Update on Life Issues - June 2023


The latest abortion statistics – where are they?
June is the month that the official abortion statistics for England and Wales are routinely published.  But not this year.  Why not?  The reason given by the UK government’s improbably named Office for Health Improvement and Disparities is a bureaucratic backlog in processing the HSA4 forms.  These are the notification records, completed by medical practitioners, whenever they terminate a pregnancy.  They are the basis of the annual statistics.

Apparently, the complete set of abortion data for 2022 will not be released until 09.30 on 1 January 2024.  In the meantime, an ad hoc publication will be released on 22 June 2023 covering abortions for the six months from January to June 2022.

There is probably nothing sinister about this delay – it simply smacks of governmental incompetence.  Or are the upcoming abortion figures so horrendous that they might somehow appear more palatable delivered in two tranches?

The latest abortion statistics – here they are
As promised, the ad hoc, six-month abortion data were published at 09.30 on 22 June 2023.  They cover abortions carried out from January to June 2022.  They are, as ever, as expected, egregious.

Overall, between January and June 2022, there were 123,219 abortions undertaken on residents of England and Wales.  This figure is significantly higher (17%) than the 105,488 abortions performed over the same six-month period in 2021.  Extrapolating to predict a total for the whole of 2022 suggests it will be about 250,000 – a new calamitous, record high.

Why the large increase?  Was it due to Covid-19, Brexit, the cost of living, ‘pills by post’, or a general downturn in the value and dignity of the unborn and their mothers?  As ever, most (98.6%, 121,433) of these half-year abortions were performed under the ‘social clause’, Ground C.  If that six-month figure is doubled to 242,866 to estimate a full year’s total and then compared with the total 2021 figure of 209,939, do these extra 33,000 Ground C abortions represent the main cause of the upsurge?

However you interpret these statistics, the ugly truth remains that in England and Wales, from January to June 2022, there were on average 945 abortions performed every weekday, every Monday, Tuesday, Wednesday ....

Carla Foster and the 1861 OAPA
Because of Sections 58 and 59 of the 1861 Offences Against the Person Act (OAPA), abortion remains a criminal offence in England and Wales.  The penalties, including lifetime imprisonment, may appear harsh.  Yet, the OAPA was, and still is, justly protective of the lives of women and their unborn children.  Moreover, the 1967 Abortion Act conferred only a defence against abortion’s illegality by permitting terminations provided certain conditions are met.  For instance, the upper limit is now typically 24 weeks.

Carla Foster, now aged 44 and mother of three, acted outside those conditions.  On 12 June, she was convicted and given a prison sentence of 28 months at Stoke-on-Trent Crown Court by Mr Justice Pepperall.  She pleaded guilty to the charge of section 58, namely that, ‘Every woman, being with child, who, with intent to procure her own miscarriage, shall unlawfully administer to herself any poison or other noxious thing … shall be guilty of a felony ….’  She was between 32 and 34 weeks pregnant.  She lied about the stage of her pregnancy when ordering ‘pills by post’ from the British Pregnancy Advisory Service (BPAS) to procure a termination during the Covid-19 pandemic in 2020.  That lockdown scheme, which supplied mifepristone and misoprostol pills, was solely for pregnancies of less than 10 weeks.  That telemedicine source of those abortifacient drugs, with its problems of estimating gestational age and detecting signs of coercion, is still in operation.  It should be revoked.  Eventually, in May 2020, she delivered Lily May, her stillborn daughter, some 2 months beyond legality and also way beyond the survival prospects of wanted neonates.

The case has caused considerable clamour, especially among pro-choice women and abortion agencies.  They say, abortion is a healthcare issue rather than a legal matter.  And how can that 162-year-old law govern a modern woman’s reproductive rights?  And what about a woman’s fundamental right to bodily autonomy?  And what about the right to choose?  Calls for the decriminalisation of abortion are few but loud.  The 2009 Labour party manifesto included such a commitment.  Yet, the basically misunderstood truth is this – abortion in the UK remains a crime, a very serious crime.  And the current government has no plans to change either the UK’s abortion laws, or its sentencing guidelines.

Of course, this exceptionally rare case is heart-rending.  We are not the Taliban – have some compassion.  This vulnerable woman was reportedly exhausted, anxious and in ‘emotional turmoil’.  Of course, she deserves our pity.  She was not a dangerous criminal.  But she did kill her baby.  And the law is the law.  And abortion is essentially a criminal act.  And an ‘old’ law is not necessarily a redundant or an out-of-date law.  There were calls for a non-custodial sentence, but the Judge explained this was ‘not appropriate’ and that his duty was ‘to apply the law as provided by Parliament.’

So what should Carla Foster have done?  She should have faced the truth, confided in a good friend, perhaps even the father of Lily, or a counsellor from a pro-life group and then gone along with the pregnancy for just a few more weeks to term, given birth to Lily and put her up for adoption.  That course of action would have been safer for her and life-giving for Lily.


China goes for broke
The Chinese government is debating whether to allow single women widespread, subsidised access to ova freezing and IVF to slow the county’s falling birth rate.  What an about-turn from the days of its one-child policy.  Such a novel strategy may be resisted by the old guard, though the assisted reproductive technologies (ARTs) commercial sector would be delighted to participate.

The figures speak for themselves – a population crisis is approaching.  China’s fertility rate has sunk to 1.18 children per woman (2.1 is needed for demographic stability) and its population has begun to decline.  Deaths are now outnumbering births.  Fewer children mean fewer workers and more elderly.  What to do?  Subsidising ova freezing and IVF are serious options.

Indeed, the giant leap forward has started.  China recently promised to build at least one facility offering IVF for some 3 million people by 2025.  It currently has 539 medical institutions and 27 sperm banks that have been approved to carry out ARTs.  Currently, these facilities undertake more than 1 million IVF cycles each year resulting in about 300,000 babies conceived.  If this approach is scaled up, it could begin to alleviate some of China’s population problem.

However, a lack of facilities is not the root of the problem.  It is cultural.  The one-child policy has changed young people’s thinking.  Now, amidst China’s economic uncertainty, they understand and worry about the financial burden of having children.  Now, for many focussing on their careers has priority while others have adopted a childless lifestyle known as ‘double income, no kids’.

Surrogacy, no and yes
During March, a hundred experts from 75 countries signed the so-called Casablanca Declaration 2023.  It calls for the universal abolition of surrogacy because it ‘violates human dignity’ and ‘contributes to the commodification of women and children.’  Furthermore, the Declaration, ‘denounces surrogacy in all its modalities and kinds, whether renumerated or not.’  And it proposes that surrogacy brokers and participants in the surrogacy process are prosecuted.  Tough words.  The common ground of the signatories is, ‘Their willingness to support the request made to States to commit to an International Convention for the abolition of surrogacy.’  Good luck with that.  Notably, among the 20 or so speakers at the launch of the Declaration in Casablanca, there was none from the UK.

By contrast, following their public consultation in 2019, the Law Commission of England and Wales and the Scottish Law Commission recently published their long-awaited 24-page Report entitled, ‘Building Families Through Surrogacy: A New Law.’  The Report makes numerous recommendations.  For instance, it calls for a new legal pathway which will allow intended parents to be legal parents from birth – currently the surrogate is the legal mother.  Also, the introduction of legal safeguards and requirements before conception for the surrogate, intended parents and the child are recommended.  And a reform of payments is proposed to ensure limitations and the risks of exploitation.  Plus, the Report supports the creation of Regulated Surrogacy Organisations (RSOs), regulated by the Human Fertilisation and Embryology Authority (HFEA), to oversee new agreements and provide support.  In addition, it says the parental order process, which currently transfers parenthood from the surrogate to the intended parents, needs restructuring.  In the UK during 2020, 413 such orders were issued.  And it recommends the creation of a Surrogacy Register so surrogate children can access information about their origins.  Furthermore, improved employment rights for the surrogate and the intended parents are advised so they are treated like any other pregnant women or those with a new child.  And finally, limited reforms on nationality and immigration issues are set forth.

This is a big Report with hefty recommendations.  Primarily, it seeks to justify the controversial practice of surrogacy and to tidy up some of its notorious hitches and glitches.  There is little, if any, discussion about the ethics of surrogacy.  That ship has long since sailed.  How far we have come since the 1984 Warnock Report stated that, ‘… surrogacy for convenience alone … is totally ethically unacceptable.’  What next?  The Government will consider the Report and conclude whether to change the law.  In the meantime, I conclude that surrogacy is best avoided.

Childbearing in the 21st century
The custom of childbearing has shifted.  There are now twice as many women giving birth over the age of 40 as there are having children as teenagers in England and Wales.  Figures from the Office for National Statistics (ONS) showed that 28,478 babies were born to mothers aged 40 to 44 in 2021, and another 2,064 to mothers aged 45 and over.  By comparison, there were only 13,739 births to mothers under 20 in the same period.  Now the average age of women giving birth in the UK has increased to 30.9 years – the highest since records began in 1938 – and the average age of fathers is 33.7 years.

Such changes in motherhood have been driven largely by career opportunities and medical advances.  Some 50 years ago, the pattern used to be marry, nurture children, go back to work.  Nowadays, women’s incomes are often needed to service a mortgage, while long and successful careers have become more attractive and ‘fun before family’ has become the slogan for many.  Moreover, this current cohort of young fertile women hope that assisted reproductive technologies (ARTs) will provide legitimate backups to ensure pregnancies at a later date.

How wrong can the hopeful be?  IVF has a miserable overall success rate of about 30% at best.  For women over 40, the rate drops precipitously to less than 10%.  They call it the ‘fertility cliff’.  So, enter a new trend – call it what you will, ova vitrification, cryopreservation or freezing.  Basically, it copies the protocol of IVF with daily injections, monitoring, and so on, to encourage superovulation, then ova retrieval, assessment and freezing of the seemingly viable.  This is apparently becoming de rigueur in the human reproductive industry.  In 2019, the HFEA reported 2,500 storage cycles of ova freezing.  By 2021, that figure was 4,200.  And that is despite the cost of perhaps £5,000 per treatment cycle, plus an annual storage fee, plus perhaps another £5,000 to use the ova in IVF.

What about the alternative – sperm donation and freezing?  No, no.  The conclusion is still the same – IVF and its associated procedures are best avoided.

Euthanasia and Assisted Suicide

Dignitas and Exit in Switzerland
Switzerland may well claim to be the global leader in premature killing.  After all, assisted suicide has been legal there since 1941.  And, of course, it is the home to the Dignitas ‘clinic’ in Zurich – the place favoured by a few Britons in which to spend their last days.

First, let us get some facts straight.  Britons are not exactly streaming into the place.  Since 2010, only something like 360 Britons have gone there on one-way tickets.  That is about 30 each year.  In 2022, that number was 33.  In context those figures must be compared with the approximately 600,000 Britons who die each year back in the UK.  Assisted suicide may be a hot issue, but the output of Dignitas is numerically tiny.

Second, Dignitas may be considered faddish, but, as of last month, there were only 1,528 British members signed up to use its facilities.  That may be an all-time high, but at the current rate of activity, the queue will stretch for the next 50 years.

Dignity in Dying, the UK’s premier assisted dying organisation, is a big fan of Dignitas.  It has supported most of those either campaigning for assisted suicide or attending the ‘clinic’.  It is convinced that the UK’s 1961 Suicide Act with its robust ethos is a bugbear that needs amending or repealing.  Yet the Act protects the vulnerable, punishes those who assist and maintains a deterrent.  That is what good laws do.

Now comes news of another first for Switzerland.  A prison inmate has ended his life with the help Exit, an assisted suicide organisation also based in Zurich.  The man was declared dead on 28 February 2023, but no more details have been released.  The authorities said that the right to assisted suicide also applies to prisoners because of their right to ‘self-determination’.  However previous requests for assisted suicide from Swiss prisoners have been refused.

The question arises, under what conditions would a person’s request to die be refused?  Switzerland may well have examples of such refusal, but other countries are happily vaulting over their legal boundaries of eligibility.  Read on.

O Canada the worst?
‘O Canada!  We stand on guard for thee’ is the refrain from the Canadian national anthem.  Hmm.  It seems the guards, perhaps including even the Mounties, have gone to sleep.  Canada is sleepwalking into a dystopian state of euthanasia.  It is MAID (medical assistance in dying) gone mad.

According to recent projections, Canada is on track for another record year of euthanasia deaths, with a 35% jump to some 13,500 state-sanctioned suicides in 2022, up from 0 in 2015.  Data from Ontario and Alberta show such steep rises with Quebec reporting that 7% of all its citizens’ deaths were state-assisted suicides last year.  Compare this with figures from the Netherlands (4.5%) and Belgium (2.5%).  And now there is talk and formal debate about legally euthanising the Canadian disabled newborn and under-18 ‘mature minors’ who are terminally ill.  And like Switzerland, Canada thinks prisoners should have access to MAID – nine prisoners have so far received euthanasia.  And already people suffering from neurodegenerative diseases, such as Alzheimer’s, can make formal ‘advance directive’ requests for euthanasia before their mental capacity declines.

Canada's MAID policy of voluntary euthanasia and assisted suicide became legal in June 2016 – just 7 years ago – and has been rapidly expanding ever since.  Don’t tell me that slippery slopes don’t exist.  Nowadays a sensible question to ask in Canada is, who is not eligible for MAID?  Canada may yet become the most permissive euthanasia jurisdiction in the world.

And what about the UK?
Oh dear, there is no comfort here if you are opposed to assisted suicide.  Dignity in Dying and its supporters are hard at work applying pressure on Parliament at Westminster and the other nearby associated legislative bodies.

Think England, Wales, Scotland, Northern Ireland, Jersey, Guernsey, Isle of Man and other adjacent dominions.  Think assisted dying, euthanasia and assisted dying.  Call it what you will, wherever you live, we are under threat.

Here is the fundamental question to ask, what have I done to prevent this greatest current threat to the value and dignity of human life?  If you are not sure how to respond, let me suggest that you read (or re-read) Chapter 8 of my 2014 book, Bioethical Issues, entitled, ‘So what must we do?'

Genetic Engineering

Mitochondrial donation (MD)
There are several incurable so-called mitochondrial diseases that are inherited exclusively from a mother’s mitochondria.  These are rare, occurring perhaps 1 in 6,000 births, but often serious, even fatal, disorders.

One potential cure, mitochondrial donation (MD), also commonly known as ‘three-parent IVF’, has been proposed.  In 2015, the Human Fertilisation and Embryology Authority (HFEA) approved the technique and in 2018, it granted a procedural licence to the Newcastle Fertility Centre for the creation of 30 MD human embryos.

There are two types of MD – pronuclear transfer (PNT) and maternal spindle transfer (MST).  PNT uses the father’s sperm to fertilise the mother’s AND the donor’s ova.  Thus, there are two embryos created.  The mother’s ‘bad’ embryo with mutated mitochondria has its nucleus removed and inserted into the donor’s denucleated embryo.  So the mother’s ‘bad’ mitochondria are discarded and instead she uses the donor’s ‘good’ mitochondria.  The donor’s mitochondrial DNA consists of 37 genes compared with the 20,000 genes in the DNA of the nucleus – it is less than 0.2% of the total DNA.  In summary, the MD embryo has DNA from 1 mother and 1 father, plus 1 donor.  This resulting ‘three-parent embryo’ is transferred to the commissioning mother by IVF.  Maternal spindle transfer (MST) is a similar process except that it takes place before the ovum is fertilised, whereas PNT occurs just after fertilisation – MST starts with ova, PNT with embryos.

On 9 May 2023, it was announced that the first MD baby in the UK had been born at Newcastle via pronuclear transfer (PNT).  The event was surrounded by a distinct lack of clarity and information.  The HFEA admitted that ‘less than five’ MD embryos had been created and ‘born’.

Unsurprisingly, MD is not without problems.  For a start, in 2016 there was a MD treatment trial in Mexico.  It resulted in 4 miscarriages and two children born, but they died at 8 months and 6 years.  So, is MD safe and effective?  There are no long-term data and less than 5 UK children have been born at only 1 clinic, the Newcastle Fertility Centre.

There are also technical problems.  For example, when used in animals there is a phenomenon known as ‘carry over’ when some of the ‘bad’ mitochondrial DNA is transferred to the donor’s embryo so making a cure of the disease less likely.  Also there is ‘reversal’, a replication of ‘bad’ mitochondria that may cause ‘serious unintended consequences’, namely the unintended severe disease in the child.
Bioethical problems include the fact that MD is germline manipulation therapy, as opposed to the acceptable somatic gene therapy, so MD is heritable.  It is a crossing of the previously widely-agreed experimental red line.  And ultimately, MD deliberately destroys human embryos.  It is therefore base.  In addition, the purposeful use of donor gametes, namely third-party intrusion, is never commendable.  The MD procedure is closely associated with genetic screening and such eugenic practices are never a praiseworthy proposal.  And consider, can the world’s regulators of human embryo science keep pace with developments and control its ethics and practice?  Also remember that such controversial science has invariably been wrecked by lawless charlatans and quacks.

The pressing question to ask is this, who are we?  Are we biological toolkits, an almost endless supply of organic bits and pieces?  And what is parenthood?  It has been argued that MD embryos contain only about 0.2% of donor mitochondrial DNA, but still three sources of DNA from three adults are involved.  This is therefore not normative parenthood.  Is it a move towards designer babies?  Ask yourself, do all intending parents have the right to children?

So, who are we?  What about worth, identity and purpose?  Or are we merely experimental biological material?  Good medicine is always to be approved,
but the means must always justify the ends.  Never say, ‘Let us do evil that good may result’ (Romans 3:8).

Where is He?
Remember the Chinese scientist, Dr He Jiankui, who claimed in 2018 to have created the world’s first genome-edited humans, the twin girls known as Lulu and Nana?  That feat stunned the scientific community and in 2019 he was fired from his university job, jailed for three years by a Chinese court and fined three million yuan (£330,000).  The court said he had been ‘illegally carrying out human embryo gene-editing intended for reproduction.’  He was released from prison in April 2022.

He is still around.  He has set up a laboratory in Beijing working on the development of gene therapies for Duchenne muscular dystrophy.  And more recently he has been seeking scientific collaborators in Hong Kong where he had been granted a research visa.  However, in late February 2023, the authorities in Hong Kong reported that He’s work visa had been cancelled.

But He is still on the lecture circuit.  For example, in February 2023, He addressed a meeting at the University of Kent.  However, in a shortened lecture, he was reluctant to speak about his previous work and he refused to answer related questions.  Then in March, He was also due to speak at the University of Oxford and the Third International Summit in Human Genome Editing in London – he cancelled both appearances.

Apparently, He has spent time reflecting on his past errors.  He is quoted as saying, ‘To summarise it up in one sentence: I did it too quickly.’  And he has acknowledged that 'scientific research must be subject to constraints of ethics and morality.’  What to conclude?  A man can do wrong.  A man can be forgiven.  But a guilty man has a history that can never be forgotten.

First CRISPR therapy seeks approval
In April 2023, two US biotech companies, Vertex and CRISPR Therapeutics, submitted their novel therapy, aimed at treating sickle cell disease (SCD) and beta-thalassemia, for approval by the US Food and Drug Administration (FDA).  A decision from the FDA is expected within the next 8 to 12 months.

This is rather exciting.  This is an example of a speedy transition of a potential therapy from tech lab to hospital bed.  In this case, it has come about with a timescale of only about 10 years.  Indeed, it was in 2012 that the CRISPR-Cas9 system was shown to be capable of accurately editing genomes.

This gene-targeted therapy, formerly known as CTX-001 and now called exa-cel (exagamglogene autotemcel), is akin to a bone marrow transplant using the patient’s own engineered cells.  Haematopoietic stem and progenitor cells (HSPCs) are harvested from the patient’s bone marrow and subsequently gene-edited ex vivo using a CRISPR-Cas9 protocol.  The patient is then subjected to harsh ablation therapy to remove any remaining dysfunctional cells before the edited HSPCs are re-infused.

The technical aspects involve the precise DNA-cutting ability of a CRISPR-Cas9 nuclease to silence the gene BCL11A.  The latter is a repressor of the foetal haemoglobin gene in the HSPCs harvested from patients.  The gene and the production of foetal haemoglobin is usually naturally silenced in the months following birth, but the re-activation of this gene produces protein that can compensate for defective beta-globin in the red blood cells of patients suffering from either of these beta-haemoglobinopathies.  In other words, the therapy switches on an existing gene rather than inserting an exogenous gene.

So far, the human clinical trial results have been described as spectacular.  Of 75 treated patients, all 31 with SCD experienced cessation of painful vaso-occlusive crises.  In the two years prior to therapy these SCD patients experienced on average 4 such crises per year.  Moreover, 42 of the 44 patients with severe beta-thalassemia reported transfusion-independence over periods of 1.2 to 37.2 months.  Just 2 patients experienced SAEs (severe adverse events).  But, of course, patient safety and treatment effectiveness are paramount.  And the use of CRISPR-cas9 raises its known potential hazards of off-target editing, and so on.  However, it will be many years before exa-cel can be confirmed as truly a safe and effective one-time therapy.  A significant hurdle for the thousands of SCD sufferers is the cost of such treatments.  No price has yet been proposed but it would be expected to be in the ballpark of $1 million per person.  That would exclude countless prospective patients in under-resourced counties in Africa and elsewhere.

Whatever the obstacles, exa-cel and similar therapies for haemoglobinopathies, are carving out a pioneering footprint.  As already stated, ‘This is rather exciting.’  And, moreover they come with none of the usual major bioethical dilemmas like embryo destruction, eugenics, IVF and abortion.  How refreshing!

Stem-cell Technologies

Synthetic human embryos
Herein, the latest from that novel field of study, synthetic human embryos.  These entities have been making headlines for a decade of more.  But now two research groups, one from England and the other from Israel, have made a significant technological leap forward, but have also unearthed a set of serious bioethical questions.

The two pieces of work were described on 15 June in two preprint studies posted to the bioRxiv server, the open access preprint repository for biological sciences.  The two research teams were led by developmental biologist Magdalena Zernicka-Goetz from the University of Cambridge and by stem-cell biologist Jacob Hanna from the Weizmann Institute of Science in Rehovot, Israel.

In essence, the teams have grown human embryo-like structures, made entirely from human stem cells, using neither ova nor sperm, or fertilisation, but just single embryonic stem cells.  They developed to a stage equivalent to that of natural embryos at about 14 days after fertilisation.  Apparently, they resemble human embryos rather than being identically alike.  Indeed, they are also known as stem cell based embryo models (SCBEMs).

The creation of these entities is justified, we are told, because they will allow the study of human embryonic development at stages later than previously possible, which may in turn advance our understanding of human infertility and early pregnancy loss.

This field of biology is moving at an astonishing pace driven in part by a thirst for knowledge, but also by fierce rivalry between research groups.  Indeed, a few days after the announcement of the Cambridge / Weizmann work, the topic had moved on significantly.  Dr Jitesh Neupane of the University of Cambridge’s Gurdon Institute reported that his team had created human synthetic embryos with heartbeats and traces of blood, typically observed in the third or fourth weeks of pregnancy.  Neupane had dodged the controversial issue of development towards the foetal stage by deliberately designing his embryos to lack the capacity to form placentas and yolk sacs.  Neupane insisted, ‘I’d like to emphasise that these are neither embryos nor are we trying to make embryos.  They are just models ….’  So, dear reader, be somewhat sceptical about such reports.  After all, it should be noted that many of these, and other associated findings, have yet to be published as papers in peer-reviewed journals.

Even so, such pioneering work is undoubtedly controversial and it has provoked some serious bioethical questions.  For example, could more advanced cultural conditions be used to grow a developing human, perhaps to the foetal stage or further?  Since these synthetic embryos are produced from stem cells rather than the normal fusion of ova and sperm, will basic biology require a rewriting?  Will the word ‘embryo’ need redefining?  What is the legal status of such ‘embryo models’?  Similarly derived synthetic mouse embryos have recently been reported with developing brains and beating hearts – is that the likely intention or outcome within reproductive research with humans?  Indeed, in China, synthetic monkey embryos have already been transferred to surrogate female monkeys, though all the pregnancies failed.  And whereas ‘normal’ and ‘synthetic’ human embryos are not identical, do the latter require a different set of guidelines and regulatory rules?  If so, where are they?  More positively, could the use of synthetic embryos lessen destructive research on real embryos obtained as IVF ‘spares’?  All this posits the big question – is the 14-day limit for human embryo experimentation about to be busted?   Pushing past the Warnock 14-day rule for embryo experimentation will certainly be contentious.  Don’t tell me that slippery slopes don’t exist.

Goodbye 14-day rule?
Way back in 1984, the Warnock Committee, faced with defining an upper time limit for human embryo research, came up with the bogus 14-day rule based on the appearance of the primitive streak.  No-one thought this was a key juncture in human embryo development, but it let the Committee off the bioethical hook and it was subsequently adopted by regulatory authorities in several other countries, including the UK’s 1990 Human Fertilisation and Embryology Act.  Yet everyone also knew it could not last – bioethical boundaries are typically temporary and 14 days is bioethical and biological humbug.

For several years, pressure has been mounting to extend the infamous rule.  Has the breaking point been reached?  The International Society for Stem Cell Research (ISSCR) is a worldwide body representing stem-cell scientists.  It has previously recommended that human embryos should be cultured for no more than two weeks after fertilisation.  However, on 26 May, the Society said it was in favour of relaxing that rule.  But rather than replacing or extending the limit, the ISSCR favours a scheme whereby scientists seeking to research beyond 14 days should be subjected to a case-by-case series of reviews with the aim of determining an appropriate endpoint.

This may sound decent and constructive.  But in reality, it will be out of the frying pan into the fire.  For instance, who is to judge what is an ‘appropriate endpoint’?  In effect there will be no upper limit.  Dr A will argue that his research on model embryos needs 18 days to come to fruition.  Prof B will insist on 21 days.  It will be like the Wild West.  Show me a fence and I will show you an old ram which can jump it.  If the proposed scheme will weigh research benefits against bioethical issues, who decides the value of future goodnesses and which bioethical framework will be the measuring stick?

More good news from hiPSCs
Induced pluripotent stem cells (hiPSCs) are our bioethically-friendly stem cells.  We like to hear of their successes, as opposed to the use of embryonic stem cells with their inevitable destruction of human embryos.

A study by researchers at Northwestern University, Chicago, have, for the first time, grown neurons, derived from hiPSCs, to maturity.  Previously, such neurons were functionally immature whereas older, mature neurons are needed to be therapeutically useful for modelling pathologies in vitro.  This novel resource opens up the possibility of additional opportunities for studying neurodegenerative diseases, such as Alzheimer’s, Parkinson’s, motor neurone disease (MND) and other memory loss disorders.

The work was entitled ‘Artificial extracellular matrix scaffolds of mobile molecules enhance maturation of human stem cell-derived neurons’ and published in Cell Stem Cell (2023, 30: 219-238) by Zadia Alvarez et al.

Be warned, this sort of work is technically complex and brain-achingly weighty.  For example, the authors highlight two features, namely ‘ECM-mimetic PAs with distinct non-bioactive domains show different molecular motion’ and ‘Culturing hiPSC-neurons on highly mobile IKVAV-PA2 nanofibers enhances ITGB1 activation.’  This is not bedtime reading.  Suffice to say that bioethically-sound stem-cell research is making progress.  For that we should be suitably grateful.


Bioethical issues to watch in 2023
There are at least seven serious bioethical issues that should be watched during the latter half of 2023.

First, there is the push to repeal Sections 58 and 59 of the 1861 Offences Against the Person Act.  In other words, it would decriminalise abortion in England and Wales.  That would make it merely a medical issue, allowable anytime, anywhere.  Two of the star protagonists in the House of Commons are the MPs Stella Creasy and Diane Johnson.

Second, there are calls to revise the 1990 Human Fertilisation and Embryology Act.  It is old and therefore, some say, out of date.  The concern is that any replacement will be more liberal, more pragmatic, less inclined to defend, protect and cherish all human life.

Third, a priority for some is to abolish / revise the 14-day rule as the upper limit for destructive human embryo experimentation.

Fourth, as opposed to the acceptable somatic gene therapies, there are calls for a wider approval of the heritable, reproductive germline editing.  After all, it has already started with the ‘three-parent IVF’ trial at the Newcastle Fertility Centre.

Fifth, is the restructuring of the Human Fertilisation and Embryology Authority (HFEA).  Its current chairwoman, Julia Chain, has already stated the 30-year-old Act needs changing and streamlining, it is often excessively bureaucratic, over-prescriptive and too cautious in its approach to science and regulation.  Changes are likely to skate over current barriers and restraints, such as implementing fewer inspections of clinics.

Sixth, future-proofing of UK fertility / research law.  Some say that implementing changes in these rapidly-shifting areas currently takes too long.  Novel treatments and laws need future-proofing to ensure the UK remains a world leader in biological sciences.

Seventh, legalising assisted suicide / euthanasia.  Both the House of Lords and Commons have big guns ready to promote the necessary law changes.  Any such measures in Scotland will be indicative of the UK’s mood.  Beware of pressure from the Dignity in Dying organisation.  Watch out for progress in the Inquiry into these matters headed by Steve Brine, chairman of the Health and Social Care Committee.

Lastly, sadly, the above issues will trample over the pro-life sensibilities of many Christians and morally-sensitive people.  Weep for our nation!

Baroness Masham of Ilton (1935 - 2023)
Susan Lilian Primrose Cunliffe-Lister, Dowager Countess of Swinton, DSG, DL, Baroness Masham of Ilton, was a crossbench member of the House of Lords, disability campaigner and a Paralympic athlete.  Her curriculum vitae overflowed with numerous activities, awards and honours.  For example, her 53-year membership of the House of Lords was the longest of any female peer.  She was Vice President of the Snowdon Trust, founded by the Earl of Snowdon, which provides grants and scholarships for students with disabilities.  And in 1974, she founded the Spinal Injuries Association (SIA).

She was born in 1935, the daughter of Major Sir Ronald Sinclair, 8th Baronet and Rebecca B Sinclair (née Inglis).  She was educated at the Heathfield School and London Polytechnic (the Royal Polytechnic Institution).  In 1959, she married David Cunliffe-Lister, Lord Masham (1937-2006), who became Earl of Swinton in 1972.  By this marriage, she became entitled to the honorifics Lady Masham, and, later, Countess of Swinton.  She was created a life peer in 1970, for ‘social services and services to the handicapped’ as the Baroness Masham of Ilton, of Masham in the North Riding of the County of York.

After suffering a T5 spinal cord injury in 1958 while racing at the Catterick point-to-point, yet despite being wheelchair-bound, she went on to compete in the inaugural Paralympic games in Rome, winning the gold medal in the 25m breaststroke in 1960.  At the Tokyo Paralympics in 1964, she won the bronze medal in the women’s doubles table tennis (her number one sport).  And she won additional medals at the 1968 Tel Aviv Paralympics.  Such was her fortitude.

Lady Masham, or Sue as she was known, was a staunch supporter of people with disabilities and especially unborn children, whom she sought to protect from disability-selective abortion practices.  In 2007, she tabled an amendment to the Human Fertilisation and Embryology Bill to prevent the late-term abortion of babies with disabilities.  The amendment ultimately failed in 2008.  Her colleague, Lord David Alton, said of her, ‘She was passionate about the rights of babies in the womb and equally passionate in her opposition to euthanasia.’  It was in that context that I knew her because she was a national patron of LIFE, the then foremost pro-life organisation in the UK.  As I recall, she worked largely behind the scenes, but having her name on LIFE’s letterhead was always a bonus.

Lady Masham was a prominent Roman Catholic convert.  She and her husband adopted two children, Clare and Jessie.  She died peacefully at the Friarage Hospital, Northallerton on 12 March, aged 87.

The uniqueness of fingerprints
Have you ever been fingerprinted by the police?  I have.  Several years ago, I was a visiting professor at a university in Japan.  For some reason, probably because I was regarded as an alien, I had my dabs taken at the local police station.  I was sanguine about the whole affair – my Japanese host was mortified.

We all know that our fingerprints are unique.  No two sets of swirls are the same, the world over.  But did you know that these intricate patterns are created during the third month of foetal development?  Those whorls, arches and loops are formed when fine ridges on the skin form on the fingertips and spread and collide leaving the one-off patterns?  Go on, have a look at yours now.  Amazing or what?

This phenomenon is described in an article published in March this year by James Glover and colleagues from the Roslin Institute, Edinburgh in the journal Cell (2023, 186: 940-956) and entitled, ‘The developmental basis of fingerprint pattern formation and variation.’

These researchers found that the periodic waves are produced by the interplay of two proteins – one that stimulates ridge formation, called WNT, and one that inhibits it, called BMP.  It is the interacting of WNT and BMP signalling that defines the spacing interval between ridges.  Moreover, the ridges emerge from three distinct, anatomically variable, regions on the fingertips – the tip of the finger; the centre of the fingertip and the crease at the base of the fingertip, where the finger bends.  It is the precise locations of these regions and the collisions between the waves that produce the unique pattern of a fingerprint.

What is the purpose of fingerprints?  It is thought that they provide added grip and sensitivity to fingertips.  And, of course, their patterns have long been used to identify individuals and to diagnose some developmental conditions.

Perhaps we really are ‘fearfully and wonderfully made’ (Psalm 139: 14).

USA and Elsewhere

Abortion post-Dobbs
What has happened since the judgement in the Dobbs v. Jackson Women’s Health Organization case uprooted Roe v. Wade on 24 June last year?  One current estimate from the so-called WeCount study is that there have been 24,290 fewer legal abortions during the nine-month period between July 2022 and March 2023 compared with a pre-Dobbs baseline.  Another estimate, from the Susan B. Anthony Pro-Life America (SBA) organisation, reported in late May that as many as 60,000 abortions have been prevented post-Dobbs.

These figures are not easy to obtain or interpret.  For instance, there were huge regional differences.  Some states, such as Texas, Georgia, Tennessee and Ohio saw numbers decrease, while Illinois, Florida and North Carolina saw numbers increase.  Some states have shut down abortion clinics, others have tightened access.  And some abortions were probably obtained outside the legal system.  In addition, there are more possible changes on the way.  For example, currently before the Florida Supreme Court is the Reducing Fetal and Infant Mortality Bill.  If that is passed, it will protect most unborn children from abortion after 15 weeks.  Despite these caveats, the statistics are encouraging – abortion across the USA is declining.

Pro-life America?
A new Gallup poll, published in June, showed that a record-high 69% of Americans think first trimester abortions should be generally legal, with 34% saying they should be legal throughout all nine months of a pregnancy with no exceptions.  These data show how the Dobbs judgement angered Americans and support for abortion post-Dobbs has increased.  In parallel, Americans wanting abortion illegal in all circumstances has fallen from 21% in 2019 to 13% in 2022 and 2023.

Also released in June was a US national poll from the Tarrance Group of pollsters.  It showed that 77% of Americans want some limits on abortions by 15 weeks with exceptions for the life of the mother, rape and incest. Only 15% supported abortion throughout pregnancy without any limits.  Thus, a clear majority rejects the abortion-on-demand throughout all nine months of a pregnancy, which is the extreme agenda of President Joe Biden and the Democratic Party.  The poll also indicated that 26% say abortion should be prohibited throughout pregnancy with another 20% saying it should be prohibited after a baby’s heartbeat can be detected at 6 weeks.  And 76% of respondents supported the existence of pregnancy centres that do not perform abortions but instead offer support to people during their pregnancy and after a baby is born.

Overall, these polls portray a substantial, but not mainstream, pro-life citizenship across the USA.  How, one wonders, would a UK poll measure up?

Abortion in France
Abortion is still a hot and unsettled issue in France.  In February 2022, the National Assembly voted to extend France’s legal limit for abortion from 12 to 14 weeks.  In November 2022, the French National Assembly voted 337 to 32 to start the process of becoming the first country in the world to enshrine the right to abortion in its Constitution.

In March 2023, President Emmanuel Macron announced that a bill would be prepared ‘in the coming months’ to enshrine in the Constitution the freedom to choose a ‘voluntary termination of a pregnancy’.

A national law made abortion legal in France in 1975, and no serious threat to its legality exists today.  However, the decision of the United States Supreme Court last year in the Dobbs case to overturn the US constitutional right to an abortion has galvanized France to act.

In practice, Constitutional revision in France is a long process requiring either a referendum or agreement by the National Assembly and Senate on an identical text that would have to be voted on by the two houses meeting together at Versailles.  Bearing in mind the French love of drawn-out bureaucracy, this event will not take place in 2023.  Maybe in 2025?

Stay away from Hawaii
You may be thinking of taking a holiday this year.  Perhaps locally, such as at that mythical seaside town of Ourgate & Bangate.  Or you may be pushing the boat out.  If so, make sure it does not disembark at Hawaii.

Just five years ago, in 2018, Hawaii legalised assisted suicide.  One of its so-called safeguards was a compulsory waiting period before obtaining a prescription for the lethal drugs.  Patients had to make two oral requests 20 days apart.  Guess what?  That stipulation has now been cut to 5 days.  But still, that leaves just enough time for that week’s holiday.  And if you suddenly turn terminally ill, the 5 days wait can be waived.

Don’t tell me that slippery slopes don’t exist.  These waiting times are being cut here and there.  For example, earlier this year, Washington state reduced its waiting period from 15 to 7 days.  Last year, California reduced the interval from 21 days to 2 days.

That traditional Hawaiian greeting of ‘Aloha’ means ‘the breath of life’.  Are you kidding?  How could it now be less appropriate?

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