Top Bioethics Stories - Spring 2013

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“In the Flesh: The Embedded Dangers of Untested Stem Cell Cosmetics”

by Ferris Jabr, Scientific American, December 17, 2012.

When cosmetic surgeon Allan Wu first heard the woman’s complaint, he wondered if she was imagining things or making it up. A resident of Los Angeles in her late sixties, she explained that she could not open her right eye without considerable pain and that every time she forced it open, she heard a strange click—a sharp sound, like a tiny castanet snapping shut. (

The latest rage in cosmetic procedures is to inject the client’s stem cells, retrieved from fat cells, into his or her face for their supposed rejuvenation effects, a procedure that has not been approved by the FDA. A woman in California received stem cell treatments at an anti-aging center. Several weeks later she experienced “considerable pain” opening her eye. Surgical investigation revealed that the stem cells injected into her eye had reacted with the dermal filler the doctors used, causing tiny bone fragments to form within her eyelid.

“Female Vaccination Workers, Essential in Pakistan, Become Prey”

by Declan Walsh and Donald G. McNeil, Jr., New York Times, December 20, 2012.

The front-line heroes of Pakistan’s war on polio are its volunteers: young women who tread fearlessly from door to door, in slums and highland villages, administering precious drops of vaccine to children in places where their immunization campaign is often viewed with suspicion. (  

Door-to-door polio vaccinations for children in impoverished parts of Pakistan are one of the country’s key public health initiatives. Often the people administering the vaccine are female volunteers. Last December, militant groups in Pakistan stalked and gunned down nine volunteers due to suspicion that the vaccination effort was either a plot to sterilize Muslim children or a front for American clandestine activities.

“Experts Aim to Redefine Healthcare and Research Ethics”

Science Daily, January 11, 2013.

In what they acknowledge as a seismic shift in the ethical foundation of medical research, practice and policy, a prominent group of interdisciplinary healthcare experts, led by bioethicists at Johns Hopkins, rejects an ethical paradigm that has guided the American system since the 1970s and calls for morally obligatory participation in a ‘learning healthcare system’ more in step with the digital age. (  

Several leading bioethicists recently published a new set of guidelines for patient research in The Hastings Center Report. These guidelines, if accepted, would relax the ethical distinction between doctor/patient and scientist/subject, as they call for integrating clinical research with clinical practice. Additionally, the report prescribes obligations on both the doctor’s and the patient’s part for improving health for all by learning from patient care.

“Belgian Twins Had First Request to Die Refused”

by Bruno Waterfield, The Telegraph, January 14, 2013.

The two men, 45, from the village of Putte, near the city of Mechelen outside Brussels, were both born deaf and sought euthanasia after finding that they would also soon go blind. (  

With some U.S. states, as well as countries such as France and Ireland, considering new euthanasia laws, the story of 45-year-old deaf Belgian twins who sought euthanasia because they were going to lose their vision as well was a hot topic in the media this past January. Belgian law allows for euthanasia if a person is experiencing “unbearable suffering,” but the brothers’ request was rejected by doctors at their local hospital because they were not terminally ill or in physical pain. They eventually found a doctor to honor their request and died by lethal injection in December.

“IVF on Steroids: The Dangerous Off-Label Use of ‘Dex’ During Pregnancy”

by Alice Dreger The Atlantic, January 16, 2013.

When Susan Manning, a 39-year-old woman just a few weeks into her first pregnancy, wrote to tell me she had been put on the steroid dexamethasone to prevent a miscarriage—and to ask whether she should be worried about taking this drug—at first I could not even process what she was saying. Dexamethasone is known to cross the placental barrier and impact fetal development, so the very idea of first trimester exposure sets off warning bells. Besides, dexamethasone is not known to help in preventing miscarriage. Susan’s story sounded too crazy to be true. (

Dex is a steroid that is known to suppress the immune system. Some IVF clinicians routinely prescribe Dex, believing that suppressing the woman’s immune system will help prevent a miscarriage; however, the data for this is scant. Furthermore, clinical trial data does show that Dex passes the placental barrier, raising questions about certain off-label use. Animal trials yield concerning data about fetal development under Dex exposure, but there is no definitive data on the safety of using Dex during human fetal development.

“Controversial Stem Cell Company Moves Treatment Outside of the United States”

by David Cyranoski, Nature, January 30, 2013.

US citizens who had pinned their hopes on a company being able to offer stem-cell treatments close to home will now need to travel a little farther. Celltex Therapeutics of Houston, Texas, stopped treating patients in the United States last year following a warning from regulators. A 25 January e-mail to Celltex customers indicates that the firm will now follow in the footsteps of many other companies offering unproven stem-cell therapies and send its patients abroad for treatment — but only to Mexico. (

Celltex is just one of many stem cell companies that have relocated outside the United States in order to avoid FDA restrictions. Celltex offers therapeutic stem cell treatments that have not been approved by the FDA; upon threat of being shut down, the company decided to move its business to Mexico where there are fewer restrictions.

“A Miami Clinic Supplies Drugs to Sports’ Biggest Names”

by Tim Elfrink, The Miami New Times, January 31, 2013.

Then check out the main column, where their real names flash like an all-star roster of professional athletes with Miami ties: San Francisco Giants outfielder Melky Cabrera, Oakland A’s hurler Bartolo Colón, pro tennis player Wayne Odesnik, budding Cuban superstar boxer Yuriorkis Gamboa, and Texas Rangers slugger Nelson Cruz. There’s even the New York Yankees’ $275 million man himself, Alex Rodriguez, who has sworn he stopped juicing a decade ago. (  

An article published in The Miami New Times revealed the results of a several-month investigation into Biogenesis, an anti-aging clinic in Miami that allegedly supplied performance enhancing drugs to high-profile athletes. The clinic closed one month before this article was published and the owner was nowhere to be found.

“Gene Therapy Cures Diabetes in Dogs”

by Amy Coghlan, New Scientist, February 12, 2013.

Five diabetic beagles no longer needed insulin injections after being given two extra genes, with two of them still alive more than four years later. Several attempts have been made to treat diabetes with gene therapy but this study is ‘the first to show a long-term cure for diabetes in a large animal,’ says Fàtima Bosch, who treated the dogs at the Autonomous University of Barcelona, Spain. (

Type 1 diabetes, while controllable, is not curable at this point. The media has devoted considerable attention to preliminary studies using gene therapy in beagles that indicate a potential treatment for the disease. Scientists inserted two genes into beagles whose pancreases did not produce the insulin needed to regulate blood sugar. Five of the dogs did not require insulin injections after treatment.

“Why Death Is Not the End of Your Social Media Life”

by Will Coldwell, The Guardian, February 18, 2013.

Launching in March is a new Twitter app called LivesOn. The service uses Twitter bots powered by algorithms that analyse your online behaviour and learn how you speak, so it can keep on scouring the internet, favouriting tweets and posting the sort of links you like, creating a personal digital afterlife. As its tagline explains: ‘When your heart stops beating, you’ll keep tweeting.’ (

One can hardly over-estimate the impact that social media has had on our culture. It changes how, with whom, and when we communicate. Never before has communication been so instantaneous to such a broad base of people. LivesOn seeks to take this development to a new level with  an app which will allow a twitter profile to keep sending updates even after its owner has died based on past “likes,” links, and updates, raising questions that push the limits of our concepts of personal identity, agency, and our mortality.

“Organ Trafficking, a New Crime of the 21st Century”

by Andrea Hayley, The Epoch Times, February 18, 2013.

Organ transplant medicine is an incredible life-saving technology, under the right circumstances. Unfortunately, due to a shortage of available organs, a new crime of the 21scentury, organ trafficking, is supplying organs to people with the money to pay big dollars for a new life. (

There are more people in need of an organ transplant than there are organs available. In desperation, some seek underground organ donations. Underground organ donation (also referred to as black market organ trafficking or the ‘red market’) typically involves exploiting the poor or the imprisoned by offering money in exchange for an organ (usually a kidney). This article describes particularly glaring abuses in which organs were illegally obtained from prisoners in China in exchange for money from wealthy clientele.

“C. Everett Koop, Forceful U.S. Surgeon General, Dies at 96”

by Holcomb B. Noble, New York Times, February 25, 2013.

Dr. Koop had never served in public office when President Ronald Reagan appointed him surgeon general of the United States in 1981. By the time he stepped down in 1989, he had become a household name, a rare distinction for a public health administrator. (

C. Everett Koop, MD, was an accomplished pediatric and neonatal surgeon who pioneered several procedures for birth defects. After his career as a surgeon, he took office as Surgeon General under President Reagan’s administration and made great strides in promoting an anti-smoking agenda, as well as educating the public on AIDS and HIV. He is also known for his opposition to abortion and co-authoring several books with Christian theologian Francis A. Schaeffer.

“Stem Cells Cruise to the Clinic”

by David Cyranoski, Nature, February 27, 2013.

In the seven years since their discovery, induced pluripotent stem (iPS) cells have transformed basic research and won a Nobel prize. Now, a Japanese study is about to test the medical potential of these cells for the first time. Made by reprogramming adult cells into an embryo-like state that can form any cell type in the body, the cells will be transplanted into patients who have a debilitating eye disease. (

Induced pluripotent stem cells (iPSc) have been hailed as a potential solution to the ethical hurdles presented by embryonic stem cells. They also avoid the risk of auto-immune rejection of donor stem cells, since they are harvested from the patients themselves. Now scientists are ready to take induced pluripotent stem cells to human subject trial stages. Scientists in Japan intend to use iPSc treatments for macular degeneration.