fertility clinic. The controversial study was given the green light by an ethics committee after nine years of consultation. The purpose of the study is to find out how cultural notions, family values and gender issues feed into a couple's desire to choose the gender of their child.

Yes, you are reading that right, folks. A team of fertility specialists at Baylor College of Medicine in Texas will be conducting a trial that involves pre-implanation genetic diagnosis (which has only been used, until now, to identify serious disabilities and potentially life-threatening conditions) to find out why people might select one sex over another. And people are clamoring to get in: there have already been 50 inquiries from would-be parents asking to participate. Can it really be that this is a worthwhile research question? And are we really including selective termination of "wrong-sex" embryos as part of an empirical research protocol? Read more here.

Rumors have been floating around for some time (see Linda Glenn's earlier blog post re the "GenderMentor" test) that existing direct-to-consumer, mail-order prenatal tests, purportedly designed to help future parents plan for the arrival of their wanted child of either sex (Hmm, shall I buy the pink sleeper or the blue one?), have in fact been used as the basis for sex-based terminations.

Just in case you thought the no-girl-babies problem was something that only happened in other countries. . . .

Quote of the day....

"Old bioethicists never die, they just lose autonomy." - Karama Neal, bioethicist and writer. I had the pleasure of meeting Karama at this past weekend ASBH meeting; what a hoot! Along with colleague/bloggers Sue Trinidad, Toby Schonfeld, Glenn McGee, and David Magnus, Hilary Bok, (I think I'm missing someone -- if I am let me know!) it's tempting to propose a blogger affinity group.

(image borrowed from http://www.biologycorner.com/quests/bioethics.html)

Have It Your Way - as long as it's not healthy

The “obesity crisis” in the US has fingers of blame wagging at everything from working moms who rely on processed food to the popularity of sedentary activities such as internet surfing. McDonalds, the world’s largest restaurant chain, has spent much time in the center of these discussions due in part to lawsuits filed by angry, obese customers and a movie documenting the disastrous health consequences of living on a McDonalds' diet. McDonalds has made a variety of responses in the last fifteen years including displaying nutritional information posters in their restaurants, hosting a website with nutritional analysis of its food and adding some lower calorie menu items. Their latest endeavor involves changing all the packaging on their food so that consumers will have a basic nutritional breakdown of their lunch literally at their fingertips. While some other fast food chains, notably Wendy’s, have also responded to consumer preferences for more healthful food there is an interesting trend developing among some of the other fast food chains. Since McDonalds has taken much of the heat for the obesity epidemic, other fast food restaurants have been able to stay under the radar. While it would be stretching the truth to claim that McDonalds has moved toward a more healthful menu in any significant way (apple slices with caramel dip merely shifts the problem from fat to sugar), Burger King and Hardees aren’t even pretending to cater to health interests. Hoping to lure away some of McDonalds’ breakfast business, Burger King has introduced a new 730 calorie breakfast sandwich. At least they honor truth in advertising, naming it the Enormous Breakfast Sandwich. Hardees has responded by trouncing the whopper with the Monster Thickburger – a monster indeed at 1420 calories even before you get to the fries and soda. Congress, feeling the need to legislate something, is in the process of passing the “Cheeseburger Bill” – a bill prohibiting individuals from suing restaurants for contributing to their obesity problems. Clearly, responsibility for a healthful diet is left right where it always has been – squarely in the lap of the consumer. If you ever had any doubt about where the loyalty of the food industry lies, in the health of the consumer or in their pocketbooks, consider this: Ruby Tuesday’s recently reversed their new, groundbreaking practice of printing nutritional information on their menus next to each food item. They claim that it is too expensive to print new menus every time there is a recipe change. Coincidentally, during the time the nutritional information was disclosed on the menu there was a dramatic drop in the number of orders of the Colossal Burger, a 1677 calorie hamburger that is a Ruby Tuesday's signature dish.

Can I Pick Your Brain?

ScienceDaily reports that neurobiologists at the Salk Institute for Biological Studies have carried out experiments that prove for the first time that the brain remembers, even if we don't. Lead investigator Thomas D. Albright explains that "For the first time, we can look at the brain activity of a rhesus monkey and infer what the animal knows."

In contrast, the NY Times reports that brain scans are promising, but not yet practical.

The other interesting news about neuroethics is that over the weekend at the annual ASBH meeting in Washington, D. C. , neuroscientist and bioethicist Judy Illes of Stanford led the launch of the Neuroethics Affinity group. Kudos to Judy for being a pioneer!

The Other Problem with IVF...

The findings of three US studies have caused some to believe that all eggs used for IVF should be screened for defects. Because the increase of chromosomal abnormalities and miscarriage increases with age, the UK currently recommends screening only for women over 35 or women who have undergone repeated miscarriages or IVF attempts.

The screening called pre-implantation genetic screening (PGS) for aneuploidy involves the testing of a single cell from a three-day old embryo. It is similar to PGD, a test that looks for specific genes known to cause inherited diseases. Preimplantation-screening of IVF embryos is expensive-the technique virtually doubles the procedure’s overall cost. Until now, eggs from younger women were generally considered to be more frequently defect-free. This concept has been challenged.

Dr. Jeffrey Nelson of the Huntingdon Reproductive Center in California used PGD to screen 289 embryos from 22 healthy egg donors under the age of 30. “Overall, 42% of the embryos had aneuploidy or abnormal chromosomes.” Two other studies, one in Maryland and one in Atlanta, conducted similar studies and also detected unexpectedly high incidences of embryos with chromosomal abnormalities in women once considered at reduced risk for such. Doctors are unclear as to whether the drugs used for IVF are responsible for such inflated risk or if defective eggs are common among the genetic population but are rejected early on by the body.

While most agree that the results have challenged traditional thinking, the ensuing recommendations vary from the radical to the cautious. Dr. Nelson believes the UK Human Fertilisation and Embryology Authority should relax its guidelines and recommend wider IVF screenings. A spokesman from the HFEA answers, “we are concerned that women are properly aware of the potential risks before they choose to have this test and that women and embryos are not tested unnecessarily. Mr. Stuart Lavery, a consultant gynecologist at Hammersmith Hospital and a spokesman for the British Fertility Society, said “it’s very interesting, but it is quite preliminary.” He recommended that caution still be exercised when considering wider screening, as the procedure is relatively new and can be invasive. “He said the benefits would have to outweigh any harms.”

[Thanks, Ana Lita]

Supplement Your Mind . . . and Body?

It is

It is said that there is no such thing as bad publicity, but Dr. Phil might not agree right now. The TV psychologist is in danger of being named in a class action law suit regarding diet products that he has endorsed. The plaintiffs charge that the diet products do not meet the claims that Dr. Phil and the product literature tout, nor were there ever any clinical trials to validate those claims. What most people don’t realize is that dietary supplements, those claiming to aid in weight loss or otherwise, do not need clinical trials before going to market. Dietary supplements are regulated by the 1994 Dietary Supplement Health and Education Act (DSHEA) which allows manufacturers to market dietary supplements without the sort of rigorous testing required for drugs or food additives. The FDA still has the power to control supplements that it can prove are dangerous, but that onus falls on the FDA instead of on the manufacturers to prove that their supplements are safe. What this means is that consumers need to be cautious about what supplements they take as they are not protected from harmful supplements, even though they may think they are. As an example, it took the FDA close to a decade to ban the sale of ephedra – a supplement often used in weight loss efforts which had dire side effects, including many deaths.

The flip side of dietary supplement regulation is that there are many dietary supplements that people have used for thousands of years that are generally regarded as helpful and safe. To require manufacturers of vitamin C, for instance, to produce clinical trials proving its efficacy and safety would effectively mean that no one would be able to produce this supplement because the costs and time associated with testing are beyond what a vitamin manufacturer could afford to invest in product development. Many common herbs and other plants, such as garlic and cilantro, are used as dietary supplements. Dietary supplementation is one way that health conscious people can be proactive about their health. Wide scale regulation and barriers to dietary supplements would be intrusive and even harmful to many people who depend on vitamin and mineral supplementation to support their health. And yet there are serious plans to do just that at both the state and federal levels.

While the regulation of dietary supplements isn’t a particularly sexy issue, it is the sort of meat-and–potatoes issue (or meat-and-veggies for the low-carb dieters) that deserves a lot more public interest than it is currently getting because it promises to affect just about everyone in one way or another. So whether you want to treat your cold with echinacea or are worried that your spouse shouldn’t take gingko biloba with her Coumadin, you might want to follow this issue.

Miers nomination "sexist"?

In an article on CNN.com about President Bush's nomination of Harriet Miers to the U.S. Supreme Court, Senator Dianne Feinstein of California alleged that the conservative criticism of Miers is "sexist." Feinstein comments that individuals instead should "...hold their fire and give people an opportunity to come before a hearing."

While I agree that there is much good to be learned from the hearing process and I applaud Senator Feinstein's call for more information, I take issue with her allegation of sexism. Gender is always a factor, both in the political arena and in career advancement. After all, it is not coincidental that Miers has been nominated to replace Sandra Day O'Connor, one of only two women on the Court. However, it is difficult to see how the far right's criticism of Miers is particularly gender related. Conservatives are concerned that Miers will not be sufficiently respectful of human life or tough enough on crime, but these are religious and/or ideological concerns, not gender concerns.

Why does it matter? It's a bit like the boy who cried wolf. To call these criticisms "sexist" when, in fact, they are not both diverts the public from the real issues and makes it more difficult for them to respond when there are, in fact, sexist claims being supported. Let's call a spade a spade, and reserve the term "sexist" for occasions when there really is something to worry about.

Embryonic stem cell research: a possible alternative?

Rick Wiess of the Washington Post and Nicholas Wade of the NY Times both report on an online article at Nature.com about a method to create nonviable embryos for embryonic stem cell research. An example cited in the articles is the creation of an embryo that lacks the specific gene to develop a placenta; therefore, the embryo cannot implant and develop. From one viewpoint (a viewpoint supported and advocated by William B. Hurlbut, a Stanford University professor and member of President Bush's Council on Bioethics) this avoids the destruction of a viable embryo, and therefore, ethically permissible. From another viewpoint, this is the equivalent of "purposeful creation of fatally hobbled beings to use as research subjects" and is therefore ethically impermissible.

While this discussion is very interesting and may lead to a compromise in the current stalemate on federal government sponsored ESCR, one question still remains to be discussed: What of the status of the women providing the embryos?

The Politics of Bioethics: Getting Progressive Voices Heard

On October 3, a group of progressive bioethicists, including WBP board member and founding scholar Jonathan Moreno, got together at a meeting for the Center for American Progress. Hoping to influence public policy, other prominent bioethicists, including Art Caplan and Alta Charo explained that their approach is more optimistic about science and technology, and they will be focusing on issues that are too often not covered by conservatives, such as inequities in the healthcare system. More on this panel is reported in today's Nature (subscription required).

I look forward to hearing more about this at the upcoming ASBH meeting in Washington, D.C....

In pain? Head for a better neighborhood.

According to a new study from the University of Michigan Health System, minorities and people with low incomes have less access to pain medication from their local pharmacies than do well-off white people.

The study, which compared the availability of opioid pain relievers in pharmacies from different areas, found that these drugs were more readily available in upscale ZIP codes than in poorer neighborhoods. While researchers point out that most of the pharmacies had "sufficient" supplies of medication--defined as at least one drug in each of three categories--the gap in the number of local pharmacies that stocked sufficient supplies was significant: 86.9% vs. 54.2%.

Inadequate pain relief is a problem across the country, which makes it especially distressing to learn that one group is particularly underserved in this regard.

The study is published in today's issue (vol 6, issue 10) of the Journal of Pain.

Attention Women: Sleep is not a Luxury

Research on the relationship between sleep and health is growing quickly. Scientists have long known that sleep disorders, such as sleep apnea, narcolepsy, and chronic insomnia, can lead to serious health problems, and now there is data that support the claim that otherwise healthy people who do not get enough sleep, or have erratic sleep patterns, risk serious illness as a result. According to Eve Van Cauter of the University of Chicago: "Lack of sleep disrupts every physiologic function in the body." Immune system dysfunction, heart attack, stroke, diabetes, and cancer are now correlated with sleep deprivation. Adults between age 32-49 who sleep less are more likely to be obese; and it is not just that obese people are less likely to sleep, it is that people who sleep less in this age group are likely to become obese, according to the October issue of the journal Sleep, the official journal of the Associated Professional Sleep Societies. Chronic insomnia appears most frequently in women and male and female elders and women are twice as likely as men to have difficulties falling asleep or staying asleep. Only recently has the medical community focused on women's sleep disorders.

Fear and Loathing in Beverly Hills

Liza Mundy, a staff writer for the Washington Post, writes about America's obsession with infertility in a sharp and incisive critique of NBC's latest medical show -- a fertility clinic soap opera called "All Too Conceivable". Watching the show with a combination of what she describes as "revulsion and fascination", Mundy points out that in the United States, "we do not have much in the way of public discussions of reproductive technology, in part because we do not seriously regulate it." Which brings up a good question: in order to have serious public discussions, do we have regulate something? What do you think? Comments welcome...

Happy Birthday to the WBP!

From our founder, Kathryn Hinsch:

Pantry, Pilgrimage, and a Promise

One year ago today: A Tribute to Our Founding Scholars
Most of us are familiar with the storied beginnings of various software companies that were started by men in their garages. The Women's Bioethics Project was started, appropriately enough, by a woman in her kitchen.

I had just been granted a leave from my graduate studies at Harvard Divinity School and was back in Seattle. During my course of study at Harvard I realized that the world didn’t need another bioethicist, what it needed was a way to get women’s underrepresented voices heard in current bioethics debates. In studying bioethics and public policy, it was quite obvious that women’s life experiences were not being taken into account by the largely male population of lawmakers. Alone in my kitchen, I cooked up the idea of a think tank focused keenly on women and bioethics. It was one of those pivotal and defining moments.

I needed a reality check, so I contact Dr. Kelly Fryer-Edwards, a professor at the University of Washington, School of Medicine who I had met the summer before during my internship there. I asked Kelly if she would be willing to meet to discuss a wild idea. She was game.

We began to hold a series of dinners with Seattle-area scholars to discuss what this think tank could become. Over Thai food and beer, quiche and wine, we debated approaches, structures, issues, and funding. Week by week we went from a blank piece of paper to paragraphs to a framework. Before we knew it we had a strategic plan, and ultimately, a business plan. I thought my time at Microsoft had prepared me for intense debate, but these scholars pulled no punches. It was arduous yet scintillating work

Finally, last October, one year ago today, we felt confident that we had a workable plan. At that point Kelly and I decided it was time to make a pilgrimage to the birthplace of bioethics: The Hastings Center. Kelly arrived in upstate New York by train; I arrived by car with a malfunctioning GPS. We had an appointment to review our plan with the scholars at the Hastings Center, which became an exciting and turbulent day of intense feedback. That night Dr. Thomas Murray, President of The Hastings Center, and his wife Cynthia, took us to dinner. Over pasta and wine, Tom gave use wise counsel and pledged his support. The evening ended with hugs all around. The Women’s Bioethics Project had been born.

Kelly and I returned to Seattle with the formidable task of actually implementing the plan. We have worked hard and accomplished a lot since that autumn day in New York, more than we ever dreamed, really. I’d like to commemorate it by thanking the scholars who spent many hours building the Women’s Bioethics Project. They only asked for one thing: if the think tank became as successful as we all dreamed it would be, that I promise not to be seduced by the lure of media-grabbing issues like cloning but instead remember the bioethics issues like poverty, access to health care, and looking after children and the elderly that truly affect women’s lives. It is a promise I intend to keep.

Kathryn Hinsch

Founding Scholars:

Licia Carlson, PhD Assistant Professor, Department of Philosophy, Seattle University Debbie Cool, PhD Co-founder, Ceptyr
Denise M. Dudzinski, PhD Assistant Professor, Medical History and Ethics, University of Washington, School of Medicine
Annette Dula, EdD Women's Studies, University of Colorado at Boulder
Marybeth Foglia, RN, MA National Center for Ethics in Health Care (VHA)
Kelly Fryer-Edwards, PhD Assistant Professor, Medical History and Ethics, University of Washington, School of Medicine
Sara Goering, PhD Assistant Professor of Philosophy, University of Washington
Suzanne Holland, PhD Associate Professor and Chair of Religious and Social Ethics, University of Puget Sound
Maggie Hooks, MD Harborview Medical Center Helene Starks, PhD, MPH Assistant Professor, Medical History and Ethics, University of Washington, School of Medicine Valerie Ross, MS University of Washington Medical Center
Janelle Taylor, PhD Assistant Professor, Medical Anthropology, University of Washington
Susan Brown Trinidad, MA Researcher, Medical History and Ethics, University of Washington, School of Medicine

Please join us in wishing the WBP a Happy Birthday! -- Anything will do, just leave a comment.

Another reason to watch the Supreme Court this year

The United States Supreme Court has made many headlines this year and will continue to do so for the foreseeable future. Most of the news has been about new judicial appointments and how they may affect the future of the court and, by extension, our country. But now there is another good reason to watch the action on the court this year and an opportunity to see how John Roberts will lead.

In Gonzales v. Oregon, the Supreme Court is being asked to determine whether federal laws regulating drug use trump Oregon's right to legalize assisted suicide. Previously the Court has found that there is no right to assisted suicide but that states have the authority to regulate the practice. US attorney General Alberto Gonzales contends that the US Controlled Substances Act prohibits physicians from prescribing lethal doses of drugs for terminally ill patients, which is exactly what Oregon's Death with Dignity Act allows. This claim is based upon the supposition that such a use of drugs is not a "legitimate medical purpose."

It is unlikely that the dispute will be settled on the basis of whether or not assisted suicide is a legitimate medical practice and more likely that the matter will revolve around the rights of states to legislate practices, such as medicine, within their own state. However, the arguments in this case will help set the stage for further public debate about assisted suicide. And given that three of the justices have themselves battled cancer and that the court just lost Justice Rehnquist to cancer, it is impossible for this issue not to engage the justices on a personal level.

Although the hearing began today in Washington and Justice Sandra Day O'Connor participated in the questioning, it is not clear that she will be voting on this issue. If she leaves before the court rules and the remaining justices are split 4-4, arguments will be held over until O'Connor's replacement joins the bench.

Regardless of who votes or what the outcome is, this is destined to be a landmark decision in the history of the assisted suicide movement.

Marriage a Legal Requirement of Motherhood in Indiana

The State of Indiana proposes that a woman in Indiana seeking to become a mother through assisted reproduction therapy such as in vitro fertilization, sperm donation, and egg donation, must be married (presumably to a man). The draft legislation can be read here. In addition to being married, potential parents must be state certified. This certification is obtained thru a successful state assessment of many things including: intended parent "values," "education," and "personality, including the strengths and weaknesses of each intended parent." A clue as to what will count as a personality strength or weakness may be gleaned from the following other requirement, namely, a "description of the family lifestyle of the intended parents, to include a description of individual participation in faith-based or church activities." I recommend reading the following article, "The Crime of 'Unauthorized Reproduction'," by Laura McPhee that is in draft form here.

Abortion and disability

A new study in the Journal of Pediatrics reports that the number of infants born with cystic fibrosis (CF) has decreased since prenatal genetic tests for the disease became available. CF is not the only condition, of course, for which such tests exist: Down syndrome and other conditions are included in maternal serum screening tests. Positive test results provide would-be parents with a choice: to terminate the pregnancy, or to become parents of a disabled child.

Some have criticized the more and more common practice of terminating these pregnancies as a new form of eugenics, designed to "breed out" common chromosomal abnormalities. Others disagree, saying that it's not "really" eugenics if the state isn't involved in deciding which fetuses get aborted.

At the very least, it raises questions about what we consider to be the normal range of human variation. It also implies value judgments about what kind of life is worth living.