A suitable donor? – Hollyoaks

January 23, 2008

I have to say from the outset that I am not usually a Hollyoaks fan and, as this post will show, I’m way off the pace as far as who’s who. However, turning on slightly early for the Channel 4 news on Tuesday 22nd January 2008 I happened to catch the end of that day’s episode of the Chester-based soap opera (TRILT code 007CA973) and was intrigued.  The storyline involved Charlie, a baby recently diagnosed with Acute Myeloid Leukaemia (AML) and in need of a bone marrow transplant. The first clip I caught was the doctor informing Charlie’s ‘dad’ Jake Dean that a blood test revealed he was not a suitable donor for the baby – on the grounds that he was not, in fact, the boy’s biological father.

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Frankie, Nancy and Jake

Recognising the potential benefit of this clip for teaching about transplantation and/or genetic testing, I decided I ought to check my facts.  This, it turned out, is more complicated than I had anticipated. So (deep breath) the woman standing anxiously by the baby’s bedside is not Charlie’s mum, she is Nancy, Charlie’s aunt (no pun intended). Charlie’s mum Becca is dead, stabbed in prison by her cellmate.  She was in prison having been found guilty of engaging in a sexual relationship with Justin, who was underage at the time. Despite the relationship being consensual, Justin made false claims of coercion based on his anger at being dumped by Becca. Justin is now with Katy Fox, Jake and Nancy are in a relationship of their own (keep up!).  Knowing about Becca’s infidelity with Justin, Jake had ordered a paternity test in January 2007, but decided not to open it, choosing instead to remain in ignorance and bring up Charlie assuming that he was the biological father.  This latest turn in the story shows that he is not. Read the rest of this entry »


MMR: our children, our choice? – Panorama

January 23, 2008

In 2002, the BBC’s Panorama series included an edition entitled MMR: Every Parent’s Choice which investigated the origins of the controversy over measles, mumps and rubella (MMR) vaccination in the UK. In particular, the programme focussed on the role of Dr Andrew Wakefield and his, now refuted, claims concerning the link between the use of ‘triple-jab’ MMR vaccine and childhood autism and bowel disease. Although the public controversy surrounding this vaccination has now largely been settled, MMR uptake still remains below the level required to ensure population (or ‘herd’) immunity (see MMR uptake still short of target, BBC News, September 28th 2007 or watch video Warning over low MMR uptake, BBC News). The 2006-07 NHS immunisation statistics in England for example report it to be 85% by the age of two (NHS Immunisation Statistics, England, 2006-07), a figure which highlights that even today, 10 years after the controversy first ignited, immunisation rates have not yet returned to their previous levels of over 90% (NHS Immunisation Statistics, England, 1997-8).

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MMR controversy makes the Telegraph headlines on February 27th 1998 (from Panorama, BBC2, February 3rd 2002, 22.15)

The MMR controversy also remains a particularly rich source of material for discussing the ethical issues implicit in mass vaccination programmes. The MMR: Every Parent’s Choice episode of Panorama is a good example of this as it explicitly explores key issues, including:

  • the tension between the rights of individual parents to choose whether or not to have their children vaccinated and the aims and objectives of state endorsed vaccination policy
  • the factors influencing parents decision-making about vaccination, and variable influence of health professionals, the media, and science in shaping these
  • the proper role for doctors as both scientific and social actors

Read the rest of this entry »


Exploiting Genetic Knowledge – Visions of the Future (2)

January 11, 2008

The Biotech Revolution, the second episode of the BBC4 Visions of the Future series, continues to describe ways in which humanity is making a “historic transition from the age of scientific discovery to the age of scientific mastery”. Presenter Michio Kaku suggests that unlocking the basic code of life will allow us to “predetermine the destiny of life itself” and to manipulate it at the most fundamental level (Start-00:02:00).

The programme begins with Kaku having his “medical future rather than history” diagnosed via a series of genetic tests for complex diseases such as heart disease, diabetes and Alzheimer’s. He describes this as an “owner’s manual” which will enable him to have greater control of his health, and to allow others to perhaps prolong their life by decades (00:02:20-00:06:20 and 00:20:05-00:23: 20). As a scientist, he is eager to discover what secrets his genome may contain however, as a person, he says “wait a minute, this could be a Pandora’s Box… I’m looking at a side of me I have never seen before, a side that has potential medical problems lurking there”.

Some of the issues raised here mirror those found in the ITV1 broadcast The Killer in Me, which illustrated particularly well the anguish associated with having such tests and the way actions could be taken in light of the results. In this programme, in contrast, there is greater emphasis placed on the potential impact on relatives and wider society that may result from taking the tests. “We really want to respect your privacy and the privacy of your relatives” the physician emphasises to Kaku.  Much of the future of this testing, if not the present, relies upon “the last great discovery of the 21st century, the Human Genome Project”.  Kaku believes that this event holds such significance that we will look at the history of medicine in two eras, “before genome and after genome”. “Having unravelled the fundamental code of our biology the stage is set for us to manipulate it” he adds (00:06:25-00:09:20). Read the rest of this entry »


Herceptin: Wanting the wonder drug – Panorama

January 10, 2008

This episode of the BBC current affairs series Panorama follows the story of seven women with breast cancer who campaigned to receive the drug Herceptin. It is a classic example of the tensions arising from the rise in effective but expensive new medicines set against the constrained budget of the National Health Service. At the time of filming (Summer/Autumn 2005), treatment with Herceptin cost £30,000 per patient per year and was exclusively licensed for use against advanced-stage breast cancer. However in light of some promising and well-publicised clinical trials, and motivated by Prime Minister Tony Blair’s pledge that “Cancer patients in all parts of the country will get the right drugs at the right time, regardless of where they live” (00:02:50-00:03:10), seven women with early-stage breast cancer believed that this drug may well help save their lives. The programme follows their campaign as it snowballs from a local issue to achieve national support (00:11:45-00:13:50).

The central ethical question raised by this programme is, therefore, one of resource allocation.  There is a cost-benefit analysis to be done for the treatment per se, but this also has to be seen in a broader context; a decision to fund one therapy means a decision elsewhere in the system that likely denies somebody the treatment that they want.  How do you evaluate one course of treatment over another? How do you fairly distribute public resources between patients? Can you judge the value of one life against another? Read the rest of this entry »


The Manipulation of Matter – Visions of the Future (3)

January 9, 2008

In The Quantum Revolution, the final episode of BBC4’s Visions of the Future series, Michio Kaku explores the influence that our understanding of fundamental aspects of physics may have on our lives in the future. After outlining the origins and impact of quantum theory within physics during the 1960s (and on his own career path), Kaku describes how its implications have given us a new, and unprecedented power to manipulate matter at the atomic level.

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Michio Kaku presents Visions of the Future: The Quantum Revolution (BBC4, Nov 19 2007, 21:00)

The episode is effectively split into two halves. The first deals predominately with the the implications of quantum theory for energy production – specifically the possibility of truly sustainable, renewable energy sources – in the future; the second with the potential development of nanotechnology. The latter is the more bio-relevant and will be the focus of this commentary (approximately 00: 32:00 to 00:50:00).

Kaku describes nanotechnology as giving us the ability to “redesign the world by building with atoms” (00:32:05) and to control “the fundamentals of nature” (00:32:13). In introducing the viewer to nanotechnology, Kaku makes reference to what could be called ‘natural nanobots’ and states that “the goal of nanotechnology is to create living machines on the scale of cells like proteins, DNA or bacteria, and design them to perform equally complex tasks” (00:33:00). Specifically, he identifies three areas in which developments in nanotechnology may have a significant impact: bioremediation, biomedicine and the military. Read the rest of this entry »


Are hybrid embryos an ethical step too far? – The Big Questions

December 31, 2007

Following the Human Fertilisation and Embryology Authority’s decision to approve the creation of ‘animal-human’ hybrid embryos, or “cybrids”, the inaugural episode of the BBC’s new ethics show The Big Questions (BBC1, Sunday Sept 9th 2007, 10 am) included a fifteen minute debate on the topic. The programme provides some useful material for discussing the issue.

This initial post outlines the thrust of the discussion.  Interested readers are strongly encouraged to look at the extended commentary Science and ethics of cybrids – reflections on some recent media coverage, which includes not only a fuller account of the exchanges on The Big Questions, but also draws upon a similar discussion on The Guardian’s Science Weekly Podcast of September 10th. The relevance of a number of recent scientific papers on the biology of stem cells is also considered.  You may also like to watch a BBC news report following the announcement – go to their News page ‘Human-animal’ embryo green light and follow the ‘Watch’ link on the right-hand side. Read the rest of this entry »


Genetic testing: would you want to know? – The Killer in Me

December 29, 2007

The Killer in Me illustrates just how far genetic testing for disease has developed. Testing for conditions caused by mutation in a single gene has been possible for some while, and examples have been considered previously in relation to programmes in the Bitter Inheritance series, e.g. Huntington’s disease (Episode 5) and Gorlin Syndrome (Episode 4). In The Killer in Me, four celebrities agree to undergo pioneering genetic tests for conditions that are under the influence of several different genes and environmental factors, such as diet. It is promised that the battery of tests will indicate their potential risk, i.e. their predisposition, to several common diseases, including heart disease, cancer and Alzheimer’s. The tests are supervised by Paul Jenkins, a Senior Clinical Researcher at Queen Mary’s School of Medicine and the co-founder of the company ‘Genetic Health’. As he explains, “We know the environmental influences that can predispose to disease, now we are able for the first time to start to determine your genetic predisposition to those diseases” (00:01:39).

The decisions about which tests to take, and the celebrities’ responses to the results of those tests, offer insights into the ethical dilemmas posed by screening. GMTV presenter Fiona Philips re-examines her mother’s past medical history, which included both breast cancer and Alzheimer’s which unfortunately led to her death. She reflects on the terrible ordeal her mother suffered for eight years, and wonders what actions she would take if the test presented that she was at high risk of Alzheimer’s (00:02:49-00:05:17 and 00:17:50-00:19:10*). Read the rest of this entry »