On the Edges of Science and Law

From Rabbits to Humans: Transplanting Wombs

  By Sarah Blenner

In 2000, the first human womb transplant was attempted in Saudi Arabia.  The transplant failed when the 26 year old woman developed a blood clot and the transplanted uterus had to be removed.  But now scientists believe that they are close to perfecting a reproductive technology that could solve some women’s infertility: transplanting a womb into a woman who lacks a functioning uterus. 

Infertility affects one in six women.  Some women are unable to get pregnant because they either do not have a uterus or do not have a properly functioning uterus.  At least 15,000 women in Britain alone are infertile because of a condition associated with uterine function.  A woman may lack a uterus because she has had a hysterectomy or may not have a properly functioning uterus because of a medical condition, such as intrauterine adhesions, also known as Asherman’s syndrome.  Currently, if women without a properly functioning uterus wish to have children, they must either adopt or turn to surrogacy.  Despite the availability of these alternatives, some women want to bear their own children and are willing to undergo surgery to achieve pregnancy. 

The Story of a Sperm with a Bad Heart

  By Keith Syverson

A study published in last week's issue of the Journal of the American Medical Association (JAMA) raises concerns about regulation of sperm banks.  The study describes the case of a 23-year-old man in good health who donated sperm to a U.S. sperm bank almost a hundred times over a two year period.  The sperm bank followed protocols standard in the industry at the time of the donation: doctors gave the donor a comprehensive medical evaluation including a complete personal and family medical history in addition to laboratory testing for communicable diseases. Several years later, a woman inseminated with the donor's sperm gave birth to a child diagnosed with Hypertrophic Cardiomyopathy (HCM) -- a heart disease characterized by the thickening of the heart muscle.  The sperm bank notified the donor and all other recipients of his sperm that their children were at risk for HCM.  Twenty-two children were born using the donor's sperm in addition to two children born to the donor's wife.  Five children showed evidence of HCM including one two and a half year old child who died waiting for a heart transplant.

This case study underscores the need for more stringent testing protocols for gamete donation.  The American Society for Reproductive Medicine has published recommendations on genetic screening for gamete donors, but compliance with these guidelines is voluntary.  Studies have shown that most gamete donor agencies do not follow these protocols.  For sperm banks, only half of programs surveyed performed a chromosome analysis and about a quarter of egg donor agencies reported that they do not screen egg donors.  Moreover, the authors of the JAMA article note that it is a surprise that the sperm bank was able to contact the donor and everyone who received the sperm because this is uncommon in the industry.

"What if our perception of normal exposure is skewed?": Analyzing the Science of BPA

by Sarah Blenner

Bisphenol A (BPA) is an estrogen mimicking chemical commonly used to create both polycarbonate plastics and the resin lining of cans.  This chemical can be found in plastic food and beverage containers, cans, dental sealants, household products, cell phones, computers, and medical devices.  Hundreds of studies link the synthetic hormone, BPA, to a variety of adverse health conditions, including, breast cancer, prostate cancer, ADHD, autism, obesity, insulin resistance, type 2 diabetes, liver enzyme abnormalities, early onset of puberty, and cardiovascular disease.

In a study conducted by the CDC, scientists found that BPA was present in 93% of Americans tested, signifying the high prevalence of BPA exposure in the American population.  One participant of the "Is It In Us?" study, which measured the presence of toxic chemicals, such as BPA, in the blood and urine of participants, was relieved to know that her results were no different than the results of most of the other participants.  But then she thought: "what if our perception of normal exposure […] is skewed?" 

Last May, Chicago became the third jurisdiction in the United States to successfully pass legislation regarding Bisphenol A when it banned the sale of baby bottles and other empty food and liquid receptacles intended for the use by children under the age of three.  Prior to Chicago City Council's passage of the BPA Free Kids Ordinance, the State of Minnesota and Suffolk County New York passed legislation regulating BPA.  In June, Connecticut became the fourth jurisdiction in the United States to address the health risks of BPA through legislation, when it passed an "Act Concerning Banning Bisphenol-A in Children's Products and Food Products."  According to the Public Act, beginning October 1, 2011, the sale of infant formula, baby food, and reusable food or beverage containers that contain the chemical Bisphenol A will be banned. 

Robin Cook and Bioethics

 By Lori Andrews 

Robin Cook attended medical school before the birth of the patients' rights and bioethics movements.  Last month in New York at Thrillerfest, the national meeting of thriller writers, Cook explained that he began writing medical mysteries as a way to make the public aware of the dangers and risks inherent in modern medicine.

"Patients used to come to me and say, 'I want to be put to sleep during the operation.'  They had no idea what was going on.  I'd say to them, 'It's not like being put to sleep.  It's like being poisoned and then revived.'"

Michael Jackson's DNA Will Be Used to Make Jewelry

By Lori Andrews

During his life, Michael Jackson's hair was at the center of a legal dispute.  When he filmed a Pepsi commercial, the pyrotechnics on the set set his hair aflame, leading to a lawsuit against the soft drink company.  In that case, Jackson donated his $1.5 million settlement to the burn unit that treated him.

Now, after his death, his hair is raising an issue central to bioethics:  What right do people have to control the use of their tissue?

During the ill-fated commercial--which some commentators think led to the singer's use of painkillers--executive producer Ralph Cohen picked up charred hairs from the floor.  John Reznikoff, a hair collector, purchased the hair and now has an arrangement with an Elk Grove Village, Illinois company, Life Gems, to create man-made diamonds out of the carbon in Jackson's hair.

Did I Say I was 16? I meant 20. The MLB tries DNA Testing to Thwart a New Generation of Cheaters.

GUEST BLOGGER Keith Syverson

Another testing controversy has arisen in the world of baseball.  This time it was not Alex Rodriguez or Roger Clemens testing positive for performance enhancing drugs, but rather it was an amateur baseball player from the Dominic Republic named Damian Arredondo "failing" a DNA test as part of an investigation to confirm his age.  It does not come as a big surprise that in an era where Bud Selig, the Commissioner of Major League Baseball (MLB), is trying to clean up the sport's image and punish cheaters such as those who use performance enhancing drugs, that the MLB is also testing to prevent other forms of cheating such as misrepresenting one's age.  A young prospect is valuable because it gives the potential signing team more time to develop the player and teach him how to be a successful hitter or pitcher in the Major League.  Additionally, as players age, they become more injury prone and are less productive as hitters.  Teams usually take a players age into account when offering a contract extension later in life.  For example, a 30-year-old player will generally be paid more and receive a longer contract then a 34-year-old player.

 Most baseball fans remember when Miguel Tejada, a Dominic Republic native, announced to the Houston Astros that he was in fact 33 years old and not 31, or when investigators discovered that a Washington Nationals prospect assumed an alter ego that was four years younger then his actual age.  In the aftermath of the steroid scandal, the MLB has established an investigative team taking extreme measures to ensure that this does not happen again by subjecting potential players and their family members to bone scans and DNA testing.

Texas Families Bring Suit Challenging State Newborn Screening Program

By Tim Welch

Another state's newborn screening program has come under fire recently, highlighting growing concerns about the protection and proper use of human tissue and genetic information. 

On March 12, 2009, five parents filed a lawsuit in the United States District Court for the Western District of Texas in San Antonio against the Texas Department of State Health Services (TDSHS), Texas A&M University, and various Texas A&M University officials (Beleno v. Texas Dept. of State Health Serv.).  The plaintiffs claim that TDSHS violated federal and state law when, as part of the legally-mandated Texas newborn screening program, TDSHS collected blood samples from the plaintiffs' newborn babies, stored the samples indefinitely, and allegedly used the samples for unidentified research purposes, all without the plaintiffs' knowledge or consent.

The Beleno plaintiffs allege that TDSHS has violated their right to be free from unlawful search and seizure, as guaranteed by the Fourth Amendment to the U.S. Constitution and Article I, Section 9 of the Texas Constitution.  The plaintiffs also claim that TDSHS has deprived them of their liberty and privacy interests, as guaranteed by the Fourteenth Amendment to the U.S. Constitution, the Texas Constitution, and Texas common law.

Should Infant DNA Later Be Used in Forensics?

By Lori Andrews

Since the 1960s, public health departments around the globe have tested hospitalized newborn babies for serious genetic disorders, generally without the parents' knowledge or consent.  Many departments save that DNA, tiny spots of blood on paper.  Now questions have arisen about whether law enforcement officials should have access to those samples.  In other words, should babies have a right not to self-incriminate themselves?

In the United States, an Institute of Medicine committee recommended that DNA banks created for medical and research purposes (such as newborn screening banks) not be used for forensic purposes.  But, in other countries, courts have handled fascinating cases on route to setting policies.

Sperm Donors, Products Liability, and the Rights of Children

By Lori Andrews

When I first started working in the infertility field 25 years ago, the AIDS crisis had emerged, but doctors still were not screening sperm donors for the virus.  One doctor actually said to me, "I didn't screen my wife before I had children with her, why should I screen a sperm donor?"

The infertile couples didn't see it that way.  There might be lots of reasons to have a child with your spouse, but when couples go to infertility clinics, they are specifically trying to have a healthy baby.  Yet, due to lack of screening, children created through sperm donation have been born with AIDS, hepatitis, cytomegalovirus, and a variety of genetic diseases.  No mechanism exists for sperm banks to learn of the children's problems and stop using the donor for future pregnancies.

Resources for European Laws on Patient Rights

By Tim Welch

Patient rights continues to be an issue of global concern due to the rapidly expanding field of biotechnology.  As genetics become more involved in the treatment of disease and electronic medical records raise challenges for privacy, the law must evolve to ensure patient protection.

A webpage run by the Center for Biomedical Ethics and Law at the Catholic University of Leuven (Belgium) provides a substantial resource for information about European laws related to patient rights.  The webpage, located at http://www.europatientrights.eu, includes information about the status of the European Convention on Human Rights and Biomedicine (Biomedicine Convention) in each EU Member State, as well as individual countries' laws regarding patients' rights to informed consent, information about health, access to medical files, privacy, and use of genetic services.