Gene therapy: two steps forward, one step back.
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Biomedical subjects
Publications and source records attributed to Josephine Johnston.
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OBJECTIVE: To determine the number of cryopreserved human embryos at all Canadian in vitro fertilization (IVF) clinics, the number of these embryos that have been donated to research, and the consent processes regarding the disposition of embryos no longer required for reproductive purposes. METHODS: A questionnaire was mailed to 24 fertility clinics identified as conducting IVF and cryopreservation, inviting completion of the questionnaire by telephone. Thirteen clinics (response rate 54%) completed the survey. RESULTS: As of August 2003, all 13 clinics cryopreserve embryos not required for intrauterine transfer; in total, 15,615 embryos are currently in storage in these clinics. Nine clinics specifically offer patients the option of donating embryos to research; in total, 299 embryos have been allocated for research, about 2% of all embryos stored by these 13 clinics. All 9 clinics routinely seek consent for research use of embryos, with 7 clinics currently using such embryos for research to improve clinic practices. CONCLUSION: The results highlight the difficulties of gathering accurate data on assisted human reproduction and related research in a context where there is no legislation governing these practices. Nonetheless, the data suggest there are very few cryopreserved embryos in Canada available for research and that even fewer of these may be potentially eligible for research due to incomplete or inadequate consent processes.
This summary lays out the basic science and methodology used in genetic testing that investigates historical population migrations and the ancestry of living individuals. The genetic markers used in this testing, and the distinction between Y-chromosome, mitochondrial and autosomes analysis, are explained and the shortcomings of these methodologies are explored.
The attempts of scholars and scientists to unravel the mystery of the ancestral origins of the Lemba are summarised, focusing on Tudor Parfitt's book, Journey to the Vanished City, and a study by an international group of genetic and social scientists. The impact of this research on identity questions is raised.
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On 4 March 2002, the Canadian Institutes of Health Research (CIHR) released their guidelines for human pluripotent stem cell research. The guidelines set out the conditions for publicly funded stem cell research, and include limitations on acceptable sources of embryos for deriving stem cells. Two months later, the Government of Canada tabled Bill C-56, governing assisted human reproduction, which will also restrict the sources of embryos for research and require that all fertility clinics and embryo researchers be licensed. These two documents strike a middle ground between the current restrictive rules for publicly funded research in the United States and the more permissive rules for both publicly and privately funded research in the United Kingdom. Both documents restrict the source of embryos for research to those that were originally created for assisted reproduction purposes but are no longer required for such purposes. Therefore, under both the guidelines and Bill C-56 (if it becomes law), an efficient and cooperative relationship between fertility services providers and embryo researchers will be necessary if researchers in Canada are to continue to work with the human embryo in fields such as stem cell research.
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A surgeon in Scotland has amputated the legs of two consenting, physically healthy patients. Although a handful of medical professionals believe that the desire for healthy limb amputation is symptomatic of a mental disorder that can be treated only by amputation, there is currently no consensus on what causes a person to desire such a disabling intervention. As long as there is no established body of medical opinion as to the diagnosis and treatment of such a condition, performing the surgery may be a criminal act. Given the ethically problematic history of surgery for psychiatric conditions, as well as the absence of sound medical data on this condition, surgeons should exercise great caution before complying with a request to amputate a healthy limb.
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