Election year pro-abortion push

If you don't want your child to suffer, you don't choose Partial Birth Abortion (Intact Dilation and Extraction or "D&X") and you certainly shouldn't complain about State laws concerning prevention of fetal pain during the abortion.

msnbc.com and Self Magazine have teamed up to discuss "When there is no good choice."

In the story, we read about abortions - one at 22 weeks and and one at 30 weeks pregnancy, after two mothers learn that their babies have severe birth defects. While the story spends a lot of space trying to explain that the mothers are having the abortions because they don't want their babies to suffer, the story condemns laws requiring anesthesia, informing the mothers that their children may feel pain during the procedure, or mandating lethal injections to kill the child before dismembering him or her. Of course, we are told how wrong it is to call "D&X" "partial birth abortion," or to ban the procedure itself.

This is a story about the politics of an election year, written to tug on our heart strings rather than inform.

Obviously, I am pro-life, and so, I must be one of those the article calls "anti-abortion." The story claims that I "demonize" the mothers who have abortions at 28 weeks, and mentions that because of George Bush, the Republicans, and "red staters," these women have troubles and the doctors claim that they worry about being charged with breaking the law. However, each woman does abort her child.

The author doesn't seem to notice the irony that she is practicing demonization, herself.

The good news is that the article reports on perinatal hospice, now available across the country:

Today some 60 U.S. hospitals, hospices and crisis pregnancy clinics offer perinatal hospice services; in Minnesota, women seeking to abort fetuses with fatal anomalies are required by law to be informed about hospice as an alternative. “Women appreciate the grieving process and being able to spend time with their babies,” says Dr. Calhoun, vice chair of obstetrics and gynecology at West Virginia University School of Medicine in Charleston. “Perinatal hospice gives women an alternative that is a better choice than abortion.”

Oklahoma abortion Bill survives Governor's veto

The Oklahoma State Legislature has overturned Governor Henry's veto of an "omnibus" bill containing abortion regulations. (The veto is explained at the United Kingdom site of Medical News Today. Besides gives the best definition of human embryo that I've seen in legislation:

“Human embryo” means a human organism that is derived by fertilization, parthenogenesis, cloning, or any other means from one or more human gametes or human diploid cells.

Pro-abortion groups are concerned that the bill requires the facility doctor to perform an ultrasound before every abortion, that the girl or woman be allowed to see it, and that the results be explained to her. Not only is there a requirement to post a notice in the facility informing the women and girls that it is "against the law for anyone, regardless of his or her relationship to you, to force you to have an abortion" and the abortionist evidently must actually speak the words out loud before each abortion!

Called the "Freedom of Conscience Act," (The text is here, in a Word document) the bill offers protection to any medical professional who refuses to act in a way that goes against his or her conscience.


The best news article that I've found is here, at the "Daily Women's Health Policy Report" of the National Partnership for Women and Families, a group I'd never heard of before. It appears that the main focus has been legislation to protect women in the workplace.
Robert Cole, an Oklahoma native, writing for Associated Content, has explained the bill in this article. Here's an article from The Feminist Majority, with good links.

Ironically, Democratic Presidential Candidate, Barack Obama, used the objection to abortion by the Senator from Oklahoma, Senator and Obstetrician Tom Coburn, to justify his relationship with the Weatherman bomb-building conspirator and now-college professor, William Ayers. (Ayers is the man who was quoted in the New York Times on September 11, 2001 as regretting that he did not do enough bombing and fighting the US government in the early '70's.)

Skeptical view on Expelled, the Movie

Michael Shermer, the Skeptic, has seen the movie, Expelled, in advance of its release Friday, April 18th, and posted a review on his blog at Scientific American.

Shermer is a spin doctor who, while purporting to follow reason, is actually better understood by the title he often sports, "skeptic." His near-"single-issue" is atheism vs. religion, specifically Christianity and Christians. He says in one of his books that he joined the Church of Christ (the conservative, no instruments) to impress a girl and never felt the conversion that should have gone with his baptism, but that he tried to justify his choice. He even went so far as to attend Pepperdine University, which is owned and run by the Churches of Christ. Rather than throwing out the bad and keeping or developing a faith in Jesus as he understands the Bible, he set about to prove to the world that religion is just one of the "weird things" that people believe. He loves to debate questions like "Is Religion a Force for Good or Evil?"

Shermer doesn't tell us that the agency that investigated Richard Sternberg's case against the Smithsonian agreed that he had been the subject of discrimination and a behind-the-scenes coordinated move to get him out of the Smithsonian. The case was dropped because he didn't belong to a protected group and he simply had no standing to sue within that agency, since he was not an employee. He did, however lose his lab space - going from a private office to a shared space and the privileges of unlimited access and his own key that he had enjoyed up to that time.

Also, Shermer claims that Sternberg went against policy in the peer review of the article by acting as editor and choosing the reviewers himself. Sternberg tells his side of the story and answers the charges against him at his own website, here, and here.


There's more on the web, including this review from 2006 Dispatches from The Cultural Wars , which details - and is an example of - the political nature of academia, research and the theme of Expelled.

Both sides spin to make a point. But, Sternberg's case appears to be a classic example of academia's - or any closed group with limited power to make change in the open - whisper campaigns and peer pressure to "expel" any doubters, gad-flies on the edge of scientific "consensus." Ironically, I've read that the reason that people don't understand the mutation that brings about changes in the gametes of individuals and eventually species, is that we don't understand really large numbers. Ironically, Intelligent Design began with the discussion about the mathematics involved in the evolution of species.

Gynecology and Obstetrics Policy makers respond to doctors on conscience

It appears that the American College of Obstetricians and Gynecologists and ABOG (the American Board of Obstetricians and Gynecologistsmay be about to abort their efforts to change laws concerning conscientious refusal in Washington. It remains to be seen whether they will deliver on their promise to support -- without limits - the Conscientious Refusal to perform or refer for certain procedures. (I'm sorry, I can't resist obvious puns, even on such a serious subject.)

LifeEthics has been covering the controversy over the American College of Obstetrics and Gynecology's "Opinion #385, Limits of Conscientious Refusal in Reproductive Medicine," which states that,

Providers with moral or religious objection should either practice in proximity to individuals who do not share their view or ensure that referral processes are in place. In an emergency in which referral is not possible or might negatively have an impact on a patient's physical or mental health, providers have an obligation to provide medically indicated and requested care."

First, "medically indicated" should be up to the physician and not dependent on autonomy - the patient's wants and wishes. Remember that Joseph Kennedy, the father of John and Robert, had his daughter lobotomized because she was too wild. At that time, according to Joe, the lobotomy was medically indicated.)

Obviously, this is not a moral obligation - but one that can be enforced by the use of the words "standard practice" and "standard reproductive services." In other words, abort, refer, or face lawsuits and risk your board certification. And the definition of "emergency" varies.

We also reported that the Secretary of Health, Michael O. Leavitt, had written to the Presidents of the American College of Obstetrics and Gynecology, the professional organization that supposedly sets the standard for these professionals, and the American Board of Obstetrics and Gynecology which certifies and tests OB/Gyns Presidents of ACOG and ABOG. He informed them that they were in danger of risking their own funding for training programs and status by any attempt to override the protections for Conscience in Federal funding regulations.


Even NPR noticed and covered the controversy.

The leaders at the Christian Medical and Dental Association have let CMDA members know that the President of ACOG, Kenneth L. Noller, MD, responded to the Fellows (certified OB/Gyns) last week and Norman F. Gant, MD, the President of ABOG, responded to Secretary Leavitt by letter on March 19, 2008.

Dr. Gant doesn't have a clue what the Secretary is talking about:

I am responding to your letter addressed to me asking about the American Board of Obstetrics and Gynecology’s stand with respect or to a physician’s choice to violate their conscience by referring patients for abortions or taking other objectionable action, or risk losing their board certification.” I can only say that I do not know where you came up with any suggestion, much less documentation, that the American Board of Obstetrics and Gynecology has ever asked anyone to violate their own ethical or moral standards.

And Dr. Noller reassures the Fellows that in this case, an Opinion is just an Opinion (and we're supposed to forget the attempts to change the laws):

We want to be clear the Opinion does not compel any Fellow to perform any procedure he or she finds to be in conflict with his or her conscience and affirms the importance of conscience n shaping ethical professional conduct. For example, while this is not a document focused on abortion, ACOG recognizes that support of or opposition to abortion is a matter of profound moral conviction and ACOG respects the need and responsibility of its members to determine their individual position on this issue based on their personal values and beliefs. We want to assure members with a diversity of views on this issue that they have a place in our organization.
Ethics Committee Opinions provide guidance regarding ethical issues. This Committee Opinion is not part of the “Code of Professional Ethics of the American College of Obstetricians and Gynecologists.” This Committee Opinion was not intended to be used as a rule of ethical conduct which could be used to affect an individuals initial or continuing Fellowship in ACOG. Similarly, it is not cited in the American Board of Obstetrics and Gynecology’s “Bulletin for 2008,” and “Bulletin for 2008 Maintanence of Certification” and an obstetrician-gynecologist’s board certification is not determined or jeopardized by his or her adherence to this Opinion.
Conscience has an important role in the ethical practice of medicine. While this Opinion attempted to provide guidance for balancing the critical role of conscience with a woman’s right to access reproductive medicine, the Executive Committee has noted the uncertain and mixed interpretation of this Opinion. Thus, the Executive Committee has instructed the Committee on Ethics to hold a special meeting as soon as possible to reevaluate ACOG Committee Opinion #385.

Dr. Nurse? Why not just Doctor?

Get ready for Dr. Nurse, who will call himself/herself "Doctor," but who, after 4 year bachelor's degree in nursing, has gone to the Doctor of Nursing school for two years with a one year internship -- that's compared to the 4 years of college, 4 years of medical school, followed by at least 3 years of residency that Family Physicians, Pediatricians and Internal Medicine docs devote to training..

The Wall Street Journal reports (please let me know if you can't access this page) that the National Board of Medical Examiners will begin testing these "DrNP" candidates this fall.

From the Wall Street Journal:

As doctors face shrinking insurance reimbursements and rising malpractice-insurance costs, more medical students are forsaking primary care for specialty practices with higher incomes and more predictable hours. As a result, there could be a shortfall ranging from 85,000 to 200,000 primary-care physicians by 2020, according to various estimates.

So,the supposed reasoning behind the new doctorate is this shortage of primary care doctors. That shortage has been artificially encouraged by all sorts of federal interventions. For some reason, no one's considered paying Family Doctors more!

Instead, there are schemes to divide and re-divide the Medicare "Pie." There are the rural health clinics, which are paid more by Medicare and Medicaid than your local family doctor, pediatrician or internal medicine doc for seeing the same patients. In order to qualify, the clinic -- get the distinction, there, not the doctor, but who ever it is that owns the clinic and contracts with doctors and hires the rest of the staff - must hire at least one "mid level practitioner" to see patients. They can't hire a doctor to do the same work and/or for the same money -- they must hire a Physician Assistant or Nurse Practitioner.

As the article notes, the main reason for the loss of primary care physicians, however, is the low pay for the thinking part of what we do, compared to the procedures of specialists, such as all the varieties of surgeons, urologists, gynecologists and gastroenterologists. We analyze, examine and determine treatment or treatment change, resulting in "Evaluation and Management" visits. Rather than the codes used for procedures, the E&M visits are divided into levels of payment based on a set of check lists and diagnoses. The money from Medicare - followed closely by the insurance companies - has consistently shifted from the office visits toward the procedures.

Needless to say, the smart medical students -- or at least the ones more interested in money than in your family history, living arrangements and whether Junior ate his peas and carrots will become interventional sub-specialists, not a Family Physician or Pediatrician.

A few years ago, Medicare payments increased for home health agencies, which encouraged RN's and LVN's to leave the hospital. Medicare quit paying your family doc to "scrub in" with the general surgeon or orthopedist as an assistant during your gall bladder surgery, colon resection or hip replacement. But, they did pay the surgeon enough to justify the hiring of a nurse practitioner or physician assistant. And studies said there was no difference or even better outcomes, since the "team" worked better in the Operating room and the peri-surgery procedure became more efficient.

(Of course, the NP or PA won't be available to your wife or kids for questions next week, and won't watch the effect of your new level of activity on your blood pressure or diabetes. And your family doctor may no longer even know that she should, since she won't even find out about the surgery until your next visit or hospitalization. But that has nothing to do with the outcome of the surgery, right?)

The increase of Federal funding for Nurse Practitioners has exacerbated the loss of good RN's and LVN's - leading to more of the Federal pie going to nursing schools. And the DrNP will probably have the same effect. The WSJ article mentions the lack of faculty in the nursing schools. The funding will have to come out of the Medicare and Federal "pie."

However, what patients need to consider is whether the DrNP training can truly accomplish the same training in 3 years that our Medical Schools can do in 5 to 7 years. Some have said that mid levels can handle 80% of what doctors do.

It's that 20% that is the difference between knowing what you don't know and planning for the 2 AM crisis.

Designated Donations (Saving black girls from punishment)

There's no way to avoid the politics if I'm going to comment on these two stories.

First, here's a link to the audio recordings of Planned Parenthood employees, agree will be earmarked to decrease the number of "African Americans" or a "black baby." The employees include the Vice President of Development of the New Mexico PP, Sue Riggs, agreeing to accept money that the caller has specifically said should go to the abortion of an African American. Another call includes the statement that the man does not want his children to face a lot of competition in college due to affirmative action.

These calls should be enough to make any thinking person condemn at least the lack of sensitivity and training at the offices of Planned Parenthood. Unless you realize that they probably think they're rescuing a black woman or girl from the punishment of having a black baby -- as stated so clearly by Barack Obama last Sunday, March 30, while campaigning in Philadelphia:

"I've got two daughters -- 9 years old and 6 years old," Obama said. "I am going to teach them first of all about values and morals. But if they make a mistake, I don't want them punished with a baby. ... So it doesn't make sense to not give them information."

The mindset that calls pregnancy a "punishment" is one that we who value human life often encounter. In a classic case of projection - seeing your own opinion, wants, flaws or tendencies in the other person - the abortion advocate will claim that we see sex as bad, and that women and girls should be punished.

No, we see women and girls as us. We see their babies as the children of the future - as our fellow human beings and citizens. The information that we give our children is that there are consequences to our actions. Each of us has a responsibility to work toward good consequences by choosing our actions. Taking responsibility, expressing compassion and empathy, and even parenthood are not "punishment."

In fact, you could call the opportunity and ability to do so a "blessing."

Edited 4/2/08 at 10:00 PM for typos.

Human-DNA-in-cow-egg embryo created in UK

Scientists in the UK report that they have created an embryo using the transfer of human nuclear DNA from an embryonic human cell into the oocyte of a cow that has had the nucleus removed. These embryos are the "hybrids" or "cybrids" that we've been discussing for the last few years.

From the Guardian:

Apparently these researchers have achieved some success - but by using the nucleus from a very early embryonic cell, which might be easier to reprogramme than an adult cell. At the moment it is impossible to assess the significance of this report until we know more details of what has been achieved ... the results have been repeated and, importantly, they have been reviewed by independent researchers in the usual way."

Josephine Quintavalle, of the pressure group Comment on Reproductive Ethics, said the research should not worry those opposed to hybrid embryos because the Newcastle work did not seem convincing. "The embryos didn't survive, they were created from embryonic stem cells rather than adult tissue, and there's a lot of question marks over the research."

But she added: "What it has done is wake up the public to this reality, that while parliament is getting in a tizz about this, while the whole country is up in arms discussing it, the HFEA is already issuing licences."

Supposedly, if the technique is perfected to allow the embryos to survive longer, these embryos will allow the study of the early embryo and production of embryonic stem cells in order to learn more about and find cures for diseases like diabetes and Parkinson's.

However, even if the embryos are disorganized and fail early, or if they are destroyed at day 5 or 6 or whenever, the ethical determination as to whether they are "human" or "bovine" has not been cleared up. We won't know what they are until several labs and several trials successfully create these embryos.

If the embryos appear to divide in an organized manner, producing human proteins and the differentiation necessary to create human embryonic stem cells, then they are essentially human embryos. This is a case of the old if it walks like a duck, quacks like a duck, etc., logic.

Since the stated intention is to destroy the embryo, and we don't know whether they are human or not, those of us who find the killing of humans, even at the earliest stages will also hold that it is inherently unethical to even begin the process.

A discussion about the discussions about the announcement can be read at one of Nature.com's blogs, "The Great Beyond."

From the thread, "UK hybrid embryo: in perspective - April 02, 2008,"

New Scientist has attacked the group for announcing the achievement through the media rather than through a scientific publication. The Independent focuses on the ethical debate. Not many organisations outside the UK gave it any coverage at all, and those that did may have been under the impression that it was a world first, not mentioning previous achievements in the field (eg. Life Scientist, Australia).

"Expelled, The Movie" Conversation Continues

The many Anonymice are still discussing world views on a post from last October.

(In case you wondered where I've been:

We've had our primary, with one hotly contested local Republican race ending in a cliff-hanger. The same seat was decided by 54 votes out of about 20,000 in 2006. This time, it looks like the winner may be decided by about 38 votes out of 30,000, before the mail in ballots are counted. We're expecting a recount.

It turns out that the consequences of politics and policy became personal this last 2 months. We've spent the last year - over 14 months, now - working out a plan to remodel our 65 year old house only to find out that the city adopted the new provisional FEMA flood plain map, and we can't remodel - we have to fill in the basement, tear down the old house, and build 2-3 feet higher. I'll admit that I haven't reacted very well. But, still, the City's bureaucrat literally lost the plan for 6 weeks before telling us that the concrete-poured-in-place house and basement that's still plumb, smooth and level after more than 60 years might float up and turn on its side.)

Surfing the web, leaving a trail

It might surprise many Internet surfers and commenters how much a slightly curious website owner knows about them.

I've always believed that I shouldn't post any thing I didn't want published in my hometown newspaper. However, I forget how much information about me is available on the Internet - whether or not I actually post.

There are several for-fee and free sites that allow me to track which pages are viewed and when, how many visitors I get, the viewer's location and the links that referred them to my website. The reports also tell me the type of browser, the length of time and divides the reports by unique visits and pages viewed. There are all sorts of reports that I don't use - or understand why I would want them.

It is cool to see that what I write has been seen - possibly read - by someone from Czechoslavakia this morning.

The images above are pictures of one report that I check most often. It shows the numbers of "hits" or visits to my blog during the last week. The top image is from this morning, the bottom is from January 8th. This website that produces the reports, Sitemeter, filters out most of the newsreader "hits." Another program shows those, inflating the numbers two or three times.

By studying the numbers and who, when and how, I keep trying to figure out how to get more readers.

I haven't found many patterns, by the way, except the "hits" seem to go up about the time midterm and end of the semester school papers might be due.

I am surprised to discover that one of the most read pages on this blog are those which deal with the subject of evolution and public policy. I post on these stories as a way of discussing the intersection of public policy and what I perceive as a bias in the science community. Few people seem to care about "Ethicists for hire," but there is a lot of interest in evolution and public policy.

One of the most frequent searches that links to LifeEthics are those on the movie, "Expelled." LifeEthics has been viewed about 12 times over the last day because someone used Google or another web search engine with the search words, "Expelled, the movie." This morning, my post from last October, "LifeEthics.org: Expelled, the movie (It's about censorship)" is the third link in a search on the US Google. One of those visits was by someone from somewhere in the United Kingdom who used the AOL and Google.uk search engines to view my page for a little over a minute, each time. They clicked on a link on my post to view the Guardian.uk article on Richard Dawkin's reaction to the movie.

There were comments yesterday on "Expelled: movie to explore politics of science" from a reader who objects to my critique of the case of one of the scientists mentioned in the press releases about the movie. This post was from August 23, 2007. That commenter and I are still having a conversation on a story about a Texas Education Agency employee who sent out an email alerting people she knew about a talk on "Creationism's Trojan Horse." Those posts were written in early December,2007 and titled, "Politics Bites," and "Texas Employees, Politics, Science."

Happy New Year! (a little late)

Okay, it's January 9th, and I'm just getting back to the blog after a couple of weeks obsessed with politics, house design, and moving. (We are about to remodel our 60 year old house.)

I do my best to keep raw partisan politics out of this blog. However, this is a Presidential election year here in the US, and so much of our Bioethics is really just Politics.

So, I'm activating a sister blog, "Bioethics and Politics." Don't be surprised if that one gets as much or more attention as LifeEthics.

Women do not want pro-abortion President

The New York Times has weighed in on the secret to Hillary Clinton's win in New Hampshire: women voters.

I am convinced that Senator Clinton’s campaign is very aware of the importance of the women's vote. (I believe that the "crying" incident of January 6th was aimed at reminding women that Hillary is a woman, and that this is their chance to have a woman President. But that's just my opinion.)

Pro-life voters who do not want a pro-abortion President must begin to emphasize and educate one another about the voting record of the candidates. Our belief that every human life has value (not the personalities of the candidates, inevitabilities, and religious identification) is something that we have in common with members of both the major parties.

There is no question that Hillary and Obama fought the Partial Birth Abortion ban (Hillary as First Lady and then as NY Senator and Obama while still in the Illinois legislature). Polls like this one (comments here and the poll in .pdf, here) from the Susan B. Anthony List, from last August, show that even among women who want to vote for a woman to get a woman President, a large number will not vote for the advocates of Partial Birth Abortion. These are the voters we need to alert/inform.

The reality is that politics will play a part in our goal of protecting human rights in medicine and science policy in the US. The next President will, like this one, be in a position to name several Supreme Court Justices.

Doctors, Abortion and Conscience

The debate on medical ethics has definitely moved from "Our Bodies, Our Choice," to "My Choice, You Don’t Have a Choice." Autonomy, the "I want" ethics, trumps the right to life, the right to liberty and the physician's duty to do no harm. Where once laws were written to punish doctors who harmed patients, doctors are now threatened with lawsuits and the loss of our licenses for refusing medications or procedures demanded by patients and their surrogates.

The American College of Obstetricians and Gynecologists ethics statement, "The Limits of Conscientious Refusal in Reproductive Medicine" is a case in point. Abortion is so important to the ACOG Ethics Committee that they deny the right not to be killed and threaten the right not to be enslaved by calling abortion the “standard reproductive care that patients request” and demands that doctors who “deviate from standard practices” (object to abortion) “practice in proximity to individuals who do not share their views or ensure that referral processes are in place” (with a willing abortionist). The President of ACOG then wrote letters asking Congress for laws to force these limits on our consciences: doctors who object to abortion should either change their practice so that they don't take care of women and girls or move close to a willing abortionist.

The Christian Medical Association and 28 other pro-life, pro-family organizations have written a letter criticizing ACOG’s Statement as “a profound misunderstanding of the nature and exercise of conscience, an underlying bias against persons of faith and an apparent attempt to disenfranchise physicians who oppose ACOG's political activism on abortion.”

GrannyGrump posted several reasons conscientious doctors should consider elective intentional abortion bad for the mother. I agree with her that abortion is wrong because it is bad for women. I also believe that she begins from the same viewpoint that I do: Even if abortion weren't bad for women, it would still be wrong.

Elective intentional abortion is immoral because it takes the life of a human being. If the mother's life is in danger, she has the right to self preservation and it is moral to help her save her life. Even then, the child's life should also be protected if at all possible. The intent can never be to produce a dead child.

State officials have mandated that all medical students learn to perform abortions in New York and that all pharmacies stock and dispense contraceptives in Illinois and Washington. ER doctors are forced to dispense Emergency Contraception in Connecticut, California, Massachusetts, New Jersey, New Mexico, New York, Ohio and Washington. How long before autonomy supersedes the physician's right to conscience at the end of life since the American Medical Association has condoned the use of Oregon's "Physician Assisted Suicide" law (now renamed and redefined as "Aid in Dying")?

Laws against the conscience are a poor substitute for medical ethics and will result in the death of those same ethics. The end result of limiting the physician’s conscience is cook book health care written in court rooms by lawyers and judges. The practice of medicine will no longer be a profession, much less a calling, practiced by men and women of conscience. It will become a job done by people capable of following orders, doing what they believe is wrong.

Lee Silver: iPCs named due to politics

Lee Silver, author of is someone that I've read about on the 'net and about whom Robert George and Patrick Lee said, "He hides his ideology under a veneer of science."


He was the guest on Carl Zimmerman's Bloggingheads.tv November 30, discussing reprogrammed skin cells.

Dr. Lee is convinced that if a couple of more labs reproduce the reprogramming (and others have since, Jaenisch and Yamanaka's lab have already published follow-up results), then reprogramming will probably be the way we get embryonic stem cells, rather than by destruction of embryos.

However, he claims that the naming of the cells "induced Pluripotent Stem cells" or iPC's is a political move to hide either the fact that the opponents of embryo-destructive research are being fooled or being hypocrites.

From the thread following the interview:

Actually, human ES cells (unlike mouse ES cells) are perfectly capable of differentiating into trophoblast (Nature Biotech 20:1261; 2002). Why do you think this isn't common knowledge? (Hint: politics) And mouse ES cells can be turned into whole mice quite efficiently with a technique that does NOT involve blastocyst injection or tetraploid embryos (Nature Biotech 25:91; 2007). Concerning your next post, how do you know what the intent was behind naming these cells iPS cells?

. . .

The question is whether continued research will soon get us to the point where fibroblasts cells can be transformed into cells that are completely indistinguishable from human ES cells, with the potential to form every human cell type (including, eventually, blastomeres which could, in theory, develop into babies without any further "tinkering"). With all of the accomplishments of the last ten years, it is very hard to imagine that this won't be possible. The ONLY reason to doubt it is based on a religious-inspired faith that there is something FUNDAMENTALLY different between blastomeres and ES cells.

So now, it's a religious opinion that there's some difference between blastomeres and ESCs?

Hat Tip to The Daily Transcript at ScienceBlogs.

Yamanaka has a conscience

“When I saw the embryo, I suddenly realized there was such a small difference between it and my daughters,” said Dr. Yamanaka.

The New York Times article on Shinya Yamanaka, "Risk taking is in his genes," (free one time registration necessary) should get the headline-writer in trouble for a sad pun.

Instead, Dr. Yamanaka might be in trouble with the objectors to conscience. (No links, just look at today's posts - or the last two months of posts - the subject keeps popping up.)

People like John Gearhart, MD will want to "put pressure" on Yamanaka to write letters to Nancy Pelossi and the rest of the US legislators making the usual reactionary case for Federal funding for embryonic stem cell research in light of the successes with non-destructive research.

The NYT reporter, Martin Fackler, can't be too popular in the next few days for pointing out that the US laws and funding are not nearly as tight as those in Japan, due to moral objections in that country:

In 1999, his career got a break when he was hired by other universities, including Kyoto University in 2004, that were willing to give him a laboratory and more money. At about the same time, he said, he visited his friend’s fertility clinic. That visit inspired him to find a way around the moral issues that had bogged down stem cell research, not just in the United States but also Japan, where the Education Ministry put tough restrictions on embryo use.

In fact, restrictions are so tight that he says he cannot use human embryos at his laboratories here. Instead, research using human embryos is done at U.C. San Francisco, where he maintains a small two-person laboratory. He said he had never handled actual embryonic cells himself, and the American lab uses them only to verify that the reprogrammed adult cells are behaving as true stem cells.

“There is no way now to get around some use of embryos,” he said. “But my goal is to avoid using them.”

For a look at the science and bioethics slant on these revelations, see Wired Science (see the comments on this one), Blog.bioethics.net, Wesley Smith's Secondhand Smoke, and Jennifer Lahl's blog, "The Human Future."

Warnock Answers

Dame Mary Warnock has written an essay which was published in the November 29, 2007 issue of Nature, which appears to be an apologetic for her part in the establishment of the ethics of embryonic research in the United Kingdom. The bloggers at Women's Bioethics Project speculate that she wrote in anticipation of Parliament's review of the Human Fertilization and Embryo Authority.
The full essay is for subscribers only - but there's a 2006 article that describes the wider function of the committee, here.

What Warnock explains (but doesn't acknowledge) is that her committee did exactly what they accused the Catholics of doing: "answering in advance the very question we were asking."

The task was to justify embryo experimentation, posed to the Committee after it was proven that the embryonic Louise Brown was the born Louise Brown. They did the job they believed that they were assigned, and then projected their own act of "answering in advance" upon anyone who drew a connection between the moral worth of the embryonic Louise Brown and the born Louise Brown.

Ironically, Dame Warnock admits to no expertise in morality yet feels justified in rejecting the moral expertise of the Catholic Church simply because it is the Church. All the while complaining about the difficulty of pleading the case that the issue is one of morals.

I wonder whether we could get murder and rape prohibited by this committee.
From the Nature essay (emphasis is mine):

When in 1978 the first baby was born by in vitro fertilization (IVF) it was inevitable that there would be calls for the procedure to be prohibited. That science develops too fast for morality had become the cliché of the twentieth century. Wisely, the UK government decided to set up a committee from which to seek advice before legislating on such a complex and emotive issue.

The Committee of Enquiry into Human Fertilisation and Embryology was founded to examine the social and ethical implications of the new techniques. Therefore the committee could not be made up entirely of physicians and scientists. With some difficulty, 16 people — including me as the chair — were gathered to look at the problem from all angles. Our areas of expertise included social work, law and theology.

We were not a group of 'moral experts', with particular moral authority derived from our expertise. Rather, our entitlement to propose legislation derived from the fact that we had been set up by government and that we had been given the time and resources to do so. The only other requirement was that we should all be capable of formulating and listening to arguments.

The central and most controversial issue before us was whether or not research using live embryos should be permitted. There was little possibility of a moral consensus. If research were prohibited, IVF could not continue. It would have been too risky for patients.

When legislation seemed imminent in Britain, the Catholic Church published an instruction condemning IVF and research using human embryos. The Church stated that its instruction was based on "the criteria of moral judgement as regards the application of scientific research and technology, especially in relation to human life and its beginnings".

The Church claimed a right to regulate science in this area, because of its superior knowledge of morality. In sharp contrast, the committee's entitlement to issue moral advice to ministers derived from its having been set up to do so, and from its having a wide and non-partisan membership.

Prohibition of IVF did not seem to the majority of the committee to be a serious option, given its widespread welcome as an innovative remedy for infertility. We all regarded infertility as a serious malfunction, causing much distress. Instead, we proposed a strict system of licensing, backed up by the criminal law. Regulation was not a mere sop to science-phobia. There was a real danger that women, desperate to conceive, might be exploited, taken in by unrealistic promises and charged extortionate fees for futile or dangerous treatment.
Establishing what limits should be placed on embryonic research entailed a decision by the committee as to the moral and legal status of the live human embryo in vitro. Those who opposed the use of embryos in research could seek to demonstrate that it was morally wrong only by answering in advance the very question we were asking. They deemed that the embryo had the same moral status as any human being.

One of the most difficult tasks the committee faced was to get parliament to understand that the status of the embryo in vitro was a matter not of science but of moral decision. The novelty of the embryo in vitro meant that there could be no appeal to precedent or existing moral convention or to religious laws.

30 years later, the evolution of the HFEA regulations - through one mutation followed by another due to pressure to expand the limits of research - allow preimplantation genetic diagnosis, selection for "savior siblings" and against low risk genes, cloning and (most recently) licensing the use of non-human oocytes and human DNA for cloning experimentation.

Colorado's Human Life Amendment

Although Time Magazine, the Denver Post and the blogs insist on calling it the "fertilized egg rights" law, Colorado's State Supreme Court has approved the wording for a proposed "Human Life Amendment." The proponents of the amendment need 76,000 signatures in order to get the initiative on the November, 2008 ballot.

The Chicago Tribune reporter at least understands that after fertilization we are talking about an "embryo." The Trib even found three ethicists who agree that the human embryo is alive. Which puts them in opposition Justice Blackburn’s opinion ( which medical school did he go to, anyway?) in Roe v. Wade that no one knows when life begins.

Unfortunately all three of those ethicists are much more worried about the definition and description of the qualities and abilities of those living humans they deem worthy of “personhood” than whether or not it is acceptable to discriminate between which humans are persons or not. Their main objection seems to be that protection of the inalienable right not to be killed, enslaved or treated as research material “would cause a lot of problems." (I'll bet that they disagree with the Dred Scot opinion, though. Overturning that one sure caused a lot of problems.)

U.S. law, based as it is on “unalienable rights” mentioned in the Declaration of Independence, should absolutely prevent courts, laws and ethicists from infringement of the right not to be killed or enslaved. Ethicists – of all people – shouldn’t need a lawyer to understand that the full exercise of unalienable rights affects infants, children, the mentally disabled and the mentally ill. Parents have special duties to their children and children can't claim the same expression of liberty (drinking, driving, entering into contracts) that their parents do. There are legal precedents for dealing with the “problems” posed by the varying abilities of the mentally ill and disabled as well as for minors – including very young infants who can legally be restrained against their will (in a crib, playpen or car seat).

The “ethicists” in the Tribune article, as well as readers' comments in both papers and in blogs all over the internet, bring out every pro-abortion objection except the coat hanger. They warn us that fertile women will be “monitored,” that women who miscarry or who drink a glass of wine will be prosecuted. They insist that if State law recognizes the human being as a person from fertilization, we’ll have to decide whether to try to save every child at miscarriage and ectopic pregnancy or fail to enforce the law. Elective intentional abortions and manipulation that is intended to end the organization of an embryo - are acts which may be prohibited under law and the State Medical regulations. Spontaneous abortions (miscarriages), and stillbirths, like so many natural deaths, are impossible to prevent and cannot be prohibited.

Since US Supreme Court rulings (Roe v. Wade and Casey, among others) all base the “right” to an abortion on the autonomy of the mother and while affirming the right of the State to protect the child in certain cases, the “extracorporeal” embryo should be protected, somehow, even in current law.

It might be worth noting that the law requires determination of the cause of death of everyone who dies, and that Texas requires a special review of children under 6 and those of any age who die within 24 hours of admission to the hospital. Texas also names a “person” as living human individual from fertilization to natural death through our Penal Code. The 2003 Prenatal Protection Act allows criminal charges when a third party causes the death of an unborn child while exempting the actions of the mother or deaths due to legal medical procedures with the consent of the mother.

In fact, 3 men have been convicted of capital murder under our 2003 Prenatal Protection Act. The convicted men were abusive, the father, and intended to kill the child(ren). One killed twins at 5 months gestation but not the mother, the other two each killed mother and child. One man received the death penalty for killing a teenaged girl he'd gotten pregnant. There are charges pending in at least one more case, a drive-by shooting that caused the death of a pregnant woman.

Last month, the Texas Court of Criminal Appeals ruled in favor of the conviction of a man who killed one of two women he was sleeping with after the first told him she was pregnant. He told his second girlfriend that he would take care of the pregnancy of the first, and shot the first woman 3 times with a shotgun, once in the face.

As for "monitoring the actions of women:" a couple of county District Attorneys in Texas have tried to turn the law into an excuse to lock up mothers for endangering their unborn children. The outcome was similar to the cases in South Carolina a few years ago, when women were arrested after being tested as part of their pregnancy screening, required by that State’s Medicaid regulations. One lawyer made a speech to a group of lawyers that the Act could be coordinated with our State's Consent Laws to charge doctors with capital crimes. Texas State Attorney General has given an official statement on the intent of the Legislature that exempts mothers and doctors.

The handling of an ectopic pregnancy is well established under the doctrine of self-defense. With our current medical technology, the child cannot be saved and he or she is a direct danger to his mother’s life.

While we can’t verify the soul, we can verify which embryos are organisms: techs do it all the time in labs. The embryo, unlike the sperm, egg, and transplanted organs, is an organized organism. It's easy to tell within a day whether the oocyte is fertilized and which are not. It's also easy to tell the difference between embryonic stem cells and an embryo.

Flash: Embryonic tissue more difficult to obtain than adult

This could liberate future researchers from relying on embryonic tissue, which can be more difficult to acquire.

"NatureNews," the news alert website for the journal Nature, has a news report (registration required) on a study published in the December 6 issue of the journal by researchers from Bonn, New York, Rhode Island, and Pennsylvania on regenerating heart muscle.

It is known that (in mice and assumed in humans) that embryonic heart stem cells or precursor cells (they're a bit more specialized than most of the "stem cells" we've been hearing about - cardiac myocytes (eCMs) and skeletal myocytes ("SMs") will bind to damaged areas of the heart and promote healing and division. However, the SMs have a much higher risk of irregular heartbeats called "ventricular tachycardia." (The "VTach" that causes most sudden deaths after heart attacks in real life and the dramatic scenes on TV.) Even though some people do have better heart function after treatment with their own SMs (from bone marrow or skeletal muscle), 15% of them die of VTach within 3 years.

The researchers found that the eCM's "coupled physically" to the damaged cells in the heart and exchanged electrical signals with the surrounding heart cells, so that they contracted in the proper rhythm.

The scientists (rather than deciding to pursue only eCM therapy) wanted to know why the SMs didn't do as well as eCM when it came to producing the correct rhythm. They discovered that the eCMs had more Cx43 than skeletal muscle. Mice were developed with gene therapy (using viral vectors to insert genes, a common technique used to create "gene mod" mice for research) so that the SMs of the mice express more Cx43 in skeletal muscle than normal. The mice hearts that received the modified SM's from these mice, when cultured and then injected into damaged hearts of other mice, did as well as the hearts that received eCMs.

The science is fascinating, but the irony of the report coming this week is pretty interesting, too. The author of the NatureNews report is truly unbiased or evidently didn't get the memo from the reactionary scientists this week.

(In case you're wondering, I don't get a memo from anyone other than the reactionaries' own blogs, and statements to the press.)

Wash this reactionary's mouth out with soap!

Bioethics.net compares the Bush administration's happiness about reprogrammed adult stem cells with that man, Mr. Clinton's, "I did not have sex with that woman!" and President Bush's statement "Mission accomplished," after our US troops captured Baghdad.

I'll accept the latter (at some future date, if the evidence supports it), but the first is at least as false as Clinton's wagging finger - and (speaking of Yuk factors) did we really need to be reminded of that?

The author, James W. Fossett (who is anything but "non-partisan") states that Yamanaka, the first to report reprogrammed adult cells in humans and mice is from Japan and wasn't affected by the US Federal funding limitations. He doesn't mention that Yamanaka's research didn't rely on the use of new embryonic cells, at all. Yamanaka took the information gleaned from animal research and the currently funded cells and moved to the front of all other stem cell researchers by pointing the way to the key to the production of stem cells from each patient who needs them - from his or her own cells.

Instead, Fossett is running scared due to the "rhetorical parity" from cell reprogramming and the possibility that the success in reprogramming cells will result in more reprogramming research!

Fossett doesn't mention that James Thomson's research using human Embryonic Stem cells (hESC). then human fetal cells harvested after abortions - and finally in skin cells harvested at circumcision of little boys - was funded by the National Institutes of Health, and that those hESC are the ones that supposedly are of no use.

Fossett also fails to mention of the new report by Yamanaka on the technique using only 3 inserted genes to the prior 4, and that the eliminated gene is the one that had scientists concerned about cancers.

I'm sure that he doesn't recall the "first transplantable lung cells" from hESC's by Texas researchers last year. These cells were developed by viral "transfection," also, and were lauded as "a platform that could potentially be useful in the development of spinal cord cells, heart cells, nerve cells and others.” These were neither the first or transplantable, but they did get much more notice than similar cells developed from umbilical cord blood cells without viral transfection.

That may be the problem: the proponents of hESC research are used to getting many times the publicity from hESC research than that received by the non-hESC researchers. And so, we get the concerns about "rhetoric."

There's those deceitful knee jerk reactionaries practicing their projection, again.

Knee Jerk Deceit (Embryonic Stem Cells)

The Washington Post has published an editorial by Alan I Leshner, Ph.D., and James A. Thomson, Ph.D. The op-ed is evidently in reaction primarily to Charles Krauthammer's November 30, 2007 column and blurs the line between fact and fiction in order to make a political plea to remove restrictions on funding for embryonic stem cell research.

Leshner is a psychologist, the Executive Director of the American Association for the Advancement of Science and the Executive Publisher of the magazine, Science. Science is the journal that published the two completely fabricated and retracted reports by Wu Suk Hwang about cloning, the letter attacking David Prentice, Ph.D., for his list of adult stem cell therapies, a letter by Dr. Prentice rebutting the attack, and yet another set of attacks-counter attacks. It is also the journal that published the article ahead of print by Thomson and Yu, et. al., describing the reprogramming of adult fibroblast skin cells on November 22, 2007, after the basic research was done using embryonic stem cells funded by the National Institutes of Health.

Thomson is the veterinarian and professor of anatomy at the Genome Center of the University of Wisconsin who first reported embryonic stem cells from human embryos and who confirmed that adult cells can be reprogrammed into embryonic stem cells. Thomson's institution oversees the NIH program for distributing the Federally funded embryonic stem cell lines and for training researchers to use those cells.

The editorial published December 3, 2007 is titled "Standing in the way of Stem Cell Research." Notice that there is no distinction made between embryonic stem (ES)cells and adult.

The opening sentence says, "A new way to trick skin cells into acting like embryos changes both everything and nothing at all." These stem cells do not act like embryos; they act like ES cells. According to Thomson in his report: "The human iPS cells described here meet the defining criteria we originally proposed for human ES cells."

Leshner and Thomson make the usual claim that ES cells can make all the cells of the body in order to treat spinal cord injuries, brain, heart and other diseases. They do not note that all these cells only come from embryonic stem cells in functioning intact embryos or with very limited, inefficient and difficult methods. In the lab, the stem cell cultures are not homogeneous clumps that can be be easily directed to the desired cells. Instead, the colonies contain cells at different stages of differentiation. Like adult stem cells and progenitor cells, the few stem cells that are amenable to some of the desired cell types must be selected and grown in special environments and nutrients.

No one has yet been able to guarantee that the cells derived from ES cells can be controlled. The risk of introducing a primitive, undirected cell line that will form tumors is the main reason that no one has yet attempted to use these cells in humans. The risk of uncontrolled - tumor causing cells is accompanied with the problem of immune rejection of transplants in patients. Researchers won't be able to obtain "patient specific" cells unless they are able to clone human embryos or learn to reprogram adult cells.

The letter points out that embryonic stem cells were used to help the researchers know how to grow human ES cells while claiming that funding has limited research, without admitting that research on those ES cells was indeed funded by Federal money. They write about the frozen embryos from IVF that would have been destroyed anyway but do not note that unless the donors of the gametes that join to become the embryo give informed consent prior to fertilization, those embryos are not eligible for ethical research. They don't mention the pleas for the intentional creation of new, disease specific embryos with the intention of harvesting research material to create '''disease specific" cell lines (like those made to "model" Fragile X syndrome and cystic fibrosis.)

The authors complain of restrictive funding that prevents young people from doing ES cell research. Then, they say that other countries don't have the same sort of problems and mention that Yamanaka did his research in Japan. In fact, there are other countries with much more rigid restrictions, and few have spent as much on ES cell research as we have here in the US. (Germany's policy actually forbids destruction of embryos.) Dr. Yamanakas' research would have qualified for Federal funding in the US since he didn't use embryonic stem cells at all in his experiments.

Leshner and Thomson tell us that it "remains to be seen whether reprogrammed skin cells will differ in significant ways from embryonic stem cells." It also remains to be seen whether human ES cells will ever be used in human beings.

Talk about reactionary science!

Edited 12/4/07 for punctuation, grammar - BBN

Texas Employees, Politics, and Science

(Just to be clear about where I'm coming from, I believe in a Creator and also believe that the evidence I've seen supports the evolution of species. When asked about evolution, I say, "It looks like that's how God did it." Now that I've alienated all but a few of my readers . . .)

The New York Times has an article today on the resignation of the Texas Education Agency (TEA) employee, Chris Comer. In my opinion, the NYT and the Austin American-Statesman focus on the wrong theme. The story is more about the politics of being a State employee than about the politics of science.

The blogosphere is full of comments relating her resignation to "creationists" and drawing an analogy to the movie, "Expelled."

However, there's a difference between speech and advocacy on scientific controversies while working in a academic position (even when paid by the State) and the same activity while working for a State Agency. While both should avoid frank political advocacy while on the State's time clock, the former is in the business of discussing and critiquing science. The Agency employee works directly for men and women who are themselves restrained by the voters of the State, who have their own politics.

The implication of the NYT piece is that Ms. Comer was under pressure due politics, the appointment of a new Chairman of the State Board of Education and the hiring of a woman who used to work for the Bush Administration. On further research, I found a possible connection between a statement that Ms. Comer made concerning the lack of "real" leadership at the TEA under an acting Commissioner and the appointment of the same man to the office of Commissioner.

In addition, it might help to know that the Texas Legislature recently mandated that each agency develop ethics policies.

Texas elects our State Board of Education, the Governor appoints (and the State Senate confirms) one of these elected officials to the Chair and he also appoints the Commissioner of the TEA. The TEA is the bureacracy that provides "leadership, guidance, and resources to help schools meet the educational needs of all students."

State employees are forbidden by policy to mix in politics while on the job and with State resources. At the very least, it's not wise to risk bringing pressure down on your appointed or elected bosses. The offense that led to Ms. Comer's resignation was sending an email from her TEA account that announced a talk entitled, "Creationism's Trojan Horse."

Ms. Comer and the author of the NYT article find something notable in the policy at TEA:

But several months ago, in response to an inquiry letter, Ms. Comer said she was instructed to strike her usual statement about the board’s support for teaching evolution and to quote instead the exact language of the high school biology standards as formulated for the Texas Essential Knowledge and Skills test.

“The student knows the theory of biological evolution,” the standards read, and is expected to “identify evidence of change in species using fossils, DNA sequences, anatomical similarities, physiological similarities and embryology,” as well as to “illustrate the results of natural selection in speciation, diversity, phylogeny, adaptation, behavior and extinction.”

I fail to see a problem in a policy requiring the quote. I would think that it would inform and educate any one with questions and protect State employees from political fallout.

Ms. Comer herself makes correlations between certain politically controversial subjects:

“I don’t see how I took a position by F.Y.I.-ing on a lecture like I F.Y.I. on global warming or stem-cell research,” Ms. Comer said.

And she did consider the email risky:

As for the e-mail, Comer said she did pause for a "half second" before sending it, but said she thought that because Forrest was a highly credentialed speaker, it would be OK.

For a step-by-step report about Ms. Comer's troubles at the TEA, see the Austin American-Statesman article and my earlier post.