Stem Cells: December 2008 Archives

I'm a siner?

The document "Dignitas Personae" can be found here.

Vatican affirms 'dignity of human embryo'

VATICAN CITY (AFP) -- The Vatican on Friday reopened ethical questions surrounding stem cell research and techniques such as cloning with a document affirming the "dignity of the human embryo."

"Dignitas Personae" (Dignity of the Person), the first "instruction" on reproductive technology in more than 20 years, comes as countries including the United States and France prepare to review policies in the controversial field.

The sweeping instruction lists biomedical techniques considered "illicit" by the Roman Catholic Church such as in vitro fertilisation, cloning, the therapeutic use of stem cells, producing vaccines from embryo cells and the use of the "morning-after" contraceptive pill.

Such practices go against the "fundamental principle" that the dignity of the person must be recognised from conception until natural death, it says.

Issued by the Congregation for the Doctrine of the Faith, the Vatican's doctrinal watchdog, the 33-page instruction updates a 1987 document, "Donum Vitae" (The Gift of Life), which asserted the integrity of the human embryo.

The new instruction virtually enshrines the embryo not only as a human being but also as a whole "person" with all the philosophical and legal consequences that such recognition might entail, according to Bishop Rino Fisichella, secretary of the Congregation for the Doctrine of the Faith.

"The recognition is implicit, but we don't get involved in the philosophical debate," Fisichella said as he presented the document.

The document, approved by Pope Benedict XVI, also reprises the Church's condemnation of in vitro fertilisation, while decrying methods that prevent implantation of the embryo or cause its elimination as "falling within the sin of abortion".

"The blithe acceptance of the enormous number of abortions involved in the process of in vitro fertilisation vividly illustrates how the replacement of the conjugal act by a technical procedure ... leads to a weakening of the respect owed to every human being," the document says.

The text also warns against a "eugenic mentality" arising from advances in genetic engineering, saying: "In the attempt to create a new type of human being, one can recognise an ideological element in which man tries to take the place of his Creator."

Catholics are called to abide by such "instructions," which have had practical consequences across the centuries.

The 1987 instruction, focussing on in vitro fertilisation, was signed by the pope, then Cardinal Joseph Ratzinger, during his 24-year tenure at the head of the Vatican's highest rule-making authority.

It had important consequences for Catholic hospitals around the world as they scrapped programmes to help infertile couples, and it affected funding for certain medical research.

While the techniques condemned by the Church are legal in many countries and widely practised, the new document says Catholic researchers have the duty to distance themselves from a "gravely unjust legal situation and to affirm with clarity the value of human life".

US president-elect Barack Obama, who is to take office on January 20, is expected to act quickly to reverse an executive order by President George W. Bush banning embryonic stem cell research.

Also, French bioethics law is set for review next year.

The Holy See is aware that it is challenging cutting-edge technology, led notably by British embryo researchers, and expects "a variety of reactions," Fisichella said.

"Some will prefer to ignore (the instruction), others will take the easier route of deriding it, and still others will file these pages away as a manifestation of obscurantism blocking progress and free research, but many others will share our concern and our analysis," he said.


I find this ridiculous.

December 4, 2008

Parents Torn Over Fate of Frozen Embryos

For nearly 15 years, Kim and Walt Best have been paying about $200 a year to keep nine embryos stored in a freezer at a fertility clinic at Duke University -- embryos that they no longer need, because they are finished having children but that Ms. Best cannot bear to destroy, donate for research or give away to another couple.

The embryos were created by in vitro fertilization, which gave the Bests a set of twins, now 14 years old.

Although the couple, who live in Brentwood, Tenn., have known for years that they wanted no more children, deciding what to do with the extra embryos has been a dilemma. He would have them discarded; she cannot.

"There is no easy answer," said Ms. Best, a nurse. "I can't look at my twins and not wonder sometimes what the other nine would be like. I will keep them frozen for now. I will search in my heart."

At least 400,000 embryos are frozen at clinics around the country, with more being added every day, and many people who are done having children are finding it harder than they had ever expected to decide the fate of those embryos.

A new survey of 1,020 fertility patients at nine clinics reveals more than a little discontent with the most common options offered by the clinics. The survey, in which Ms. Best took part, is being published on Thursday in the journal Fertility and Sterility.

Among patients who wanted no more children, 53 percent did not want to donate their embryos to other couples, mostly because they did not want someone else bringing up their children, or did not want their own children to worry about encountering an unknown sibling someday.

Forty-three percent did not want the embryos discarded. About 66 percent said they would be likely to donate the embryos for research, but that option was available at only four of the nine clinics in the survey. Twenty percent said they were likely to keep the embryos frozen forever.

Embryos can remain viable for a decade or more if they are frozen properly but not all of them survive when they are thawed.

Smaller numbers of patients wished for solutions that typically are not offered. Among them were holding a small ceremony during the thawing and disposal of the embryos, or having them placed in the woman's body at a time in her cycle when she would probably not become pregnant, so that they would die naturally.

The message from the survey is that patients need more information, earlier in the in vitro process, to let them know that frozen embryos may result and that deciding what to do with them in the future "may be difficult in ways you don't anticipate," said Dr. Anne Drapkin Lyerly, the first author of the study and a bioethicist and associate professor of obstetrics and gynecology at Duke University.

Dr. Lyerly also said discussions about the embryos should be "revisited, and not happen just at the time of embryo freezing, because people's goals and their way of thinking about embryos change as time passes and they go through infertility treatment."

Many couples are so desperate to have a child that when eggs are fertilized in the clinic, they want to create as many embryos as possible, to maximize their chances, Dr. Lyerly said. At that time, the notion that there could be too many embryos may seem unimaginable. (In Italy, fertility clinics are not allowed to create more embryos than can be implanted in the uterus at one time, specifically to avoid the ethical quandary posed by frozen embryos.)

In a previous study by Dr. Lyerly, women expressed wide-ranging views about embryos: one called them "just another laboratory specimen," but another said a freezer full of embryos was "like an orphanage."

Dr. Mark V. Sauer, the director of the Center for Women's Reproductive Care at Columbia University Medical Center in Manhattan, said: "It's a huge issue. And the wife and husband may not be on the same page."

Some people pay storage fees for years and years, Dr. Sauer said. Others stop paying and disappear, leaving the clinic to decide whether to maintain the embryos free or to get rid of them.

"They would rather have you pull the trigger on the embryos," Dr. Sauer said. "It's like, 'I don't want another baby, but I don't have it in me; I have too much guilt to tell you what to do, to have them discarded.' "

A few patients have asked that extra embryos be given to them, and he cooperates, Dr. Sauer said, adding, "I don't know if they take them home and bury them."

Federal and state regulations have made it increasingly difficult for those who want to donate to other couples, requiring that donors come back to the clinic to be screened for infectious diseases, sometimes at their own expense, Dr. Sauer said.

"It's partly reflected in the attitude of the clinics," he said, explaining that he does not even suggest that people give embryos to other couples anymore, whereas 10 years ago many patients did donate.

Ms. Best said her nine embryos "have the potential to become beautiful people."

The thought of giving them up for research "conjures all sorts of horrors, from Frankenstein to the Holocaust," she said, adding that destroying them would be preferable.

Her teenage daughter favors letting another couple adopt the embryos, but, Ms. Best said, she would worry too much about "what kind of parents they were with, what kind of life they had."

Another survey participant, Lynnelle Fowler McDonald, a case manager for a nonprofit social service agency in Durham, N.C., has one embryo frozen at Duke, all that is left of three failed efforts at the fertility clinic.

Given the physical and emotional stress, and the expense of in vitro fertilization, Ms. McDonald said she did not know whether she and her husband could go through it again. But to get rid of that last embryo would be final; it would mean they were giving up.

"There is still, in the back of my mind, this hope," she said.

At the Genetics and IVF Institute in Fairfax, Va., Andrew Dorfmann, the chief embryologist, said many patients were genuinely torn about what to do with extra embryos, and that a few had asked to be present to say a prayer when their embryos were thawed and destroyed.

Jacqueline Betancourt, a marketing analyst with a software company who took part in the survey, said she and her husband donated their embryos at Duke "to science, whatever that means." It was important to them that the embryos were not just going to be discarded without any use being made of them.

Ms. Betancourt, who has two sons, said: "We didn't ask many questions. We were just comfortable with the idea that they weren't going to be destroyed. We didn't see the point in destroying something that could be useful to science, to other people, to helping other people."

Ms. Betancourt said she wished there had been more discussion about the extra embryos early in the process. If she had known more, she said, she might have considered creating fewer embryos in the first place.


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