News Review

First cloned baby claim

The world’s first cloned human baby, Eve, was born on 26 December 2002, according to Clonaid, the company linked to the Raelian sect.

Dr Brigitte Boisselier, Clonaid’s chief executive, claimed a clutch of cloned pregnancies with parents of various backgrounds: ‘Of the 20 of them I think there are six or seven who are infertile couples, eleven who are parents of a lost child…two single women, one lesbian couple, and one homosexual male.’ Five babies were allegedly due before mid February.

Eve was reportedly cloned using a skin cell from her 31 year old mother. Scientists have been quick to denounce the claims, believing it unlikely that such a rogue band of researchers have been successful so soon. Calls for independent DNA tests to corroborate the claim have gone unanswered. The ‘parents’ have apparently taken Eve to Israel, beyond the US courts’ jurisdiction, and are reluctant to have tests done because of fears that the child will be taken away from them. Dr Boisselier asserted that she would not prove her credibility at the expense of cloned children and their parents: ‘Potential customers of our company have to know that they will always have the priority and I will [not] ask future parents by contract to reveal their identity…There will always be a time to re-establish my reputation…other babies are coming and among them, some will be made public.’

The Raelian sect was founded by Frenchman, Claude Vorlihon (alias ‘Rael’) in 1973 and now boasts a membership of 64,000. Rael claims he was visited by aliens who revealed that they had created human beings using genetic engineering, commissioning him to prepare humanity for their return by teaching a message of sexual freedom and eternal life through science. The Raelians’ founding tenet is that humans can achieve immortality by cloning themselves and transferring their consciousness into the newly cloned brains. This will enable the accumulation of knowledge ad infinitum through successive ‘generations’ of clones such that, ‘man’s ultimate dream of eternal life…becomes a scientific reality’.

Rael has welcomed the publicity created by the cloning claims: ‘If it isn’t true, it’s the most beautiful scientific joke but, in any case, it has allowed us to communicate our messages to the whole planet.’ (Daily Mail 2003;30 December, bbc.co.uk 2003;29 January, spuc.org.uk 2003;20 January, www.clonaid.com)

Law Lords give cloning the all-clear

The Law Lords have unanimously dismissed the appeal of the Pro-Life Alliance (PLA) against the legalisation of therapeutic cloning. The decision means that the Human Fertilisation and Embryology Authority (HFEA) is now free to license experiments using cloned human embryos.

The 13 March judgment brings an end to the ‘cloning saga’ that began in October 2000, when the government proposed amendments to the 1990 Human Fertilisation and Embryology (HFE) Act that would permit therapeutic cloning. The PLA applied for judicial review of these proposals, arguing that the HFE Act could not be interpreted to allow therapeutic cloning; either it set a complete ban on cloning or did not cover cloned embryos at all. They wanted a full Parliamentary discussion of cloning and development of effective primary legislation to govern it.

In November 2001 the High Court upheld the PLA’s case, effectively leaving cloned embryos ungoverned. In the ensuing hype, with Severino Antinori claiming he would come to England to make cloned children, the government quickly pushed through the Human Reproductive Cloning Bill, which prohibits placing an embryo created ‘otherwise than by fertilisation’ in a woman.

In the Court of Appeal, the government managed to overturn the previous ruling, but all cloning licensing had to be put on hold until the PLA’s appeal to the House of Lords had been heard. Now that this last hurdle in the English legal system has been cleared, the government is free to proceed as it desires.

This position contrasts with the situation in the US, where the House of Representatives recently passed a bill to ban all forms of human cloning, whether for research or reproduction. The bill even makes importing cloned embryos and using products derived from cloned embryos a criminal offence, with maximum fines of $1 million and ten years in prison. The issue now lies in the Senate, where rival bills also await passage. (prolife.org.uk 2003;14 March, bbc.co.uk 2003;13 March, reuters.com 2003;27 February)

Dolly’s death fuels cloning concerns

Dolly the sheep, the world’s first animal to be cloned from an adult cell, has died at the age of six – half the normal life expectancy for a sheep.

Her early death raises questions about the long term health implications of reproductive cloning. Previous reports of premature arthritis indicated that Dolly was growing old before her time. The final lung disease that prompted vets to put her down is a common problem in older sheep, particularly those housed inside.

Dolly was created by cell nuclear replacement, in which the nuclear DNA from an adult cell is placed in an enucleated egg cell. The egg is then given an electric ‘shock’, which makes it divide as if fertilised by a sperm. Some scientists argue that since Dolly was created using nuclear DNA from a six year old sheep, she was actually ‘genetically’ twelve when she died. Further evidence about whether her death was linked to her cloned origins will be very important. ‘It will provide further evidence of the dangers inherent in reproductive cloning and the irresponsibility of anybody who is trying to extend such work to humans’, commented Professor Richard Gardner from the Royal Society.

A full post mortem is being conducted by scientists at the Roslin Institute in Edinburgh, where Dolly was created; any significant findings will be reported. Dolly’s Australian counterpart, Matilda, unexpectedly died aged three years, a few weeks before Dolly. Researchers claim it was not due to premature aging. The body has been cremated. (Daily Mail 2003;15 February, spuc.org.uk 2003;7 February)

Stem cell progress

Scientists in the US have successfully managed to modify human embryonic stem cells genetically. The method is similar to that used to breed ‘knock-out’ mice, where specific genes are targeted and removed, to provide models of human disease.

Researchers at the University of Wisconsin, the first laboratory to create a stem cell line, inactivated specific genes in the cells. Every part of the human genome could be open to such manipulation, making the cells very useful for medical research. Such stem cell lines would supplement, and perhaps largely replace, the knock-out mouse. It is hoped that the manipulated cells will develop into specific cells and tissues for transplantation. Using human knock-out cells could also bypass the need to clone host cells as the genes that cause host-graft reactions could be removed.

The use of embryonic stem cells has ethical implications, and many hope that adult stem cells will provide an alternative therapeutic means. A team at the US Institute of Neurological Diseases and Stroke have found that stem cells from bone marrow can develop into brain cells.

Autopsies of four women who had received bone marrow transplants from men during their lives, revealed clumps of cells in their brains which contained the Y chromosome. These cells must have come from the donated bone marrow. Eva Mezey, who heads the team, thinks that raw stem cells circulate all the time and are recruited to damaged sites by cell signalling. Finding the specific signalling mechanism will be the next step; it may then be possible to expose adult stem cells to the signals and encourage them to develop into the desired tissue.

Similar research from Australia shows that bone marrow stem cells can convert into oligodendrocytes, the cells that make myelin. This may be particularly useful in treating patients with Multiple Sclerosis (MS), although trials in humans will be years away. (Guardian 2003;10 February, New Scientist;20 January, 21 January)

Fatherhood - the IVF way

The President of the High Court Family Division, Dame Elizabeth Butler Sloss, has ruled that the black father of mixed race twins born to a white couple after an IVF blunder, is also their legal father.

Mr B’s sperm was accidentally used to fertilise the white woman’s eggs, which were then transferred into her womb and carried to term. The court had previously confirmed that he was the biological father, but did not confer any paternal rights upon him at that time. The white couple, known as Mr and Mrs A, claimed that he was only a sperm donor and therefore had no rights over the children. Counsel for Mr and Mrs B argued that he could not be regarded in the same category as a sperm donor since neither of the couples had given consent to what happened. Custody of the children was given to the white couple.

The ruling means that Mr B could have rights over the children’s upbringing, and Mr A will have to apply for adoption if he wishes to become their legal parent.

In another case, the mother of a girl conceived through IVF has obtained a court ruling that her former partner is not the girl’s legal father. The couple from Merseyside had originally applied for IVF treatment together, and both signed consent forms to use donor sperm. First attempts failed and they subsequently parted, but the woman returned a year later to use the stored embryos. She did not inform the clinic of the changed situation. The man argued that he was the legal father, since he had signed the original consent form.

In the Court of Appeal, Lady Justice Hale ruled against him. She said that ‘fatherhood’, as defined by the Human Fertilisation and Embryology Act, does not begin until the embryo is placed inside the woman. Since the couple were not together when this happened, he is not the father. (bbc.co.uk 2003;26 February, 20 February)

Backdoor euthanasia by nurses?

Five percent of nurses believe colleagues are helping terminally ill patients to die, according to a survey for Nursing Times magazine.

Of the 1,173 nurses questioned, 55 agreed that, ‘Health professionals already quietly help patients to die’, while 50% feel that the law on assisted suicide should be changed. Many expressed confusion about whether the administration of ‘the last dose’ of morphine constitutes assisting the patient to die.

A spokeswoman for the Royal College of Nursing (RCN) responded that the poll represents a small sample. She told the BBC, ‘We don’t think it’s the right time for a change in the euthanasia laws’ and highlighted the RCN’s support for increased investment in palliative care.

A different study, covering nearly 1,000 elderly people in Thames region nursing homes, found that patients are often prescribed strong tranquilisers without therapeutic justification. Of the 25% of patients given neuroleptic drugs, the therapy was inappropriate for 82.8%. The drugs are given to ‘quieten’ patients with ‘behavioural problems’, but are likely to exacerbate patients’ dementia and increase their risk of falling. The research team rejected ‘aggression’ as sufficient medical justification, but accepted ‘biting and hitting others’. The Alzheimer’s Society said that the same statistics could be applied to up to 100,000 of the 500,000 in residential care across the country, and hope that this report will help put an end to such indiscriminate prescribing. (bbc.co.uk 2003;5 February, Guardian 2003;10 February)

Assisted death proposals

A bill to legalise euthanasia has been introduced to the House of Lords by Lord Joel Joffe, a prominent retired human rights lawyer, with further debate expected in early May.

The ‘Patient Assisted Dying Bill’ would allow a terminally ill adult who remains competent to receive medical help to die at his own considered and persistent request; it also gives them a legal right to maximum pain control. The recommended safeguards are that two doctors must confirm the diagnosis and ensure that all alternatives have been fully considered, a written declaration must be made in the presence of a solicitor, a ‘waiting time’ between the request and final act is enforced, and each death must be reported to a monitoring commission. Additionally, if there is doubt about the patient’s competence, a psychiatric assessment must be sought. There is a conscientious objection clause for doctors who feel unable to participate.

Lord Joffe commented, ‘The Diane Pretty and Reginald Crew cases highlighted the pressing need to allow terminally ill competent adults greater choice in the manner of their death’; he cited media polls indicating that 80% of the public favour a change in the law. (www.ves.org.uk/nw_press.html,)

Arnica - jury still out

A recent study suggests that arnica, a favoured homeopathic remedy used to alleviate bruising and swelling and promote recovery after local trauma, has no clinical advantage beyond a placebo effect.

Professor of Complementary Medicine at Exeter University, Edzard Ernst, led the study, which analysed arnica’s healing effects in three groups of patients undergoing surgery for carpal tunnel syndrome. All patients took medication for seven days prior to and 14 days after surgery; 20 received a low homeopathic dose (6C), 20 a high dose (30C) and 22 a placebo. Pain, bruising, swelling and requirement for further analgesia were all measured. No differences were observed between any of the groups for any of these criteria.

Professor Ernst, a trained homeopath, is a strong advocate of rigorous studies into homeopathy. He agrees that patients can exhibit positive effects following homeopathic treatments, but it is not possible to pin down the actual cause of this. The placebo effect is a candidate, along with natural recovery and the empathy that homeopaths show to their patients. ‘We need to do the science’, says Ernst, ‘at present I cannot say whether [it] does or doesn’t work…if it truly is nonsense – and I’m not saying it is – it is still better to use effective treatments.’

Ernst emphasises the limits of the study for drawing firm conclusions about homeopathy as a whole, asserting that the case is far from proven and this report only debunks ‘one tool in the homeopathic tool kit’. Some would even doubt this however, since the doses used in the study are far greater than conventionally used. Francis Treuherz, secretary of the Society of Homeopaths, was ‘astonished’ at the amount, saying, ‘Homeopaths give it after an operation or possibly one dose just before.’ He claims that administration over a prolonged period may actually stimulate the symptom it was meant to treat. (Guardian 2003;3 February, 4 February, Journal of the Royal Society of Medicine 2003; 96(2):60-5)

Tobacco advertising banned

Legislation to ban tobacco advertising in the UK, which could save up to 3,000 lives a year, came into force on 14 February.

The new law was finally passed by Parliament in October 2002, after making slow progress since its initial introduction well over a year ago. The Tobacco Advertising and Promotion Bill bans press, billboard and internet advertising of tobacco products and will prohibit promotion through the distribution of freebies. There are also restrictions on the display and promotion of tobacco products in shops. Advertising through sponsorship of Formula One motor racing and other sporting events has been delayed until 2006.

At the international level the World Health Organisation (WHO) has agreed to the world’s first anti-smoking treaty, due to be adopted at their annual meeting in May. The treaty fell short of a complete ban after opposition from countries with big tobacco industries, most notably the US and Germany. The final wording agrees that warnings should take up a third of all adverts, countries should increase funding for anti-smoking programmes, and public health must take priority in conflicts between health measures and trade agreements. Countries may choose to enforce a complete ban, depending on their constitutional principles.

Smoking is an increasing problem in developing countries. About half of all global smoking-related deaths in 2000 were in the developing world. Officials recognise that tobacco is a drain on the poor and can contribute to malnutrition, yet these countries have been increasingly targeted by the tobacco industry in recent years. The World Bank and European Union has pledged to provide the financial aid that many of these countries will require if they are to put the WHO treaty into action.

Although poorer countries pushed hard for a stricter advertising ban, they remain pleased with the outcome. However, like all international treaties, it will only be as strong as the countries that sign it. (Reuters 2002;21 October, bbc.co.uk 2003;14 February, 1 March)