GESTIÓN EN SALUD PÚBLICA: BioEdge: Preparing for medicine with artificial gametes

sábado, 6 de febrero de 2016

BioEdge: Preparing for medicine with artificial gametes

Preparing for medicine with artificial gametes

by Michael Cook | 6 Feb 2016 |

Foreseeing bioethical problems is one responsibility of the UK think tank, the Nuffield Council on Bioethics. It has just released three background papers on increased lifespan, dual use in biology and biomedicine, and artificial gametes.

The last of these is particularly interesting, in view of the hubbub over the rapid advances in gene editing, which could accelerate research in this field. Artificial gametes are eggs and sperm produced from other cells. There has been some success with creating them for mice, but not with humans -- yet. Success is probably many years away. But as the authors point out, the time to prepare is now.

Written by Anna Smajdor, of the University of East Anglia and Daniela Cutas, of Umeå University, in Sweden. the white paper is “necessarily speculative” and does not recommend specific policies. But it does outline some of the opportunities and hazards that lie ahead.

Artificial gametes could be useful for research into infertility. But the four ways in which they could be used in reproduction are far more controversial: for pre-pubescent children who have been rendered infertile because of cancer treatment; for women whose eggs are exhausted after the menopause; for single women; and for gay and lesbian couples.

What are the benefits? Some bioethicists hail artificial gametes as “democratising reproduction” for anyone who wants offspring. But first and foremost is relief from involuntary childlessness, although as Smajdor and Cutas point out, this entrenches the privileging of genetic ties between parents and children, which many bioethicists question.

The medical hazards would be considerable, at least initially, and these are regarded by many bioethicists as the only real ethical obstacle to any technique in artificial reproduction. But there is also psychosocial harm to consider. By confusing traditional forms of parentage, artificial gametes would give rise to novel types of family structures.

One hazard might be the commodification of embryos, as prospective parents “shop” for one with ideal qualities. Another might be the multiplication of parents. By using artificial gametes, the number of genetic parents could be anywhere between one (if a woman created her own sperm cells) to 4 or more.

For example, suppose two people provide gametes from which an embryo is derived, in order to generate ESCs. These ESCs are differentiated into eggs, which are fertilised with sperm derived from ESCs obtained from a different embryo. If the sperm and eggs obtained through this process are fertilised, the offspring will be genetically related to the four adult ‘parents’, and clearly, by continuing through the cycle, many more contributors would be able to participate. Those who fear the effects of family confusion on offspring, may regard this as a worrying prospect.

Governments already face challenges in creating legislation to accommodate new forms of relationships. “If until now every child has had a genetic mother and a genetic father, even this basic statement could be challenged,” the authors write.

And if sex is no longer required to create children, then gamete theft becomes possible. Theoretically a cheek swab or a handkerchief could be used to create sperm, eggs, embryos and children.

The authors offer no answers, just questions. But it could be enough for a gripping script for Hollywood science thriller a la Gattaca

- See more at: http://www.bioedge.org/bioethics/preparing-for-medicine-with-artificial-gametes/11744#sthash.gW1kJdxC.dpuf

Bioedge

I’m sure it’s just randomness and not something in the water, but often our newsletters seem devoted to a theme, be it euthanasia, or IVF, or stem cell research. This time, unfortunately, it’s skulduggery.

Below you can read about a Los Angeles doctor who has just been sentenced to 30 years in jail for prescribing powerful pain-killer to drug addicts, some of whom ended up dead. Then there’s another euthanasia scandal in Belgium in which a 37-year-old woman died at the hands of an incompetent doctorafter being diagnosed with autism. (Autism? Are you kidding?)

The most colourful, however, is the on-going controversy surrounding trachea surgeon Paolo Macchiarini, who made headlines for creating artificial windpipes with stem cells. It turns out that his research, his CV and his romantic life all involve a fair bit of unsubstantiated creativity. Some of his patients died, too.

No surprises here. Human nature being what it is, there are bound to be a few bad apples in the medical barrel.

But it should lead us to reflect that governments need to take the possibility of misconduct very seriously when they are crafting legislation for the new genetic technologies. An English academic recently wrote in The Guardian that “playing God with our genes … is a good thing because God, nature or whatever we want to call the agencies that have made us, often get it wrong and it’s up to us to correct those mistakes.”

But if it is people like the doctors above who are playing God, it’s very likely that they will make irreparable mistakes. If scientists want to sack God, they should think very carefully about the CVs of the persons who will be moving into his office.