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NPR discusses sex selection
Posted by Parita Shah on December 22nd, 2006
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It seems that sex selection makes its way into headlines as frequently as stem cell research nowadays. In many countries, particularly in Asia, the issue is in the political forefront. In the US it makes it as far as the media but still remains on the backburner in the policy and political worlds. Pre-implantation Genetic Diagnosis (PGD), one of the technologies used to perform sex selection is offered widely in the US. For now, there are only guidelines set by the American Society for Reproductive Medicine (ASRM) for non-medical uses of PGD, though clinics around the country are allowing parents to choose the sex of their child anyway. The stories about Indian immigrants in the US taking advantage of this troubling technology are particularly interesting. Check out what Sujatha Jesudason (CGS program director) has to say about this on an "All Things Considered" series on NPR.
Related: In India this week, a debate was underway about what impact sex selection has had on the country's female population.
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| Cloning concerns from a stem cell researcher
Posted by Jesse Reynolds on December 20th, 2006
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 | | Austin Smith |
Research cloning is a peculiar beast. Although its utility and necessity as a component of regenerative medicine is uncertain, research advocates are generally willing to "go to the mat" in its defense. It's not been proven in animal models, it raises more concerns than stem cell research with leftover IVF embryos, and it arouses greater opposition among the public. Are the advocates just unwilling to take anything off the table? Or do they feel a need to close their ranks? Are they overextending themselves? Or is there a bevy of unpublished data supporting its utility?
Some scientists, though, are open with their skepticism towards the use of cloning techniques in stem cell research. The latest is embryonic stem cell researcher Austin Smith, the Director of the Wellcome Trust Centre for Stem Cell Research and "one of Britain's most respected experts in the field." He stated that, "Its prominence is out of proportion to the significance of what's being done, and there are real question marks about whether it has any utility at all."
Read the full article at The Times (London).
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| Slippery When Wet
Posted by Osagie K. Obasogie on December 15th, 2006
| Between Iran’s Holocaust-questioning conference, the New York Timesarticle on disabled parents designing babies with disabilities matching their own, and Armand Marie Leroi’s controversial article on eliminating fetuses with undesirable traits, eugenics seems to be the soup de jour on many people’s menus these days.
The prestigious Journal of the American Medical Association (JAMA) is also serving this particular dish, albeit with a side order of subtlety. This week’s issue features an article encouraging the use of preimplantation genetic diagnosis (PGD) for screening out embryos genetically inclined towards developing cancer. After noting that a growing number of cancers have been associated with more than 30 gene mutations, the authors conclude
men and women at hereditary risk for cancer can take advantage of the potential of assisted reproduction, including PGD, to decrease the psychological burdens imposed by these diseases, by threat or occurrence, from one generation to the next.
PGD was initially developed to allow parents to avoid having children with early-onset diseases that are genetically determined, almost certain to occur, and dramatically diminish life expectancy. Tay-Sachs is a prime example. But this JAMA article highlights how new arguments are being put forth to expand the use of screening technologies to exclude embryos with genetic predispositions for often treatable adult-onset diseases that are not simply hereditary or sure to happen, but are complicated by environmental influences and lifestyle choices.
While understated, this article reflects an extraordinary shift in how we think about reproductive technologies’ appropriate use as well as their social impact. And rather than being an isolated incidence of biomedical overreaching, there are other prominent examples of how this approach is taking hold in the medical community.
Lowering the PGD bar seems to be, as Slate’s Will Saletan puts it, a “gentle descent towards eugenics” where medicine’s role becomes controlling the types of people born rather than helping individuals manage the medical risks we all have at some level. Even more troublesome, it’s only a small yet slippery slide down the slope to future understandings of “risk” that conflate social and medical determinants; after all, people with genes for blond hair and blue eyes seem to lead “healthier” and “better” lives. Not exactly Hippocrates’ vision of modern medicine.
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| Should we rely on a "culture of compliance?"
Posted by Jesse Reynolds on December 14th, 2006
| Billions of dollars in public subsidies for anything should be managed in a way that's accountable and transparent. But the enabling law [PDF] for California's $3 billion stem cell research program creates neither accountability nor transparency. Meanwhile, the repeated message from the research agency has been, "Trust us. We're scientists."
Stem cell research, and especially the use of cloning techniques in it, raises a host of concerns beyond the moral status of the embryo, so the research standards are critical. But the staff member at the stem cell research agency responsible for the standards, Geoff Lomax, used this message again:
Lomax said the key to successfully pursuing stem cell research lies in effective oversight of the program and developing "a culture of compliance" among scientists engaged in it. We've long advocated for "effective oversight," but neither the stem cell research agency nor the institutionally-affiliated committees that it asks to approve each research project are accountable to anyone else. While a "culture of compliance" sounds good, that's another way to say "trust us." And I don't trust self-regulation.
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