Tuesday, July 31, 2007
Small Things, Big Issues: Oversight of Nanotech
With the joint release today of Principles for the Oversight of Nanotechnologies and Nanomaterials, a broad international coalition of consumer, public health, environmental, labor, and civil society organizations spanning six continents called for strong, comprehensive oversight of the new technology and its products.
The manufacture of products using nanotechnology–a powerful platform for manipulating matter at the level of atoms and molecules in order to alter properties–has exploded in recent years. Hundreds of consumer products incorporating nanomaterials are now on the market, including cosmetics, sunscreens, sporting goods, clothing, electronics, baby and infant products, and food and food packaging. But evidence indicates that current nanomaterials may pose significant health, safety and environmental challenges posed by nano-scale technologies have yet to be addressed.
As Chee Yoke Ling of the Third World Network explained, “Materials engineered at the nano-scale can exhibit fundamentally different properties–including toxicity–with unknown effects. Current research raises red flags that demand precautionary action and further study.” She added, “As there are now hundreds of products containing nanomaterials in commerce, the public, workers, and the environment are being exposed to these unlabeled, and in most cases, untested materials.”
George Kimbrell of the International Center for Technology Assessment continued, “Since there is currently no government oversight and no labeling requirements for nanoproducts
anywhere in the world, no one knows when they are exposed to potential nanotech risks and no one is monitoring for potential health or environmental harm. That’s why we believe oversight action based on our principles is urgent.”
This industrial boom is creating a growing nano-workforce which is predicted to reach two million globally by 2015. “Even though potential health hazards stemming from exposure have been clearly identified, there are no mandatory workplace measures that require exposures to be assessed, workers to be trained, or control measures to be implemented,” explained Bill Kojola of the AFL-CIO. “This technology should not be rushed to market until these failings are corrected and workers assured of their safety.”
“Nanomaterials are entering the environment during manufacture, use, and disposal of hundreds of products, even though we have no way to track the effects of this potent new form of pollution,” agreed Ian Illuminato of Friends of the Earth. “By the time monitoring catches up to commerce, the damage will already have been done.”
Ron Oswald, General Secretary of international trade union IUF, highlighted the importance of defending against the massive intrusion of nano-products into the global food chain, pointing out that “hundreds of commercially available products–from pesticides to additives to packaging materials incorporating nanotech–are already on the market or just a step away. Workers, consumers, and the environment must be adequately protected against the multiple risks this development poses to the global food system and the women and men who produce the food we all depend on.”
“The makers of these materials are winning patents based on novelty and uniqueness, but
industry then turns around and says their nano-products do not need to be regulated differently because they are the same as bulk materials,” pointed out Kathy Jo Wetter of ETC Group, an international civil society organization based in Ottawa, Canada. “This contradiction benefits industry, but it cannot stand. Mandatory, nano-specific regulatory oversight measures are required.”
“Although governments worldwide spent over $6 billion on nanotech R&D last year, research spending on risks and social effects comprises only a ‘nano’ portion of that,” noted Rick Worthington of the Loka Institute an organization that promotes public participation in all matters related to science and technology. “We’ve seen the outcome of unregulated ‘miracle technologies’ such as synthetic chemicals before in the toxic pollution of entire communities. A portion of the nano research on social and environmental issues should involve active participation by communities, whose insights can help us avoid the catastrophic problems experienced in the past.”
The coalition’s declaration outlines eight fundamental principles necessary for adequate
and effective oversight and assessment of the emerging field of nanotechnology:
I. A Precautionary Foundation: Product manufacturers and distributors must bear
the burden of proof to demonstrate the safety of their products: if no independent
health and safety data review, then no market approval.
II. Mandatory Nano-specific Regulations: Nanomaterials should be classified as new
substances and subject to nano-specific oversight. Voluntary initiatives are not
sufficient.
III. Health and Safety of the Public and Workers: The prevention of exposure to
nanomaterials that have not been proven safe must be undertaken to protect the
public and workers.
IV. Environmental Protection: A full lifecycle analysis of environmental impacts
must be completed prior to commercialization.
V. Transparency: All nano-products must be labeled and safety data made publicly
available.
VI. Public Participation: There must be open, meaningful, and full public participation
at every level.
VII. Inclusion of Broader Impacts: Nanotechnology’s wide-ranging effects, including
ethical and social impacts, must be considered.
VIII. Manufacturer Liability: Nano-industries must be accountable for liabilities
incurred from their products.
“We’re calling upon all governmental bodies, policymakers, industries, organizations, and all other relevant actors to endorse and take actions to incorporate these principles,” said Beth Burrows of the Edmonds Institute, a public interest organization dedicated to education about environment, technology, and intellectual property rights. “As new technologies emerge we need to ensure new materials and their applications are benign and contribute to a healthy and socially just world. Given our past mistakes with ‘wonder technologies’ like pesticides, asbestos, and ozone depleting chemicals, the rapid commercialization of nanomaterials without full testing or oversight is shocking. It is no surprise that the public of the 21st century is demanding more accountability.” The complete document is available at numerous endorsing organizations websites, including www.icta.org.
Organizations can endorse the principles by emailing gkimbrell@icta.org.
Monday, July 30, 2007
It's Cool to be Smart
As Ariel Levy noted in her Colbert Report appearance earlier this year, our culture is starting to revere the female chauvinistic pig; young girls idolize Paris Hilton and Lindsay Lohan, and the media shows very few positive role models for girls - or at least what I would deem positive, showing that you can be both pretty and smart, or that your worth isn't in how small your clothes are and how blonde your hair is.
I don't want to idolize my youth, and say "things were better when..." - after all, I'm sure my parents thought Cyndi Lauper and mid-80s Madonna were as bad as I view Hilton, Lohan and their ilk these days. But I don't remember there being this overwhelming focus on it being bad to be smart, or desirable to be seen as dumb as a post. And I take some relief, today, in noticing via Wil Wheaton's blog, that I'm not the only one who thinks this: Danica McKellar, who some of you might remember as "Winnie" from The Wonder Years, has a new book coming out called Math Doesn't Suck.
CNN is running a short profile on the book, talking about the book and quoting McKellar's motivations for writing it:
The book includes tips to avoid mistakes on homework, ways to overcome test-day anxiety and profiles of three beautiful mathematicians. "I want to tell girls that cute and dumb isn't as good as cute and smart," she said.
I'm not in a position to write a book to inspire girls to be cute and smart. I'm not even in a place right now where I can do any one on one, big sister style participation in a local girl's life. But I am in a position where I can participate in a blog like this - and so I do, and hope that by adding my voice, we are all strengthened.
Shape Up or Pay Up
While this is targeting more than just those who are obese - Clarian Health Partners are determining weight based on a BMI of 29.9 or greater - it's pretty likely that the majority of interest in this will focus on people who are heavier being penalized for being heavier, and not those who have a normal BMI but high cholesterol or blood pressure.
The article also discusses financial incentives being used by various companies, from the Los Angeles school districts to other health care insurers, that "reward" people for healthy lifestyles/behaviour by reducing their deductibles. For example, the UnitedHealthcare plan has a $5000 yearly (family) deductible that can be reduced to $1000 if the employee isn't obese and doesn't smoke.
Obviously these incentive programs cover a lot of ground - weight, smoking, blood pressure, cholesterol, etc. The question becomes - is this right? Is this the appropriate way to deal with spiraling out of control health costs? Should people be penalized for not being in good health? And is refusing to hire people because of their BMI the next logical step, after refusing to hire people who smoke?
Smoking is an addiction, and one that we know can be broken with effort and encouragement. But should obesity, high blood pressure, and high cholesterol - things that can be genetic - be looked at with the same light? Should you have to pay $60 a month because your father gave you his high cholesterol? Should you have a higher insurance deductible because you have a chronic health condition that leaves you unable to exercise as much as others, thus pushing your BMI higher than it should be?
Perhaps most troubling, though, is the simple fact that the "solution" to our growing health coverage crisis is to pass the cost along to the individual employee, who may or may not have direct control over the issue they are being financially penalized for.
Connecting the Dots
A new public-policy group called the National Institute for Reproductive Health wants to take this contradiction and make it the centerpiece of a national conversation, along with a slogan that stops people in their tracks: how much time should she do? If the Supreme Court decides abortion is not protected by a constitutional guarantee of privacy, the issue will revert to the states. If it goes to the states, some, perhaps many, will ban abortion. If abortion is made a crime, then surely the woman who has one is a criminal. But, boy, do the doctrinaire suddenly turn squirrelly at the prospect of throwing women in jail.
Lawmakers in a number of states have already passed or are considering statutes designed to outlaw abortion if Roe is overturned. But almost none hold the woman, the person who set the so-called crime in motion, accountable. Is the message that women are not to be held responsible for their actions? Or is it merely that those writing the laws understand that if women were going to jail, the vast majority of Americans would violently object?
It is interesting that the conversation of punishment always centers around the doctors and never the woman. If abortions were illegal, could we really consider it anything less than first-degree murder? (It's willful... it's premeditated...)
You can read the rest of the article here.
You can see the YouTube video here. ** updated link**
Saturday, July 28, 2007
Where to start?
Linda kindly invited me to join you in posting items of interest and this is my first post on any blog ever so be kind if I've made obvious mistakes. A colleague send me this article suggesting it might be interesting when I next teach insurance law. To introduce myself, I am director of the health law program at Texas Tech University School of Law (and an adjunct at the TTU School of Medicine) and teach, among other things, bioethics, med mal, and insurance law. The legal issue of this case was whether the doctor was covered under his professional liability insurance--not for medical malpractice but for mistreating an employee. The concept of whether something is, or is not, in the scope of employement is a highly subjective finding. The most recent example of how subjective is the Valerie Plame decision in which a court found it in high administration official's scope of employment to disclose the identity of active CIA agents.
The larger issue here, of course, is how a health care professional imagined it was appropriate to implant "tusks" while a patient was unconscious and then distribute pictures for the amusement of the entire office. For the particular purposes of this blog, I suggest this post says a lot about the role of women in the workplace and as patients. Without suggesting that this particular dentist wouldn't have done this to a man, I would suggest that this article could be a good way to generate a discussion of professional ethics.
With best wishes,
Jennifer Bard, JD, MPH
Court: Dentist covered in tusk implanting prank
Story Highlights
Court rules insurance policy covers dentist who implanted tusks as joke
Employee sues dentist, who settles case for $250,000
Insurance company says intentional acts such as pranks aren't covered
Insurance company won't pay; dentist sues insurer
OLYMPIA, Washington (AP) -- An oral surgeon who temporarily implanted fake boar tusks in his assistant's mouth as a practical joke and got sued for it has gotten the state's high court to back up his gag.
A Washington court ruled a dentist's malpractice insurance covers practical jokes.
Dr. Robert Woo of Auburn had put in the phony tusks while the woman was under anesthesia for a different procedure. He took them out before she awoke, but he first shot photos that eventually made it around the office.
The employee, Tina Alberts, felt so humiliated when she saw the pictures that she quit and sued her boss.
Woo's insurance company, Fireman's Fund, refused to cover the claim, saying the practical joke was intentional and not a normal business activity his insurance policy covered, so Woo settled out of court. He agreed to pay Alberts $250,000, then he sued his insurers.
A King County Superior Court jury sided with Woo, ordering Fireman's Fund to pay him $750,000, plus the out-of-court settlement. The insurance company won the next round, with the state Court of Appeals saying the prank had nothing to do with Woo's practice of dentistry. On Thursday, the state Supreme Court restored Woo's award.
In a sprightly 5-4 decision, Supreme Court Justice Mary Fairhurst wrote that Woo's practical joke was an integral, if odd, part of the assistant's dental surgery and "conceivably" should trigger the professional liability coverage of his policy.
Dissenting Justice James Johnson said the prank wasn't a dental procedure at all and only "rewards Dr. Woo's obnoxious behavior and allows him to profit handsomely."
The back story, the court wrote, is that Alberts' family raises potbellied pigs and that she frequently talked about them at the office where she worked for five years.
Woo said his jests about the pigs were part of "a friendly working environment" that he tried to foster.
The oral surgery on Alberts was intended to replace two of her teeth with implants, which Woo did. First, though, he installed temporary bridges that he had shaped to look like boar tusks, and while Alberts was still under anesthesia, he took photos, some with her eyes propped open. Before she woke up, he removed the "tusks" and put in the proper replacement teeth.
Woo says he didn't personally show her the pictures but staffers gave her copies at a birthday party.
Woo's lawyer, Richard Kilpatrick, described the surgeon as a kindhearted, fun-loving man who was chagrined that an office prank turned out so badly. He was delighted with the high court's decision, Kilpatrick said.
Attorneys for the insurance company did not immediately return calls seeking comment. E-mail to a friend
Copyright 2007 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.
All About Civil Trials • Trials
Friday, July 27, 2007
5 Surgeries You Really Don't Want to Have
- Hysterectomy
- Episiotomy
- Angioplasty
- Heartburn surgery
- Lower back surgery
To read on, click here.
Patient in Gene Therapy Trial Dies
"A patient in a gene therapy experiment died on Tuesday in what may have been a reaction to a novel treatment for arthritis, federal health officials said late yesterday.
The precise cause of death remains unexplained. But the event immediately revived memories of a similar tragedy in 1999, when teenager Jesse Gelsinger succumbed in a gene therapy test in which researchers were eventually shown to have violated safety rules.
That disaster was a major setback for the field, which for more than 15 years has sought to treat diseases by giving people new genes. The only documented successes -- in a handful of children -- were undermined when the treatment was found to have caused cancer in some."
To read the rest of the article, click here.
Thursday, July 26, 2007
Bots, Blade Runner and Bioethics
”You want that story,” says Dr Stuart Meloy, laughing. It's a frantic day for the pain-relief surgeon at the Piedmont Anaesthesia and Pain Consultants in North Carolina, but the chance to talk about his discovery is irresistible. ”In 1998 I was placing a spinal-cord stimulator into a woman with leg pain,” he says, describing a pain-relief procedure where electrodes placed parallel to the spine stimulate nerves supplying the leg, removing the pain. ”When I turned the energy on, the patient let out something between a wail and a moan — very different from the ”Wow’ I sometimes hear.” Meloy leant around the curtains to ask the patient what she felt. She caught her breath and said: ”You're going to have to teach my husband how to do that.”
”I had no idea what she was talking about,” he chuckles. It turned out the electricity had given her an orgasm. She had another one when he tweaked the power to find out if that had caused it. After news leaked out that Meloy had patented a cigarette-packet-sized implant that could stimulate an orgasm using a handheld remote, the media went crazy. Everyone wanted to hear about "Dr Pleasure" and his "orgasmatron". But Meloy, who aims to have an affordable product, similar in price to breast implants, on the market in about three years, insists there is a serious reason for the device. According to the surgeon, orgasmic dysfunction affects about a quarter of women in the US, and he hopes that this implant will help women worldwide."
For more on this, read on here.
Domo Arigato, Mr. Roboto!
Towards a Womb with a View?
Womb-on-a-chip may boost IVF successes
Can conception, the most intimate of human experiences, be automated?
Teruo Fujii of the University of Tokyo in Japan and his colleagues are building a microfluidic chip to nurture the first stages of pregnancy. They hope, eventually, to create a fully automated artificial uterus in which egg and sperm are fed in at one end and an early embryo comes out the other, ready for implanting in a real mother. They say using such a device could improve the success rate of IVF.
"While there have been many advances in the production of in vitro embryos, these embryos are still sub-optimal [compared] to their in vivo counterparts," says Matt Wheeler of the University of Illinois in Urbana-Champaign who is also working on automated IVF systems. One reason for this is that during IVF, eggs or embryos are often moved or washed with culture fluid, causing changes in temperature and pH, he says.
The rest of the article, click here.
Is Obesity Contagious?
"They say it's not what you know but who you know. A new study suggests that this aphorism might hold true when it comes to your body weight.
If a friend of yours becomes obese, you have a nearly 60% higher chance of sliding into this category as well, according to the analysis. The finding has prompted researchers to call obesity a "socially contagious" disease in which a sense of what constitutes a normal body weight passes from one person to the next."
For the scoop on the whole enchilada, click here.
Wednesday, July 25, 2007
Effects of Obesity May Stretch Beyond Health
- if obesity was uncommon in their high school they were less likely to enter college
- the disconnect was more prominent if the girls were not white, or their parents did not attend college
- there is no correlation between college attendance and physical size in boys
- the obese girls had a negative self-image (who would have guessed?), but were also more likely than non-obese peers to attempt suicide, drink, and use marijuana
Of course, the most interesting thing I noticed was that the UT Austin press release specifically says "obese" in all their wording - the Austinist report on the press release uses the word "overweight".
Now, obviously these words mean different things in medical parlance - and might be at the point where they mean different things in the vernacular as well. After all, assuming the study used the (controversial) BMI levels, anyone with a BMI over 25 is overweight, while a BMI over 30 qualifies you as obese. There is clearly a range here.
Crosnoe did the study utilizing numbers from the National Longitudinal Study of Adolescent Health; I don't have access to the journal or the time to crunch the numbers myself, but it would be interesting to see just what the numbers are - overweight, obese, morbidly obese, or something different altogether.
I suppose the next step would then be to see whether or not something is being missed, or if it is true that obese/overweight women really do go to college less because of their weight - and if so, what can be done about it?
Man (and Woman's) Best Friend: They Feel Empathy, Don't They?

'Do animals feel empathy? This question could draw scoffing dismissal from many scientists only a few decades ago. Now it receives marvelously productive attention in neuroscience, psychology, and the burgeoning field of neuroethology. Below, two leaders in these fields, Emory University primatologist Frans de Waal and University of Chicago neurobiologist Peggy Mason, review both the history of animal studies of empathy and a particularly thought-provoking recent mouse study from the McGill University lab of Jeffrey Mogil. As de Waal and Mason note, this clever study holds surprises about both the baseline and the limitations of empathy in these small, "simple" rodents. One can't read these reviews without seeing one's own empathetic capacities and limitations in a new light.'
Which only serves to illustrate that our relationship with all living beings, human or otherwise, is not something that can be neatly classified into nice little hierarchical packages -- our relationship with the other living beings on this planet is much complicated and nuanced than the "Great Chain of Being". A recent article and the corresponding open peer commentaries in the American Journal of Bioethics, Thinking About the Human-Neuron Mouse, suggests that conferring humanity is an an either/or proposition -- that one is either a human (and therefore, a person) or one is not (and therefore not a person, but mere property). Funny thing about the way the law has developed, though -- corporations and even ships are recognized as persons, even though they are not human. So perhaps it is time to start looking at in-between categories, a recognize that our differences are more of a continuum, rather than clear cut dichotomy. No one thing is for sure, as the above article and the recent AJOB article suggest: More work is needed on the question of cognitive abilities of human and non-human entities and what, if any, differences, there are.
Tuesday, July 24, 2007
Almost 2 years later, New Orleans Hospital still struggling
Grand Jury Declines to Indict Dr. Anna Pou in Katrina Deaths
"A grand jury Tuesday declined to indict Dr. Anna Pou, the surgeon accused of killing four seriously ill patients in the aftermath of Hurricane Katrina.
Pou and two nurses were arrested last summer after Attorney General Charles Foti's investigation concluded they gave four patients a "lethal cocktail" at Memorial Medical Center amid the chaotic conditions that followed the August 2005 storm.
Lawyers for the three said they acted heroically by staying to treat patients rather than evacuating.
Charges against the nurses, Lori Budo and Cheri Landry, were dropped after they were compelled to testify last month before the grand jury under legal guidelines that kept their testimony from being used against them.
The Orleans Parish grand jury had been investigating the charges since March.
Assistant District Attorney Michael Morales, who conducted the grand jury hearings, had asked the grand jurors to return one charge of second-degree murder and nine of murder conspiracy.
The grand jurors sat calmly while the judge read the possible charges and each response of "no true bill."
Morales said afterward that he could not comment on the decision." See the rest of the article here.
Clinical Ethics: Re-defining medicine and lives
"About 15 years ago, I had a shy patient who ate nothing but white foods and who assaulted anyone who entered her air space on the hospital ward. She was mute but not uncommunicative, and with a little effort it was possible to learn her language.
Some of her problem was her psychosis. Most of it was her mother, who was her legal guardian, appointed by a court to monitor her medications. But the mother was also convinced that psychiatric medications were poison; the patient would go home on weekend passes and return with all her pills in bottles and without a shred of sanity.
This continued for months..." Rest of the article here.Monday, July 23, 2007
The Period of Choice
[Cross-posted from blog.bioethics.net] --
Very soon in pharmacies across the country, the contraceptive Lybrel will become available to those women with a prescription. Instead of menstruating once a month, as with traditional oral contraceptives, or once every three months, as with the more recent Seasonale and Seasonique, women will be able to eliminate menstruation altogether.
Wyeth hails Lybrel as the great liberalizer (hence the name). Advertising from the manufacturer stresses the drug's practical benefits -- less time off from work, higher productivity, and healthier relationships.
Unfortunately, this marketing strategy has created a backlash in a community of women still reeling from the Supreme Court's most recent holding on abortion. Instead of framing the decision to use Lybrel as one of choice, the marketing campaign has been accused of being paternalistic ("use it because it will be better for your husband or your boss"). Whether or not the marketing team was composed of more men than women is unknown, but the consensus is that the advertisements indeed emphasize how wonderful Lybrel is for those surrounding the woman, as opposed to the woman herself.
Ever since the advent of the pill feminists have been concerned with the implications of treating menstruation as a disease as opposed to a natural occurrence. By characterizing the process as an ailment in need of treatment, such drugs only further enforce the view that a woman's body needs to be "controlled." At the same time, the multi-million dollar industry clearly indicates many women see the personal benefits of regulating menstruation, particularly those women who suffer from severe premenstrual syndrome.
So what's savvy Big Pharma to do? Focus on the benefits Lybrel will have for the woman on a personal level. Not only will this strategy serve the useful function of informing potential patients, but it will also emphasize what many women feel is threatened today - choice.
-Roopali Malhotra
Friday, July 20, 2007
Sperm donor wins landmark legal battle to keep son in country
Full story here.
Pass the Placenta Pate, Please?
"I Told Him We've Already Got One . . ."
[we may be] be only “a matter of months” from reaching the Holy Grail of biotechnology – producing an “ethical” human stem cell without using a human embryo
"Holy Grail"?
Leaving aside whether all of biotechnology is actually on a quest for the "Holy Grail", why exactly is that goal the creation of stem cells with a particular provenance (especially given that we're more or less swimming in stem cells ready for use already), and what about that makes those cells themselves "ethical"?
The issue, of course, is the controversy created over stem cells by those who view the human embryo as having moral standing equal to or greater than that of full human persons or the goals or projects that human persons may have. That vocal minority has succeeded in establishing its views and objections as practical barriers to almost all research carried out on human embryos, and to the harvesting of stem cells from such embryos. Given that the compromise position on that issue imposed by the Bush administration has proven increasingly unworkable, attempts have been made to find ways to move science forward in spite of such barriers. Some have sought alternate sources of funding to evade the federal ban, while others tout adult stem cells or other technological work-arounds as ways of conducting the research without using embryonic stem cells. From that latter perspective, the recent news of, supposedly, totipotent cells derived from pluripotent "adult" stem cells in mice was a welcome step forward. The thinking is that this may be a pathway to producing embryonic stem-cell equivalents without harvesting cells directly from embryos - thus answering objections to the use of the embryo.
It is understandable that those who have such objections would be interested in the recent report. But I still find it strange than anyone else is (for other-than-scientific reasons, at least), still less accepts it uncritically as some sort of ethical milestone.
What I think has happened is that the pro-science and pro-personhood communities have allowed themselves to be stampeded by religious activists, who have successfully imposed their particular beliefs as the perspectival framework on the stem-cell "controversy". That controversy itself was created out of whole cloth by those activists. That is, there is controversy over stem-cell research only in the sense that a specific part of a specific segment of the right-wing religious/political spectrum is offended by this research and have used their influence in the Republican party to interfere with it. It is an active controversy only because that minority is allowed to exercise its influence in this way. It is an active moral controvery - as opposed to being a straightforward exercise of power politics - only because the ethics and scientific communities, who are virtually unanimous in seeing no major ethical barriers to the work, have allowed themselves to be inveigled into a pretended moral argument actually fought on political grounds, where they cannot prevail but where their participation lends credibility to the moral claims propounded by the right-wing activists.
As a political strategy, this has paid huge dividends to the religious right. In adopting sectarian religious framing for an otherwise uncontroversial moral question - accepting a distinction between "ethical" and "unethical" stem cells, or that the development of non-embryonic totipotent cells is a necessary goal of stem-cell therapy research - researchers and ethicists have ceded to religious activists, as moral principle, the idiosyncratic beliefs that bring those activists to the struggle in the first place, and without which there would be no "controversy". Though virtually no one who is not ideologically committed to moral status for embryos on religious grounds regards this matter as even a live issue, they have in many cases implicitly ratified the manufactured moral objections of their opponents by accepting the challenge of solving problems whose moral significance is otherwise far from demonstrated. The matter of "ethical" stem cells thus functions for the religious right, in the research arena, the way creationism does in the educational sphere: the importance of their suggested solution to the problem is not that it fills a need in and of itself, but that seeking and accepting that solution implicitly concedes the truth of the beliefs that make it necessary. The difference is that, while the religious right's "equal time" demand was rejected by the courts in the case of creationism, their encouragement of the expenditure of time and resources on a search for other cells that might perform the functions of the cells already available has been adopted by the research community (with some strong-arming by the Executive Branch) as a legitimate goal. This not only diverts, to some degree, resources from research on existing totipotent cell lines, but it implicitly ratifies the assertion that research on embryonic cell lines is inherently questionable - again, a position that enjoys almost no support on grounds other than religious dogma. The implications for other questions involving embryos and fetuses are obvious, and an acknowledged part of the religious-right's strategy in these matters. I would think some kind of critical test of this putative "controversy" would be in order before so much ground would be given up so readily.
Retroverted adult stem cells are far from a "holy grail" in scientific terms. Even assuming that totipotency can be achieved by some manipulation of the cell's genes, doing so adds an extremely complex additional process to the further manipulation of those cells for therapeutic purposes. The use of totipotent cells for any therapeutic purpose is still in its earliest stages, and will, even when perfected, require extensive genetic invasions of the cellular development process. Each such manipulation raises the possibility of mishap, and the risk to the patient, even if beginning with normal embryonic stem cells. Partially-differentiated adult stem cells, manipulated first backwards and then forwards along a different developmental pathway, will always carry inherently greater risks simply because more has been done to them along the way, and there is thus more to go wrong. Besides that, insisting that the scientific community solve one immensely complex problem - how to force differentiated cells to alter themselves in ways they never do in nature, and to undo developmental processes that have already begun, to recover capacities that have already been lost - before even beginning to solve the already-daunting problem of guiding them along specific (but otherwise normal) developmental pathways, necessarily sets back the development of whatever cures may be possible by however long it requires to do that currently-unimaginable preliminary work. Other suggested - but so far almost entirely untested - sources of "ethical stem cells", such as William Hurlbut's proposed "Altered Nuclear Transfer" process, are even less scientifically grounded and require even more drastic genetic manipulations of the cell prior to implantation in a human body for therapeutic purposes. Putting promising stem cell work on hold, to go off on a tangential chase for a process to create, from differentiated cell lines, retroverted adult stem cells to perform the functions of the stem cells that we already have available, is a massive displacement of scientific effort, focus, and time. But that - all of the above - is what the "ethical stem cell" advocates would have us do.
That would seem to require some considerably compelling justification. But the only justification that is even offered is that these hypothetical retroverted adult stem cells are "ethical", while actual totipotent stem cells are not. The reason for that claim, again, is that the latter are derived from human embryos, to which some (not all) among the religious right object. Absent this objection - absent only the assertion that there is no "ethical" way to conduct research on stem cells derived from human embryos - there is no "controversy" over the issue at all, and there is no reason at all for these alternative lines of research. (NB: Some forms of this research - including the effort to control the differentiation pathway both forwards and backwards - are inherently scientifically valuable and should go forward. But that is incidental to their implications for so-called "ethical stem cells".) To emphasize that: the search for "ethical" stem cells has no importance whatsoever, other than the fact that it responds to objections raised by a certain segment of the religious right and grounded on their religous beliefs. There is no need for them otherwise, and they are less desirable therapeutically than the already-available alternative of actual embryonic stem cells. Such lines of research, and the diversion of time and resources they represent, have no point unless that religious objection is demonstrated to be a compelling moral claim. But the question of the use of embryos can be and has been debated extensively, with, again, an almost-unanimous consensus among the community of ethicists and widespread support within the general public.
So, why has the research community adopted, even implicitly, as its "Holy Grail", the almost literal "Holy Grail" of the religious community? How is it that the ethics community accommodates such manipulative, distracting, and dubious rhetoric without demur? I think this language, in the context of the stem-cell controversy, and in fact the existence of that "controversy", expose a failure to interrogate the conceptual and rhetorical framing of the issue assumed, and brought into the ongoing discourse, by those who have made it their business to take an obstructive stance toward this work. In acknowledging, even implicitly, that it is important to find "ethical stem cells" to replace the "unethical stem cells" currently under study, an opportunity is lost to ask on what grounds such concepts have entered the discussion to begin with, and how it is possible to apply the evaluative term "ethical" to biological entities as such, let alone single cells. But it may not be too late,yet, to abandon the quest for the Holy Grail.