Oh brother. Nature has editorialized against exaggerating adult stem cell potentials for medical cures, which it claims occurred at a Vatican stem cell conference. From, “Smoke and Mirrors:”

Many scientists around the world were appalled by the events in Rome, and rightly so. It is wrong to exploit the desperation of the disabled and the terminally ill and to raise false hopes of quick fixes, as some at the Vatican meeting tried to do. It is also wrong to try to use such patients as experimental animals by bypassing regulatory agencies, as the Italian parliament seems to want to do.

What hypocrisy! During the Bush years, extravagant claims of pending CURES! CURES! CURES! that were (perpetually) just around the corner from embryonic stem cell research permeated the popular and scientific media. Surely you all remember the ceaseless and ever more extravagant claims. And yet, I didn’t see Nature archly editorializing against such politicized science and the flagrant abuse of the ill and their families for political gain. Indeed, it still happens, such as in an article published just last year in Fortune:

MDs and Ph.D.s are making the paralyzed walk and the impotent virile. A stem cell therapy for two types of macular degeneration recently restored the vision of two women. Once they were blind. Now they see! Some experts assert that AMD could be eradicated within a decade. Other scientists are heralding a drug-free fix for HIV/AIDS. Various forms of cancer, Parkinson’s, diabetes, heart disease, stroke, and ALS have already been eradicated in mice. If such work translates to humans, it will represent the type of platform advancement that comes along in medicine only once in a lifetime or two.

But, Wesley, some will say, Fortune isn’t a scientific publication. Okay, how about this old bromide from the Alliance for Medical Research put out in a video in 2006, that pushed both ESCR and human cloning research:

Now with this revolutionary breakthrough of regenerative medicine doctors will actually be able to cure diseases, not just treat them with pills and shots. Insulin-producing cells will be injected into the diabetic child to cure diabetes. Retinal cells will be injected to make the blind see. Nerve cells will be used to make the quadriplegic walk again. Stem-cell research has the potential to cure over 130 million Americans plagued by chronic degenerative diseases and conditions. This is the potential that stem-cell research holds for us.

Recounting all the embryonic stem cell hype over the last decade could fill a very long book.

I agree these things should not be exaggerated, whether embryonic, adult, induced pluripotent stem cells, or any other emerging medical technology. But please. Nature’s righteous anger rings very selective.

This is very bad. The Secretary General of the United Nations, Ban Ki-moon, has enthusiastically supported “nature rights” in his Earth Day speech. From the UN Press release:

In his speech, Mr. Ban also noted the growing momentum among world leaders to support sustainable development, citing in particular the efforts of Bolivia, which adopted a legal framework that specifically protects Mother Earth, with the rights of nature included in the national Constitution, and which led the effort to create the Day

Nature rights is anti-human, both implicitly and explicitly. As I have written elsewhere:

It [nature rights] is a self-demotion of humankind to merely one among the billions of life forms on earth–no more worthy of protection than any other aspect of the natural world. Viruses are part of nature. So, too, are bacteria, insects, trees, weeds, and snails. These and the rest of Ecuador’s flora and fauna all now have the constitutional and legally enforceable right to exist, persist, and regenerate their vital cycles.

The potential harm to human welfare seems virtually unlimited. Take, for example, a farmer who wishes to drain a swamp to create more tillable land to better support his family. Now, the swamp has equal rights with the farmer, as do the mosquitoes, snakes, pond scum, rats, spiders, trees, and fish that reside therein. And since draining the swamp would unquestionably destroy “nature” and prevent it from “existing” and “persisting,” one can conceive of the farmer–or miners, loggers, fishermen, and other users and developers of natural resources–being not only prevented from earning his livelihood, but perhaps even charged with oppressing nature.

Not only would “nature rights” further depress our economies and keep destitute countries mired in their misery, but here’s another point to ponder: If everything has “rights”–and let’s face it, ”Nature” encompasses just about everything–then in the end, nothing will–including us. 

I am not surprised that the head of the UN has embraced the subversive idea. I am surprised that so many don’t seem to care. 

Once again, so much for embryonic stem cells being the “only hope.” Scientists have turned bone marrow cells into brain cells. From the U.S.News and World Report story:

Scientists have discovered an antibody that can turn stem cells from a patient’s bone marrow directly into brain cells, a potential breakthrough in the treatment of neurological diseases and injuries. Richard Lerner, of the Scripps Research Institute in California, says that when a specific antibody is injected into stem cells from bone marrow, normally turn into white blood cells, cells can be triggered to turn into brain cells. “There’s been a lot of research activity where people would like to repair brain and spinal cord injuries,” Lerner says. “With this method, you can go to a person’s own stem cells and turn them into brain cells that can repair nerve injuries.”

Scientists like my friend, the FRC’s David Prentice, who opposed federal funding of embryonic stem cell research on ethical grounds and who argued that adult stem cells offered tremendous opportunity for regenerative medical treatments, were slanderously branded by the ESCR hypers as “anti science.” Wrong. Apologies are owed, but you watch, none will be offered.

A small prediction: Once cloning is accomplished–coming soon, I fear–the same crowd will be making the same arguments in favor of that unethical technology, along with the same smears against their debate opponents, all duly parroted by the willfully amnesiac media.

Animal rights = anti-humanism. I am not referring to supporters of animal welfare, too often conflated with “animal rights.” The former accepts human exceptionalism, the propriety of using animals for food and in necessary experimentation, while properly imposing a duty upon us to treat animals humanely. There is much room therein for argument about what the standards should be, but the fundamentals are sound. 

Animal rights, in contrast, is an ideology that sees humans and animals as morally equal. As I explained in A Rat is a Pig is a Dog is a Boy, animal rights activists believe the ability to suffer accords moral value, and that means what is done to animals should be judged as if the same things were done to people. Hence, cattle ranching is slavery. Understand: They mean that literally, and their ultimate goal is an end to all animal husbandry, no matter the human harm thereby caused.

Which is why animal research is the bulls eye on the animal rights target of subversion–no matter how much knowledge researchers derive or human (and animal) suffering that their work ameliorates–and no matter the diseases that animal research helped cure, as in polio, or identify, as in SARS. Monkey experiments, as I wrote, were the necessary prelude to a tremendously successful treatment or the effects of stroke and cerebral palsy. But the animal rightists don’t care. They only care about “those who can’t speak for themselves.”

This fanaticism leads to violence on occasion. More often, attacks on labs to destroy the fruits of experimentation. For example, fanatics in Italy recently invaded a research lab and destroyed the experiments. From the Nature story:

Activists occupied an animal facility at the University of Milan, Italy, at the weekend, releasing mice and rabbits and mixing up cage labels to confuse experimental protocols. Researchers at the university say that it will take years to recover their work. Many of the animals at the facility are genetic models for psychiatric disorders such as autism and schizophrenia.

The irony here is that by destroying the experiments, the animal “sacrifice”–for those who would use the term–is rendered meaningless by destroying the fruits already gained from the research. It will also mean more mice and lab animals will have to be used as the colony is rebuilt. Not only that, but the “liberation” has doomed some of the animals:

Some of the mice they removed were delicate mutants and immunosuppressed “nude” mice, which die very quickly outside controlled environments.

Their answer to the harm they are causing the animals, is that it is better for the animals to die now than suffer later.

Perhaps worse, the rightists named the names of experimenters on Facebook for later use in threats of violence–or actual attacks–on researchers: The threat to researchers from the Brown Shirt thugs is real.For example, in Santa Cruz a few years ago, a researcher’s house was fire bombed after her face was put on a wanted poster. She lamented that she was using trying to cure breast cancer. That sound you heard was me yelling, “They don’t care about the women with cancer, they care about the mice!”

Suffering humans could be materially harmed by the rightists’ slowing down or stopping the material benefit to be gained from the research. There is zero compassion in that. But that’s the animal rights movement for you: subversion, anti-humanism, and nihilistic romanticism coming and going. 

The pernicious search and destroy mission to wipe people with Down off of the planet through eugenic abortion is taking so much love out of the world. Case in point: Last year, Cincinnati Reds fan, Teddy Kremer, visited the clubhouse. Joy ensued. From the Cincinnati Enquirer story:

When Cheryl gave birth to Teddy, she was told the next day by the doctor that her son would likely never smile, probably wouldn’t talk, might not walk, and would never have more than a 40 IQ.

Wrong! Last year, he was a Reds bat boy for a day:

Later, Phillips explained his delight over Ted’s exuberance. “People are blessed in their own way,” said the Reds second baseman. “Teddy came in here and blessed us with his energy and his presence that day: Enjoy life, be yourself, go out and play hard. Give it all you got. That’s Teddy. He’s a reminder to us all.” When Frazier hit a towering home run in the fourth inning to score Bruce, Frazier circled the bases and, upon entering the Reds’ dugout, bellowed, “C’mon, Teddy, give it to me!” And player and batboy exchanged a big hug.

Read the whole story and especially, look at the photos. 

I once cared for a developmentally disabled man, and the thing that struck me hard and often was how he gave others permission to offer unconditional love. Those are very good karmic seeds planted!

We need our brothers and sisters with Down as much as they need us. 

HT: Ricochet

After Gosnell, I would think abortion rights activists would want stringent oversight of abortion clinics. That point aside, I see it as only good news that a Virginia abortion clinic is going out of business. From the Norfolk Pilot story:

For four decades, Hillcrest Clinic – South Hampton Roads’ first medical facility devoted to providing legal abortions – defied efforts to close its doors. That run ends Saturday. Virginia’s new licensing standards for abortion clinics, coupled with a drop in demand for pregnancy terminations, have driven the clinic out of business.

This is win-win. Pro choicers can point out that the “rare” part of “safe, legal, and rare” seems to be moving forward in Norfolk. As for the new rules, they require abortion clinics to be regulated like out-patient surgical centers. Isn’t that what they are? But let’s be honest. Gosnell aside–which dealt with a psychotic refusal on the part of bureaucrats to enforce existing regulations–these kinds of policies are intended to discourage abortion. They apparently do. That’s fine with me, just like laws to discourage smoking.

Back in February, I complained about Texas SB. 303, which would allow doctors to impose a Do Not Attempt Resuscitation (DNAR) Order on a patient’s file without consent. Since then, I have been to Austin testifying against the bill, and some salutory changes were made, although the bill still seems unacceptable to me.

In the prior version of the bill, the DNAR stayed in place–even if the patient/surrogate complained and an ethics committee adjudicatory process was started. Now, once the process formally starts, the DNAR comes off the patient’s chart.

That’s better, but still not good enough. The revised S. 303–which has now passed the Texas Senate–continues to allow doctors to impose a DNAR on the chart without consent, and moreover, requires the patient/surrogate to complain in writing, even though the notice of imposition of DNAR can be oral. From the passed version of S 303:

Sec. 166.012.  STATEMENT RELATING TO DO-NOT-ATTEMPT-RESUSCITATION ORDERS. 

(c)  Before placing a do-not-attempt-resuscitation (DNAR) order in a patient’s medical record, the physician or the facility’s personnel shall inform the patient or, if the patient is incompetent, make a reasonably diligent effort to contact or cause to be contacted the surrogate. The facility shall establish a policy regarding the notification required under this section.  The policy must authorize the notification to be given verbally by a physician or facility personnel.

(d)  The DNAR order takes effect at the time it is written in the patient’s chart or otherwise placed in the patient’s medical record.

Prisoners at Guantanamo are apparently on a hunger strike, requiring forced-feeding to keep them alive. And that has some in high dudgeon, with the New York Times  aiding the prisoners’ cause (of course!) by publishing an op/ed essay in which one inmate purports to describe the physical ordeal forced feeding causes and to plead for his release. 

Hunger strikes are a time-honored way of getting attention to a cause.  But a hunger strike does not arise in a vacuum, and the question becomes whether authorities have to cooperate by allowing prisoners to starve themselves to death.  Many among the Medical Establishment say it is wrong to force-feed prisoners on a hunger strike because it purportedly violates their right to “refuse treatment.” From an open letter signed by 250 doctors published in The Lancet in 2006:

Fundamental to doctors’ responsibilities in attending a hunger striker is the recognition that prisoners have a right to refuse treatment. The UK government has respected this right even under very difficult circumstances and allowed Irish hunger strikers to die. Physicians do not have to agree with the prisoner, but they must respect their informed decision.

This is more of a political argument, I think, than one truly steeped in medical ethics.

Inmate hunger strikers aren’t cases in which medical treatment is refused for a true medical malady–which should usually be permitted in prison settings, even if prisoners’ autonomy have limits. Rather, they are trying to commit slow motion suicide as a tactical tool to obtain a political benefit. They are self-harming. Why should doctors be ethically required to be complicit by just standing aside and letting the prisoners harm their health or die, or indeed, make it easier by offering palliation?  

Look at it this way: If an inmate hanged himself and the guards could save him, should they instead stand back and let him swing?  Should doctors refuse to resuscitate a self-hanged prisoner because he clearly “wanted to die” or left a note refusing treatment?  Or, if prisoners decided to bash their heads repeatedly into a wall as a means of protest, should officials be prevented from restraining them and doctors be ethically prohibited from staunching the bleeding and binding up their wounds?  Of course not.

If that is true, the same rules apply to hunger strikes when they reach the point of health/life endangerment. 

One of the perks of what I do is becoming friends with some of the great thinkers of our time, and one of those is Leon Kass. Kass is the reigning intellectual champion for upholding intrinsic human dignity. He also served splendidly for about six years as the chairman of the President’s Council on Bioethics–receiving undeserved brickbats from the bioethical Left–despite, or perhaps better stated, because of–the Council’s incredibly good analytical work about the vexing bioethical issues of our time, including cloning, the definition of death, and the transhumanist impulse, among other issues.

Kass was recently interviewed by the Wall Street Journal. It is worth reading the whole thing, and one can see that he is no two-dimensional thinker falling lockstep into a specific ideological pigeon hole.

I thought two parts of the interview are particularly interesting for people interested in human exceptionalism. First, Kass revisits his idea of the “Wisdom of Repugnance,” first published in The New Republic (and well worth your time reading). From, “Leon Kass: The Meaning of the Gosnell Trial:”

These and other appalling details of the Gosnell trial elicit reactions that might be called revulsion or disgust or horror. The word that eminent bioethicist and physician Leon Kass prefers is “repugnance.” This intense human reaction reflects a sort of deep moral intuition, he says, and it is one that deserves much more serious consideration than our too-sophisticated culture allows.

“As pain is to the body so repugnance is to the soul,” Dr. Kass says as we sit down for an interview in his book-lined office at the American Enterprise Institute, where he is the Madden-Jewett Scholar. “So too with anger and compassion. Repugnance is some kind of wake-up call that there is something untoward going on and attention must be paid. These passions are not simply irrational. They contain within them the germ of insight. You cannot give proper verbal account of the horror of evil, yet a culture that couldn’t be absolutely horrified by such things is dead.”

Kass’s less intellectually endowed critics laughed at the “Wisdom of Repugnance,” claiming that revulsion isn’t an “argument.” Kass never said it was. But it is a human way of alerting us that something could be–not necessarily is–very wrong. And what is the alternative to being alert to the inner voice? Moral relativism and terminal non judgmentalism, which too often amount to the eschewing of morality.  

Kass also takes acute aim at scientism:

“Unlike questions of segregation and, before it, slavery, where evil was clear and the only question was how to deal with it,” Dr. Kass says, “the evils that I saw close to my own area of work were ones that were embedded in very high-minded pursuits: better health, peace of mind and the conquest of nature. Yet they contained within them the seeds of our own degradation.” The trouble wasn’t so much with science itself, he thought, as with “scientism,” by which he means “a quasi-religious faith that scientific knowledge is the only knowledge worthy of the name; that scientific knowledge gives you an exhaustive account of the way things are; and that science will transcend all the limitations of our human condition, all of our miseries.” Scientism’s primary goal, Dr. Kass says, “is to put the final nail in the rule of revealed religion. But scientism also hits traditional, humanistic understandings of the special place of the human being, of the importance of soul, of inwardness and purposiveness.”

The idea that materialism “can cure men of the fear of God and the fear of death,” as Dr. Kass puts it, is at least as old as ancient Greece. But today it has become especially potent thanks to “the new genetics, which bore more deeply than ever before into the molecular basis of living processes.” Then there is the rise of neuroscience and evolutionary psychology, which purport to explain absolutely everything about human life in materialistic terms.

Such subversion of human exceptionalism is a dangerous game. But I am convinced that human dignity is the hill that can be defended successfully against the would-be new eugenicists. People just need to be awakened to the threat that this way comes. I just wish I were half as articulate as Leon Kass in raising the alarm. 

There’s gold in them thar hills! Ounce for ounce, human eggs are probably the most valuable commodity on the planet, with highly intelligent and beautiful university women offered $50,000 or more for their ova for use in eugenic IVF. 

If–or better stated, when–human cloning is successfully accomplished, the egg demand will go vertical. Each cloning attempt requires an enucleated human egg in which to place genetic material, in a process called somatic cell nuclear transfer. SCNT is the essential technology to develop the Brave New World technologies such as genetic engineering. 

All of this threatens to commodify women as egg suppliers for a fee. Destitute women from the developing world are already being so exploited. Pending California legislation would, in fact, open the door to an egg market for use in biotech–currently not allowed–which makes me think cloning is very close. (The way these guys work is to be cool with prohibiting things they don’t yet need or can’t yet do–until they need or can do it–as a way to keep a wary public quiet.)

I get into this–and the very real health hazards for women who allow their eggs to be harvested–such as loss of fecundity and in rare cases, death–over at my biweekly First Things column. Here’s my conclusion:

It used to be that women’s bodies were primarily objectified for sexual services. If we are not careful, we will soon add their procreative substances and reproductive capacities to that sorry list. Caveat venditor.

Seller beware, indeed.

Assisted suicide is not about terminal illness. It is about creating a legal right to be made dead. In the USA, this agenda is more hidden than elsewhere, but anyone with eyes to see can discern that truth.

Latest example in the UK where a paralyzed man has sued to create a right to assisted suicide. From The Guardian story:

A paralysed builder who has required round-the-clock care since a car accident 23 years ago has applied to the high court to be allowed to die with the help of a doctor, carrying on the legal fight begun by another seriously disabled man last year. Paul Lamb, 57, has taken on the case brought by Tony Nicklinson, a sufferer of “locked-in syndrome” who died last year, a week after losing his high court euthanasia battle…

On 13 March this year, a high court judge agreed to let Lamb take over Nicklinson’s appeal. This week the court agreed that Lamb could be named publicly after he told them he was ready to die. “I cannot carry on as all that my life consists of is being fed and watered,” he said in a witness statement. He needed help to end his life, he said: “I am simply not in a position to take tablets, jump off a tall building, hang myself, throw myself in front of a moving train.” His case will be joined to another brought by Jane Nicklinson, appealing against the judgment that condemned her husband to a life he no longer wanted to lead.

That last comment, which I italicized, is an example of truth in advertising: The real issue in the euthanasia/assisted suicide debate is whether anyone–even minors–with a sustained desire to die should have access to assistance, either through a lethal prescription, a lethal injection, or a suicide clinic. That is the debate we should be having. Anything else is tactical subterfuge.

Sometimes it is as if hospice never happened. People now often die at home, surrounded by loved ones, without heroic efforts forced upon the dying to keep them alive. Yet, those who want to have a “conversation” about death and increase “options” (wink, wink) talk as if people are still forced to be hooked up to ICU machines against their will, when the real problem these days–thanks to changes in the economics of medicine–is getting the machines when you want them. 

I bring this up because the LA Times ran a big story about a group that converses about death. From the story:

The way we die is about to change, Burzynski says. He’s convinced of it. Aging baby boomers will demand better options, and they know how to get things done. His mother, he says, grew up in a village. As a girl, she helped wash and lay out the bodies of the dead. Most deaths used to be at home, he says. Now that’s rare.”We all want to make a good death. If you ask anybody, ‘How do you want to die?’ they’ll say, ‘In the bosom of my family, with my friends around.’ They don’t say, ‘In a hospital bed with tubes coming out of my nose and my ears, in a semi-coma � that’s my perfect death.’”

Sigh. In fact, the number of hospital deaths is shrinking and the number of home deaths is growing–now, nearly 30%. Many die in nursing homes, it is true, but that is because many morbidly infirm elderly live in skilled nursing or assisted living facilities. But only about 20% of people die in ICUs, and often that is because of serious accidents, violent acts, or sudden illnesses, certainly not forced efforts to keep a dying person alive against their will.  

So, if we are going to have a “conversation” about death, and it is going to be reported in a major metropolitan newspaper, let’s at least get the facts straight.

Human cloning is in the wind! Researchers are working diligently to learn how to accomplish such asexual reproduction, as can now be done in many animals, including monkeys. Once that happens, expect the debate over the legality and ethics of  humancloning to make the embryonic stem cell brouhaha seem like a playful snowball fight.

Cloning of the kind used to make Dolly the sheep, known as somatic cell nuclear transfer, requires one human egg per try. But human eggs (oocytes) are in very short supply. This “egg dearth” (as I call it), has hobbled the bioethic industry from successfully cloning human embryos. I have predicted that will soon change, and now–fueling my suspicion–new California legislation has been filed to permit payment by researchers to women for undergoing egg extraction–which can cost them their health, fecundity, even their lives.

First, the prices paid would be set by the researchers: From AB 926:

(j) This bill will reverse the current ban on compensation for women providing human oocytes for research. Compensation amounts will be determined by human subject research panels and institutional review boards.

Not only that, but IVF clinics will be given a financial incentive to extract eggs or create embryos in excess of need. The bill would permit the set price to be waived if the eggs or embryos came from qualified IVF clinics:

If a woman providing human oocytes for the purposes of fertility is compensated, and any human oocytes or embryos in excess of those needed for fertility are offered for research, the institutional review board shall disregard the amount of compensation if all of the following conditions are met:

(a) The clinic performing oocyte retrieval is a member of the Society for Assisted Reproductive Technology.

(b) The procurement and disposition for research purposes of human oocytes initially provided for reproductive uses, either for use by the donor or another woman, shall not knowingly compromise the optimal reproductive success of the woman in the infertility treatment.

(c) The infertility treatment protocol is established prior to requesting or obtaining consent for donation for research purposes and the prospect of donation for research does not alter the timing, method, or procedures selected for clinical care. 

(d) The woman in infertility treatment makes the determination that she does not want or need the oocytes for her own reproductive success.

(e) The donation of oocytes for research is done without valuable consideration as defined in Section 125350.

I can’t figure out whether the women would have to consent to using their eggs and embryos in research, or whether they or the clinic would receive the money. But this I do know: Women are being objectified for their procreative body parts, and nascent human life is increasingly being looked upon as a natural resource akin to a copper mine or prize cattle herd. Human objectification is culture changing. We trod down this path at our moral peril.

There is a paranoid article in the Topeka Capital Journal asserting that “haters” of IVF may have the practice “in the crosshairs,” not because any legislative proposals have actually been filed or proposed, but because of the new Kansas law that symbolically states that human life begins at fertilization. (Isn’t it funny how the “pro science” side bridles so often at accurate biological science?)

In any event, I hope it is. No, I don’t want it “banned,” which the article implies is in the wind, but regulated properly. Beyond statistical issues, IVF is almost wholly unregulated in this country. That needs to change, considering the many important ethical issues at stake, including:

• Informed consent requirements for egg donors, a process that can be dangerous to health and life.
• The practice of buying eggs from women, which ounce-for-ounce, may be the most valuable commodity in the world.  If human cloning is ever achieved, tens of thousands of eggs will be needed to perfect the technology, only making matters worse.
• Paid surrogacy, which can exploit poor women;
• The dehumanization of surrogates into “gestational carriers,” and the emotional impact of surrogacy on the women who give birth.
• Biological colonialism, using destitute women in the developing world for procreative purposes.
• Eugenic embryo selection, including for sex selection or to be disabled;
• The potential to make “three parent” babies;
• The potential for genetic engineering of embryos;
• The creation of hundreds of thousands of “extra” embryos that are either frozen, destroyed, or used as a natural resource in research;
• Embryo selling;
• Embryo adoption; 
• Whether IVF should be paid by health insurance or government benefits for the infertile;
• Whether gay and lesbian couples should have paid access to IVF even if fecund;
• Using IVF to make “anchor babies” who are U.S. citizens.

Despite these (and other) issues, any attempt to regulate the field are throttled a’borning by the rich industry that uses its big financial war chest and the intense emotionalism around childbearing to remain powers onto themselves.

This story demonstrates both the tremendous potential of ethical biotechnology and the continuing need for using animals in scientific research. A rat kidney has been built from “adult” cells and successfully transplanted into an animal. From The Guardian story:

Scientists have grown a kidney in a laboratory and shown that it works when implanted into a living animal. The work is an important step towards the longer-term goal of growing personalised replacement organs that could be transplanted into people with kidney failure…Finding a new source of replacement organs that could be grown using the patient’s own cells and that could last a lifetime would, therefore, be a big leap forward.

In the latest work, Harald Ott of Massachusetts General hospital led a team of scientists who grew a kidney by using an experimental technique that has previously been used to create working hearts, lungs and livers. Ott first took a rat kidney and stripped out its functional cells using a solution of detergent. That left behind a white cellular matrix, the collagen scaffold that gives the organ its three-dimensional structure. His team then introduced kidney and blood vessel cells from newborn rats onto the scaffold and cultured the growing organs for 12 days, until the cells had grown to cover the scaffold. The team then implanted the organ into a living rat, where it successfully filtered the animal’s blood and produced urine. 

There’s still a long way to go, of course. But whatever happened to embryonic stem cells being the “only  hope?”

According to Ott, further refinement of the technique would be needed, but it could lead to bioengineered kidneys one day replacing diseased or damaged kidneys in the same way that donor kidneys via transplant do now. Ideally, the engineered kidneys would be grown from a patient’s own cells, thereby removing the need for the patient to take immunosuppressant drugs for the rest of their lives.

Note that none of this would be possible if animal rightists got their way and banned the use of lab animals. And it disproves their oft-stated lie that animal research offers no human benefits. 

As history shows, human subject research is fraught the potential for terrible abuse, requiring strong government regulation and oversight. This is particularly true when the people being experimented upon are vulnerable or desperate. Now, the government has accused scientists at several universities of failing to disclose the dangers of research on premature babies. From the New York Times story:

A federal agency has found that a number of prestigious universities failed to tell more than a thousand families in a government-financed study of oxygen levels for extremely premature babies that the risks could include increased chances of blindness or death…

The letter said that “the researchers had sufficient available information to know, before conducting the study, that participation might lead to differences in whether an infant survived, or developed blindness, in comparison to what might have happened to a child had that child not been enrolled in the study.” The risk the consent form did mention was far less significant: abrasion of the infants’ skin by an oxygen monitoring device. It also said there was a possible benefit to participating — a decreased need for eye surgery depending on the group the infant was assigned to.

This still remains an accusation, not a final determination of misconduct. But good on the government for staying on top of this. The trust of the people in the research enterprise depends on maintaining good ethics, most particularly when the subjects are vulnerable human beings with consent obtained from parents desperate to help their critically ill baby. 

For Baby Boomers–my profoundly disappointing generation–it has always been about us. And now, according to Ray Kurzweil, inventor extraordinaire, some of us may live forever. 

Yes, he’s on again about human immortality. From the story in the Wall Street Journal:

“I’m right on the cusp,” he adds. “I think some of us will make it through”—he means baby boomers, who can hope to experience practical immortality if they hang on for another 15 years. By then, Mr. Kurzweil expects medical technology to be adding a year of life expectancy every year. We will start to outrun our own deaths. And then the wonders really begin. The little computers in our hands that now give us access to all the world’s information via the Web will become little computers in our brains giving us access to all the world’s information. Our world will become a world of near-infinite, virtual possibilities…

We will have vast new brainpower at our disposal; we’ll also have a vast new field in which to operate—virtual reality. “As you go out to the 2040s, now the bulk of our thinking is out in the cloud. The biological portion of our brain didn’t go away but the nonbiological portion will be much more powerful. And it will be uploaded automatically the way we back up everything now that’s digital.”

“When the hardware crashes,” he says of humanity’s current condition, “the software dies with it. We take that for granted as human beings.” But when most of our intelligence, experience and identity live in cyberspace, in some sense (vital words when thinking about Kurzweil predictions) we will become software and the hardware will be replaceable.

I don’t believe it for a minute, and living in Google’s “do no evil” cloud raises some profound dictatorial possibilities.

But consider the utter selfishness of the thing. If we stopped dying, we would also have to stop birthing. Rather than making the world a better place for our posterity, we will throttle the future and be constantly looking for new ways to entertain ourselves, because it can get pretty boring living forever. Heck, that’s a problem now in the decadent West. Children still die of measles in Africa and some of the richest people in the history, blessed with tremendously inventive minds, look in the mirror and think the most important thing in the world is that they never die. 

Kurzweil tells the reporter that he has good ideas about how to cure cancer. But he isn’t going to hop on that project unless he gets diagnosed. Then he’ll drop his current toys and set about developing the treatments. That is very telling. The immortality project is high tech Baby Boomer narcissism. Nothing more. 

I have been warning for several years that many in bioethics and the organ transplant community hope to legalize killing for organs, that is, taking organs from the living. The latest example comes in the Cambridge Quarterly of Healthcare Ethics by Canadian philosophy professor (of course!) Walter Glannon. 

It’s a long article and I don’t have space here to deal with every aspect. But a few points: First, he claims that all decisions about organ donation and the treatment of patients are kept strictly segregated.  From, “The Moral Insignificance of Death in Organ Donation:”

All transplant policies and protocols require that decisions about withdrawal of life-sustaining treatment be separated from decisions about organ donation,procurement, and transplantation. This prevents a conflict of duty for critical care teams, whose primary duty is to provide appropriate care to critically ill patients,as well as for transplant teams, whose primary duty is to patients with organ failure who need a transplant. Separating these decisions and duties minimizes the risk of compromising the care of critically ill patients and prevents treating them instrumentally as nothing more than a source of transplantable organs.

I thought that was true, too. But as I posted about yesterday, the Organ Procurement and Transplantation Network permits discussion of organ donation to occur before the decision to withdraw life support.

Glannon claims that death is morally insignificant in procuring organs.

Many will emphasize that organ procurement before a declaration of death would be killing. But organ procurement causing death is not necessarily harmful to an organ donor. A donor may be beyond experiential harm before the permanent cessation of all brain or circulatory functions if he or she lacks the neurological and psychological capacity to be harmed. Moreover, donors may be the subject of nonexperiential harm if ischemia [organ decay] defeats their interest in donating their organs…

What matters is not that the donor is or is not dead, or when death is declared, but that the donor or a surrogate consents, that the donor has an irreversible condition with no hope of meaningful recovery, that procurement does not cause the donor to experience pain and suffering, and that the donor’s intention is realized in a successful transplant. These conditions are consistent with the principles of respect for patient autonomy and physician nonmaleficence. None of these conditions requires that donors be dead before organ procurement can proceed.

A lot of water can flow under the “meaningful recovery” bridge.” And as Glannon writes, the pain free part can be accomplished through anesthesia.

I wish Glannon were a lone wolf in this kind of thinking. Alas, as I have written elsewhere, such articles are becoming ubiquitous. But here’s the thing: I can’t think of a better way to undermine public support for organ transplant medicine than to permit killing for organs. Not only is this kind of advocacy foolhardy, but it would have the transplant community break solemn public policy promises made to gain support from a public wary of the entire enterprise. 

The Montana Supreme Court issued a muddled decision a few years ago ruling that assisted suicide was not against the public policy of the state under the law that deals with advance directives. That didn’t actually legalize doctor-prescribed suicide, but left the state of the law in a big mess.

Now, HB 505 is being debated in the Montana House that may formally outlaw the act in the state. Some are upset that the law could result in physicians who assist suicides being jailed–as if that is a radical notion. Such is the law today in most states. The real radical notion is that assisting suicide should be considered a medical act. 

For more information, here’s the Montanans Against Assisted Suicide Website.

There are two protocols for donating vital organs after death. One involves brain death, and one involves removing life support, waiting for cardiac arrest, and then procuring organs after a few minutes.

This post deals with the latter. I have always thought that the organ procurement administrative processes were kept strictly segregated from decision making about whether to end life support. Apparently, I was mistaken. A reader sent me a 2012 discussion of protocols by the Organ Procurement and Transplantation Network (OPTN), in which the Organ Procurement Organization Comittee is asked to clarify the model rules for obtaining organs from a non heart-beating donor. First, the request as set forth in the report:

Explicitly endorse in the Proposal the longstanding ethical safeguard that the donor family not be approached about organ donation until the time at which a decision to withdraw life sustaining measures has been agreed to by the patient’s next of kin, as recommended by the Institute of Medicine. The proposed Requirements remove the important stipulation separating patient care from donation solicitations. Whereas previously the hospital’s primary healthcare team and the legal next of kin must have decided to withdraw ventilated support or other life-sustaining treatment before the patient is evaluated as a DCD candidate, under the proposed policy a patient may be evaluated as a DCD candidate prior to a decision by family members and caregivers, which ought to be free from external pressure. Gone is the crucial wall separating patient care from donation solicitations. Such undue influence on difficult decisions at a heart-wrenching time is ethically unacceptable.

That seems absolutely right to me, indeed, essential if we are to maintain proper ethics and sensitivity–and most particularly–family trust. After all, we don’t want anyone thinking about catastrophically ill or injured patients as organ systems rather than as patients.

And now, the chilling answer from the Committee:

The OPO Committee disagrees with the position that a patient may not be evaluated as a DCD candidate prior to a decision by family members and caregivers to withdraw life sustaining measures, or the position that a donor family not be approached about organ donation until the time at which a decision to withdraw life sustaining measures have been agreed to…The timely referral of a potential organ donor occurs prior to family knowledge of donation options for two primary purposes: 1) the evaluation of a patient as a potential organ donor can be facilitated without OPO communication with the family, and 2) the patient may have already been registered as an organ donor, which requires no further authorization by a surviving family or caregiver.

By not allowing for an OPO’s evaluation for donor candidacy prior to a decision to withdrawal, the health care system may expose families to the following misrepresentations: 1) to imply that their loved one is not a donor candidate, when in fact they might be a candidate; 2) to cause a delay in carrying out patient withdrawal procedures as agreed to by a surviving family, but prior to OPO involvement (The 2006 version of the UAGA allows for an OPO to “conduct any reasonable examination necessary to ensure the medical suitability.” The UAGA has been enacted in 44 of 50 states and legislation pending in three states;

Yowee!

HT: B.A. Olevitch