Top Bioethics News Stories, December 2020–May 2021

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“Little Is Known About the Effects of Puberty Blockers”

The Economist, February 18, 2021

All drugs offer a mix of harms and benefits. But despite their popularity, the effects of puberty blockers remain unclear. Because they are not licensed for gender medicine, drug firms have done no trials. Record-keeping in many clinics is poor. (https://tinyurl.com/bdhe2vj9)

Prescribing puberty blockers for gender dysphoria is an off-label use of the drug. Although requests for puberty blockers for gender dysphoria have increased substantially in the past ten years, there have been no large clinical trials to determine the potentially deleterious effects to children who take puberty blockers. The studies that have been done are small and non-representative or are flawed. Several people who have taken puberty blockers for the prescribed use, such as precocious puberty, have sued the pharmaceutical companies for harmful side effects including cognitive defects, brittle bones, chronic pain, sterility, and the onset of artificial menopause. Further complicating matters, because of push-back from interest groups, research on puberty blockers and other forms of “gender affirmation” therapies often does not get funding or is shut down.

“First Independent Report into Xinjiang Genocide Allegations Claims Evidence of Beijing’s ‘Intent to Destroy’ Uyghur People”

by Ben Westcott and Rebecca Wright, CNN, March 9, 2021

The Chinese government’s alleged actions in Xinjiang have violated every single provision in the United Nations’ Genocide Convention, according to an independent report by more than 50 global experts in international law, genocide and the China region. The report, released Tuesday by the Newlines Institute for Strategy and Policy think tank in Washington DC, claimed the Chinese government “bears state responsibility for an ongoing genocide against the Uyghur in breach of the (UN) Genocide Convention.” (https://tinyurl.com/4899dh75)

Human Rights Watch World Report for 2020, published in January 2021, noted that the Chinese government continues to surveil and detain Uyghur people and other minorities in the Xinjiang Autonomous Region and that human rights in China is at its worst since the Tiananmen Square massacre in 1989.[1] Detainees are forced to work in factories or cotton fields, and there are reports of torture and forced sterilizations. The Newlines Institute for Strategy and Policy report demonstrates the Chinese government’s responsibility for violating UN Genocide Convention of 1948. While normally an international declaration of genocide would be determined in a UN International Tribunal, because China is a UN member with veto power, the determination of genocide was conducted by a multi-national independent group. Several countries have formally accused China of genocide, and several organizations are calling for participating countries to boycott the 2022 Beijing Olympics.

“Scientists Plan to Drop the 14-Day Embryo Rule, a Key Limit on Stem Cell Research”

by Antonio Regalado, MIT Technology Review, March 16, 2021

For the last 40 years, this voluntary guideline has served as an important stop sign for embryonic research. It has provided a clear signal to the public that scientists wouldn’t grow babies in labs. To researchers, it gave clarity about what research they could pursue. Now, however, a key scientific body is ready to do away with the 14-day limit. (https://tinyurl.com/29yya36x)

“New Models Could Help Scientists Study the Earliest Stages of Embryonic Development”

by Andrew Joseph, STAT News, March 17, 2021

A pair of research teams unveiled two new ways to replicate a key structure from the earliest days of embryonic development—an advance that could provide important new insight into human development and pregnancy loss, but which also raise thorny questions about research with embryo-like models. The models described in the two papers, both published Wednesday in the journal Nature, are meant to mimic human blastocysts. (https://tinyurl.com/y972bs5x)

Since the birth of the first baby produced through in vitro fertilization, the 14-day rule has been a hard-and-fast international guideline for researchers. The rule has largely gone uncontested because the science has not been able to keep embryos alive for more than 14 days. (Note: this is different from frozen embryos, which are essentially in suspended animation.) But research with synthetic blastocysts, or “blastoids,” as well as recent studies with human-animal chimeras and genetically modified embryos, have prompted scientists with the International Society for Stem Cell Research to publish guidelines calling for a change in 14-day rule. The new guidelines were published in May 2021.[2]

“The Foundations of AI Are Riddled with Errors”

by Will Knight, Wired, March 31, 2021

The current boom in artificial intelligence can be traced back to 2012 and a breakthrough during a competition built around ImageNet, a set of 14 million labeled images. In the competition, a method called deep learning, which involves feeding examples to a giant simulated neural network, proved dramatically better at identifying objects in images than other approaches. That kick-started interest in using AI to solve different problems. But research revealed this week shows that ImageNet and nine other key AI data sets contain many errors. (https://tinyurl.com/2p99wu9e)

“Europe’s Proposed Limits on AI Would Have Global Consequences”

by Will Knight, Wired, April 21, 2021

The European Union proposed rules that would restrict or ban some uses of artificial intelligence within its borders, including by tech giants based in the US and China. The rules are the most significant international effort to regulate AI to date, covering facial recognition, autonomous driving, and the algorithms that drive online advertising, automated hiring, and credit scoring. The proposed rules could help shape global norms and regulations around a promising but contentious technology. (https://tinyurl.com/3nmvyfnt)

When an algorithm identifies a person’s face from thousands of hours of video, it does so by “learning” from labeled data input in the system. But the algorithm is only as good as the data fed into it. If the data is mislabeled or if it is biased, such as labeling women who work in hospitals as nurses, then that bias is perpetuated in healthcare settings, police systems, and hiring practices. In December, one of Google’s AI ethicists was fired for co-authoring a relatively unremarkable research paper describing the limitations of AI to generate text. Several articles during the first half of 2021 point to ethical issues popping up in machine-learning systems, and the EU has proposed strict boundaries on the use of AI.

“First Monkey-Human Embryos Reignite Debate Over Hybrid Animals”

by Nidhi Subbaraman, Nature, April 15, 2021

Scientists have successfully grown monkey embryos containing human cells for the first time—the latest milestone in a rapidly advancing field that has drawn ethical questions. In the work, published on 15 April in Cell, the team injected monkey embryos with human stem cells and watched them develop. They observed human and monkey cells divide and grow together in a dish, with at least 3 embryos surviving to 19 days after fertilization. (https://tinyurl.com/2p8a9emj)

Scientists from universities in China and the U.S. injected cynomologus monkey embryos with “human extended pluripotent stem cells,” or induced pluripotent stem cells that can make all cell types including those typically only seen in embryos.[3] The U.S. does not permit federal funding for research of human-primate chimeras, so the research was done at a Chinese university and was funded by the Chinese government, a Spanish university, and a U.S. foundation. Critics of this research question why a human-monkey chimera is necessary since human-cow and human-pig chimeras are more useful and less ethically contentious. Additionally, the National Academies of Science, Engineering, and Medicine expressed concern over human nerve cells entering animals’ brains. Notably, the embryos were not allowed to grow long enough for the nervous system to develop; however, the researchers admitted they cannot control what cell types the pluripotent stem cells become.

References

[1] Human Rights Watch, “China,” in Human Rights Watch 2021 Annual Report: Events of 2020 (New York: Human Rights Watch, 2021), https://www.hrw.org/world-report/2021/country-chapters/china-and-tibet.

[2] “The ISSCR Releases Updated Guidelines for Stem Cell Research and Clinical Translation,” ISSCR.org, May 26, 2021, https://www.isscr.org/news-publicationsss/isscr-news-articles/article-listing/2021/05/26/the-isscr-releases-updated-guidelines-for-stem-cell-research-and-clinical-translation.

[3] Yang yang et al., “Derivation of Pluripotent Stem Cells with In Vivo Embryonic and Extraembryonic Potency,” Cell 169, no. 2 (2017): 243–57.e25, https://doi.org/10.1016/j.cell.2017.02.005.