Update on Life Issues - June 2022


Friday 24 June 2022 – a landmark day.  The Justices of the Supreme Court of America have today voted by 5 to 4 to overturn Roe v. Wade, the 1973 ruling that supposedly gave American women the constitutional right to abortion.  While today’s judgement will not ban all US abortions, it is a mighty significant move in the right direction.  The personal and political ramifications will continue but, above all, unborn human life in the USA now has a restored dignity and greater protection.  Rejoice and give thanks!

Abortion statistics, England and Wales: 2021
Tuesday 21 June, the first day of summer – a beautifully warm and bright morning.  And then in the afternoon came the publication of the latest abortion statistics for England and Wales – horribly chilling and bleak.  And they are the worst ever.  The total figure is 214,869 abortions.  The vast majority of these (214,256) were for residents of England and Wales.  That is an average of 825 abortions every weekday – every Monday, Tuesday, Wednesday …

All the data can be viewed at https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2021/abortion-statistics-england-and-wales-2021  You may have to Copy and Paste this URL.

As ever, most abortions (98%, 209,939) were performed under ground C, the so-called social clause.  A further 1.6% (3,370 abortions) were carried out under ground E, the risk of serious handicap.  This is an increase of 287 from the previous year.  We are still no more compassionate towards the disabled.

In 2021, 89% of abortions were performed under 10 weeks gestation – an increase from 88% in 2020 and 78% in 2011.  There were 276 abortions performed at 24 and more weeks.  Why are early abortions better?

During 2021, 43% of women undergoing abortions had had one or more previously.  This proportion has increased steadily from 36% in 2011.  Is abortion a form of contraception?

The trend towards medical abortions continues – 87% of all abortions in 2021 were medically induced, up 2% from 2021.  Some of this increase was due to the ‘pills by post’, ‘DIY abortion’ scheme introduced during the Covid-19 pandemic.  Taking both medications (mifepristone and misoprostol) at home is now the most common procedure, accounting for 52% of all abortions in 2021.

During 2021, there were 88 selective abortions, an increase from 65 in 2020.  These are usually performed for multiple pregnancies often caused by overzealous IVF.  80% of these selective terminations were performed under ground E.

These figures mock us – they are stark and irrefutable.  What to do?  What should we think, what do we say, how can we respond when faced with this increasing tragedy of human life destroyed in the womb?  First, we educate ourselves.  We need to be clear about the personal and societal devastation caused by abortion.  Second, we speak out against this calamity and educate others.  Third, we care.  Abortion tells us that many woman and girls need real help, principled compassion in their lives.  So we give of our time, money and energy probably by joining and supporting a pro-life organisation.  Without such responses nothing much will change.  Except it will get worse.

DIY abortions
Are you familiar with the concept of a government U-turn?  Here is an excellent example, but it is also an appalling case of political shenanigans.

In March 2020, in the midst of the Covid-19 pandemic, the UK government introduced an emergency arrangement whereby the two pills required for an early medical abortion, up to 10 weeks of a pregnancy, could be accessed by post.  This so-called DIY abortion scheme was said to be needed because women could not travel to pill providers, such as doctor’s surgeries, and take part in face-to-face appointment because of the national lockdown.  So after a simple video or telephone consultation with a healthcare professional, the pills could be mailed to the approved patient.

These new rules were promised to be temporary.  And so, in the not too distant future, women would have to revert to the old scheme of in-person medical supervision.  After all, this is safer in determining medical suitability, proper informed consent, fraudulent access, whether coercion was involved, and so on.  However, the battle lines of the temporaries versus the permanents were drawn.

Between November 2020 and February 2021, the government launched a public consultation.  More than 600 medical professionals wrote an open letter to the prime minister and the equivalent heads of Wales and Scotland.  The majority (70%) of 18,000 respondents to the public consultation called for the temporary scheme to end immediately.  The outcome was that on 24 February 2022, the Minister for Vaccines and Public Health, Maggie Throup MP, stated that, ‘The temporary approval will end at midnight on 29 August 2022.’  So, a win for the temporaries?  Not so fast.  That decision was welcomed by many, but not by the abortion lobby.  It pushed to make the pills by post permanent.  And on 16 March, Baroness Sugg tabled an amendment to the Health and Care Bill seeking to overturn the government’s decision, even though the issues had never been raised in the Lords.  Furthermore, this amendment, voted on in the Lords during the early hours of the morning, without prior debate and scrutiny, was never the proper way to decide a controversial policy.

And then on 30 March 2022, MPs debated the issue, claimed that the old scheme would increase late abortions, and finally on a free vote, decided to make the temporary scheme an indefinitely permanent fixture in England by 215 votes to 188.  Therein, a government U-turn, or two.  The Welsh and Scottish governments have already acted to make the continuation of at home DIY abortions lawful.

The WHO and abortion worldwide
On 9 March 2022, the World Health Organization (WHO) published its new guidelines on abortion.  The WHO is biased.  It maintains that, ‘Being able to obtain safe abortion is a crucial part of healthcare.’  Of course there are unsafe abortions everywhere – the WHO reckons there are 25 million each year – but pressing for unlimited abortions everywhere under the guise of human rights and creating an abortion-minded world is not a rational or moral policy.

The pages of Abortion Care Guideline are a terrible read.  The opening Guideline Highlight sets the tone.  It reads, ‘The abortion care pathway.  Comprehensive abortion care includes provision of information, abortion management (including induced abortion and care related to pregnancy loss), and post-abortion care.  This guideline includes recommendations for different abortion indications, and for different stages of the continuum of care (the “who”, “what”, “where” and “how”.)’

Then follows pages of details that underscore the fact that the WHO has little, if any, ethical framework to abortion.  For example section 1.3 states, ‘Securing sexual and reproductive health including availability of safe abortion respects, protects and fulfils the right to health.’  Basically, the WHO wants to allow abortion under all circumstances.  It calls on states to remove all legal time limits on abortion.  It claims that laws preventing abortion at any point during pregnancy risk violating the rights of ‘women, girls or other pregnant persons’.  It wants to limit medical professionals’ rights to refuse to take part in abortions.

This is all bad news.  The WHO is a powerful, influential global organisation.  Its Abortion Care Guideline is set to become the vade mecum of the world, at least, the developing world.  It looks like a dystopian future.

Abortion in Guatemala
Given an atlas, can you truthfully put a finger on the Republic of Guatemala?  It may be famous for the ancient Maya civilisation, a recent bloody civil war and good coffee.  But it also has a strong pro-life culture.  In March 2022, its Congress approved a bill that will increase prison sentences from 3 years up to 10 years for women who have abortions.  Heavier penalties will be imposed on doctors and others who assist women in ending pregnancies.  Exceptions, like when the life of the mother is in danger, remain.  The new legislation was passed by 101 votes versus 8 with 51 abstentions by absence.  This is the opposite of the trend in most other Latin American countries, such as Colombia, Mexico and Argentina, which are busy expanding access to abortions.

In addition in March, Guatemala celebrated its national ‘Life and Family Day’.  President Alejandro Giammattei declared, ‘This event is an invitation to unite as Guatemalans to protect life from conception until natural death.’  It is expected that he will soon sign the bill into law.

A question.  Does this new Guatemalan legislation seem harsh?  Why is that?  Is it because we live in a so-called progressive society and have too easily adopted its pro-abortion patterns of thought and mores?  Drifting with the tide is easier than swimming against it.  Do we regard abortion, perhaps not exactly as a woman’s right, but often as the easiest way out of a sticky situation?  Is the unborn child not really one of us?  Are we against murder and infanticide, but are persuaded that abortion, taking the life of the unborn, is somehow different, perhaps because the victim is unseen?  These are testing cross-examination questions.

IVF and ARTs

Surrogacy and war
Ukraine has long been the second most popular destination, after California, for commercial surrogacy.  It is estimated that there are between 2,000 and 2,500 babies born each year to Ukrainian surrogates, mostly for foreign couples.  There are at least 50 commercial surrogacy agencies in Ukraine.  BioTexCom, one of the leading outfits in Kyiv, estimates that it arranges at least a thousand births each year.  Ukraine’s popularity for surrogacy is due to its favourable legal framework and its significantly lower costs compared with California and elsewhere.

The Russian invasion of Ukraine has created many victims, including hundreds of surrogate mothers.  Many have escaped, but many have remained in dangerous situations, sheltering in basements, unable to access medical assistance and essential drugs.

Like most surrogacy industries, the Ukrainian is dependent on cross-border travel and international intended parents (IPs) have frequently been unable to attend the birth of, or collect, their commissioned babies.  Under Ukrainian law, IPs are regarded as the legal parents throughout the transaction and surrogates have no legal rights with respect to the baby when born.  After the birth, the IPs are named on the birth certificate as the parents, whereas in the UK, it is the birth mother’s, the surrogate’s, name that is registered.

Among the additional problems created by the war are the practical and legal issues of who is now responsible for the stranded children born to Ukrainian surrogates.  Meanwhile, the husbands of Ukrainian surrogates are probably on the frontlines fighting the Russian aggressors.  It is a parlous situation.  War has added an additional dilemma to the already troublesome issue of surrogacy.  Is surrogacy ever really a sensible option?

IVF – good or bad?
We all like to choose – look at the following two studies, and their conflicting outcomes, and decide which you would choose.  ART or natural?  Never let it be said that these Updates are biased.

First, there is a recent study which concluded that adults conceived through assisted reproductive technology (ART), principally IVF, have a better quality of life during their adulthood compared with those who were naturally conceived.  The work was reported as ‘Does being conceived by assisted reproductive technology influence adult quality of life?’ by Karin Hammarberg et al., and published online in Human Fertility (22 March, 2022).

The study looked at a group of 193 adults conceived through IVF treatment and 86 naturally-conceived adults at two separate time points – when they were between 18 and 28 years old and then again between the ages of 22 and 35.  The methodology used consisted of the volunteers completing questionnaires.

The authors finally stated, ‘In conclusion, when accounting for other factors present in young adulthood, being ART conceived appears to confer some advantages in quality of life, particularly in the Social relationships and Environment domains.  In addition, and not surprisingly, this study found that, independently of mode of conception, a more positive relationship with parents, less psychological distress, and a better family financial situation contributed to better quality of life.’

Second, there is another recent study entitled, ‘Conceived by Assisted Reproductive Technologies’ by Penseé Wu et al., and published in the Journal of the American Heart Association (Vol. 11, Issue 5, 1 March 2022).  It showed that women who conceived using IVF are 2.5 times more likely to experience kidney injury and incur hospital costs on average of US$6,722 higher when hospitalised, compared with women who conceived naturally.

The authors concluded, ‘Pregnancies conceived by ART have higher risks of adverse obstetric outcomes and vascular complications compared with spontaneous conception.  Clinicians should have detailed discussions on the associated complications of ART in women during prepregnancy counseling.’  There are already numerous studies that have demonstrated that IVF can have adverse physical and biological effects on both the unborn and the born, as well as their mothers.

So, is IVF good or bad?  What to conclude?  Not much from these two studies.  They are interesting, but they are apples and pears, about as diverse as possible – an Australian sociological piece and a UK-US scientific article.  They were never designed to compare and contrast – they just happened to be published in journals during March 2022.  To decide if IVF is good or bad what is needed is a meta-analysis, a systematic review of all the relevant literature, which for IVF would run into thousands and thousands of studies.  And anyway what is meant by ‘good’ or ‘bad’?  It is far easier, and far more useful, to assess IVF from a bioethical perspective.  And a sensible and practical conclusion can be found in my 2014 Bioethical Issues book, page 99, which states, ‘All IVF is best avoided.’

IVF in China
IVF in most of the world can be eye-wateringly expensive.  In the high-income UK, with the exception of NHS-funded treatment, a typical IVF cycle can cost £5,000 and usually much more.  So it is a little surprising that low-income China, or at least Beijing, has begun offering to pay towards its citizens’ fertility treatments.

Are there not too many people there already?  After all, the population is reckoned to be about 1.4 billion.  But demography tells a different story.  China is facing a serious falling birth rate, despite the abandonment of its infamous one-child policy and the new policy allowing couples to have up to three children.  In 2021, the number of births per woman in China was only 1.15, well below the 2.1 needed to maintain a stable population.

From last March, for couples subscribing to its public medical insurance scheme, the Chinese government has been contributing an estimated £3,000 towards the costs of 16 types of fertility procedures, such as IVF and intrauterine insemination (IUI).  Moreover, there is no limit to the number of IVF cycles couples can have subsidised.  A spokesman from the Beijing Perfect Family Hospital has said, ‘Those who choose assisted reproductive technologies have a strong willingness to have a child.  But the success rate of the technologies is limited.  The services were previously not included under the public medical insurance scheme because they are costly.’

Donating doctors

Lots can, and does, go wrong with IVF arrangements.  Yet another Dutch doctor, the third in recent months, has been found to have used his own sperm to inseminate probably dozens of his women clients.

Jan Beek, an IVF doctor, who worked for 25 years at the Elisabethziekenhuis Hospital in Leiderdorp, secretly fathered at least 21 children.  The hospital cannot contact others of his potential children because the relevant records have been destroyed.  Beek died in 2019, long before his fertility deception was discovered.  The scandal came to light last year after a DNA investigation found a match between Beek’s DNA and 21 children whose mothers had received treatment at his clinic between 1973 and 1986.  They had expected to be inseminated by sperm from their husbands or from anonymous donors, not their IVF doctor.

What is wrong with Dutch IVF doctors who also happen to be called Jan?  Two others, Jan Wildschut and Jan Karbaat, clandestinely fathered at least 60 children between them from the 1970s to the 1990s.  In October 2020, DNA tests confirmed that Jan Wildschut, a gynaecologist who worked in Zwolle and who died in 2009, was the biological father of 17 children.  In 2019, it was discovered that Jan Karbaat, a doctor from Rotterdam, where he ran his private fertility clinic, fathered at least 49 children using his own sperm in IVF treatments unbeknown to his women patients.

The numbers of children fathered by these doctors varies depending on the sources quoted.  But here is the big question – will there be more IVF doctors, Dutch or otherwise, who took part, or who are even now taking part, in such wicked deceptions?  Of course there will.

Euthanasia and Assisted Suicide

The campaign goes on
Fans of euthanasia and assisted suicide in the UK are continuing to press for legalisation.  Their recent rallying point has been a private member’s bill in the House of Lords tabled by Baroness Meacher in May 2021.  Her Assisted Dying Bill, which would have enabled adults, who are terminally-ill to end their own lives, did not make the Queen’s Speech in May 2022 so it is unlikely to appear before the House of Commons in the current session.  Nevertheless, Baroness Meacher now believes that there is enough support among MPs for it to pass into legislation there.

The leading campaign organisation on these issues, Dying in Dignity, has been busy rallying its supporters to sign the petition it has set up on the UK Government and Parliament site to ‘legalise assisted dying for terminally ill, mentally competent adults.’  At the 10,000 signature mark the government is obliged to reply.  On 3 February, it responded, ‘The Government’s position is that any change to the law in this area is a matter for Parliament and an issue of conscience for individual parliamentarians rather than one for Government policy.’  Then, by mid-May, the petition hit the required 100,000 signatures for Parliament to consider it for a debate in the House of Commons.  And so it has been confirmed that on the afternoon of Monday 4 July, there will be a Westminster Hall debate relating to assisted dying.  It is in the name of Tonia Antoniazzi, the Labour MP for Gower.

Similar legislation has also been introduced into the Scottish Parliament by Liam McArthur MSP.  The Consultation on the draft proposal was closed on 22 December 2021.  No further details have been announced.  Meanwhile during November 2021, Jersey's States Assembly became the first parliament in the British Isles ‘to decide “in principle” that assisted dying should be allowed and make arrangements for the provision of an assisted dying service.’  During March and April 2022, Islanders were asked to take part in the first phase of public engagement on the assisted dying proposals.  The States Assembly debated more detailed proposals in November 2022.  Following the preparation of the draft legislation, which will be debated in the States Assembly in May 2023, and, if the legislation is passed, then an assisted dying service will be implemented in Jersey from May 2023.  This is a grisly timetable.

The Health and Care Act 2022
Back in February 2022, you may have missed an important government announcement that will almost certainly benefit you and yours in times ahead.  The memo probably got buried in news about Ukraine, Brexit and Covid-19.  Anyway, here it is – dying people, at least those in England, will now have an explicit legal right to healthcare, including specialist palliative care.  It is a powerful antidote to calls for legalising euthanasia and assisted suicide.

It comes because the UK government has pledged to back an amendment in the House of Lords tabled by Baroness Finlay.  Several end-of-life charities have called this a 'milestone' moment that will help to resolve the current patchy postcode lottery of palliative care provision.  Currently, it is estimated that around 215,000 people in the UK miss out on proper end-of-life care each year.
Baroness Ilora Finlay of Llandaff has been a long-term and tireless champion of palliative care, after all, among her many other duties, she is a professor of palliative medicine at the Cardiff University School of Medicine and vice president of Hospice UK.  Concerning the government’s announcement, she said, ‘This change is incredibly important.  For the first time the NHS will be required to make sure that there are services to meet the palliative care needs of everyone for whom they have responsibility in an area.  People need help early, when they need it, seven days a week – disease does not respect the clock or the calendar.’

On 24 March 2022, following agreement by both Houses of Parliament on the text of the Bill, it received Royal Assent on 28 April.  The Bill is now an Act of Parliament, the Health and Care Act 2022.
There is much to do.  There are about 450,000 deaths in England each year.  And there are about 600 specialist palliative medicine consultants working there with a population of 55 million.  That is about one consultant for every 100,000 people.  Not a lot.  It is also one consultant for every 1,000 deaths. Not a lot either.  In addition, there are around 5,000 specialist palliative care nurses working for both the NHS and end-of-life charities.  Still not a lot.  And what about the palliative care needs of Wales, Scotland and Northern Ireland? Truly, there is much to do, but the Health and Care Act 2022 is a great start.  We should be thankful.

Death in Canada

What is wrong with Canadians?  Why are they so bent on becoming the most permissive euthanasia jurisdiction in the world?  Next year, from March 2023, Canada will become one of the few countries in the world to allow its citizens, whose sole underlying condition is a mental illness, such as depression, bipolar disorder, personality disorders, schizophrenia, PTSD or any other mental affliction, to be eligible for death by its so-called medical aid in dying (MAiD) scheme.

How has it come to this?  Back in 2015, Canada’s high court ruled that an absolute prohibition on doctor assisted dying violated the country’s Charter.  Moreover, a competent adult who suffered a ‘grievous and irremediable’ medical condition causing intolerable physical or psychological suffering had a constitutional right to a medically hastened death.  That ruling lead to Canada’s MAiD law, Bill C-14, which allowed for assisted dying in cases where natural death was ‘reasonably foreseeable’.  Then in 2019, a Quebec Superior Court justice ruled the ‘reasonably foreseeable’ death restriction was unconstitutional and that people who were intolerably suffering, but not imminently dying, still had a constitutional right to be eligible for euthanasia.

In March 2021, Bill C-7 was passed that made changes to the eligibility criteria.  The ‘reasonably foreseeable’ criterion was deleted.  And on 17 March 2023, a two-year sunset clause will expire and MAiD will be expanded to competent adults whose sole underlying condition is a mental illness.  Can you detect a slippery slope here?

Assessing the eligibility of candidates for euthanasia must be a gruesome occupation.  At least for those patients with cancers, a diagnosis involves something that can be physically seen and touched.  But how can a ‘grievous and irremediable’ mental illness be verified?  Is not the truth plain that Canada will, in the near future, open up euthanasia for everyone?  In a country where ‘euthanasia’ and ‘assisted suicide’ are euphemistically referred to as ‘medical assistance in dying’ (MAiD), surely anything dubious seems possible.  What could be next?  Why of course, MAiD for the poor, those who cannot afford much-needed therapy, medications and care.  Wait for those floodgates to open.  Why bother with robust legal boundaries when the criteria can be expanded year after year?

Genetic Technologies

Parthenogenic mice

A team of Chinese scientists have created a fertile mouse from an unfertilised ovum.  It’s a parthenote!  It’s a virgin birth!  The work was described in an article entitled, ‘Viable offspring derived from single unfertilized mammalian oocytes’ by Yanchang Wei et al., and published in Proceedings of the National Academy of Sciences (22 March, 2022).

In mammals, a new, genetically-unique life begins with the fusion of an ovum and a sperm to create a single cell called a zygote, a zygotic embryo.  Parthenogenesis is the development of an embryo from a single unfertilized ovum.  The offspring are clones, genetically identical to their mothers.  The process occurs naturally in several species of aphids, fish, reptiles, mites and some bees.  But never in mammals – until now – because of problems arising from genomic imprinting.  What is this?  The US National Human Genome Research Institute defines genomic imprinting as ‘the process by which only one copy of a gene in an individual (either from their mother or their father) is expressed, while the other copy is suppressed.’  Suffice to say it is like a spanner in the works if parthenogenesis is your goal.

Yanchang Wei and colleagues from the School of Medicine, Shanghai Jiao Tong University, Shanghai, overcame these hurdles and achieved parthenogenesis in mice by the targeted use of DNA methylation or demethylation to rewrite seven imprinting control regions so silencing genetic contributions from either the mother or the father, but not both.  I know this is mind-stretchingly complex – hang in there!  Using CRISPR technologies they were able to mimic the genes a male would have contributed during normal fertilisation.  These modified parthenogenetic embryos were transferred into a surrogate mother resulting in the birth of viable full-term offspring.  The research team began with 220 unfertilised ova but only one survived to adulthood yet was able to produce offspring.

This is a significant step in the development of mammalian research.  It is preliminary and therefore demands much more work if it is to have any applications in real-world agriculture or medicine.  As the scientists concluded, ‘These data demonstrate that parthenogenesis can be achieved by targeted epigenetic rewriting of multiple critical imprinting control regions.’  Does it spell the end of men in human procreation?  No, of course not!  NB, so far it has been achieved in mice, not in humans.

He is out
In November 2018, He Jiankui, the Chinese biophysicist, announced that he had created the world’s first genetically-engineered human babies.  It lead to serious uproar among the scientific community and the general public.  He had broken just about every rule in the genetic technologist’s unwritten handbook.  He was hauled before the Chinese authorities, sacked from his university employment and handed a three-year prison sentence and a hefty fine.  There are now calls that He be made financially, morally and legally responsible for the health and wellbeing of the three children he genome-edited.

Various media outlets have reported that He was released from prison sometime in April.  So far, he has refused to give press interviews – his future plans are therefore unknown.  But what differences, three years on, will he notice in the world of genetic engineering?  Certainly his controversial foray has not stopped basic research on genetically engineering human embryos.  But little research has been reported on the sort of research that He conducted, namely heritable human genome-editing.  Of course, no publications does not necessarily mean no experimentation.  Moreover, pledged oversight has stalled.  There was promised a global registry of such work – none has appeared.  Global surveillance and restrictive measures were promised – none has appeared.

Yet there are reported experiments that are pushing the boundaries.  For instance, in March, a biotech research team in New Jersey, USA, using surplus human embryos obtained from IVF clinics, demonstrated how CRISPR could delete an extra copy of a chromosome from a newly-fertilized ovum – a technique that might lead to treating or preventing chromosomal medical conditions such as Down’s syndrome.  This was reported as ‘DNA Double Strand Breaks cause chromosome loss through sister chromatid tethering in human embryos’ by Jenna Turocy et al., and published in bioRxiv on 22 March 2022.  Other groups are exploring how to introduce heritable genetic changes via human sperm or ova.  Even so, the consensus is that all of these methods are too risky and none is ready for human clinical trials.

Cats can cause allergic reactions in about 15% of people.  Tough if you visit friends with feline friends.  Help is maybe at hand.  All cats produce a protein known as Fel d 1, which is the apparent cause of the adverse reaction.  Fel d 1 consists of two different subunits, and there are two genes – called CH1 and CH2 that encode each subunit.

InBio, or Indoor Biotechnologies, is a US company that has used CRISPR technology to delete the two genes of the Fel d 1 protein.  The work used only in vitro cultures of cat cells.  Nevertheless, InBio says it is the first step to creating hypoallergenic cats.  However, it may take several years before allergen-free moggies are available from your local pet store.

Stem-cell Technologies

James Thomson retires
This is not an obituary notice, but a retirement notice.  James Alexander Thomson is retiring from the University of Wisconsin-Madison this July.  He is 63 years old.  So what?  Well, he is the man who first isolated and cultured human embryonic stem cells.  He is therefore the man who ignited one of the most vehement bioethical debates – should scientists be allowed to create and use embryonic stem cells, rather than ‘adult’ stem cells?

His landmark study appeared on 6 November 1998.  It was entitled ‘Embryonic Stem Cell Lines Derived from Human Blastocysts’ by James Thomson et al., and published in Science (1998, 282: 1145-1147).

The crux of the matter was simple – the harvesting of embryonic stem cells results in the unavoidable destruction of human embryos.  On the other hand, ‘adult’ stem cells are available from several bioethically-neutral sources, such as bone marrow, umbilical cord blood, milk teeth, eyes, adipose tissue and so on and they are relatively plentiful and easily collected.

Accordingly, Thomson’s 1998 paper sparked off a bioethical battle, a stem-cell war – embryonic v. ‘adult’.  Thomson astutely recognized the existence of this bioethical conflict zone when he declared, ‘If human embryonic stem cell research does not make you at least a little bit uncomfortable, you have not thought about it enough.’  In the meantime, stem-cell science was marching on and successful medical treatments using ‘adult’ stem cells were multiplying whereas embryonic stem-cell remedies were few and far between.

Then in 2006, a biological bombshell exploded.  Shinya Yamanaka of Kyoto University discovered how to induce ordinary, ‘adult’ somatic cells (not ‘adult’ stem cells) to revert to an embryo-like state.  He cultured skin cells from adult mice and, using transcription factors, was able to ‘undifferentiate’ these somatic cells.  Yamanaka called these new entities ‘induced pluripotent stem cells’ (iPS cells).  This ‘reprogramming’ or ‘deprogramming’ has been likened to winding back the clock, taking adult cells back to their embryonic precursors from which they originated – the very reverse of the process of cell differentiation.  Previously, this was thought to be an irreversible pathway, that is, the biological traffic went only one way from embryo to adult – we now know differently.

And so a new race was triggered and the bandwagon was rolling – could the same reprogramming occur with human somatic cells?  The answer was, yes.  In November 2007, two research groups, led separately by Thomson and Yamanaka, simultaneously reported the generation of iPS cells from human adult fibroblasts, that is, human skin cells.  This was revolutionary science.  Thomson’s contribution was entitled, ‘Induced pluripotent stem cell lines derived from human somatic cells’ by Junying Yu et al., and published in Science (2007, 318: 1917-1920).

It is hard to overstate the medical and bioethical implications of such reprogramming.  In a nutshell, iPS cells are stem cells that can be made from an individual’s own somatic cells without the need for ova, cloning, or the subsequent destruction of an embryo.  What is more, they appear to have most, if not all, of the biological properties of embryonic stem cells.  And because iPS cells are ‘patient-specific’, they are genetically matched to, and therefore would not be rejected by, the patient, who would therefore not need any immunosuppressive drugs if these cells were used in regenerative treatments.

Yamanaka’s revolutionary work was rightly recognized and rewarded by his winning the 2012 Nobel Prize in Physiology or Medicine.  The production of iPS cells was – and still is – a game-changing breakthrough that was destined to become the future of stem-cell research.  James Thomson, commenting on the stem-cell bioethical war, stated that, ‘Human ES [embryonic stem] cells created this remarkable controversy, and iPS cells, while it’s not completely over, are sort of the beginning of the end for that controversy.’  In 2007, he further claimed that, ‘A decade from now, this [the adult v. embryonic stem-cell controversy] will be just a funny historical footnote.’

James Thomson’s work may have played second fiddle to that of Shinya Yamanaka, but the former undertook world-beating science, even if it was bioethically controversial and divisive.  Looking back on his career and his pending departure from work, Thomson recently said, ‘I accomplished what I wanted to accomplish.  People hang on too long and tend to kind of fade out.  And I didn't care to do that.’  Happy retirement, James.

Stem-cell treatments and the elderly
Japan has the world’s oldest population.  It is therefore investing $970 million in ‘regenerative medicine’, which includes the transplantation of induced pluripotent stem cells (iPS cells) to replace non-functioning cells in its elderly citizens.  After all, iPS cell technology was devised by their very own Shinya Yamanaka.

Numerous small-scale trials have already been conducted in Japan for diseases like age-related macular degeneration, Parkinson's disease and arthritic disorders.  For instance, in 2019, a Japanese stem-cell transplant treatment was approved for spinal-cord injuries.  In 2020, a six-day-old infant with a liver disorder received an iPS treatment that enabled the child to survive until he was old enough for a liver transplant.  iPS therapies also offer hope for treating intractable diseases like motor neurone disease (MND) and Alzheimer's.

An example of such sought-after success was reported in April, when a team of researchers at Osaka University announced the results of an experimental treatment involving four practically-blind patients suffering from corneal disease.  The patients, who ranged in age from their 30s to 70s, received transplanted corneal epithelial cell sheets created from iPS cells grown in the laboratory.  Three had their eyesight improved and all were free of side effects one year later.

‘This could be a revolutionary treatment that could overcome the challenges that existing treatment has faced, such as a shortage of cornea donors or transplant rejection’, so said Koji Nishida, an Osaka University professor of ophthalmology, at a news conference.  Future plans at Osaka include a large-scale clinical trial in collaboration with biotech companies with the aim of making the novel procedure a widespread treatment.  However, the required success and approval may be years away.  Yet the application of bioethically-sound treatments is to be welcomed.  It is the way forward.

Stem cells and Parkinson’s treatment
Parkinson's disease is that neurodegenerative disorder characterised by the loss of neurons which produce the neurotransmitter dopamine.  When these neurons die, patients experience a lack of movement coordination due to loss of dopamine in their brains.  Drug treatments are available to replace the dopamine, but their efficacy often wanes with time.  A recent study has created dopamine-producing cells from induced pluripotent stem cells (iPS cells).  When transplanted into rats with Parkinson's disease, they successfully alleviated the disease symptoms.

The work, conducted at the Arizona State University, has been reported as, ‘Optimizing maturity and dose of iPSC-derived dopamine progenitor cell therapy for Parkinson’s disease’ by Benjamin Hillier et al., and published in Nature Regenerative Medicine (21 April 2022).

This was a proof-of-concept study.  As the paper states, ‘These data support the concept that human iPSC-derived D17 mDA progenitors [17-day differentiated, midbrain dopamine-producing cells] are suitable for clinical development with the aim of transplantation trials in patients with Parkinson’s disease.’  Indeed, its findings will soon be tested in a human clinical trial of patients with a specific type of Parkinson's disease caused by a mutation in the so-called Parkin gene.  For many, such treatment, if successful, cannot come soon enough.

Stem cells and cancer treatments
Glioblastoma are highly-malignant brain tumours that account for more than 60% of all tumours found in adult brains.  Surgery can be effective in eliminating the primary tumour but recurrence is typically more than 90%.  How could this rate be reduced?  Moreover, glioblastoma create difficulties with normal treatments because most drugs cannot cross the blood-brain barrier.  A new type of post-surgery stem-cell therapy has been developed and tested in mice for the treatment of glioblastoma.

This study, conducted by scientists at Brigham and Women's Hospital and Harvard Medical School, is entitled, ‘Target receptor identification and subsequent treatment of resected brain tumors with encapsulated and engineered allogeneic stem cells’ by Deepak Bhere et al., and was published online in Nature Communications (19 May, 2022).

The scientists collected circulating tumour cells that entered the bloodstream from the primary glioblastoma of patients and used these to identify receptor molecules expressed specifically on these glioblastoma cells, termed 'death receptors'.  Then the team used mesenchymal stem cells (MSC) obtained from a healthy human donor, and engineered them to express proteins that could bind to the ‘death receptors’ on glioblastoma cells.  This elicited a cascade of reactions in glioblastoma cells, leading to their death.  Finally, these engineered stem cells were packaged into a biodegradable hydrogel capsule, allowing them to pass through the blood-brain barrier.

This is a clever approach that could lead to personalised medicine based on the patient’s specific tumour, but to ensure speedy treatment, it also employed pre-made allogenic stem cells, a sort of ‘off-the-shelf’ remedy.  It may be possible to create a bank of stem cells derived from healthy donors that have been previously engineered to tackle different cancers – a pre-made bio-bank of fully-characterised stem cells.

Generally, with cell-based therapies, the patient's own cells are harvested, reprogrammed to target diseased cells or tissues, and then reintroduced into the patient's body.  In patients with glioblastoma, however, the disease is so fast-moving that surgery must be performed within the first week after diagnosis, leaving little time to develop therapies using the patient's own cells.  Hence, the need for pre-made stem cells, or this sort of ‘off-the-shelf' remedy, developed using cells from healthy donors.

This stem-cell based therapy was tested in mice with primary or recurrent glioblastoma.  The tumours were removed and the stem-cell based therapy administered.  Mice that received the treatment were alive 90 days after surgery, whereas those that only had the surgical removal of the tumour survived for an average of only 55 days.  Various doses of the therapy were administered, but no adverse effects of toxicity were detected in the mice.

This is exciting, but of course it is only ‘in mice’, not men.  Nevertheless, the authors reckon that Phase I/II human clinical trials could begin within the next two years.  And they hope that this stem-cell based therapy could be used to treat other solid tumours.  Don’t we all?

Stem-cell treatment failures

Many stem-cell treatments are wonderful – some are diabolical.  Some clinics produce amazing therapies – others are fraudulent.  Unproven stem-cell treatments are everywhere.  And the USA is among the worst affected.  Surprisingly, the US Food and Drug Administration (FDA) has approved only blood stem-cell transplantations for cancers and disorders of the blood and immune systems.  Yet hundreds of US clinics are offering untested, undocumented stem-cell therapies.  Indeed, scores have been implicated in deaths and injuries to their clients.

Of course, the USA population can be overeager for both medical and litigious procedures.  Hence, stem-cell quacks and hungry attorneys make for an explosive combination.  Take for example the long-running legal dispute between StemGenex, a US stem-cell treatment provider, and a group of its dissatisfied customers.  The lawsuit started in 2016, when a group of its patients complained that the StemGenex claim of ‘100 percent consumer satisfaction’ was misleading.

These former patients had sought treatments for a range of medical conditions including lupus, diabetes, multiple sclerosis and spinal cord injury.  However, none had ‘received any significant benefit’ from StemGenex procedures, despite their costly treatments.

The StemGenex treatments involved removing adipose tissue cells from patients and treating them to concentrate the stem cells.  These were then tweaked according to the disease to be treated, before being injecting back into the patient.  The clinic had claimed that the treatment was effective against a variety of conditions, including Alzheimer's and Parkinson's.  Moreover, the high patient satisfaction rate quoted by StemGenex was based on interviews conducted shortly after fat cell harvesting, namely, before the results of the treatment would be apparent.

This disgraceful episode of quackery has at last reached a settlement.  A total of $3.65 million will be paid by StemGenex to 1,063 of its former patients.  That may bring about some financial satisfaction for the maltreated patients, but it maligns authentic stem-cell technologies and their dedicated medical practitioners.

And there is yet another distasteful aspect to this sad saga.  The lawyers were the real winners.  The financial settlement meant that each plaintiff received just $1,936 from the compensation fund despite having paid around $14,900 per treatment.  The majority of the settlement disappeared in legal fees and expenses.

The moral of this story – if you ever consider using a stem-cell treatment be very, very cautious.  Better be sceptical than ripped off.  Do not believe a stem-cell company’s hype.  Research the scientific evidence.  Ask a stem-cell expert.  Ask two or three.  Beware – there are stem-cell treatment fraudsters out there.


Mandy Allwood (1965 – 2021)
Mandy J Allwood was a rather ordinary girl.  She was born in Warwick in 1965, the daughter of Brian Allwood, who owned an electrical company, and his wife Marion.  She left school at 16 and worked for her father’s business.  In 1983, she met Simon Pugh, a plasterer from Solihull.  They married in 1986 and had a son, Charlie, but the marriage was dissolved after she became involved with another suitor, Paul Hudson.

By 1995, Allwood had begun a serious relationship with Paul Hudson, who already had another family, and in December of that year Allwood suffered a miscarriage.  She resolved to become pregnant again.  By the following April she had not conceived and was referred for fertility treatment.  In August 1996, this rather ordinary woman became the world-famous Octomum.  Mandy Allwood had managed to superovulate and conceive octuplets.  She went against medical advice and had sexual intercourse while being treated in a private clinic in Birmingham with fertility drugs.  Why a previously fertile woman, with a 5-year-old child, a previous abortion and a recent miscarriage, was recommended such treatment, especially in the absence of counselling with her partner, who apparently lived with another woman, was a mystery.  Nevertheless, she insisted on keeping all of them.  She seemed adamantly, but perhaps naively, prolife.  ‘I know some people will call us irresponsible but, as far as I’m concerned, the more the merrier’, she claimed.

Enter Max Clifford, the now-discredited PR consultant.  If sex and money make the biggest headlines then here was the near-perfect story.  Clifford sold the story of Octomum to the sleazy News of the World for an alleged six-figure sum.  He also organised sponsorship deals with car, baby food and baby supplies’ companies.  He declared the more births the better because of the greater media interest.  Around that time, I happened to be in London one day when the three of them rushed out of a media office and into a waiting taxi.  They were, for a little while, celebrities.

What followed was most instructive.  Much of the medical profession, rather than rise to the challenge, spoke only in terms of gloom and doom.  Dr Thomas Stuttaford, a medical writer for The Times, declared, ‘In medical eyes this pregnancy is a catastrophe.’  The universally offered treatment was the barbaric selective reduction – ‘kill six to save two’.  Mandy Allwood refused.  That is, she took advantage of that well-known liberal slogan, ‘a woman’s right to choose.’  And then what happened?  The pro-abortion press immediately rounded on her, often with near-hysterical spite.

On Monday 30 September, Allwood went into labour at 24 weeks.  She was taken to King’s College Hospital, London, where she lost three of her boys.  The very next day one girl was stillborn in the morning, and that afternoon the remaining three boys and one girl all died.  Seven were registered as live births and subsequent deaths while one was a miscarriage.  ‘I cradled each of them for two and a half hours as they died in my arms,’ she recalled.  ‘It was horrible.  When I felt the last one coming, I said, ‘Please, God, let at least one of them live.  But it wasn’t to be.  I was inconsolable.’

Much of the medical profession was aching to say, ‘We told you so.  You should have aborted six.’   But the ends do not justify the means and it is simply wrong for doctors to kill their patients.  Poor Mandy Allwood – she was devastated.  She was a mother, who wanted, but suddenly lost, eight of her children.  Undoubtedly she grieved, but her one consolation was that she did her best for them all and did not consent to killing any of them – for that she needed to experience no guilt.

She named the six boys Adam, Cassius, Donald, Kypros, Martyn and Nelson, and the two girls Layne and Kitali. They were buried in tiny white coffins decorated with butterflies.  ‘I have a treasure box which I keep next to my bed with their scan pictures and photos of them when they were born along with their birth certificates and teddy bears’, she told The Sun newspaper 19 years later.  After losing their octuplets Allwood and Hudson had three daughters – Color, Kitali and Rade.

Things then went downhill, again.  In 2007, Allwood separated from Hudson and was arrested for drink-driving with her children in the back of the car – she lost custody of them.  Two years later she was given an anti-social behaviour order (ASBO) for playing loud music and upsetting her neighbours in Warwick.  The money from selling her story had dried up.  She admitted two counts of fraud.  She sued Clifford, accusing him of deceit and in 2001 he was ordered to pay her £15,200.  She became estranged from her family, spiralled into depression and alcoholism and had suicidal thoughts.  Her name lives on in medical ethics books and she also appears in media law textbooks.  Small recompense for fleeting fame.

She finally moved to Stratford-upon-Avon, where she was a regular at the Yard of Ale public house.  In 2015, she told The Sun how she still felt phantom movements from her doomed pregnancy.  ‘Ever since I gave birth I have felt them kicking and moving every day,’ she said.

Mandy Allwood started out as a rather ordinary girl, who became a rather ordinary woman, who was suddenly shot into global stardom and then ditched to fade into near oblivion.  Hers was a sad and troubled life.  Bioethically, it was a disaster.  She died of cancer on 8 December 2021, aged 56.

DNA, the final blueprint

It started in 1953 when James Watson and Francis Crick first described the three-dimensional structure of the double helix of deoxyribonucleic acid (DNA), the carrier of the genetic code.  Then in 1990, efforts began to sequence it.  By 2000, a huge team of international scientists working on the Human Genome Project ‘cracked’ this human genetic code, that is, they sequenced the 3.3 billion chemical ‘letters’ of our DNA.  It was a first draft.  A revised version was published in 2003, but that was only about 92% complete.

Now, after a 32-year quest, the final version has been delivered – the gaps have been filled.  Technically, this has been a mammoth scientific achievement.  It was only recently that the required sequencing technology has been available to decode that final, previously inaccessible, 8%.  It allowed the scientists to move some sequences, decipher some repetitive segments, transfer other sections to their correct positions and to add more than 200 million missing ‘letters’.

Evan Eichler, from the University of Washington School of Medicine and co-chairman of the Telomere to Telomere (T2T) consortium, which carried out the work, said, ‘The complete blueprint is going to revolutionise the way we think about human genomic variation, disease and evolution.’  It is reckoned that this ultimate version may help doctors better understand medical conditions, such as neuroblastoma, a cancer that mainly affects young children, schizophrenia, lung cancer and some forms of muscular dystrophy and immunodeficiency.

This research, this seminal, historical study is published across six papers in Science (2022, 376: 44-53) by Sergey Nurk et al.,
under the title of ‘The complete sequence of a human genome.’

So, have the sequencers finished their work?  No!  The demand now is to get similarly complete genome sequences from a greater diversity of people – so far the sequencing has relied on DNA from a very limited number of sources.  The T2T consortium has already made a start by deciphering 70 more human genomes, with a goal of 350 from people of diverse ancestries.  Eventually, it is said, ‘We want every genome to be telomere to telomere.’

Deaths among the young
What is the most common cause of death among children, adolescents and young adults aged between 1 and 24 in the United States?  Well, if you are pro-life minded, you will say, and quite rightly, abortion.  After all there are currently about 800,000 abortions performed every year across the USA.

The alternative answer is death by injuries of a physical nature.  For more than 60 years, motor vehicle crashes have been the leading cause of injury-related deaths among these young people.  But from around 2017, firearm-related injuries became the number one cause of death from injury.  Why this crossover?  Simple.  Motor vehicle crashes have become increasing safe – seat belts, speed restrictions, better constructed cars, and so on.

According to the US Centers for Disease Control and Prevention (CDC), between 2000 and 2020, the number of firearm-related deaths among children, adolescents, and young adults increased from 6,998 to a colossal 10,186.  In 2000, motor vehicle-related injuries resulted in 13,049 deaths among young people.  By 2020, that number had fallen to 8,234 motor vehicle traffic deaths – equivalent to a 40% decrease.

These data demonstrate that concerted governmental efforts to reduce road-traffic crashes, especially those with fatal outcomes can be achieved.  Now USA, what about concerted effort with respect to firearm fatalities?  We are horrified by the outcomes of your ‘right to bear arms’ and the regularity of news headlines reporting mass murders on your streets and in your schools and homes.  Firearms, however, are one of the few products whose safety is not regulated by a designated US federal agency.  Perhaps it should be.  Perhaps it is now too late to retrofit such regulations.  Yet undeniably something needs to be done.  How cheap is human life?

USA and Elsewhere
Roe v. Wade
Presently there is but one hot bioethical topic in the US – the possible/likely overturning of Roe v. Wade.  Since its introduction into US federal law in 1973, this case, which depended on a dubious constitutional right to privacy, created a sort of right of US women to abortion in the first three months of pregnancy, and limited rights in the second trimester.  It has since been contentious and the target of the pro-life community.  Now, almost 50 years on, there is the real possibility that it will be overturned or at least scaled back.  If so, abortion in the US will not cease, but it will become more restricted and individual states will again be allowed to pass legislation to protect their unborn children.

Currently, the Supreme Court of the United States of America (the SCOTUS), is adjudicating in a challenge to Roe v. Wade under the legal aegis emanating from the Mississippi case of Dobbs v. Jackson Women’s Health Organization and its ban on abortions after fifteen weeks.  Dobbs arrived before the SCOTUS on 1 December when oral arguments were heard.  Judgement has been expected by the summer of 2022, perhaps in late June or early July.

The latest move occurred on Monday 2 May, when a draft opinion on the case, written by Justice Samuel Alito, was leaked and published by the news outlet, Politico.  The document, which had been circulated among the SCOTUS members on 10 February, suggests that the Court is ready to overturn Roe.  Alito is quoted as writing, ‘Roe was egregiously wrong from the start.  Its reasoning was exceptionally weak, and the decision has had damaging consequences.  And far from bringing about a national settlement of the abortion issue, [it has] enflamed debate and deepened division.’  Is this the final opinion of the SCOTUS?  Is this the majority view of Roe?  It is reported that Alito and four other Justices are in favour of an overturn, with Chief Justice John Roberts as an unknown.  Would that mean the SCOTUS majority could be 6 to 3 in favour of overturning?

Make no mistake – this is BIG law.  If Roe is overturned its implications will not only affect America but they will ricochet around the world.  Abortion will never be the same again.  We await the decision of the nine Justices of the SCOTUS.  By the time you read the next Update on Life Issues, in Novenber, something significant will have happened to abortion in the USA.

In the meantime, as well as the heated debates, a rash of violence by radical abortion activists has broken out.  Offices of pro-life groups in Wisconsin and Oregon have been firebombed.  Numerous churches and pregnancy care centres across the country have been vandalised.  In early June, an abortion activist was arrested near the home of Supreme Court Justice Brett Kavanaugh after he threatened to assassinate the conservative justice.  Then in mid-June, young women from the Rise Up 4 Abortion Rights group demonstrated in blood-soaked clothes right outside the home of US Supreme Court Justice Amy Coney Barrett in Virginia.

After killing 63 million unborn children by abortion – itself a typically violent and bloody procedure – perhaps we should not be surprised that abortion radicals have resorted to defend it by violence.

Elsewhere in America
Washington DC may be the hub of all this abortion activity, but the action is nationwide.  It may be that the loudest chanting of the pro-life activists and their ‘Roe v. Wade has got to go’ and their pro-choice counterparts shouting ‘abortion is healthcare’ is most apparent in the capital, but this is not only a Washington-centric affair.

For a start the stretch of Roe v. Wade is being determined against the backdrop of the contentious 2021 Texas Heartbeat Act and its ban on abortions after six weeks.  Though challenged in lower courts, eventually, in January 2022, the SCOTUS intervened so that the Texas Heartbeat Act remains and the lives of thousands of unborn children have been spared.

Then there are numerous other states which are gearing up for a post-Roe situation.  Already ‘trigger’ laws are on the books across the US so that abortion would become illegal in at least 22 states if Roe is quashed.  And there are still states currently introducing anti-abortion laws.  For instance, in late May, Oklahoma legislators passed a bill that would ban nearly all abortions, from the moment of fertilisation, across that state.  The bill defines an unborn child as ‘a human fetus or embryo in any stage of gestation from fertilization until birth and fertilization is defined as the ‘fusion of a human spermatozoon with a human ovum’.  Exceptions would be to save the life of the woman or if the pregnancy is the result of rape or incest.  It would be the nation’s strictest abortion law and would save an estimated 4,000 unborn lives a year.  On 25 May, the Oklahoma governor, Kevin Stitt, signed it into law.  The new legislation went into effect immediately and began protecting the unborn from abortion.  Even if Roe v. Wade stands, this law would remain in force, unless a court steps in to block it.

News from Hungary
In March 2022, Katalin Novak, a 44-year-old former cabinet minister, was elected by the Hungarian parliament as its first female president.  She is also both pro-life and pro-family.  She has spoken of the importance of children in a society that promotes killing the unborn by abortion.  In her victory speech, Novak drew attention to the importance of families – including her own – and said, ‘Having children was one of the most important decisions of our lives.’

In 2011, Hungary adopted a new Constitution.  It includes Article II that protects human life from the moment of conception.  It states, ‘Human dignity shall be inviolable.  Every human being shall have the right to life and human dignity; embryonic and foetal life shall be subject to protection from the moment of conception.’

Katalin Novak faces a tough future attempting to uphold and implement that aspect of the Constitution.  Hungary is a country where abortion has been widely practised legally since 1953, though now in diminishing numbers – currently about 20,000 per year – though such official government figures can often be huge underestimates.  Come on Hungary, show the world what it means to be pro-life and pro-family.

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