Headline Bioethics: Enviropig – significant advance or environmental ‘band-aid’?

January 9, 2013

[A printable version of this Headline Bioethics Commentary is available via this link]

EnviropigMediumAuthor: Rebecca Hyde

Clip: ‘Enviropigs’: genetically modified for food consumption

Date of Story: 4 January 2011

Summary of story: For the past decade, researchers at the University of Guelph, Canada, has been developing a line of Yorkshire pigs now known as Enviropig. In January 2011, a BBC reporter had the opportunity to see the pigs in a research facility while applications to approve the Enviropig for human consumption were being deliberated by the US Food and Drug Administration. The Enviropig has been genetically modified to contain genes from Escherichia coli and mice and bred over several generations to become more environmentally friendly by reducing the toxicity of their waste.

Discussion of ethical issues: Development of the Enviropig raises a number of ethical questions. Some of these relate to issues of animal rights, some relate to genetic modification of organism in general and foods in particular. Given the reasons behind the investment in the Enviropig research, there are also specific issues relating to environmental ethics, and this represents a good place to begin evaluation.

Intensive pig farming produces large amounts of manure which contains high levels of phosphate. Whilst some phosphate is vital to life, and is necessary for good plant growth, high concentrations can lead to disruption and poisoning of ecosystems. Runoff from pig farms can lead to eutrophication of nearby water ecosystems, which can potentially lead to the water becoming anoxic and unable to support life (University of Guelph, 2011). Enviropig has been genetically modified to produce phytase in its saliva. This enzyme is important for the breakdown of phytic acid, an indigestible form of phosphorus commonly found in cereal-based foodstuffs. Bacteria in the guts of cattle and other ruminants, but not pigs, normally provide this enzyme allowing this dietary phosphate to be released and used by the mammal. Read the rest of this entry »

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Headline Bioethics: Too NICE to Push? Ethical issues surrounding a woman’s decision for elective caesarean section

January 7, 2013

[A printable version of this Headline Bioethics Commentary is available via this link]

Author: Matthew Taylor

Clip: Women can choose caesarean birth

Date of story: 23rd November 2011

Summary of story: In November 2011, The National Institute of Health and Clinical Excellence (NICE) updated its clinical guidance to health care professionals regarding caesarean sections. This update helps ensure “every mum-to-be in England and Wales can request [a caesarean birth].” The story examines the case of Leigh East, who had concerns over a vaginal birth due to a pre-existing back injury. She was initially refused a caesarean section (CS), but was allowed the treatment after her own research persuaded her midwife to allow it. East said, “There was a great deal of pressure initially to not plan a caesarean”.

The report continues by covering how women who have had a traumatic experience with natural childbirth in the past should be treated. This includes offering counselling and, ultimately, the option for a caesarean birth if the woman is not reassured. Jenny Clery, Head of Midwifery at Whittington Hospital, said “you shouldn’t force anything on anybody, i.e. go into labour and we’ll see what happens.” The report finishes by stating the new guidelines are there to help women make an inform decision regarding mode of birth (BBC, 2011a).

Discussion of ethical issues: There are many ethical issues surrounding a woman’s choice regarding the mechanism of delivery for her unborn child. Doctors are faced with decisions requiring them to take each case individually, taking a consequentialist approach to each mode of birth, whilst also considering patient autonomy. The Changing Childbirth report (Expert Maternity Group & Cumberlege J., 1993) makes it an explicit right for a woman to be involved in decisions regarding all aspects of her pregnancy and childbirth. Read the rest of this entry »


Headline Bioethics: Cut out by the NHS

January 4, 2013

[A printable version of this Headline Bioethics Commentary is available via this link]

Author: Arnold GangaidzoNHSrationingmedium

Clip: NHS obesity surgery court bid lost

Date of story: 27th July 2011

Summary of story: In July 2011 Tom Condliff, a 22-stone man lost his Court of Appeal case for a life-saving gastric bypass operation which had a detrimental impact on his family life and mental well-being (BBC, 2011a). The North Staffordshire primary care trust (PCT) refused to fund the procedure arguing that he failed to fulfil their IFR (individual funding response) policy and his body mass index (BMI) of 43 was below their threshold. He claimed the main reason he gained weight stemmed from drugs that he took for long term diabetes and the procedure was the best solution in order to prolong his life. In August 2011, subsequent to the events in this story, the PCT reviewed his case again and decided to fund his procedure as they now saw his case as an exceptional circumstance (BBC, 2011b). After having the operation, Condliff was reported to have lost six stone (Doward, 2012).

Discussion of ethical issues: The ‘four principles’ of autonomy, beneficence, non-maleficence and justice are widely recognised as the cornerstones of biomedical ethics. In this case, the principle of justice is brought into question. Chadwick (2008) says ‘justice in allocation’ is a bioethical issue since resources can be unfairly distributed and people can be discriminated against. Article 2 of The European Convention on Human Rights (ECHR, 1950) state “everyone’s right to life shall be protected by law…” but also notes that this must not be interpreted in a way as to put an impossible burden upon the authorities (Foster, 2007). Tom Condliff, a man seeking a gastric bypass, had to battle against his PCT to have them fund the operation. He argued that it was a breach of his rights under Article 8 of the ECHR (right to a family life) for the PCT to restrict their decision to clinical factors, and Article 6 (right to a fair trial) for not giving him sufficient details regarding their reasoning (Alexander Thomas Condliff v North Staffordshire Primary Care Trust, 2011). The Court found against Mr Condliff (though, as noted above, the PCT eventually relented). Read the rest of this entry »


Headline Bioethics: GM chickens offer solution to bird flu problem?

January 4, 2013

[A printable version of this Headline Bioethics Commentary is available via this link]GMchickenmedium

Author: Rachel Bell

BBC News Clip: Chickens that cannot spread bird flu developed

Date of story: 13th January 2011

Summary of story:   Scientists from the Universities of Edinburgh and Cambridge have created genetically modified chickens that are unable to transmit the H5N1 “bird flu” virus between individuals. This effect was generated by inserting genetic information coding for a ‘decoy’ RNA hairpin molecule that acts as an inhibitor for the RNA polymerase enzyme required for replication of the flu virus (Lyall et al, 2011). It has been suggested that this approach may offer a means to reduce the extent to which bird populations act as a reservoir for flu and other diseases.

Discussion of ethical issues:  This story presents ethical tension on two levels; the possible benefits and complications for the chickens themselves, but also the implications for the human population. Laws relating to the use of Genetically Modified Organisms (GMOs) vary in different parts of the world. In the UK, the law covering the creation and use of GMOs is set out by the Health and Safety Executive. This requires any experimentation to undergo strict risk assessment, notification of the authorities regarding any GM activity, and total clarity and public availability of information gathered by the research (HSE, 2011). In this case, Sang and her team at the Roslin Institute, Edinburgh have complied with these regulations and the necessary details are included in the final paper (Lyall et al, 2011). Read the rest of this entry »