Following up: "no destruction" embryonic stem cells, cocaine vaccine
Here are a few updates and extensions to earlier posts on blog.bioethics.net:
New development on creating human embryonic stem cells; same answer from NIH
ACT's Robert Lanza talked with MSNBC's Alan Boyle about ACT's claim this week that it had created embryonic stem cell colonies without harming the embryos from which the cells were derived. Boyle asked Lanza about some the ethical questions this technique might prompt:
Since this still involves extracting cells from an embryo, I suppose people might ask the ethical question about what happens to those embryos that are sampled. Could you get into a situation where you’re creating life to save a life, then have an open-ended fate for that life that you’ve created and frozen?
Actually, we’re rescuing embryos, because these embryos would be slated to be destroyed, and we’re not harming them so they’re frozen down. By generating these lines, those embryos will be protected and will not be harmed. Period.
That’s one thing. But the other thing to consider here is if you just look at PGD [preimplantation genetic diagnosis], these are couples who will have one of the cells from an embryo sent off to the lab to be tested. And of course when it goes off to the lab, that cell is destroyed.
What we could do is, before you send that cell off for testing, just let it divide overnight. Then send one cell off for testing, and you create a stem cell line from the rest of those cells. So you then have a genetically matched line for that child without any additional risk to the embryo. In other words, it has no impact on the clinical outcome of that procedure - but yet, there’s a benefit in that you have a line that matches the child. And that line can also be used by the whole world.
The ACT claim seems to have elicited little more than a shrug from the political world. NIH already said it wouldn't get on board. And Democratic Congresswoman Diana Degette, who's been a sponsor of bills that would expand federal funding for embryonic stem cell research, didn't seem to think the ACT paper would change anything.
And in a follow up flashback, here's Art Caplan's skeptical take from when ACT announced an earlier version of this technique in 2006.
The cocaine vaccine
The announcement from researchers at Baylor that they were looking to do final round trials of a vaccine that would blunt the high from cocaine prompted Time to talk with The Hastings Center's Tom Murray about some of the ethical questions:
Should we be concerned about giving the vaccine to children?
In general, parents will want to use any tools at their disposal to help their children, and a vaccine that prevents cocaine addiction could well fall into this category. There are a couple of problems, however: The vaccine as currently designed is not for prevention of addiction, but for use by current or former addicts who want to guard against relapsing. The drug is not likely to be tested in children, but if trials in cocaine-addicted adults lead to FDA approval, the vaccine will be available for "off-label" use — meaning that doctors will be free to prescribe it for anything they want.
Plenty of drugs that are not specifically approved for use by children are nevertheless given to them off-label, but medically speaking, children are not merely tiny adults, and scientists cannot predict how children will respond to a drug that has been tested only in adults. Without solid research confirming that the vaccine works in children as a preventive against addiction — without damaging side effects — parents who decide to give it to their children will be exposing them to unknown and possibly serious risks. At a minimum, if children are given the vaccine, doctors should follow them carefully in order to pick up any evidence of side effects.
The interview also takes up questions about cost, informed consent and discrimination.
-Greg Dahlmann
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I have concerns about using any treatments that could affect brain receptors in children unless it is medically indicated. Psychoactive drugs affect us because our brains have receptors that respond to particular drug molecules; these receptors probably have some other function in normal life. Stimulating the body to produce antibodies that bind to drug molecules to inhibit them from binding to our receptors could have adverse impacts on the natural auto-stimulation and regulation from our bodies. In children whose brains are still developing (and will go into overdrive during puberty), we cannot safely anticipate what the long-term effects on neurotransmitters and brain activity could be.
Because the vaccine has been show to be effective on adults, and because there is usually sufficient time to respond to cocaine addiction, I do not feel that vaccinating children in this case is justified.
(for transparency, my ethos opposes permanent modification of children unless there is a compelling health reason, such as routine vaccination to prevent communicable diseases or body modification only for an urgent health crisis)
And because I still am bitter about the controversy over the HPV vaccine: aren't moralists worried that giving the cocaine vaccine to children will tell them it's okay to start doing drugs?
- by SabrinaW on Jan 11, 2008 at 2:22 PM | link
"aren't moralists worried that giving the cocaine vaccine to children will tell them it's okay to start doing drugs?"
Sabrina, the situations are a bit different.
The HPV vaccine could be construed as making it safer for girls to have sex and thus removing a reason for them not to. The cocaine vaccine would be directly giving the recipient a reason not to use cocaine. If there were a vaccine that would make the recipient not want to have sex, that would be a better comparison (and one that possibly some parents would sign on to!)
Also, there's been no discussion of mandating the cocaine vaccine for kids. I don't think most moralists have a problem with the HPV vaccine being available to girls - they just don't want it assumed that their own daughters are having sex, and being basically given permission to by the state government when they themselves don't give that permission.
Totally agree with not wanting to mess with those brain receptors in this way. It's not hard to imagine some pretty severe consequences.
- by Laura(southernxyl) on Jan 13, 2008 at 9:25 PM | link