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IVF and Birth Defects: Is there a Moral Problem?

21 May, 12 | by Iain Brassington

It was reported a couple of weeks ago that researchers had found a link between certain forms of assisted conception and an increased risk of birth defects.  The paper, published in the NEJM, suggested that ICSI (intra-cytoplasmic sperm injection) correlated with defets in just about 10% of births.  The base rate is about 5.8%, rising to around a 7.2% defect rate from IVF.

Does this tell us anything of any great moral import?

Several things spring to mind.  One is that, granted the claim that it’s better not to be born with a defect, it’s presumably also better for assisted reproduction not to elevate the risk of defects above the natural level.  There might even be an obligation to do more research into assisted reproduction, so that we can ensure the fewest possible birth defects (and maybe get better at generating healthy babies than nature: even a rate of 5.8% looks a bit slapdash).  Slightly more radically, some might claim that there ought to be a moratorium on certain assisted reproduction procedures – ISCI in particular – for the sake of minimising the number of birth defects.

Let’s deal with the radical claim first (what can be said about that will also speak to the less radical one). more…

Some Responses to Giubilini and Minerva

5 Mar, 12 | by Iain Brassington

I did mention last week that I’d post links to sites that mentioned Giubilini and Minerva’s paper as they crossed my radar; but it turned out very quickly that there’d be no way to keep up.  And, to be frank, a lot of the blogosphere’s response has been fairly scattergun outrage rather than dispassionate engagement with the paper, and directed at Giubilini and Minerva themselves rather than at the argument they put forward.  There’s been much more heat than light.

This is perhaps unsurprising, as considered responses are almost certainly going to take a while to materialise.  However, they have begun to appear.  Here’s the first that I’ve spotted; I’ll post links to more in this thread as and when.  And if any readers have responses on or SSRN that they’d like mentioning, or if anyone spots anything of interest, do let me know. more…

CfP: Criminalizing Contagion: Ethical, legal and clinical challenges of prosecuting the spread of disease and sexually transmitted infections

3 Feb, 12 | by Iain Brassington

The BMJ Group journals Sexually Transmitted Infections and Journal of Medical Ethics, in conjunction with academics at the Centre for Social Ethics and Policy (University of Manchester) and the Health Ethics and Law Network (University of Southampton), would like to publish a collection of articles on the criminalization of disease and sexually transmitted infections. We invite article contributions to be published as part of this themed collection.

Funding has also been sought from the ESRC for a seminar series on the same theme and, if successful, authors contributing to this collection may also be invited to present their papers at one of the seminars (which will take place in winter 2012/13 and summer 2013 in Southampton, and winter 2013/14 and summer 2014 in Manchester).


The use of criminal law to respond to infectious disease transmission has far-reaching implications for law, policy and practice. It presupposes co-operation between clinicians and criminal justice professionals, and that people who infect others can be effectively and fairly identified and brought to justice. There is a potentially difficult relationship between criminal justice and public health bodies, whose priorities do not necessarily coincide. We are interested in receiving papers of broad interest to an international readership of medical ethics scholars and practicing clinicians on any of the following topics:

·      Legislative and policy reform on disease and sexually transmitted infections

·      Health services and the police: privacy, state interference and human rights

·      Evidence and ethics: prosecuting ‘infectious’ personal behaviours

·      Clinicians and the courts: the role of health professionals and criminal justice

·      The aims of criminalization and public health: a compatibility problem?

·      International comparative studies on disease and criminalization: policy, practice and legal issues

More details below the fold. more…

Calling Charlton Heston…

27 Jan, 12 | by Iain Brassington

It’s been a while since the last post, and there’s a couple of serious entries on the way – but they’ve been displaced by a bit of silliness from Oklahoma.  State Senator Ralph Shortey (or SHortey, if you follow his Facebook style) has introduced a Bill demanding that

[n]o person or entity shall manufacture or knowingly sell food or any other product intended for human consumption which contains aborted human fetuses in the ingredients or which used aborted human fetuses in the research or development of any of the ingredients.

Robin Marty elaborates:

The Republican has proposed a bill that will ban the use of “aborted human fetuses in food,” despite his admission that he doesn’t know of any companies that actually…well..use them.

So where did Sen. Shortey get this idea?  According to him, from the internet.

The “internet research” Shortey is referring to likely is an ongoing anti-choice crusade that began months ago, when an activist group began demanding a boycott of PepsiCo, which works with a research and development company that uses a line of embryonic kidney stem cells created in the 1970′s to test “flavor enhancers.” The boycotters, led by a group called Children of God for Life, say that’s the same as using aborted fetuses.

Ah: teh interwebz.  I see.  (For the record, the LA Times reports that “[a] U.S. Food and Drug Administration spokeswoman told the Associated Press that the agency has never gotten any reports of fetuses being used in food production.”)

Since there’s never likely to be a better excuse to link to [SPOILER ALERT] the final scene of Soylent Green on this blog, that’s precisely what I’ll do; I only wish I could get the clip to embed.

But there’s more to this than lampooning a typographically-challenged Senator, because the Bill, in its brutal simplicity, is brutally simplistic. more…

Is Bird Flu Research a Security Risk?

21 Dec, 11 | by Iain Brassington

A story that has had a little airtime on the news over the last 24 hours or so concerns requests by US officials that details of research into a bird flu variant be held back from publication on the grounds that it might be of use to terrorists:

The National Science Advisory Board for Biosecurity recommended that the “general conclusions” be published but that final manuscripts not include details that “could enable replication of the experiments by those who would seek to do harm”.

The BBC’s health news blog reports that

Professor John Oxford from Barts and the London School of Medicine [says], “They should definitely publish. The biggest risk with bird flu is from the virus itself. We should forget about bio terrorism and concentrate on Mother Nature.”  [He and Prof Wendy Barclay from Imperial College London] agree that the influenza virus would make a pretty poor bioterrorist weapon, unless your aim was to spread the infection across the world. Influenza has no respect for borders, so introducing a virus in one country would inevitably spread it globally.

But Michael Parker, Professor of Bioethics and Director of the Ethox Centre at the University of Oxford, disagrees.  “The position that everything should be published is not tenable. There must be some scientific information which contains an immediate threat to public safety if it fell into the wrong hands.”

Parker’s worries reflect those articulated by Tom Douglas and Julian Savulescu in the JME a little while ago; they argued that synthetic biology raises significant new ethical problems, not least because of the potential for “dual use”.

I have to admit that I have yet to be convinced by the biosecurity worries.   more…

Reiki Research: Not Quite the Maddest thing on the Net.

18 Aug, 11 | by Iain Brassington

Right now, physicists are pondering the fallout from the collision of high-energy particles.  (Probably.)  And I, for my part, am pondering the fallout from the collision of high-energy nonsense.

Having had this brought to my attention, I’m led fairly quickly to this, then this, and, finally, this Mail on Sunday piece.  All the links refer to a story in which a hospital is apparently using £200k or so of Lottery money to fund research into spiritual healing based on Reiki.  I’m willing to bet dollars to doughnuts that the research finds that spiritual “healing” is utterly ineffective, except when it means people don’t avail themselves of real medicine – in which case, it’s very effective and its effects are undesirable.  Spiritual healing is bunk; one could reasonably think that a trial into it is a waste of money.  We oughtn’t to waste money, so, modus ponens, we oughtn’t really to be doing this kind of research.

In fact, there’re likely to be big problems with spiritual healing research of any sort, simply because participants may feel that there’s less need to continue using established treatments, and thereby end up worse off.  And when others continue with conventional treatments, it’s going to be hard to tell which of their outcomes was attributable to which – so the research’ll likely tell us nothing.  Hence I wonder whether the research will yield anything publishable: if not, then the whole thing will have been in vain, and there’s something problematic about enrolling people in trials that stand a chance of being, from a publication point of view, barren.

I’m not actually going to go down that route here, though. more…

Fighting Fire with a Different Kind of Fire?

16 Aug, 11 | by Iain Brassington

How much would I love to have been on the ethics committee that was faced with this?

Researchers at the University of Pennsylvania were interested in a method of treatment for leukaemia that made use of modified versions of white blood cells.  Cells were taken from leukaemia patients and genetically modified in two ways: first, they were adapted to target the cancer cells; second, they were adapted to reproduce like crazy.  This second modification is important, because attempts to make use of the first have hitherto fizzled out as the modified cells died off.  Or, in slightly more scientific language, the New England Journal of Medicine explains that

[f]irst-generation chimeric antigen receptors had limited clinical activity, primarily because in vivo activation of the chimeric antigen receptor T cells induced only transient cell division and suboptimal cytokine production, which failed to produce prolonged T-cell expansion and sustained antitumor effects. These deficiencies were overcome by the addition of a costimulatory signaling domain in second-generation chimeric antigen receptors, which enhanced the proliferation, survival, and development of memory cells — features that appeared to be the hallmarks of successful therapy with EBV-specific T cells and tumor-infiltrating lymphocytes.

And this approach, based on preliminary results, seems to be very promising, having exceeded expectations.  The paper reporting the experiment is available here.

But how do you get the modification into the cells to begin with?  The team

used HIV-derived lentiviral vectors for cancer therapy, an approach that may have some advantages over the use of retroviral vectors.

And that, of course, is where things get interesting. more…

Couldn’t find the language – the positive counterparts of risk and hazards

9 Jun, 11 | by David Hunter

Continuing my recent theme of the impact of language on ethics and decision making I’m presently writing a paper on the use of claims based on justice to object to new technologies such as human enhancement or synthetic biology. In the process of writing this paper I’ve encountered a rather odd gap in our language. It is the case when discussing future technologies that the harms involved are more properly thought of as risks (that is uncertain harms where the probability of the harm is predictable) and hazards (that is uncertain harms where the probability of the harm is not predictable). The same applies to the benefits of future technology but we don’t have the language to directly describe them thusly, ie there is no obvious counterparts to risk and hazard in regards to benefit. This seems odd given that benefits can be just as uncertain as harms.

And while we might think of this as just a linguistic oddity it may actually have an impact on decision making. For example in research ethics it is common to talk about the risks and benefits of research – but this creates

Any suggestions of appropriate terms would be gratefully received!

Stem-Cells: To Patent or Not?

8 May, 11 | by Iain Brassington

In spare moments, I’ve been wondering about the Advocate-General of European Court of Justice’s recent recommendation that patents involving human embryonic stem-cells be prohibited, and the response that it’s generated.  One of the best-publicised responses was the letter from Austin Smith et al that appeared in Nature, which complained that the recommendation would be bad for European science:

Scientists working in stem-cell medicine will not be able to deliver clinical benefits without the involvement of biological industry. But innovative companies must have patent protection as an incentive to become active in Europe.

The advocate-general’s opinion therefore represents a blow to years of effort to derive biomedical applications from embryonic stem cells in areas such as drug development and cell-replacement therapy. If implemented, European discoveries could be translated into applications elsewhere, at a potential cost to the European citizen.

At the same time, there’s a number of pro-life organisations and blogs that have welcomed the recommendation as a straw in the wind, and for just the same reason.  Where the pro-lifers and Smith agree is in the supposition that not being able to patent hESC-derived procedures will remove the commercial incentive to try them out; which means that they won’t get tried out; which means the hESCs won’t be used.

I may be missing something, but I don’t see it that way. more…

Conference: Synthetic Biology: A Better Future?

1 Mar, 11 | by Iain Brassington

This workshop looks potentially interesting.

Public Dialogue Wednesday 9 March

Lindisfarne Centre, St Aidan’s College, Durham University

5pm Wednesday March 9th


5.15 pm Introduction to the Meeting – Dr Patrick Steel (Durham University)

5.20 – 6.45 pm A series of short talks from experts in the field providing a personalised view of synthetic biology and its future impact:

Dr Ray Elliott, Syngenta Ltd, “What Synthetic biology can do for agriculture”
Prof Mark Harvey, Centre for Research in Economic Sociology and Innovation, University of Essex, “Energy, food, materials and climate change: the 21st century challenge to biological science and technology”
Prof John Ward, Institute of Structural and Molecular Biology, University College London, “What synthetic biology can offer for bioengineering”
Prof Robert Song, Department of Theology Durham University, “Synthetic Biology: Some ethical issues”

6.45-7.00 Refreshments

7.00-8.30 pm Open Discussion Between Panels and Audience Chaired by:

Prof Robert Edwards, Chief Scientific Officer for the Food Environment Research Agency
Prof Phil Macnaghten, Institute of Hazard Risk and Resilience, Durham University

8.30 Buffet – free for all registered participants

SPPI-NET is a BBSRC funded network which has the objective of promoting interdisciplinary collaborative ventures, involving both academics and industrialists, to explore the potential for producing synthetic plant products for industrial applications.  The IAS (Institute of Advanced Study) is Durham University’s ideas-based Institute which brings together some of the world’s finest researchers from every discipline to examine themes of major intellectual, scientific, political and practical significance.

pace my earlier post about theological ethics, I’m assured by people whose opinion is sound that Song is a decent ethicist; I’ll suspend my grumbles in his case.

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