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Bioethikos: Bringing Life to Bioethics

Archive for the ‘commentary’ Category

 

Protecting Babies with Down Syndrome

Thursday, May 21st, 2015
L to R: Dr. David Prentice, Edwin Vance (holding photos of son Justin who has Down syndrome), Stephanie Ranade Krider, Jackie Keough, Mary Kate Keough, and Dr. Dennis Sullivan

L to R: Dr. David Prentice, Edwin Vance (holding photos of son Justin who has Down syndrome), Stephanie Krider, Jackie Keough, Mary Kate Keough, and Dr. Dennis Sullivan

Last Tuesday evening, I presented testimony at the Ohio Statehouse in Columbus, representing the Center for Bioethics and Ohio Right to Life. I spoke before the Community and Family Advancement Committee in the Ohio House, in favor of H.B. 135, a statute to prohibit abortion solely because of a diagnosis on Down Syndrome. Here is an excerpt from my testimony:

It is highly relevant to our purposes today how we will protect the disadvantaged and vulnerable among us, and how we will prevent genetic discrimination among those who currently have no voice. Seven other states ban abortion for gender selection, and one other state bans abortion for genetic abnormalities. What we are proposing with this statute is rather simple: to protect unborn individuals with Down Syndrome from being killed simply because they have this condition. Anything else is discriminatory. Failure to protect these innocent unborn children is simply eugenics, and it is morally wrong.

 

Please communicate with your state legislators, to encourage them to support and pass H.B. 135, the Down Syndrome Non-Discrimination Act (for my full testimony, click on the link below).

Sullivan HB 135 Testimony

Ohio Right to Life Press Release

Could understanding nature help us treat trisomy?

Monday, May 4th, 2015

21_trisomy_-_Down_syndrome Image Courtesy of Wikimedia Commons

by Dr. Heather Kuruvilla

What if we could actually treat the root cause of conditions like Down’s Syndrome, rather than simply ameliorating symptoms?  Although the life expectancy of Down’s Syndrome patients has increased dramatically in the past few decades, and is now approximately 60 years of age, patients continue to experience serious medical conditions such as congenital heart defects, hearing loss, and a susceptibility to Alzheimer’s Disease (National Down Syndrome Society).  Since all of these conditions correlate with the presence of an “extra” 21st chromosome, gene dosage is hypothesized be the root cause of these issues.  So, can we simply turn that extra chromosome off?

In human females with a normal chromosomal composition, somatic (body) cells contain two X-chromosomes.  Normally, in each cell, one X-chromosome is completely silenced.  Recently, scientists have discovered how long, non-coding RNAs (lncRNA) interact with proteins to cause inactivation of the entire X-chromosome.  It is hoped that understanding this mechanism will eventually lead to better treatments of autosomal trisomies, such as the most common, Down’s Syndrome, as well as trisomy 14 and trisomy 18, which are sometimes viable.  According to Genetic Engineering and Biotechnology News:

This information soon may have clinical applications. The Xist lncRNA silences the X chromosome simply because it is located on the X chromosome. However, previous studies have demonstrated that this RNA and its silencing machinery can be used to inactivate other chromosomes, e.g., the third copy of chromosome 21 that is present in individuals with Down’s syndrome.

 

Click here for more information on this discovery.

 

CRISPR–It’s not just for the refrigerator anymore!

Monday, April 27th, 2015

CRISPR_Sterics.pdf image courtesy of Wikimedia Commons

 

by Dr. Heather Kuruvilla

For most of us, “crisper” means the drawer at the bottom of the refrigerator.  But if you Google CRISPR, which stands for Clustered Regularly Interspaced Short Palindromic Repeats, you will find that it is a powerful genomic editing technology.  CRISPR can be used to inactivate  or to edit genes.  For more on how this technology works, see this article.

Obviously, any technology capable of editing genes becomes a possible target for gene therapy.  Imagine if CRISPR could be used to cure genetic disease!  This attractive possibility is why Chinese scientists recently used CRISPR to modify unviable human embryos.

The data themselves are telling.  As reported by Genetic Engineering and Biotechnology News:

It noted that out of 86 human embryos that were subjected to genetic manipulation, 71 survived. Of the surviving embryos, 54 were genetically tested. Just 28 of these 54 embryos were successfully spliced. An even smaller number turned out to contain the desired genetic material. Also, off-target effects were seen.

 

The experiment has ignited a firestorm of controversy.  Although CRISPR has shown promise in the laboratory, many scientists are wary of using this technology on human embryos when its safety and efficacy have not yet been proven.  If the study above is any indication of what would happen in a viable human embryo, there appear to be a number of troubling results.  “Off-target effects” were seen, meaning that unwanted genetic modifications were occurring.  If this is the case, using CRISPR would potentially create genetic defects that are more severe than the disease we were trying to treat.

Another problem comes with the splicing success rate.  “Just 28 of these 54 embryos were successfully spliced.”  If we were using this technology to treat embryos with genetic defects, what do we do with the embryos if our treatment fails?  Are these embryos then discarded, or  are they allowed to implant with their genetic defect still present?  I would argue that these embryos deserve our protection, as human persons created in the image of God.  However, by treating them, have we caused further damage?  In other words, are we raising the probability that these already genetically impaired embryos will not be viable?

CRISPR is an exciting new technology, and may even help us create adult stem cells for therapy.  When it comes to genetic modification of human embryos, however, this technology is definitely not ready for primetime.

Center Launches New Academic Journal

Wednesday, April 22nd, 2015

BFP logo

The Center for Bioethics is launching a new peer-reviewed academic journal, entitled Bioethics in Faith and Practice. We are excited about this new venture, which will help healthcare professionals and academics with a faith perspective to articulate their values in the pluralistic arena of medical practice.

Why a new online journal, in a field already filled with academic voices? It is because of a particularly vexing problem in our public discourse, one which the late Richard John Neuhaus referred to as “The Naked Public Square.” Father Neuhaus spoke out about the aggressive exclusion of religious ideas from our national debates. This is especially true in medical ethics, where biblically-derived values are conspicuously absent. Of course, this makes no sense, because most of our patients have religious ideas that they desperately turn to in times of illness and suffering. Yet many physicians, nurses, and pharmacists are ill equipped to speak this language, and they have been taught that it is “unprofessional” to discuss these topics.

Theologian George Weigel, in discussing the Neuhaus legacy, put it this way:

[Fr. Neuhaus pointed out that] the secularism of late modernity (and, now, post-modernity) would not be neutral, civil, and tolerant, but aggressive, rude, and hegemonic. It would demand, not a civil public square in which the sources of all moral convictions would be in play in a robust debate, but a naked public square — a public square in which secularism would be de facto established as the national creed (or, perhaps better, national moral grammar). The new secularism would not be content to live and let live; it was determined to push, not only religion, but religiously informed moral argument, out of public life, and to do so on the ground that religious conviction is inherently irrational. And of course it would be but a short step from there to the claim that religious conviction is irrational bigotry . . .

 

And so we have the modern crisis of conscience rights, where the State would force doctors to perform abortions and pharmacists to dispense abortive drugs. We have angry resistance to common-sense evidence that late-term unborn babies feel pain and perhaps should be sedated before their lives are snuffed out. And we have a rising tide of states declaring it legal for doctors to discard a 2400-year Hippocratic tradition and give lethal medications to their patients to commit suicide. And if anyone invokes a Deity in protest, they are called bigoted, intolerant, and irrational.

So we need your help to bring another voice to the table. Doctors, nurses, pharmacists, healthcare students, pastors, priests, philosophers, and other scholars: please join us to bring a perspective informed by faith and Scripture back to the Public Square. Go to our website, consider our call for scholarly input, and join the discussion. From essays to opinion pieces, from book reviews to full-fledged research articles, share your insights. We guarantee thoughtful, objective editorial consideration from our world-class Editorial Advisory Board.

Yes, the Public Square is still naked, and a reasoned voice of faith is needed now more than ever.

Press Release

Call for Papers and New Journal Website

George Weigel Commentary on Neuhaus

PGD: Eugenics Is Not Dead

Monday, April 13th, 2015

EugenicsTreeLogo

by Dr. Heather Kuruvilla

There is no genetically perfect person.  Every one of us carries mutations, both genetic and epigenetic, in our genomes.  In the future, we may be able to repair these defects.  Gene therapies have shown promise in treating some types of cancer, and may eventually be used to treat or cure diseases such as sickle-cell anemia and cystic fibrosis.  But right now, genetics is being used to discriminate against, and even destroy embryonic human beings.

Preimplantation genetic diagnosis is marketed as a way to help infertile couples conceive, and is usually done in embryos which have been created by in vitro fertilization.  According to the americanpregnancy.org website,

Preimplantation genetic diagnosis involves the following steps:

  1. First, one or two cells are removed from the embryo.
  2. The cells are then evaluated to determine if the inheritance of a problematic gene is present in the embryo.
  3. Once the PGD procedure has been performed and embryos free of genetic problems have been identified, the embryo will  be placed back in the uterus, and implantation will be attempted.
  4. Any additional embryos that are free of genetic problems may be frozen for later use while embryos with the problematic gene are destroyed.

 

In the future, we may be able to use such technologies to diagnose and repair genetic defects.  But at present, this technology is only used to destroy embryos, since we don’t yet have the capability to fix them.  Is this technology simply giving hope to infertile couples?  Or has eugenics reared its ugly head yet again?

Battle Over Admitting Privileges Gets Ugly

Wednesday, April 1st, 2015

medical-clinic

The abortion industry has claimed for years that a right to legal abortion is necessary to protect women’s health. In fact, just the opposite is true. Abortion at any stage is an unnatural intervention into a natural process. While first-trimester abortion has a low risk overall for the procedure itself, the safest course is for a woman to carry her pregnancy to term. And there is much more at stake. Long-term risks include:

  • Premature birth: At least 130 studies have shown an increased risk of subsequent premature birth and low birth weight infants following abortion.
  • Placenta Previa: the condition during pregnancy in which the placenta covers the
    cervix, increasing the risks of life-threatening maternal hemorrhage, premature birth, and
    perinatal child death.
  • Breast cancer: It is undisputed that a woman’s first full-term pregnancy reduces her risk of breast cancer. Moreover, numerous studies have shown that abortion may increase a woman’s lifetime risk of breast cancer.
  • Mental health: A 2011 study in the British Journal of Psychiatry examined 22 studies conducted from 1995 to 2009 and found that women face an 81 percent increased risk of mental health problems following abortion. There were increased risks of 34 percent for anxiety, 37 percent for depression, 110 percent for alcohol abuse, and 155 percent for suicide.
  • Maternal mortality: Abortion advocates have long incorrectly asserted that abortion is safer than childbirth. Many studies show the opposite, including one that found maternal death to be three times more likely from abortion than from childbirth.
  • Risks of later-term abortions: Abortion’s risks increase the further into pregnancy it is performed. Beginning at five months of pregnancy, the risk of complications from abortion rises dramatically.

So why not reduce the risks? Why not require that abortion facilities be regulated just like other minor surgical care centers? If abortion is such a boon for women, why shouldn’t we require the facilities where the procedure is performed be sterile and have procedures to care for women if complications arise?

Oh no, that would be restrictive, and since 1973 abortion has become a “constitutional right,” that we cannot infringe on. And so “women’s health centers” have sometimes become places where women die.

More details on admitting privileges

Is Premeditated Targeting of an Unborn Child Murder?

Monday, March 23rd, 2015

637px-Placenta.svg(courtesy Wikimedia Commons)

by guest blogger, Erica Graham

Should personhood be ascribed based upon whether or not the person is wanted?  If this seems like a strange question, consider the following case.  This past week in Longmont, Colorado a 26 year old woman who was 7 months pregnant went to an apartment to pick up baby clothes she’d seen advertised on Craigslist. The woman was stabbed and beaten upon entering the apartment.  The assailant then cut the unborn child from the victim’s womb and fled the scene. The mother-to-be survived but the child did not. The suspect brought the deceased child to the hospital where the victim was being treated, claiming the baby was her own miscarriage. The suspect was apprehended and is now facing charges. Prosecutors, however, are uncertain if murder charges can be filed. In the State of Colorado, a murder charge cannot be pressed unless the child was alive outside the womb.

Our hearts break when we hear this story. A mother is bereft of her child, and the justice system may not allow the suspect to be charged for murder. The prosecutors are working around the question of how long a baby has to live outside the womb to be considered “alive” and thus considered “murdered”.  So, where do we draw the line?  Is one breath outside the womb sufficient? One minute of breathing? When is an unborn child a human person? When do they deserve human rights of their own? Are they just a part of the mother’s body?  Is this grisly attack murder, or merely assault?

Most people would say there was an obvious loss of life here. The expectant mother’s child was violently killed. That fact seems obvious. But what makes a 7 month old fetus different than an 8 week old fetus? And why are we ok with killing one but angered when the other is killed? The only difference is whether or not the mother desires the child.

This horrific Colorado crime shines light on the ugly reality that we let other people decide whether or not someone is valuable enough to live.

 

We let children be killed only when the pregnant woman decides it is permissible. How can we offer justice to a woman who had her baby literally stolen from her womb when we cannot acknowledge her child was even alive?  Should we follow an ethic that allows such injustice?

I believe this potential failure of justice should make us rethink how we legally define life. For the sake of justice we should declare the child alive at conception. This allows expectant mothers to defend their babies’ lives before they are born. Our gut tells us this baby was murdered and I think we should listen to our instincts here. Unborn children can be murdered just any other child can, and they deserve the same rights to justice.

CNN Article describing the case above

The Coming of Medical Martyrdom

Monday, March 16th, 2015

caduce

Do you remember a time when folks talked about a doctor’s oath, something that dictated his or her ethics? Most don’t realize that this originally came from Hippocrates in about 400 B.C., but they assumed that healthcare was guided by professionalism and compassionate care.

Today, the New Medicine is no longer concerned with the Hippocratic Oath, and we no longer hear much about doctors as healers. Now it is all about individual choice, about radical autonomy run amok. In this modern world of consumer health care, the customer is always right.

So what about those who refuse to play along? What about those doctors, nurses, and pharmacists who refuse to cooperate with patient demands for abortion or for drugs to help them kill themselves? In more and more cases, they are censured by their professional societies, and may even be subject to lawsuits. In Belgium, in the Netherlands, in Australia, in Canada, and now increasingly in the U.S., the highest priority is placed on an individual patient’s choice, and these strictures are increasingly finding their way into our laws.

Wesley J. Smith, a moral philosopher and commentator for the Discovery Institute, puts it this way:

If these trends continue, twenty years from now, those who feel called to a career in health care will face an agonizing dilemma: either participate in acts of killing or stay out of medicine. Those who stay true to their consciences will be forced into the painful sacrifice of embracing martyrdom for their faith.

 

With such assaults on health care rights of conscience, the newest martyrs may be those who wear a white coat.

Wesley J. Smith Commentary

Remembering Spring in the Midst of Winter

Monday, March 9th, 2015

1280px-Colorful_spring_gardenPhoto Courtesy  of Wikimedia Commons

by Dr. Heather Kuruvilla

Just days ago, much of the nation was facing wind chill advisories and subzero temperatures.  But walking around my neighborhood yesterday, I heard the sounds of rushing water as the snow melted, the song of birds, and the honking of geese.  The sun was shining, and the smell of spring was in the air.  We knew it was coming.  For weeks now, folks I’ve encountered, whether in line at the post office or ringing up my groceries at Wal-Mart, have been encouraging each other with the hope that “spring is on its way”.

Even on the coldest day, no one doubted that spring was coming.  We’ve seen the seasons change again and again. The pattern of resurrection is woven throughout the fabric of nature.  For every winter, there is a spring.

The fact that we’re still talking about Brittany Maynard proves that the “winter” of our lives is often difficult.  Brittany  Maynard, diagnosed with terminal cancer, chose to end her life last November rather than face the certain pain that lay ahead of her.  I think any of us who has seen the ravages of cancer can empathize with what must have been an agonizing decision.

Her decision illustrates our very basic, human need for hope; the hope that winter will give way to spring.

As Christians, we hold to the hope of resurrection, knowing that the darkness of Good Friday gave way to the triumph of Easter Sunday.  Christ, then, is our ultimate hope.

 

But a terminal patient needs “short-term” hope, too.  What are some ways we can help suffering persons to embrace hope?  According to Cancer Research UK:

Everyone needs to have some sense of hope for their future. When you are dying, this hope may be that you can visit a place that you love. Or you may hope that you can enjoy being with your family and friends for a time. Some people believe that there is life after death and find that this gives them hope…many people hope for comfort, dignity, friendship and love to surround them in their final days.

 

That means every one of us has the potential to be a hope-giver.  For more information on helping the terminally ill, check out these resources:

Hospice Foundation of America

Get Palliative Care

 

Your 3-person Embryo Questions Answered

Monday, March 2nd, 2015

8-cell_stage_embryoPhoto Courtesy of Wikimedia Commons

 

by Dr. Heather Kuruvilla

Since Britain legalized the creation of 3-person embryos on February 24th, I’ve been asked a number of questions about this procedure. Below are a few commonly asked questions as well as some resources that I hope will be helpful.

Why is this procedure sometimes called making a “3-person embryo”?  Gametes from three individuals are being used to create one embryo.  The biological mother and father contribute eggs and sperm respectively.  However, in this case, the nuclei of the biological mother’s egg and the father’s sperm will be injected into an enucleated donor egg that has healthy mitochondria.

Whom would this procedure help? The procedure would enable women with mitochondrial disease to bear healthy children who are biologically related to them.  Mitochondria are cellular organelles that are passed down from mother to child.  Therefore, a woman with mitochondrial disease would normally pass diseased mitochondria to her offspring.

Will embryos be destroyed in order to carry out this procedure?  It depends upon how the procedure is carried out.  There are several methods by which 3-person embryos can be made, and not all are embryo destructive.  I’ve linked an article from the Center for Genetics and Society below.  Using their definitions, pronuclear transfer would involve the destruction of embryos, but maternal spindle transfer and nuclear genome transfer would not.  Polar body transfer would not directly result in the destruction of an embryo, but if the polar body were produced by fertilizing an egg so that the polar body could be produced, the resulting embryo would likely be destroyed since it would contain damaged mitochondria.

Is this procedure risky to humans?  The short answer to this question is that we don’t know.  It is a relatively untested procedure, which raises safety concerns.  In addition, the Center for Genetics and Society (CGS) mention other concerns, such as violating an EU ban on modifying the human germline, risks to the women from whom eggs were extracted, and potential identity struggles that a person might face once he/she learns of the unusual circumstances surrounding his/her conception.  CGS suggests preimplantation genetic diagnosis (PGD) as an alternative to the three-person embryo technology.  However, since PGD generally results in the destruction of genetically imperfect embryos, this alternative cannot be supported by those who believe that embryos are human persons worthy of protection.

For more information: I’ve put links to several helpful articles below.

BBC Article on 3-person embryo

Center for Genetics and Society Article

 

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