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What’s special about selling gametes?

What’s special about selling gametes?

Dominic Wilkinson posted yesterday on the issue of whether payment for egg and sperm donation should be legalised. This question attracted significant media attention yesterday after Lisa Jardine, of the HFEA, called for debate on the existing UK ban on payment for donors. Today's Guardian contains a piece highlighting several ways in which people can already sell their bodily parts or products, ranging from livers to breast milk, and from blood to hair. Sale of many of these bodily parts/products is regarded is ethically problematic, and is, in many cases, illegal. But not in all cases. For example, few would have a problem with the sale of hair for use in wigs.

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Feetility – should we pay egg and sperm donors?

Lisa Jardine, the head of the UK Human Fertilisation and Embryology Authority, has called for public debate about paying egg or sperm donors. Currently donors are given a maximum of £250 in reimbursement for expenses. But donation rates have fallen in recent years, at least in part related to changes in rules in 2005 preventing donor anonymity. As a consequence a significant number of patients seeking donor egg or sperm for in-vitro fertilisation have been forced to travel overseas. In essence Jardine suggests that a regulated local market in donor eggs and sperm may be better than unregulated fertility tourism.

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A tiny step forward

Researchers have managed to produce live-born mice (original article) descended from induced pluripotent stem cells (IPS cells), cells taken from adult animals and treated to become stem cells. That individuals could be produced from embryonic stem cells was already known, but this proves that the IPS cells can produce all kinds of cells in an adult body. Good news for people uneasy about the need for embryonic stem cells… or is it?

If one argues that it is wrong to use embryonic stem cells because embryos carry moral rights, then the question is whether the creation of IPS cells produce something that also has moral rights.

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In a world of low risk obstetrics, is home birth unethical

It is reported that women who give birth at home with an independent midwife are nearly three times more likely to have a stillbirth than those who give birth in hospital; many other outcomes were “significantly better”. 

 

Perinatal deaths following home birth were associated with an underestimation of the dangers of high risk pregnancies such as preterm birth, twins, vaginal breech births and fetal distress (Bastian H et al.  BMJ. 1998; 317: 384–388). Even some IVF pregnancies were managed at home.

 

Midwives are trained in carrying out normal deliveries, not complex high risk manipulative deliveries such as breech deliveries; these should not be performed by unskilled operators. In addition, caesarean section is advocated for most women with a breech presentation or twins. 

 

Home birth in high risk patients is inadvisable and experimental (Bastian) and is opposed by professional colleges and here and here. Women with an increased risk of complications should be delivered in hospital where obstetricians can spot those complications. Women should be told this – in the recent study there is no suggestion that UK midwives told them. 

 

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Revisiting the Moon

40 years ago marked the pinnacle of human space exploration. 500 million people around the world watched or listened as the first human to walk on the moon, Neil Armstrong, stepped out onto the dusty lunar surface, proclaiming “That’s one small step for man, one giant leap for mankind." Over the next three years, 11 other astronauts walked on the moon. At the time, most people viewed the Apollo Missions as merely the beginning of a bold new era of interplanetary exploration. Yet to this date we have never returned to the moon, nor have we attempted to set sail for more ambitious celestial destinations. NASA’s fraction of the U.S. GNP declined from 4% at the height of the cold war to its current low of .5%. Indeed, the cold war and the space race seemed to ascend, crescendo, and fizzle out in unison, leading one to believe that the moon missions were driven more by ephemeral political brinkmanship rather than any firm scientific or humanistic commitment to space exploration. Nowadays, the costs and risks associated with manned missions to the moon and beyond are viewed by both policymakers and the public at large as prohibitive, especially in this time of acute financial and environmental crises. Although former U.S. President G.W. Bush had declared his intention of putting humans back on the moon by 2020 and sending them on to Mars shortly thereafter (the cost of which has been estimated at over 150 billion dollars), the proposal is currently being reviewed and likely to be scrapped by the Obama administration in light of the latter’s ambitious and resource-draining domestic agenda.

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The Poverty of Philosophy at Melbourne

A war of words has broken out in the pages of The Australian between friends of the
University of Melbourne School of Philosophy and the Dean of Arts at the
University of Melbourne, Mark Considine. See: http://www.theaustralian.news.com.au/story/0,,25816073-12332,00.html and

http://www.theaustralian.news.com.au/story/0,,25759103-12332,00.html.
At the end of 2007 six of the school’s thirteen permanent faculty members took
voluntary redundancy packages.  Despite the large number of philosophers lost, the school has
only been promised one replacement position. The friends of the school, who
include international figures in philosophy such as Frank Jackson and Peter
Singer, make the obvious point that a school of only seven will be unable to
provide specialist teaching in all the major areas of philosophy as well as the
equally obvious point that a school that is reduced in size by almost a half is
going to suffer a corresponding loss of reputation. They back up this latter
claim by pointing to a drop in the international rating of Melbourne in the
most recent edition of Brian Leiter’s ‘Philosophy Gourmet Report’ (see http://www.philosophicalgourmet.com/).


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Animal experimentation vs factory farming

Recent figures showing a large increase in the number of animal experiments in the UK have spurred strong complaints from animal rights campaigners (link). Nearly 3.7 million experiments were performed on animals last year, an increase of 14% over last year and the largest yearly increase since the 1980s. 

There has been a longstanding debate in the UK about whether medical experiments upon animals can be ethically justified and this debate shows no signs of ending soon. However, even setting aside this question, there is a strong argument that animal rights campaigners would better meet their own objectives by devoting most of their energy to combatting factory farming. 

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The Independent Safeguarding Authority

Anyone who wishes to work with children, including even a parent who wishes to help out in the school their child attends, is required to undergo vetting by the Independent Safeguarding Authority. The politicians responsible say that this will protect children from paedophiles.

 

Philip Pullman (children’s book author) has refused to be vetted because “It is insulting and I think unnecessary, and I refuse to be complicit in any scheme that assumes my guilt.” (here) As a result he will be banned from reading his books to children in schools. The Children’s Laureate thinks that ‘the scheme [is] "governmental idiocy" which [will] drive a wedge between children and adults’. Arguably, then, believing it right to vet the enormous number of people that will be vetted (11.3 million by November 2010) is corrupting of the relations between adults and children, and is in part a manifestation of something poisonous in our attitude to adults. So there is a broad question over whether the ISA, simply through existing, has bad consequences and  is unjustly disrespectful. That is not what I want to discuss. I want to consider only the issue of the epistemic duty of the politicians who have created it and of the authority itself.

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Pandemic ethics: Mild flu and Tamiflu – the patient’s dilemma

In recent days there have been reports of a jump in the number of cases of H1N1 influenza (swine flu) in the UK. There have been 29 deaths associated with pandemic influenza in the UK, and there are 652 people in hospital in England with the flu. Faced with the prospect of primary health care services becoming overwhelmed, the government has set up a telephone hotline to allow those affected by the flu to access antiviral drugs (for example oseltamivir or Tamiflu) without needing to see a doctor. But there are also suggestions that not all patients with flu-like symptoms should be treated. Patients with mild or vague symptoms of the flu, without other medical conditions that put them at particular risk, may not be given medication.

This sets up a problem for patients who develop mild flu-like symptoms. Although there is only a small chance of them becoming seriously ill or dying from the flu it is possible that early treatment with anti-virals would reduce that risk. (Antivirals were only effective in trials if given in the first 48 hours of illness) Should they demand treatment from their doctor in the hope of avoiding a serious complication of influenza? Should they exaggerate their symptoms? If the doctor refuses, should the patient self-treat with medications that they have obtained privately (for example over the internet)? There is a form of the classic prisoner’s dilemma involved in such questions.

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Arificial sperm: a woman needs a man like a fish needs a bicycle?

Professor Karim Nayernia and his team at Newcastle University produced sperm cells from embryonic stem cells (here and here)
Italian newspapers ( here and here) (English ones were more restrained here) ran articles about this research claiming that  in the next future men will be not necessary in human reproduction because it will be possible to develop sperm cells from women’s somatic cells, like skin cells.  The fact that women may, sooner or later, be able to reproduce without men’s help did not shock me too much. Reproductive human cloning should allow us to do more or less the same thing: Dolly the sheep was born in 1997, so it’s almost 12 years that we have been aware of this. 

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