Cloning

So, it has begun.

Or at least, sort of. Those clever people at Harvard are proceeding directly against the wishes of Mr. Bush and they are starting to clone human stem cells.

This is a link to the CBC story: http://www.cbc.ca/story/science/national/2006/06/06/stem-cells.html?ref=rss

This is a link to the BBC story: http://news.bbc.co.uk/2/hi/health/5056554.stm

This is a link to the Harvard Stem Cell Institute: http://stemcell.harvard.edu/index.jsp

So how do we feel about cloning? This particular project will not actually produce cloned individual humans. They are cloning human stem cells (or at least, that is what the stated goal is). There is a big difference.

For today's purposes, let's take them at their word and assume that they're just going to clone stem cells. Why is Mr. Bush so against this? He has apparently banned the use of federal funds for research in this area. What harm could there possibly be in cloning human stem cells?

First and foremost, stem cells are essentially the building blocks of the human body. These cells are the precursors to all of the other cells in the body so theoretically, any type of tissue can be grown from stem cells. That's why hospitals are saving babies' stem cells now; so that in case the child ever needs something in the future (blood, bone marrow, a new liver etc.) they will have their own stem cells available from which to grow the potential tissue.

Theoretically, this will eliminate the need for donor organs; or at least reduce the need. I don't mean tomorrow, I mean in the long term. Being able to grow new organs for replacement when the original ones give out will also mean that there will be a much greater chance of those organs being compatible and not being rejected by the rest of the body. Think of the lives this technology and skill will be able to save. At the very least, think about skin grafts. How many burn patients could be helped using grafts grown from stem cells and their DNA? Where is the harm in that?

Some people automatically look to the negative. They are the 'glass is half empty' type of people that we typically call pessimists. Others, like me, automatically look at the positives that are to be found. Strangely enough (I know, some of you may find this hard to believe) I am an optimist. I think that while there will almost always be moral quandaries, we cannot allow fear to hold us back from learning all that we can. I do not believe that we should allow a narrow view to hem in or create boundaries for science and our body of knowledge.

Yes, there will be negatives. Yes, there are possible harms; there almost always are. However, if the potential benefits outweigh the potential harms, then I don't think that we should hold ourselves back simply because there may be harm. There will always be people who will bring up the negatives. And there will always be people who will try to take advantage of any situation that they can. That is an unfortunate side effect of our current society. I don't want to come down too hard on capitalism (because once again, I don't have a better option at my fingertips), but some of the bigger moral dilemmas would arise from the gap between the haves and the have-nots and the distribution of the available technologies / services.

For example this technology is being developed in the US, using private funding at a private university. They do not support the idea of socialized or universal health care in the US. I doubt very much that the people who are funding this research are really doing so solely for the good of humankind. Not that one can ever truly know another's motivation, but certainly those funding the research will own any patents that will result from it and will profit from being the first across the line. The actual scientists will gain fame and acclaim and perhaps a certain degree of personal profit as well, and certainly there will be some amount of rigorous testing (any medical procedures require testing) which involves volunteers and double blind experiments etc. However, once the procedures are tried, tested and true, they will be offered to patients at a cost.

To begin with, how many of us have our stem cell blood available? Well, we don't, but some of our children do. But whose children do? In the GTA (greater Toronto area) there are some hospitals that offer the service for an initial harvesting fee then a yearly storage fee. This is in Canada, the land of universal health care. So, if you're not a yuppie, don't understand what the potential benefits of stem cell blood may be, or just can't afford the extra expenditure (which is relatively reasonable, less than most people spend on coffee in a year I believe), then you are excluded from this service. At least in the GTA. In Calgary or Edmonton (please forgive me for not remembering which) the hospitals have created a stem cell blood bank. Apparently, they harvest the stem cell blood from every birth at the hospitals and store it (they don't ask for permission and they don't charge) so that it can be used when and where needed. This resonates more with the universal health care chords in my head, except that your child's contribution is taken without your permission and may be used randomly, also without consent.

But I digress slightly. The moral issue I was intending to raise was the dilemma regarding distribution of services. It's one thing in Canada where we're saving our own stem cells, but what they're doing at Harvard is going to enable people to use stem cells to replicate anyone's cells. They will, theoretically, be able to remove the DNA from the donor stem cells and replace it with the DNA of the person who needs the new liver (for instance). Then the stem cells will generate a new liver according to the DNA of the intended recipient. It will be a clone (so to speak) of the person's original liver. So, the problem will arise in places like the US of A, where people will maybe not have to wait on lists for someone with compatible organs to die and have their loved ones consent to donate them. They will simply have to cough up a certain amount of money and wait for a new liver to grow in a lab somewhere. Then they can have their life-saving surgery. A person of lesser means on the other hand, may still have to wait for a donated organ. Once again, the haves will benefit and the have-nots will not.

Is this ethical? Well, I guess that depends on your basis of measurement, but my answer is no. Does that mean that I think the people at Harvard (or anywhere else) should stop their research until we can solve all of these possible moral dilemmas? Again, my answer is no. Some good will come of this. Some 'not so good' will also come along as well. We have to be prepared to deal with the bad along with the good, and we can't let the 'bad' prevent us from doing good.

Clearly there is a lot more to this subject, but that's all I have time for right now peeps.

a bientot,

Hippocrates & Hypocrisy

Hi,

I can't sleep again, so I thought I would keep myself occupied by scribbling a little.

To further develop the train of thought I last hopped on, I thought I might discuss the role that doctors can/should/do play in this whole jumble we call life. First and foremost, it is a physician's responsibility to 'do no harm'. That is basically what the Hippocratic oath is. They take an oath to not hurt people. Beyond that, the rest is gravy.

Seems simple enough right? Unfortunately nothing is simple when it comes to abortion. The first question here is what constitutes harm? Then, harm to whom? Then, how to weight harms? Who decides the answers to these questions? On what basis are those decisions made?

Not so simple anymore...

So what constitutes harm? The new legislation passed in South Dakota makes it a felony for a doctor to perform an abortion unless the pregnant woman's life is in danger. Whether you are pro-life or pro-choice, you have to stipulate that a law which prohibits doctors from acting in the best interests of their patients on an individual basis is one which prevents them from upholding their oath to do no harm. You may argue that an abortion is harming a fetus, but not performing an abortion on an unwanted pregancy is also doing harm; perhaps not as dramatic, but harm nonetheless. It is refusing the woman's right to self-determination.

So let's get back to our doctors' role in this mess. What's a doctor in South Dakota to do? Or better yet, what's a doctor in El Salvador to do? If a woman is admitted to hospital and a doctor suspects her of having had an abortion, that doctor is supposed to report her to the police. Not only is that a breach of what we would consider doctor patient confidentiality, it would most likely lead directly to harm. So, a doctor in a place where abortion is a felony finds herself stuck between a rock and a hard place: obey the law or uphold the Hippocratic oath.

If a woman and her physician decide that the right course of action is an abortion, then that should be the result. A doctor should not face criminal charges for helping patients. Pierre Trudeau once said that the government had no place inside the bedrooms of the citizens of the nation (or something to that effect). I don't believe that the government has any right to be inside the doctors' offices of its citizens either. I'm not suggesting that doctors are infallible; they are human, and thus, prone to err. However, we can't expect them to excel when we won't even let them uphold the basic oaths of their office. Abortion is not always the answer, but neither is abstinence; clearly. This situation is complicated enough without the threat of jail time.

One of the articles I read quoted a woman (an American who worked for Planned Parenthood) who said something to the effect that Republicans only cared about protecting life until birth. After that, they didn't care about the child anymore. I'd never seen that written or heard it said that way before, but it seems so true. Where are all the pro-life protesters when the unwanted children are abandoned and become part of the foster system? Where is all the love and respect for the child after she is born and becomes neglected?

I think that's probably enough of my rant for today.

Ciao ciao,
Lesle

Felonies & Pharmacology

Greetings from sunny Toronto!

I've been reading lately about the recent passing of legislation in South Dakota which "makes it a felony for doctors to perform any abortion, except to save the life of a pregnant woman." So, if the mother's health is at risk, they still can't have an abortion, they have to wait until she's about to die. Even in the case of rape and incest, this legislation would make abortion a felony. The doctor would (theoretically) face jail time.

The purpose of this legislation is to challenge Roe v. Wade in the Supreme Court of the US now that there are two new Justices sitting who were appointed by President Bush (and are theoretically pro-life).

This situation has sparked quite a debate and prompted me (among many others I'm sure) to start looking into the frightening possibilities. This is not the only state in the union that has taken a step down this path. Clearly, there is a large contingent of 'The Moral Majority' that would still like to control women and what we do with our bodies. If not South Dakota, then Ohio, Georgia, Indiana or Tennessee (similar bills are in the works there).

Whilst I was surfing the web looking into this, I found some articles about abortion bans in other countries... the ones in latin America. The ones that are almost entirely Catholic. They can't have abortions there either. In El Salvador, for example, doctors can't even perform an abortion if a woman has an ectopic pregnancy until the fetus is no longer viable (for anyone who doesn't know, an ectopic pregancy is what they call it when a fertilized egg attaches itself somewhere outside the womb, and the embryo / fetus is 'viable' until just before the mother starts hemorrhaging). In El Salvador, if a woman has a late-stage abortion, she can be charged with aggravated homicide and the minimum sentence for that is 30 years (the maximum is 50 years). If they catch the doctors, they would be charged also. (I wonder how long rapists get?)

It's possible that some of you may not have a position on the pro-life / pro-choice debate. It's possible that some of you may be pro-life. Either way, I'm about to sound a little bit feminist again... I think my position is probably pretty clear.

Has it ever occurred to you that several of the 'hot-button' feminist issues are directly related to women's bodies and our control over them?

I am not a 'conspiracy theorist feminist' and I do not think that men have deliberately conspired over the ages to keep us oppressed and 'all men are evil' and all that stuff, but think about it for a minute or two; abortion, prostitution, pornography. Three things that you should not bring up in polite conversation at the dinner table; they all have to do with women's bodies, and yet none of them are controlled (completely) by us. We've never been in charge when it comes to prostitution or pornography, but it wouldn't exist without our bodies. What would they do without us?

And even though we think we've won the abortion debate, they keep wanting to open it up again. I know that not all men want to control women. And I know that not all women are pro-choice. However, for those of us who are in Canada and are now being governed by Stephen Harper and his former Alliance cronies (sorry Owen), this is just a little reminder that this debate is not closed. There is a Minister in this Cabinet who has very publicly stated that he does not believe in evolution. Yes, there are former Progressive Conservative members governing us as well, but there is nothing stopping any of them from introducing a private members' bill.

This debate is not over. Unfortunately.

The one bright light is that pharmacology is getting better. Soon, we may be better able to provide women with the means to terminate unwanted pregancies that will not risk their lives in botched back alley-style abortions. Because the bottom line is: just because it's illegal doesn't mean it's going to stop.

I'm thinking that there will be more to this particular train of thought, but not at the moment. I gotta book.

Ciao for now,
Lesle

ps - Happy Birthday to my nephew John! He's 14 today!