Dr. Maureen Condic Gets Her Say

Nearly two months ago, I posted an entry about the science journal Nature Neuroscience's unfair editorial attack on Dr. Maureen Condic because she dared to question embryonic stem cell research dogma that ES cells offer the best hope for treatments, in the religious journal First Things. Making matters worse, after unfairly maligning her as "anti science," the journal had refused to allow Condic to respond to its criticisms in the same forum in which they were made.

A lot of pressure was placed on the Nature Neuroscience and it relented. Condic's letter to the editor published in the July 2007 issue is too long to print in full here, and there is no link. But here are a few choice excerpts:

Although the editors acknowledge that I am "correct in asserting that there are formidable hurdles to overcome before hESCs might serve therapeutic purposes", they groundlessly assert that my article is "anti-scientific", "polemical" and "disingenuous distortion of scientific arguments." I will not attempt to refute this false characterization. I will simply restate what the editors do not--and cannot--deny: the scientific evidence overwhelmingly indicates that hESCs are unlikely to be useful for human therapies in the near future.

The issues of immune rejection, tumor formation and hESC differentiation raised in my article are not distortions or mere polemic; they are matters of scientific fact. These same concerns have been raised in the scientific literature.

Indeed. If there were polemics being thrown around, it was the editors of Nature Neuroscience who were doing the slinging.

Condic concludes on this powerful note:

Although serious scientific obstacles may not constitute sufficient reason to "abandon the search for stem cell therapies", such obstacles can be addressed with far greater scientific power using animal models. For ethically controversial hESC research, we must engage in a frank, public discussion of the formidable hurdles preventing the development of stem cell therapies, if public policy is to be based on scientific fact, and not on science fiction. Rather than promoting such a rational civil discourse, the editors of Nature Neuroscience have sent the clear message that scientists who break ranks and publicly discuss the serious obstacles confronting hESC research will be groundlessly maligned in the editorial pages of a prestigious scientific journal.
Attempting to suppress public disclosure of the facts is, in the words of the editors, both a "disingenuous distortion" and an attempt "to spin science...to fit an anti-scientific purpose".

Condic nails it again. Suppressing and punishing heterodox views is not only corrosive of science, it is disrespectful of democratic discourse.

Terrorist Bombing Scare

No, not the one in London: In Los Angeles, where animal rights terrorists claim to have planted a bomb under the car of a UCLA primate researcher. From the L.A. Times story:

The FBI and the Los Angeles Fire Department are investigating an anonymous claim that animal rights extremists placed an unexploded incendiary device found under the car of a prominent UCLA eye doctor last weekend. The incident was similar to one last year in which another UCLA researcher was the intended target.

A gasoline-filled device was discovered Sunday by the car outside the Westside home of Dr. Arthur Rosenbaum, who is chief of pediatric ophthalmology at UCLA's Jules Stein Eye Institute. The device did not ignite despite evidence of an attempt to light it, authorities said Thursday.

An e-mail on Wednesday signed by the Animal Liberation Brigade said the group put the device there to stop experiments on animals in Rosenbaum's laboratory. The message claimed a gallon of fuel was set alight under the vehicle, but authorities said there was no fire.

Animal liberationist fanatic, Jerry Vlasak, applauded the move:

A Woodland Hills-based group called the North American Animal Liberation Press Office, or NAALPO, alerted reporters to the anonymous claim signed by the Animal Liberation Brigade concerning Rosenbaum's car. NAALPO said it had nothing to do with the incendiary device and does not know who was responsible.

However, NAALPO spokesman Jerry Vlasak, a trauma surgeon, said he agreed ideologically with such violent tactics against anyone leading painful experiments, particularly on primates. When peaceful protests don't work, "we certainly advocate taking it to the next level," he said.

Readers of SHS will recall that Vlasak was previously barred from entering the UK due to his advocacy of violence in the name of animal rights. Valsak also testified in front of a Congressional committee that murder to protect animals from medical researchers is morally justified.

This is terrorism most foul. Someday, one of these thugs is going to kill somebody. After that line is crossed, the next one will be easier--and then, I worry, it will be Katy bar the door!

Scientists Transform One Type of Organism Into Another

The creativity of biotechnologists sometimes astounds. In this instance, as reported in Scientific American, scientists transformed one type of bacteria into another by transferring the latter's total genetic makeup into the former. Why transmute one species into another?

As radical as this transformation is...it represents only the first step toward man-made organisms. "Synthetic biology itself and the synthetic genome still remain to be proven but we are much closer to knowing that it is theoretically possible," biologist J. Craig Venter says. "Just the naked DNA, just the chromosome itself without any accessory proteins, is all that is necessary to boot up this cell system. It really simplifies the task."

The goal is ultimately to design new organisms that fulfill specified functions, such as manufacturing new fuels to replace oil and gas or capturing carbon dioxide, without evolving so that these capabilities are locked in over time. Venter hopes to create fuels from such an engineered organism within a decade or less.

Do we have the wisdom to become the creators of new and novel life forms? Is this safe? Such questions are beyond my pay grade. But boy...

Bone Marrow Stem Cells Significant Help With Spinal Cord Injury?

Keep in mind this isn't peer reviewed, hasn't been replicated, and was released as part of a PR move, but get this:

From May 2006 to January 2007, 25 patients with SCI were treated at Luis Vernaza Hospital in Guayaquil, Ecuador. They were treated with autologous bone marrow stem cells--meaning the cells were extracted from the patients' own bone marrow.

Fifteen patients (60 percent) could stand up, ten patients (40 percent) could walk on the parallels with braces, seven (28 percent) could walk without braces, and four (16 percent) could walk with crutches. Patients demonstrated improvements in sensitivity, motility, bladder sensation, even controlling sphincters, erection and ejaculation. No adverse event was observed.

No one should tout this as a cure, or even yet a proven treatment. It is very preliminary human subject research. There is a very long way to go before this could be available, even if it pans out. But there is great hope out there.

Pushing for Assisted Suicide on Demand

The Hastings Center Report is probably the most prestigious bioethics journal in the world. Thus, when an opinion article appears in its pages, the ideas expressed are definitely in play among the bioethical elite. I bring this up because an article appeared in the May-June edition advocating assisted suicide for the mentally ill.

I have long maintained that the weight-bearing ideological pillars of assisted suicide advocacy--radical individualism that includes the right to choose the time, manner, and method of death, along with the view that killing is an acceptable answer to the problems of human suffering--preclude legalized assisted suicide from being limited to the terminally ill. The force of human logic--one of the most powerful forces in the universe--simply would not permit such a "restricted" approach, proved by the experiences of the Netherlands, Belgium, and Switzerland.

In "A Suicide Right for the Mentally Ill?" Brown University professor Jacob M. Appel echoes the above--with the exception that he approves of a broad assisted suicide license and I oppose all legalization. Subscription is required so I can't link the whole article, but here are a few key quotes:

At the core of the argument supporting assisted suicide are the twin goals of maximizing individual autonomy and minimizing human suffering. Patients, advocates believe, should be able to control the decision of when to end their own lives, and they should be able to avoid unwanted distress, both physical and psychological.

Appel claims that assisted suicide would "empower" patients with mental illness:

Most likely, the taboo against assisted suicide for the mentally ill is a well-meaning yet misplaced response to the long history of mistreatment that those with psychiatric illness have endured in western societies. Psychiatrists and mental health advocates may fear that their patients will be coerced to "choose death" against their wishes, or that, once suicide is an acceptable option, the care for those who reject assisted suicide will be diminished. But as the plaintiff argued before the Swiss high court, in challenging "medical paternalism," we are entering an era during which psychiatric patients do not need to be protected, but empowered. Our goal should be to maximize the options available to the mentally ill.

Of course, this was known all along, but political expediency (my term) prevented proponents from being, shall we say, candid with the people:

Since assisted suicide for the terminally ill was itself taboo fifteen years ago, it was unrealistic to expect that a mainstream debate would arise over the issue of suicide rights for psychiatric patients. Contemporary psychiatry aims to prevent suicide, yet the principles favoring legal assisted suicide lead logically to the extension of these rights to some mentally ill patients. But now that several Western nations and one U.S. state have liberalized their laws, it seems reasonable to question the policies that universally deny such basic opportunities to the mentally ill.

Ponder that last sentence; self destruction as a basic opportunity. Finally, the real agenda is coming into the open. Good. It is disrespectful of democracy to continue to play a game of hide the ball by pretending that assisted suicide would be permanently limited to the terminally ill for whom nothing else can be done to alleviate suffering.

So, let's debate near death on demand. Let's debate having euthanasia clinics widely available so the suicidal don't have to kill themselves by jumping off bridges. Let's have an open and honest debate about the limits, if any, that should be placed by society on destructive individual actions.

A Thwarted Dehydration

I have been watching this case since it first hit the news in Arizona. On May 30, Jesse Ramirez was arguing with his wife when their SUV rolled over. He was left unconscious. The doctors said his case was "hopeless," that he would never wake up. The wife moved him to a hospice and had his feeding tube removed, that is, she decided to dehydrate him to death.

The parents objected. They obtained help from lawyers affiliated with the Alliance Defense Fund, and obtained a court order requiring sustenance to be maintained while the case was investigated.

And now, this news:

Two weeks ago, he was the center of a family battling over of whether he should live or die.Now, he can hug and kiss, nod his head, answer yes and no questions, give a thumbs-up sign and sit in a chair...Jesse is now ready to move from a hospice to a rehabilitation facility.

"We have had a lot of miracles," said Betty Valenzuela, Ramirez's aunt. "He would have been gone."

No, it wasn't miracles: It was a family that refused to give up on their loved one. It was a judge who didn't just decide that the wife had the right to pull the plug, especially given certain potential conflicts of interest in the case. It was the Alliance Defense Fund that was willing to step in to the breach and help a family in desperate need.

I also think that if Ramirez's doctors really called his case hopeless, they have a lot of explaining to do. As we have discussed here previously, PVS is often misdiagnosed. More importantly, it can't be done accurately after only a few weeks post trauma. So, why the rush in this case to write the man off?

This much is sure: But for parents willing to fight for his life, Ramirez would be dead today rather than entering the rehabilitation unit. And therein lies an important lesson for us all.

Reverse Suicide Tourism May Lead to Extradition

We often think of "suicide tourism," as sick or despairing people traveling to a suicide friendly venue like Switzerland to have help shuffling off this mortal coil. Several years ago, George Exoo, then a Unitarian minister, did the suicide circuit in reverse. Admitting to running the "compassionate chaplaincy" in which he counseled suicidal persons and attended their suicides, Exoo traveled to Ireland to the home of the late Rosemary Toole (at her expense) and merely watched (he says) while she swallowed some crushed pills, covered her head with a plastic bag and breathed helium until she died.

The Irish authorities were not amused, contending that Exoo violated the law, that his activities amounted to assisted suicide. In 2004, Irish authorities requested that Exoo be extradited to face trial. He has now been arrested pending an extradition hearing. He claims that he didn't know assisted suicide was against the law in Ireland. Perhaps, but you know what they say: Ignorance of the law is no excuse.

Brave New Britain: Here Comes Health Care Rationing

The UK's National Health Care service is such a mess that some are now openly calling for explicit health care rationing. (Of course, ad hoc or sub rosa rationing already exists within the NHS.) One idea, according to this article in the Scotsman, is to make up a list of treatments that would be provided:

Alex Smallwood, from the BMA's junior doctors' committee, told the meeting in Torquay it needed to be accepted that rationing must take place in the NHS, but this had to be done much more openly.

"It is no longer possible to provide all the latest to absolutely everybody without notable detriment to others," he said.

"Rationing is reduction in choice. Rationing has become a necessary evil. We need to formalise rationing to prevent an unregulated, widening, postcode-lottery of care. Government no longer has a choice."

Dr Smallwood said that a list of acceptable treatments could be drawn up after debate and public consultation. But this might include a restriction on treating things like hernias and varicose veins - conditions with which people could live. "If somebody had a specific condition, it would be about how you could fairly say to them, 'This is not life-threatening; there's probably a better way we could manage this'. "When it comes to the list of conditions, it's all about quality of life. It would be about the prioritisation of clinical need," he added.

Well, now there's a slippery slope. What some might say is a bad quality of life, others might say is perfectly acceptable, thank you very much for your opinion. Moreover, in the end, such approaches reward the politically powerful with complete coverage while denying those on the outskirts. We saw this in Oregon when it created its Medicaid rationing scheme that omits some life-sustaining or curative approaches for the terminally ill. The thing is: When first conceived, late stage AIDS patients were to be listed among those rationed out. But the politically potent AIDS community engaged and that exclusion was, shall we say, remedied.

I don't blame AIDS activists, but other disease communities didn't have the same clout, the point being that if you want to increase the politicization of medicine and turn MS patients against cancer patients, against people with profound cognitive or developmental disabilities, against people with Alzheimer's--health care rationing based on quality of life is the way to do it.
Let's learn from the UK and find a better way.

"Artificial Intelligence is Lost in the Woods"

Some of our discussions here at SHS about human exceptionalism have considered the prospect for Artificial Intelligence (AI), and engaged the advocacy by some that such intelligent computers or robots--meaning those that had attained true consciousness--be declared persons and accorded what today are called human rights. I have expressed profound doubt that any machine would ever be actually intelligent in this sense. This position finds articulate support in this article by Professor David Gelernter in Technology Review. It's a very long article, too long to fully consider here, but well worth the read.

Gelernter believes that "conscious software" is "a near impossibility," in other words, that scientists won't ever create true AI because consciousness involves more than just rational thought, but also emotions, sensations, etc., which a machine could almost surely never truly actually experience. However, he believes that what he calls "unconscious" artificial intelligence--what might be described as capable of two-dimensional as opposed to three-dimensional responses--might be doable. He writes:

Unfortunately, AI, cognitive science, and philosophy of mind are nowhere near knowing how to build one. They are missing the most important fact about thought: the "cognitive continuum" that connects the seemingly unconnected puzzle pieces of thinking (for example analytical thought, common sense, analogical thought, free association, creativity, hallucination). The cognitive continuum explains how all these reflect different values of one quantity or parameter that I will call "mental focus" or "concentration"--which changes over the course of a day and a lifetime.

Without this cognitive continuum, AI has no comprehensive view of thought: it tends to ignore some thought modes (such as free association and dreaming), is uncertain how to integrate emotion and thought, and has made strikingly little progress in understanding analogies--which seem to underlie creativity.

Gelernter explains the difference between conscious thinking and unconscious machine thought:

In conscious thinking, you experience your thoughts. Often they are accompanied by emotions or by imagined or remembered images or other sensations. A machine with a conscious (simulated) mind can feel wonderful on the first fine day of spring and grow depressed as winter sets in. A machine that is capable only of unconscious intelligence "reads" its thoughts as if they were on cue cards. One card might say, "There's a beautiful rose in front of you; it smells sweet." If someone then asks this machine, "Seen any good roses lately?" it can answer, "Yes, there's a fine specimen right in front of me." But it has no sensation of beauty or color or fragrance. It has no experiences to back up the currency of its words. It has no inner mental life and therefore no "I," no sense of self.

As a consequence, any computer or robot would actually not be conscious, but no matter how dazzling its responses, remain a mere machine. Such a machine would thus not present us with the problem of according it human-equivalent moral status, the prospect of which some enjoy raising in discussions of human exceptionalism and personhood theory. He also points out the folly of attempting to create a truly conscious machine, believing that if it could be accomplished, it would be cruel, pointing out that in any event, "No such mind could even grasp the word "itch."

An unconscious machine intelligence could be a useful tool in teaching humans about the workings of the brain. But it would be just that, an inanimate object, a machine, a very valuable piece of property--nothing more.

Perhaps it is time to put the AI argument against human exceptionalism to bed and focus on ensuring that human rights apply to all of us--not just those who are able to hurdle subjective barriers to full inclusion in the moral community.

Another Swiss "Suicide Tourist" Proves the Euthanasia Debate is not About Terminal Illness

A Canadian woman with MS traveled to Switzerland with her husband for assisted suicide. The Euthanasia Prevention Coalition has demanded a legal investigation. I doubt that will happen, but I post this story because I want y'all to look at the way in which the reporter romanticized family support for the suicide (don't any family members oppose their loved ones' suicides any more?), but most particularly, for us all to ponder the attitudes expressed in the comments section.

Elizabeth McDonald, age 38, was not terminally ill. She was disabled and depressed. (Depression is caused by MS in some cases.) But the fact that McDonald was not dying matters not a whit to the readers commenting on the story. And of course it wouldn't. If one believes that killing (whether of self or by others) is an acceptable response to human suffering, then terminal illness has absolutely nothing to do with it. Moreover, the comments indicate a trend I have noticed in the last decade that among general society the "better dead than disabled" meme is growing increasingly strong--which chills the blood of disability rights activists who see disabled people in the cross hairs of the entire movement. And, of course, the reporter never bothered to contact disability rights spokespersons or suicide prevention professionals about the impact of stories such as this on disabled people generally or people with MS, specifically. Typical of the genre.

So, let's can the smoke and mirrors arguments about assisted suicide being limited to the terminally ill in irremediable suffering, and have an honest debate. The real issue is a "right" to suicide for whatever reason people determine that they want to check out--so long as the desire to die is not transitory. This is sometimes called "rational suicide," about which I have written on several occasions, including here in the NRO. (Along these same lines, recall the post from the other day about The Economist seeming to advocate prevention primarily for the "confused, temporarily depressed or in need of sympathetic attention," but only equivocally for those with a "determined" desire to die. )

Some will disagree, but to me, widespread support for suicide in the face of illness and disability is a symptom of a growing disintegration of mutual cohesion and caring in society. The new attitude seems to be, "If you want to die, go ahead and die. It's none of my business," which masks as respect for "choice" but is actually a form of abandonment. If this attitude continues to proliferate, it is going to be increasingly difficult to be a dependent person in society.

A Pro Stem Cell Research Advocate's Defense of Bush

Columnist Jeff Jacoby has written a very good column in the Boston Globe about the hue and cry among pro ESCR advocates in the wake of President Bush's veto of expanded federal funding criteria. Jacobi, who inhabits the right of center political realm, disagrees with President Bush's veto. But he noticed something off kilter about many of the anti-Bush statements that are worth repeating here. From the column:

To judge from the criticism of Bush's stem cell veto last week, nothing outranks the claims of science, and only a zealot could think otherwise.

"With one pen stroke," charged Governor Bill Richardson of New Mexico, "President Bush has ignored hard science, embraced misplaced ideology, and turned his back on the millions who stand to benefit from . . . stem cell research."

Similarly, Senate majority leader Harry Reid blasted Bush for "putting the politics of his narrow ideology ahead of saving lives."

So did Senator Hillary Clinton: "This is just one example of how the president puts ideology before science."

And Senator Barack Obama: "The promise that stem cells hold does not come from any particular ideology; it is the judgment of science, and we deserve a president who will put that judgment first."

What these statements have in common is their use of "ideology" as a pejorative for the principles and ethical values that have guided Bush's thinking on the stem cell issue. They treat "science" as an unqualified good, and reproach the White House for letting ethical qualms impede scientific progress. Yet not all science is progress. Not all ethical qualms are impediments.

Anyone who doubts Jacoby's last statement hasn't paid attention to history.

Blank Check Ethics: Here Come the "Manimals"

Get ready for the "manimals." In Sunday's Washington Post, Will Saletan describes how some scientists have cut themselves loose from the tether of self restraint and are busily planning the creation of human/animal chimeras with increasingly human attributes. From his column:

So far, our [human/animal] mixtures are modest. To make humanized animals really creepy, you'd have to do several things. You'd increase the ratio of human to animal DNA. You'd transplant human cells that spread throughout the body. You'd do it early in embryonic development, so the human cells would shape the animals' architecture, not just blend in. You'd grow the embryos to maturity. And you'd start messing with the brain.

We're doing all of these things.

Of course we are. Too many of "the scientists" have decided that curiosity, the laudable desire to achieve increasingly miraculous scientific and medical advances, and/or the drive to gain fame and fortune with the newest biotechnological breakthrough justifies their doing whatever they decide is necessary to achieve their desired ends. And so, they zoom along, heedless of the ethical objections that society might have to their biological manipulations, bitterly denigrating anyone who might express doubts as "anti-science."

This intimidates some people, but not everyone. Reading Saletan's piece brought to mind one of my favorite essays on the subject, written for the Weekly Standard several years ago by my good friend Joseph Bottum (now the editor of First Things) in reaction to a probably false news story that "the scientists" had created a human/pig embryo through cloning. "The Pig Man Cometh" is a wonderful, if hyperbolic, expression of wholly justified righteous rage by one of our best thinkers and writers. Here's a sampling:

You can't say we weren't warned. This is the island of Dr. Moreau. This is the brave new world. This is Dr. Frankenstein's chamber. This is Dr. Jekyll's room. This is Satan's Pandemonium, the city of self-destruction the rebel angels wrought in their all-consuming pride...We have reached the logical end, at last. We have become the people that, once upon a time, our ancestors used fairy tales to warn their children against-and we will reap exactly the consequences those tales foretold.

Like the coming true of an old story-the discovery of the philosopher's stone, the rubbing of a magic lantern-biotechnology is delivering the most astonishing medical advances anyone has ever imagined. You and I will live for many years in youthful health: Our cancers, our senilities, our coughs, and our infirmities all swept away on the triumphant, cresting wave of science.

But our sons and daughters will mate with the pig-men, if the pig-men will have them. And our swine-snouted grandchildren-the fruit not of our loins, but of our arrogance and our bright test tubes-will use the story of our generation to teach a moral to their frightened litters.

Saletan doesn't think any of this can be stopped. He concludes:

If you want permanent restrictions, your best bet is the senator who tried to impose them two years ago. He's the same presidential candidate now leading the charge against evolution: Sam Brownback, a Kansas Republican. He thinks we're separate from other animals, "unique in the created order." Too bad this wasn't true in the past -- and won't be true in the future.

I'm not so pessimistic. It isn't just Senator Brownback who opposes these agendas. Even most scientists don't want to take things as far as Bottum's metaphorical "swine-snouted grandchildren." And a big push back is coming. At some point either common sense will prevail and scientific freedom will be exercised responsibly or society will finally say, "Enough!" and apply the appropriate corrective. If that leads to the over regulation of science, the anything goes crowd will only have themselves to blame.

The ECONOMIST Misses the Obvious

The Economist, which I consider the best newsweekly in the world (and no bylines!), published an article apparently bemoaning the increased rate of suicide around the world. And yet, although the article ostensibly urges governments to try and prevent suicides, it actually seems to back the notion of permitting some suicides. From the story:

Measures can be taken to make it harder for people to kill themselves. They may not be able to (and arguably, should not try to) stop the really determined, but they can save the lives of many who are confused, temporarily depressed or in need of sympathetic attention.

Talk about abandonment of those in need! Why shouldn't we try to stop the determined? Aren't their lives as important and valuable as those who are "confused" and "temporarily depressed?"

Such mixed messages fundamentally undermine suicide prevention and amount to an acceptance of the concept of "rational suicide." If some suicides are deemed okay--then it becomes harder to tell a self destructive person, "Your cause for wanting to die isn't good enough." Should we ever get to that point, we might as well put suicide prevention centers in a museum.

A Coming "Vaccine" Against Alzheimer's?

I have decided to highlight stories like this because I have concluded that the bitter ethical controversies over ESCR and human cloning have distorted the true picture of what is happening in the exciting field of biotechnology. So much of the hopeful research that is moving into human trials is not morally contentious at all: Adult/umbilical cord blood stem cell research, gene therapy, and now a potential vaccine to prevent the worsening of Alzheimer's disease that has started what is often called Stage 1 human trials. From the story:

The vaccine uses a tiny section of the amyloid protein attached to an empty virus shell to trick the immune system into attacking and breaking up deposits of protein clogging the brain

Clever. Get the body attacking the enemy as it would a virus or bacteria.


So far, the indications are good:

Early tests showed the vaccine is highly effective at breaking up the sticky protein that clogs the brain in Alzheimer's, destroying vital connections between brain cells. When the jab was given to mice suffering from a disease similar to Alzheimer's, 80 per cent of the patches of amyloid protein were broken up.

The vaccine is now being tried out on 60 elderly Swedish patients in the early and middle stages of Alzheimer's. Half of the men and women are being given the vaccine while half are being given dummy jabs.

Although the year-long trial is designed to show that the treatment is safe, the researchers will also look at its effect on the patients' symptoms. While the results are not due until early next year, the initial findings are promising. Dr Renner told a Zurich conference earlier this week: "I am glad to report that the vaccine is very well tolerated."

If the trial is successful, larger-scale trials will follow, in which researchers will work out the best dose to give and how often it should be given. The finished product is six to eight years from the market.

Of course, it is always wise in stories such as this to keep in mind that an early human trial does not an efficacious treatment make. And, the information release could be an attempt to raise venture capital. But the animal studies were encouraging. If this works, it will provide tremendous relief of human suffering.

Human Trafficking in France

Babies for sale in a parking lot. Good grief.

Brave New Bioethics Podcast: The DEA's Big Chill on Pain Control

With all of the traveling I have been doing lately, and with Jack Kevorkian being sprung from the hoosegow, I have been remiss in recording my Brave New Bioethics podcasts. I am back in the verbal saddle again with this edition, which discusses the chilling effect that the DEA appears to be placing on proper and aggressive pain control. Check it out.

More Good News in Human Parkinson's Trials With Non Controversial Biotechnology

I was on a radio program today, and the host played for my comment a shameless clip from an AP report depicting a Parkinson's patient's fury at President Bush for vetoing expanded federal funding for ESCR because he believes--because that is what he has been told--that embryonic stem cells are his "only hope" for an effective treatment.

This is just not true. There are already hopeful treatments, such as electrode implants that are helping people today. New medications are moving forward toward clinical use. Even better news seems to be in the pipeline. We have already reported here, for example, that neural stem cells taken from miscarried fetuses have apparently substantially helped monkeys with Parkinson's. One human patient also appears to have been placed into an extended remission using his own brain stem cells. And now another apparently wonderful biotech success with Parkinson's involving a non controversial approach: This time with gene therapy. From the story in the Telegraph:

In a pioneering study, researchers used the treatment to bring about significant improvements in the mobility of Parkinson's sufferers. They said it could also herald a breakthrough in the treatment of other neurological disorders, such as Alzheimer's or epilepsy.The 12 patients involved in the study--a world-first human gene therapy trial for a brain disease--all reported a substantial reduction in their symptoms after having a human gene injected.

Within months, their ability to move had improved on average by 30 per cent. Some reported a 65 per cent improvement in their mobility.

It must be said that in the past gene therapies have disappointed far more often than excited. Still, if this success is repeated in further patients, it offers tremendous hope for people with disabling neural conditions.

The tired mantra that embryonic stem cells offer the "best hope" is getting old and losing steam. The published science is telling a different story.

This Just In...The United Nations has Supported Human Exceptionalism--since 1948

According to the United Nations Declaration on Human Rights, adopted by the General Assembly in 1948, "Everyone has the right to recognition everywhere as a person before the law."

Somebody had better tell the bioethicists, transhumanists, deep ecologists, philosophical materialists--and the others who would base rights on criteria other than being a member of the human species--that the word "everyone" means each and every one of us. In other words, the advocated policies of those who would distinguish between human beings who are "persons" and those who are non persons based on capacities would violate one of history's most important human rights documents. And no, you animal liberationists, the word "everybody" does not apply to animals. It is an agreement about the rights to which all and only human beings are due--simply and merely because they are human, e.g., human exceptionalism.

Vegetative State Often Misdiagnosed

This report confirms past research demonstrating that many people diagnosed as unconscious--aren't, or at least, many who are unconscious eventually wake up.

Around a quarter of patients in an acute vegetative state when they are first admitted to hospital have a good chance of recovering a significant proportion of their faculties, and up to a half will regain some level of consciousness, researchers from Belgium found out. Another study shows that around 40% of patients were wrongly diagnosed as in a vegetative state, when they in fact registered the awareness levels of minimal consciousness. Comparing past studies on this issue shows that the level of misdiagnosis has not decreased in the last 15 years. These studies should foster debate about appropriate standards of care for these patients, and about end of life limitations

At the very least.

Here are a few thoughts: First it should give great pause to those who advocate not supplying or quickly removing life support for people with traumatic head injury. Second, when family members claim that they detect signs of consciousness in their "unconscious" loved ones, doctors should be less quick to assert that they are merely seeing "what they want to see." Third, people ought to consider this problem when determining in an advance medical directive to have themselves dehydrated to death if they become permanently incapacitated.

Of course, what really needs to be done is to reject the notion that people with severe brain injuries are somehow less "human" or are not "persons." Unless and until we do that, people in these devastated states will not be safe.

William Hurlbut: The Power of the Individual

Holy cow! My pal William B. Hurlbut is on the podium behind President Bush as he makes his stem cell speech in the East Room. What a moment for Bill! I knew he was meeting with the president, but I had no idea it would result in such a public and high profile presidential pat on the back. I am so happy for him.

Hurlbut is the moving force behind altered nuclear transfer (ANT), one of the alternatives to ESCR that we have discussed here at SHS. But this isn't the point of my post. I have always believed in the power of the individual to improve the human condition. My heroes have been people like William Lloyd Garrison, Martin Luther King, and Ralph Nader, strong individuals who often swum against powerful cultural tides to the great benefit of society.

Bill has worked himself to near-exhaustion in promoting ANT in the hope of bridging the gap between the "scientists" and those who worry about using nascent human life instrumentally, as occurs in conventional ESCR. In this, he is an idealist, as most crusading (in the good meaning of that term) individuals are. Bill is very enthusiastic about science, he is unequivocally "pro-science," and he yearns to find a "solution," (in his term) that would fulfill all of the scientific hopes for embryonic stem cell research, while maintaining what he sees as proper ethical boundaries. Frankly, I don't believe "the scientists" want a solution. They want to get their way. Thus, even if ANT or another alternative method works, the "scientists" will shrug their shoulders and keep on cloning. But Bill does, and so he has willingly suffered the brickbats of many of his scientific colleagues, and some on our side of the issue, and pressed on.

And this (finally) is the point: One can disagree with his approach. One can disagree with his ethical analysis. No one has a monopoly on wisdom, after all. But it seems to me, that Hurlbut's commitment and desire to do what is right--even at a personal cost--illustrates the best of us. I am proud to be Bill's friend.

The Euthanasia Crowd Keeps Playing With Words

Euthanasia activists are obsessed with lexicon. They believe that if only they can find the right words to use in identifying mercy killing and assisted suicide, people will see the wisdom of their proposal and embrace medicalized homicide.

This obsession with words and terms has marked the euthanasia movement from the very beginning. Indeed, euthanasia, the current word for mercy killing, once meant a pain free natural death, experienced in a state of grace, and ideally, surrounded by family--akin to the modern concept of hospice. But as Professor Ian Dowbiggin noted in his splendid book, A Concise History of Euthanasia, the word was co-opted in one of the first modern essays supporting mercy killing, authored in 1870 by a school teacher named Samuel D. Williams. From Dowbiggin's account:

In advocating voluntary active euthanasia and physician-assisted suicide, Williams was instrumental in redefining euthanasia as an act of mercy killing rather than a passive process in which the discomforts of death are mitigated but not intentionally ended by pain killers.

Euthanasia advocates have been at it ever since, as Rita Marker and I describe in "Words, Words, Words," published in the Duquesne Law Review several years ago .

The current gooey euphemisms of choice for the euthanasia crowd are "death with dignity" and "physician assisted death." But the great word project continues, with new advocacy for yet another term that proponents are convinced will persuade people of the goodness of euthanasia. Thus, in this essay, one James Park proposes "gentle death" as the advocacy phrase that will turn the tide, writing:

The opposition will complain that we have just given a new name to an old evil, but the people in the middle will think twice before they easily and automatically turn against gentle death.

This would be pathetic if not for the seriousness of the controversy. In any event, this much is sure: Assisted suicide and euthanasia advocates don't want people to focus on the precise act they seek to legalize and legitimize, and hence, they will continue to search for their Holy Grail, the right phrase or words that will convince people to drink the hemlock. Indeed, as Dowbiggin notes, they have been at this task for more than 100 years.

Bush to Fund Stem Cell "Alternatives" Research

I had heard this was in the offing: When President Bush vetoes the bill today that would overturn his embryonic stem cell federal funding policy, he will also sign an executive order intended to ultimately fund research into "alternatives," to destructive embryonic stem cell research, e.g., altered nuclear transfer (ANT), "regression" (reverting differentiated cells into stem cells), using "dead" embryos, etc.

The New York Times story presents the story as if it is a mere political ploy to deflect criticism from his veto, complete with the views of skeptical pro ESCR scientists. I am sure there is some truth in this, but it is not, in my view, the primary reason for the new policy. Bush really is not "anti science" as so many of his political opponents accuse. Indeed, his original "compromise" in 2001 was designed to permit research without violating what Bush considered to be important ethical concerns. And so this initiative must be seen as supporting science--since, thanks to Bush, so many new avenues of pursuing regenerative medicine are being discovered.

From the Times story, here is the gist of the new policy:

First, Mr. Bush will an announce that the registry of embryonic stem cell lines eligible for research with federal tax dollars will be reconfigured as the "human pluripotent stem cell registry," a change intended to allow other types of stem cells to become eligible for federal financing if they have the same properties as embryonic stem cells.

Mr. Bush will also order Michael O. Leavitt, secretary of health and human services, to "support alternative techniques," the officials said. He will instruct Mr. Leavitt to come up with a plan describing how scientists and researchers who want to get new stem cell lines approved for the registry might do so.

I don't understand opposition to this research and its funding. The controversy over ESCR is an argument over ethics. But I don't know of many people who find these areas of research--at least at their current state of investigation--ethically contentious. (Some are opposed to ANT, but it is currently in animal studies to which no one objects.) With few ethical objections, there seems every reason to go forward with this research with appropriate levels of federal funding. Moreover, many of the scientists and bioethicists who point out supposed ethical problems with these approaches, support destructive ESCR and believe it to be perfectly ethical. Thus, their ethical analyses seem aimed at convincing opponents of ESCR to also resist these initiatives in the hope that by tearing down the alternatives, it will somehow boost funding for conventional ESCR.

ESCR and its funding will be a big issue in the 2008 campaign. If any Democrat or if Republicans Rudy Giuliani or John McCain is elected, Bush's policy will fall. If Fred Thompson, Mitt Romney, or Sam Brownback is elected, his policy will most likely continue. And isn't this where the great issue really belongs--as the subject of a great democratic debate among people of good will who differ in their opinions on the ethical propriety of ESCR, but who are all committed to scientific advancement as mediated by proper ethical guidelines? In the end, the people will decide.

Lanza: THIS TIME we REALLY Did It

Last year, Robert Lanza of Advanced Cell Technology, claimed to have derived human embryonic stem cells without destroying embryos. That report turned out to be, shall we say, exaggerated. In fact, ACT's researchers had destroyed all the embryos they worked on.

Now, Lanza has announced that they really, really did do it. An article published in the on-line ScienceNOW Daily News (subscription required), reports that Lanza told a stem cell conference in Australia that the researchers at ACT removed one cell from an embryo, kept the embryo in close proximity to the cell, which stimulated the removed cell to continue to divide as a stem cell line, and then returned the embryo "safely to the freezer."

Whenever ACT makes a big announcement of this kind, it is always prudent to be skeptical. But given the bright red faces caused by its previous exaggerated claims, I think we can probably assume that Lanza and his team did accomplish the feat. How practical it would be is another matter.

But this is the gist of the story--as it always seems to be whenever ACT makes a big announcement:

Lanza is now waiting on the findings of a legal review within NIH to determine whether the technique will get around the current federal funding ban on stem cell research. Lanza has also submitted a grant proposal to test his cell lines alongside two other types of stem cells that are also considered "ethically acceptable." Among other things, the work would compare the ability of the cells to give rise to different tissues or tumors.

Yes. It is always about the money.

By the way, I assume SHSers caught the reporter's (what I assume to be an) inadvertent error: There is no "federal funding ban on stem cell research." Indeed, the NIH puts out about $40 million per year on human ESCR. What Bush does not permit is the Feds to fund research on ES cell lines created after August 9, 2001.

Back to ACT and its desire for grant money: Since, the Bush decision was based on the government not funding embryo destruction--either explicitly or in anticipation of future federal grants--ACT might well qualify for an NIH grant, assuming, of course, that Lanza did what he said. But merely having created a stem cell line would not be enough. The application would otherwise have to be deemed worthy of funding. And there could still be other ethical issues to consider since the President's Council on Bioethics looked with disfavor on this approach.

Oh well: Time will tell. In any event, it is fascinating how creative scientists have been in finding alternatives to destructive embryonic stem cell research--thanks to President Bush. Ain't it amazing what the power of money will do?

Dog "Art" Isn't

This is a fun story about a school that trains dogs to assist people with disabilities that came up with a novel way of raising funds for their important work: Dog "art." Here's the story:

The owner of a fledgling dog-training academy in Salisbury has come up with a bizarre money-raising scheme. Mary Stadelbacher figured that if she could teach dogs to become service animals for the disabled, why couldn't she teach them to hold a paintbrush and swab a piece of art? Two years later, the owner of Shore Service Dogs has a collection of abstract paintings created by her three service dogs in training. Twenty of the works are being shown this month at a gallery at Salisbury University.

The doggie DaVincis also have a line of greeting cards that has sold out as word spreads about the unusual works of art. One of the original works has sold for 350 dollars.

A nice little feature to start the week, worth a chuckle and nothing more? Perhaps, but I see deeper currents. Perhaps I am obsessed--and there is certainly evidence for that proposition--but I see the story of the dog "artists" as pertinent to the crucial issue of human exceptionalism.

The dog art isn't actually art--at least not art created by a dog. The dogs are not expressing their aesthetic yearnings or attempting to create a thing of beauty. Rather, they are engaging in trained behavior that, for them, has no deeper meaning. (The same is true about similar elephant paintings that are created in India, an example of which is reproduced at the right margin.) Any artistic elements in this story spring exclusively from human activities, and thus, the story beneath the story is that the paintings made by dog and elephant "artists" illustrate the truth of human exceptionalism.

Only we could train a dog to paint--indeed only we can intentionally create a species with desired characteristics like we did with dogs. Moreover, only we can paint splotches on canvas and intend it as an artistic expression. And only we can look at a painted canvas--whether created by an artist or a trained animal--and perceive deeper levels of beauty and elegance. (The elephant painting is pretty good, I think. I like the red.) Yes, indeed: This story is really about human exceptionalism, and the amazing activities in which humans engage that are unique in the known history of the universe.

Now, you can see why I am invited to few parties.

The DEA's Big Chill Against Aggressive Pain Control

The New York Times Magazine published an important article today about pain control and the fear put into doctors by the Drug Enforcement Administration (DEA) that treating patients too aggressively with opioids (narcotics) could be dangerous to one's freedom.

The story, byline Tina Rosenberg, hits on all cylinders, too many in fact, to discuss fully here. The focal point tells of the imprisonment--effectively for life--of Ronald McIver, a doctor who was convicted of drug trafficking for too liberally prescribing opioids to treat severe chronic pain. (I take no position on McIver's case, but he is certainly not the only pain control doctor so imprisoned.) The article also does a nice job of educating the public about pain control, such as detailing how opioids are not addicting when used for a proper medical purpose of controlling pain, and how dosages can be titrated up slowly when needed without adverse impact on the patient. (Dr. Eric Chevlen and I discuss these matters more fully in our book Power Over Pain: How to Get the Pain Control You Need.)

The crux of the article involves the negative role the DEA plays--I hope inadvertently--in preventing people suffering from severe chronic pain from obtaining medically available relief. From the story:

In addition to medical considerations real or imagined, there is another deterrent to opioid use: fear. According to the D.E.A., 71 doctors were arrested last year for crimes related to "diversion"--the leakage of prescription medicine into illegal drug mar