Tag: fetuses

Bioethics News

The human embryo mapped in three dimensions. Technique and bioethical approach

A team of researchers from the Institut Vision in Paris and the Jean-Pierre Aubert Research Centre, under the direction of Alain Chedotal, have managed to map the human embryo  in three dimensions (see HERE the published study), which, they believe, permit better understanding of the mechanisms of formation of embryonic organs in normal and pathological conditions. Until this technique was developed, 3D embryonic reconstructions were obtained from thousands of embryos and fetuses, in which microscopic sections were cut at different stages of development. However, this new technique enables the inside of the entire embryo to be seen during the first trimester of its life. To that end, the researchers labeled the cells that they wanted to study with fluorescent proteins, and then made the embryo transparent by immersing it in different solvents, which removed its membranes, but conserved its protein structure; the embryo was then scanned under fluorescence microscopy. Using this technique, they analyzed embryos and fetuses from 6 to 14 weeks of gestation, constructing a three-dimensional atlas of the human embryo that can be used for both teachings and possibly for experimental techniques. There is no need to highlight the great ethical difficulties with these techniques, as they destroy human embryos with no further consideration. Therefore, although the results obtained are experimentally positive, the method used ethically disqualifies the overall process.

Photo: A view of an embryonic lung with this technique by Inserm

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

‘Being a burden’: a illegitimate ground for assisted dying

The issue of the legality in England and Wales of physician-assisted suicide has recently been revisited by the Court of Appeal. Judgment is awaited. The judgment of the Court of Appeal, granting permission for judicial review, is here.

The basic issue before the Court of Appeal was the same as that in Nicklinson v Ministry of Justice and R (Purdy) v DPP: does the right to determine how one lives ones private life (protected by Article 8 of the European Convention on Human Rights)  confer a right to have an assisted death?

Many factors have been said to be relevant to decisions about assisted dying. They include are intractable pain (rather a weak criterion, given modern palliative methods), hopeless prognosis – likely to result in death in a short time, and simple autonomy (‘It’s my right to determine where, when, and in what circumstances I end my life, and that’s an end of the matter’). One factor, commonly in the minds of patients asking for help in ending their lives, but rarely mentioned by advocates of assisted dying, is that the patient feels that she is a burden to her family and carers.

A recent systematic review of the literature concluded that 19-65% of terminally ill patients felt that they were a burden to others.  The 2016 Report relating to the Oregon Death with Dignity Act  concluded that 48.9% of patients whose lives were ended under the Act cited seeking an assisted death cited ‘being a burden’ as one of their concerns.

Concern about being a burden should not be a criterion to which any law relating to assisted dying should be permitted to have regard.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Pray Tell, What Does Harvey have to do with Abortion?

Nothing brings out the true color of people as clearly as a national catastrophe such as hurricane Harvey. “Beautiful” has been the color of the vast majority of people who have been victims of, or responders to, one of the worst natural disasters in U.S. history. Many people who watched their houses and possessions float away, who must have wondered how they will ever recover from their losses, nevertheless are painting the beautiful colors of faith, trust, courage, and patience. Many people who have put their own jobs and lives on hold to go down to Houston to help strangers in need, to pluck them out of the flood waters, to feed and shelter them, and to give them the proverbial shirt off their backs, are painting the beautiful colors of love, service, and sacrifice toward fellow human beings in need. Yes, Harvey has brought out many beautiful colors, as the vast majority of people have displayed the best of what human beings are capable of.

However, tragedies also bring out the true “ugly” colors of other people. Looters have broken into business and private dwellings and have wantonly stolen what did not belong to them. On some occasions, first responders have been robbed and even shot at. And when the flood waters recede and flood victims begin to rebuild their homes and lives, be assured that scammers will make the rounds, taking advantage of people in great need to pad their own greedy pockets with ill-gotten gain. Yes, Harvey has brought out many ugly colors, as a few people have displayed the worst of what human beings are capable of.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Fetal tissue and commerce

You may have seen in the general press that Indiana University is asking a federal judge to declare unconstitutional that state’s law banning research on the remains of aborted fetuses.  I noticed an article in the Wall Street Journal (subscription required).  An open-access account can be found here.

I oppose abortion, but I can imagine for the sake of argument that, if one allows for abortion, that it might be claimed that the tissue of an aborted unborn human could ethically be donated for research.  It seems to me that such an argument would construe this donation to be similar to donation of organs for transplantation.  In this case, the mother would be speaking for her (newly-deceased) unborn to make the decision, since the aborted one would not have decision-making capacity.

For such an action to be remotely ethical, donation of tissue could not in any way influence the decision to have an abortion–as, indeed, federal restrictions on fetal tissue research currently require.  There should be no profit to the donor or the abortion provider in the process.  In light of the Planned Parenthood brouhaha over this subject, I might suggest that the researchers seeking the tissue for research be required to bear any costs for the preparation of the tissue.  And something like the dead donor rule for organ transplantation would have to apply.  But that’s probably a trivial point in this case.  Never mind that the dead donor rule itself is under attack these days.

I imagine it’s clear that I don’t find this argument very persuasive. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The ‘Weird’ First Fortnight of the Foetus: Implications for the Abortion Debate

Guest Post: William Simkulet
Paper: The Cursed Lamp: The Problem of Spontaneous Abortion

For many people, the moral status of abortion stands or falls whether or not a human fetus is morally comparable to you or I; whether its death is a significant loss.  Many people believe human fetuses have a right to life from conception, and thus conclude that there is good reason to think induced abortion is seriously morally wrong.  Judith Jarvis Thomson challenges this belief, constructing a scenario where she believes it is morally acceptable to end the life of a person because although he has a right to life, his right to life does not give him a right to use your body.  Her example should be familiar:

Violinist:  You wake up in the hospital, surgically attached to a violinist.  Your doctor explains that last night the Society of Music Lovers kidnapped the two of you and performed the surgery.  The violinist has a serious condition that will result in his death soon unless he remains attached to your kidneys for the next 9 months (you alone are biologically compatible).

The violinist has a right to life, and surely you are free to let him remain attached to your body to save his life.  It would be a great kindness for you to do so, but Thomson says that the violinist’s right to life does not give him the right to use your body.  Anti-abortion theories that focus on the moral status of the fetus neglect to show why the fetus’s moral status – its argued for right to life – would give it a right to use the woman’s body.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Human genetic editing (engineering) is here

A “hat tip” again to Wesley Smith, who at the National Review Online blog, provided a link to this week’s report in the MIT Technology Review that the first editing of genes in human embryos in the US is underway—and apparently not yet formally published—at an academic center in Portland, Oregon.  Similar efforts have been undertaken in China, but US scientists have been a little more tentative about taking this step in humans.

In 2015, US scientists were clearly against trying to initiate a pregnancy with an IVF embryo whose genes had been altered in the laboratory.  They were, apparently, divided on whether experiments on early human embryos, sperm, or eggs in the laboratory were “responsible.”

This blog discussed the matter back then.

Earlier this year, the National Academies of Science, Engineering, and Medicine were more open to proceeding with changing human genes in a way that would be permanent—inherited from generation to generation—as long as the process was done as carefully as they thought it could be. 

The work still appears to be held very close to the vest.  Funded by private money—the law prohibits public expenditures for this kind of work on humans—the MIT report says the Oregon scientists changed some genes (the MIT reporters did not find out which ones) in “many dozens” of IVF embryos that were created and destroyed specifically for research.

The ultimate goal sounds laudable:  repairing genes that cause inherited disease.  The posts linked to above reviewed some of these arguments, or provided further links to those discussions.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

‘A bit of a compromise’: Coming to terms with an emergency caesarean section by Terena Koster

During the midwife-hosted antenatal class Cath attended in a private hospital in Cape Town, South Africa, where she would eventually give birth, pregnant women were encouraged to name the kind of birth they wanted. They were presented with three options: “natural all the way with no medication”, “natural but open to medication”, or “elective caesarean”. The ‘choice’ women were expected to make featured as an important point of concern in their antenatal care and in their preparations for birth.

Hannah, a participant in the class, recalls a particularly striking moment when the midwife went around the room and pointed at each of the participants and asked, “Who is your gynae”. She went on to predict diverse birth outcomes, irrespective of participants’ stated intentions to birth vaginally. For Hannah this was an “eye opening” experience. A first time mother, she was now invited into a highly politicised birthing environment. Hannah had been uncertain about what kind of birth she wanted, but at 8 months pregnant she had decided on a ‘natural’ birth as opposed to a ‘caesarean’, with the caveat that in the event that an emergency caesarean section was a likely outcome, she would proactively opt for an elective caesarean.

At 39 weeks and near the end of her pregnancy, she found herself sitting opposite her obstetrician who told her there was “a real threat of the umbilical cord wrapping around [the baby’s] neck as she … drop[s] down,” adding that because the baby was “so big” there was “a high likelihood of [Hannah] tearing”. For the first time, the obstetrician instructed her to make a birthing decision: to continue trying for a vaginal birth or to opt for an elective caesarean section.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Medical tourism for controversial treatment options

By Dominic Wilkinson

 

Baby C’s parents had done their research. They had read widely about different options for C and had clear views about what they felt would be best for their child. They had asked a number of doctors in this country, but none were willing to provide the treatment. After contacting some specialists overseas, they had found one expert who agreed. If the family were able to pay for treatment, he was willing to provide that treatment option.

However, when C’s local doctors discovered that the parents planned to leave the country for treatment the doctors embarked on court proceedings and contacted the police.

One of the questions highlighted in the Charlie Gard case has been whether his parents should be free to travel overseas for desired experimental treatment. It has been claimed that the NHS and Great Ormond St are “keeping him captive”. Why shouldn’t C’s parents be free to travel to access a medical treatment option? When, if ever, should a state intervene to prevent medical tourism?

On the face of it, stopping patients or parents from undertaking medical tourism appears to violate two important freedoms – the freedom to travel and the freedom to make decisions about medical treatment. There might be reason for a country not to provide a particular treatment option – for example because it is unaffordable within a public healthcare system, or because doctors in that country do not approve of it, or lack experience or expertise in providing it. But why should patients or parents be prevented from accessing treatment overseas.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Zika Vaccines Protect Mouse Fetuses

With comments from our Ruth Faden: The first-of-its-kind study follows on the heels of ethicists’ urging vaccine developers to conduct clinical trials in pregnant women.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Rise in sexually transmitted diseases according to WHO last report

Experts have warned in the 46th edition of the spanish journal EIDON of an upturn in sexually transmitted diseases, as a result of the social and cultural changes derailing the efforts and decline achieved after the “hardest” years of the HIV epidemic. According to the latest World Health Organization (WHO) report published in August 2016,

  • 131 million people contract chlamydia each year,
  • 78 million gonorrhea and
  • 5.6 million, syphilis.

In total, 357 million new cases are caused annually by one of the most prevalent sexually transmitted pathogens. It is also estimated that there are more than 500 million people with genital herpes simplex virus (HSV), and more than 290 million women are infected with human papillomavirus (HPV). In some cases, these diseases can have serious negative consequences for reproductive health, such as infertility or mother-to-child transmission. Specifically, according to the WHO, in the last year, over 900,000 pregnant women were infected with syphilis, which due to mother-to-child transmission can result in 350,000 fetuses with different degrees of impairment, including stillbirths. Furthermore, resistance to antimicrobials is a threat to controlling these diseases worldwide. The causes of the growth of STDs are complex and rooted in social and cultural changes, among them the loss of fear of contracting a disease considered as fatal, such as HIV. “Its solution ranges from improving sex education and culture from early stages in the education of individuals to improving rapid detection systems to easy access to counseling and health care of the entire population without discrimination as to whether or not they belong to a

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The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.