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Julian Savulescu

Sport, Sudden Cardiac Death and Liberty

Sport, like life, is dangerous. Several fit young footballers have died of sudden unexpected heart attacks. Doctors are now calling for mandatory testing using ECGs of all athletes. Italy has been pursuing mandatory testing for 25 years. This has revealed over 5% have some abnormality. Some people have congenital heart rhythm abnormalities which place them at high risk of sudden heart attack during or after sport. The call for mandatory testing is a sensible one. The interesting question is what is to be done with the results.

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“Reanimation” and Taking Organs from Living People

One of the greatest fears associated with organ transplantation is that the person from whom organs are taken is not really dead.

That nightmare was almost realised in France last week when a French patient “came back to life” after 30 minutes of unsuccessfully heart massage. In 2007, in order to address the shortage of organs for transplantation, French authorities allowed the trial of using people whose hearts have stopped beating, but who have not met brain death criteria for being dead, as organ donors. These are called Non-Heart Beating Donors. Organs can also be taken from such donors in the UK. Such patients’ hearts have stopped beating but they have not met brainstem criteria for death.

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Setting a Minimum Price for the Sale of Organs

Professor Maqsood Noorani, a leading surgeon made the headlines asking for legalisation of the sale of organs to prevent the exploitation that exists in the black market. Yet his comments show that he is uneasy with the concept of a market in organs. He believes that the sale of organs in richer nations would ‘tarnish the process’, and suggests that even in poorer countries accommodation or education should be offered in exchange instead of cash. 

When two people want to freely exchange some good or service, we need good reasons in a free market to prevent the exchange. Moreover, when it comes to a market in organs, the good in question is life saving. Why then should we prevent such exchanges when there are willing buyers and sellers?

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HFEA and Regulating Reproduction:Triumph for Rationality and Victory for Secular Ethics

MPs voted on Tuesday on two of the most controversial issues surrounding reproduction- the provision of IVF treatment, and the availability of legal abortion. Under the new laws, IVF clinics will no longer have a legal requirement to consider the need for a father, but will instead be asked to ensure provision of ‘supportive parenting’, removing any barrier to single women and lesbian couples conceiving through the treatment. In a separate amendment, MPs were asked to consider the legal time limit on abortion, which currently stands at 24 weeks. Given the option to reduce this limit to 22, 20 or even just 12 weeks, MPs voted by a comfortable majority to stick with the status quo. 

The UK is now at the forefront of rational reform to legislation governing reproduction and research. The Human Fertilisation and Embryology Bill has now approved the creation of human admixed embryos, with important implications for scientific advance.

Blog on Admixed Embryos
Savulescu, J., The Case for Creating Human -Non Human Cell Lines, Bioethics Forum
Human Enhancement papers, media and other resources for free download

It has also reformed the regulation of reproduction in a thoroughly sensible manner.

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The New Law on Admixed Embryos and the Genetic Heritage of the Living Kingdom

Scientists in the US recently created a fluorescent human embryo. This was achieved by inserting a gene for green fluorescent protein. This shows that it is possible to successfully transfer a gene from a non-human animal to a human and for that gene to express its function. Other animal studies have shown that such gene transfer is both safe and effective, creating super animals, such as mice with colour-vision derived from human genes transferred.

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The Ethics of ‘Human Admixed Embryos’: Concerns and Responses

By Loane Skene, Professor of Law, University of Melbourne and Julian Savulescu,  Uehiro Chair in Practical Ethics and Director Uehiro Centre for Practical Ethics, University of Oxford

The Human Fertilisation and Embryology Authority (HFEA) Bill, currently before the UK Parliament, will, if passed, permit HFEA to license the creation for research of embryos that combine human and animal genetic material (called, in the Bill, ‘human admixed embryos’). These embryos include cybrids which are formed by inserting the nucleus of a human body cell into an animal egg that has had its nucleus removed. Cybrids would produce embryonic stem cells that are 99.9% human. The Bill would also permit other types of embryos to be formed from human and animal genetic material that would be up to half animal. This post explains why scientists want to create human admixed embryos. It then outlines some ethical concerns about the creation of these embryos and responses that may be made to those concerns.

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The Choice to Have Artificial Blood: Less than the Best?

Controversy has erupted around whether experiments to test artificial blood should stop. Experimental blood substitutes raised the risk of heart attack and death, yet U.S. regulators allowed human testing to continue despite warning signs, says a scathing new report.

Blood substitutes, or artificial blood, could be stored for years without refrigeration, and be used in battlefield situations. It would carry no risk risk of infection with hepatitis or HIV. It would be an acceptable alternative to Jehovah’s Witnesses who refuse life saving blood transfusions.
In a new report, researchers pooled data from 16 separate studies of five different blood substitutes, involving over 3,700 patients. Researchers found a 30 percent higher risk of death overall for patients who received transfusions using the blood substitutes. The risk of heart attack was nearly tripled in the groups receiving blood substitutes.

“Experts speculate that hemoglobin in the blood substitutes scavenges nitric oxide from the blood, causing blood vessels to constrict and sticky platelets to build up. That increases the risk of heart attacks.”

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Is it Wrong to Deliberately Select Embryos which will have Disabiltites?

A current bill before Parliament would revise the current regulation of IVF. One clause has caused great debate, especially amongst people with disabilities. It states:

(9) Persons or embryos that are known to have a gene, chromosome or mitochondrion abnormality involving a significant risk that a person with the abnormality will have or develop—

(a) a serious physical or mental disability,
(b) a serious illness, or
(c) any other serious medical condition, must not be preferred to those that are not known to have such an abnormality.

Some people with disabilities like deafness or dwarfism wish to use IVF to select embryos with the same disabilities. For reports of such cases, see Sanghavi, D. M. ‘Wanting Babies Like Themselves, Some Parents Choose Genetic Defects’, The New York Times, (December 5, 2006).

According to a recent survey, deliberate selection of children with conditions such as deafness or dwarfism is not uncommon: 5% of 190 of PGD clinics surveyed in the US have allowed parents to select embryos with conditions commonly taken to be disabilities (See Baruch, S. Kaufman, D. and Hudson, K. L. ‘Genetic testing of embryos: practices and perspectives of U.S. IVF clinics’ Fertility and Sterility (2006).)

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