News Review

Curate wins abortion review

An Anglican curate has been awarded the right to a judicial review in a case where a fetus was aborted because it had a cleft palate. Rev Joanna Jepson, who was born with facial deformities herself, won a High Court appeal, permitting her to challenge the Chief Constable of West Mercia Police for failing to prosecute the doctor involved.

The Human Fertilisation and Embryology Act 1990 amended the Abortion Act 1967 to impose a 24-week limit on abortion (the age when a baby is capable of independent existence outside the womb), except in special circumstances. But paradoxically it also legalised abortion up until birth in the case of 'serious handicap'. Jepson argues that a cleft palate is not a sufficient reason for termination, and constitutes 'unlawful killing' under the Act.

Rev Jepson issued a statement saying that people must resist the belief that the value of human life is found in physical perfection; disability should not be viewed negatively. Paul West, the Chief Constable of West Mercia, defended his decision not to prosecute the doctor, saying that he took the best medical and legal advice available at the time. In papers submitted to the High Court, the force says it took the advice of a senior member of the Royal College of Obstetricians and Gynaecologists before making the decision not to take the matter further. The College argued that since what constitutes a 'severe abnormality' is not fully defined under the Act, doctors can therefore apply a degree of discretion when taking the mother's wishes into consideration. About 100 abortions beyond 24 weeks are carried out each year in England and Wales for 'severe abnormality', so the case could have far-reaching implications. (Reuters 2003; 1 December, Times 2003; 23 November, bbc.co.uk 2003; 19 November, 1 December)

Reaction to partial-birth abortion in the US

There were mixed reactions in America as President Bush signed the Partial-Birth Abortion Bill into law. This makes it illegal to perform partial birth abortion, except if it is necessary to save a mother's life. The procedure is used during the second half of pregnancy and involves partially delivering the baby in breech position before the contents of the baby's cranial cavity are aspirated prior to delivery of the head.

The National Right to Life Committee, the major pro-life organisation in the USA, welcomed the legislation and 'strongly commended' President Bush. They described the president's statement that a partial-birth abortion kills a baby who is 'inches from birth' as the 'literal, painful truth'.

On the other side, the National Coalition of Abortion Providers said that the orders would accomplish nothing. They said that abortion is a 'patient-driven procedure' and women with unintended pregnancies will still seek out abortion services, despite the legislation. They suggested taxpayers' money would be more wisely spent determining what causes women to delay their decision to have an abortion in the first place, rather than using it to process unnecessary legislation. There are currently about 2,000 partial-birth abortions annually in the US. (nrlc.org/abortion, ncap.com)

UN blocks cloning ban

The United Nations has rejected calls for a worldwide ban on research into human cloning. The decision came after a close vote, in which the UN General Assembly's legal committee voted 80-79 in favour of an Iranian proposal to delay any decision on a ban for two years.

The issue of human cloning has created a division between two groups of member states. One, headed up by the USA, is seeking a ban on all types of cloning. This was also backed by the Nigerian delegation, which expressed concerns that women from Africa would be susceptible to pressure from multinational firms to act as a source of embryos. The other group, led by France and Germany, wants to see reproductive cloning prohibited, but not cloning for biomedical research - so called therapeutic cloning. However the general committee has not had a chance to vote on the two proposals following the acceptance of the Iranian proposal. It is hoped that this delay will buy the organisation time to reach a consensus on the issue. The UK government continues to encourage research into therapeutic cloning because of their highly controversial conviction that it 'offers so many patients and their families the hope of life-saving treatments'.

Meanwhile, the European Parliament has voted to use public funds for embryonic stem cell research. Advocates of this research believe it will offer unparalleled opportunities to treat diseases such as Alzheimer's and Parkinson's. They also say that this new funding support will enable them to compete on level terms with scientists in the United States.

EU research ministers have yet to make a final decision about the exact details of the proposal. Countries opposed to the public funding, such as Austria, Germany and Portugal, may yet scupper the deal by not giving it final and concrete approval. Embryonic stem cell research is currently legal in Britain and Sweden. (bbc.co.uk 2003; 6 November, Reuters 2003; 7 November, New Scientist 2003; 19 November)

Diane Blood re-registers her sons

In the latest instalment of the ongoing saga, Diane Blood has re-registered the births of her children. Having campaigned for many years, she has finally won the right for her late husband, Stephen, to be recognised as their legal father.

Stephen Blood contracted bacterial meningitis in 1995 and lapsed into a coma. At this time, Mrs Blood asked for samples of his sperm to be collected and stored for later use. After his death a legal battle ensued as the collection, storage and use of sperm without consent contravenes the 1990 Human Fertilisation and Embryology (HFE) Act. The courts finally allowed her to export his sperm to Belgium and undergo fertility treatment there, although they upheld that the removal of his sperm without his consent was illegal. She now has two sons, four year old Liam and Joel who was born in 2002.

The 1990 HFE Act does not allow fathers to be named on the birth certificate when the child is conceived after its father's death. Diane Blood has been fighting to have this changed since 1998, and in February 2003 the High Court backed this challenge. The Human Fertilisation and Embryology (Deceased Fathers) Act 2003 was approved by the House of Lords in September. It came into force on 1 December and gave the mothers of children conceived posthumously six months in which to re-register their children's births, to include information about their paternity.

Mrs Blood will thus be able to re-register her children; it is estimated that another thirty families are similarly affected. The children of deceased fathers who are born in the future will have both parents recorded on their birth certificate. The new legislation is expected to benefit up to ten families each year. (bbc.co.uk 2003; 18 September, 1 December)

How many parents do you have?

Genetic material from three separate individuals has been used to create embryos, according to researchers from the US and China.

The scientists extracted a fertilised nucleus from one embryo and inserted this into another egg. The original nucleus had been removed from this, but its mitochondrial structures and associated DNA were intact. The re-engineered embryo was then implanted into the woman from whom half of the nuclear genetic material came. In this particular case, one of three embryos was aborted to increase the survival chances of the other two, but neither of them survived beyond five months. The deaths were allegedly the result of multiple pregnancy, rather than abnormalities caused by the technique. The procedures are banned in both the UK and the US.

Problems with mitochondrial DNA, which is found outside the nucleus of a cell, may result in fertility problems. If alternative sources of such DNA could be used, this may increase the likelihood of individuals being able to have their own natural offspring.

James Grifo, the Director of Reproductive Medicine at New York University, is one of the pioneers of this development. He claims that the cloning debate has overshadowed his work on infertility treatments and prevented progress in this area, because some people have described his research as being 'very, very close to cloning'. (New Scientist 2003; 14 October, bbc.co.uk 2003; 14 October)

Cheaper HIV drugs

Former US president Bill Clinton has been behind a deal to cut the cost of drugs treating HIV/AIDS to less than one third of the patented price. The deal was made with pharmaceutical companies who manufacture generic versions of the anti-retroviral drugs. They will be made available to nine countries in the Caribbean. Mr Clinton hopes that two million people might benefit from the new agreement by 2008.

Drug companies were also encouraged to use profits from other drugs not related to AIDS to cross-subsidise anti-retroviral drug research and development. Wealthier nations will contribute to part of the costs of production, as well as funding improvements in healthcare in the developing world. Some African nations have managed to acquire funds from the World Bank as well as the Global Fund to Fight AIDS, Tuberculosis and Malaria. AIDS organisations have hailed this as an important step forward. (bbc.co.uk 2003; 24 October)

Global HIV rates at record levels

A report from UNAIDS and the World Health Organisation (WHO) claims that a record number of people around the world were infected with HIV in 2003.

The figures released on World AIDS Day (1 December), put the number of new infections at five million and estimated that three million people died from the disease last year. Altogether the report estimates that 40 million people worldwide are infected with HIV/AIDS; 2.5 million of these are children. It also warns that the figures could rise sharply in the years ahead, with Eastern Europe and Central Asia on the verge of epidemics. Officials say the figures are more reliable than previous estimates, following improvements in the way the data is collected.

The report also outlined the WHO's strategy to bringing antiretroviral treatment to three million people by 2005 - the so-called '3 by 5' initiative. The organisation predicts that the price of HIV and AIDS medications will drop to levels once thought impossibly low. The cost of treatment in affluent countries where pharmaceutical companies have patents on their medicines is more than US$10,000 (£5,800) a year. Copies made by generic companies in India, where the same patent rules do not apply, are now being sold to African nations for around $300 a year. It is hoped that this price will fall by half by the end of 2005.

Meanwhile, the Indian government has become the latest nation to promise free drugs for 100,000 of its 4.6 million citizens infected with HIV. The medications will be bought at a specially negotiated low rate and made available at district hospitals in the six worst-affected states. (bbc.co.uk 2003; 2 December, Guardian 2003; 2 December)

Civil gay partnerships

The government is intending to allow same-sex couples legal recognition of their partnerships. The Civil Partnership Bill, announced during the Queen's Speech at the state opening of Parliament, will allow each partner to have pension and property entitlements similar to those available to married couples. Nine other European countries have similar civil partnership agreements.

The bill makes no provision for inheritance tax exemptions for gay partners, and falls short of couples being allowed a marriage ceremony. At present, further consultation is taking place on the inheritance tax issue.

The government has been criticised for failing to recognise the rights of unmarried heterosexual couples, as they are excluded from this bill. Current UK law does not confer any special rights to couples outside of marriage, except in cases of claiming a will from deceased partners. (bbc.co.uk 2003; 27 November)

BMA calls for review of ethics teaching

The British Medical Association (BMA) has called on the government to fund a review into the standard of ethics teaching in medical schools.

The organisation claims that doctors need better ethics training to enable them both to provide good patient care and deal with the increasingly complex ethical and legal dilemmas they have to face every day. These range from common questions about the rights of unmarried fathers to make decisions about their children's medical care, to more complex issues about when life-prolonging treatment can be withdrawn from very sick patients.

Dr Michael Wilks, chairman of the BMA Ethics Committee, said that most modern doctors are unprepared for the analytical skills and understanding of the law that are increasingly expected from them. He also said that the BMA receives thousands of enquiries every year from doctors needing assistance with ethical issues. In just one week at the end of November 2003 the organisation's online ethical guidance was accessed by more than 1,400 visitors. He suggested that a review of training in this area would help to restore the public's confidence in doctors, which he says took a 'severe knocking after the Alder Hey and Bristol Royal Infirmary hospital scandals'.

A comprehensive review of ethics programmes in UK medical schools was published by the Institute of Medical Ethics in 1987. This recommended that another evaluation should take place five years later, but this never happened.

The BMA says a new review is needed to establish how effectively medical ethics and law are taught and identify areas for improvement. Although medical ethics is now an accepted part of undergraduate courses, it is thought that the quality of teaching varies considerably. (bbc.co.uk 2003; 2 December, bma.org.uk 2003; 2 December)

And finally...

Prior to England's victory in the final of the Rugby World Cup 2003 in Sydney, Australia, Anglican clergy were praying for the match. The Rev Mervyn Roberts, of the Diocese of Warwick, offered a prayer at the church's General Synod meeting, beginning: 'Lord, grant that after the last try has been touched down, the last conversion gone over and the last penalty scored at the end of the game, may we know for sure that it mattered not most who won or lost, but just how that game was played.' (Times 2003; November 22)