Posts Tagged ‘stem cells’

Why Bad Arguments Suck

February 8, 2012 2 comments

Nothing puts the rapid pace of technological change in perspective like seeing the ridiculous pile of links that I want to talk about stored in my draft email. No matter how much I write, it seems, there is always so much more to say. Often, I want to write about things that will help me share as many links as possible in a post, but writing that way either forces me to take a pass on weighty topics that require saying a little more, create a post that covers a hodgepodge of topics, or simply resign myself to sharing just a link or two so that I can say everything that needs to be said. Today is going to be one of those latter types of posts because I want to talk about intellectual honesty for a minute.

Let’s start with an article from Rebecca Taylor at Lifenews seems to focus on pro-life issues which, given my views about technology, probably doesn’t seem like the first blog I’d read. But I do like to see what the people who think differently than I do are saying, and so whenever lifenews pops up on my ‘transhumanism’ Google feed I head over to see what’s going on. In this case, Dr. Taylor is arguing that transhumanism, coupled with Roe v. Wade, is leading to a dystopia of eugenics and genetic engineering. In this, I think, Dr. Taylor is potentially half right. Unfortunately, Dr. Taylor either doesn’t understand the law she cites, or else is deliberately misrepresenting it to make a rhetorical point. For instance, she briefly mentions Roe v. Wade and then asserts that the case lead to the unborn having “no legal protection.” Because the unborn have no legal protection, she argues, immoral scientists can do what they want with them.

The first problem with Dr. Taylor’s argument is that it’s just wrong legally. First, Roe v. Wade hardly stripped all legal protection for the unborn; fetuses continued to be protected after the first trimester, and abortion could still be outlawed in the third trimester. Assuming Roe had stripped those protections, however, they would have been replaced in Casey v. Planned Parenthood, the more recent abortion case that doesn’t pack the same rhetorical appeal. There, the Supreme Court decided that states could ban abortion past the point of viability, and institute processes that women must go through to undergo an abortion even prior to viability so long as the processes are not “unduly burdensome.” Outside of the abortion context, the unborn continue to enjoy widespread protection in criminal and tort contexts.

Dr. Taylor goes on argue that Roe lead to an “unregulated” market for fertility treatments; a term she equates with cloning and genetic enhancement. But a quick glance at US law shows that this simply isn’t so. Aside from state laws that regulate cloning, the FDA and other administrative agencies regulate many of the processes involved with human cloning and the FDA has publically stated that they will not allow research projects involving human cloning.

Putting aside the legal problems with Dr. Taylor’s argument, she goes on to list a parade of horribles stemming from this supposed lack of legal protection. But that argument, too, is based on a lot of outdated science. Mainly she seems concerned that researchers are using fetal stem cells, though she strongly implies that fetuses are aborted to supply these cells, instead of recognizing that stem cells from fetuses already aborted for other reasons are then used for medical research. Dr. Taylor seems to overlook the fact that we often use cadavers for medical research, or else distinguishes using parts of aborted fetuses from using parts of cadavers without explanation. Either way, using parts of our dead to help the living is a well-established and generally uncontroversial matter; our entire organ transplant system is based around just that idea.

Finally, Dr. Taylor spins into a diatribe about transhumanists, though she doesn’t really say much about why transhumanism is bad except that people might (gasp!) lop off their own limb to replace it with something better and that the divide between the haves and the have nots might widen (an issues, it’s worth mentioning, that transhumanists themselves are concerned about.)

It’s easy to argue against transhumanism when you’re misquoting law, using outdated science, and not bothering to connect ideas with logic. Indeed, many of the experts Dr. Taylor cites to say that the policies she’s decrying are the natural extension of current scientific and ethical policies.

I want to be clear about why I’m calling out this article. It’s not that I dislike Dr. Taylor, or disagree with everything she says even, but I abhor bad arguments. I don’t expect blog posts to look like academic articles (I’d be in trouble if that was the case) but I don’t think accurate is too high a bar to expect. It’s not just that articles like Dr. Taylor’s are wrong, it’s that they’re wrong and likely to influence public opinion with bad facts. And that, at the heart of it, is the problem. It’s also why, should I misrepresent something, I want people to correct me. We can have debates about human cloning, genetic engineering, and the divide between the haves and the have nots without resorting to bad law and bad facts. The ethical issues surrounding transhumanism are difficult enough to debate without also having to defuse straw man arguments. To make real progress in these ethical debates we have to remain intellectually honest.

An excellent example of a well written article exploring a transhumanist ethical problem is this article by Carolyn Abraham at The Globe and Mail. While I highly recommend reading the whole article for a serious debate about the merits of human cloning and genetic engineering, what I want to point out here is that the article is accurate, balanced, and presents both sides of the argument. I really look forward to well-reasoned arguments from people not as optimistic about technology as I am because I realize the world isn’t so black and white that this technology is obviously great or terrible. Reasonable minds could disagree with the conclusion (not made by the article) that the technology is good or bad, but they would be disagreeing based on accurate information. That’s the sort of debate we need, and the only thing that will help us come to any sort of conclusion about how to proceed in the future.

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Stem Cell Advances

January 28, 2012 3 comments

Let’s talk about stem cells for a bit.

Few technologies are as contested as stem cell treatments; particularly embryonic stem cells, harvested from embryos specifically for research purposes. The National Institute of Health has a helpful FAQ here that explains more about stem cells generally, including the embryonic variety and the newer induced pluripotent form (where adult stem cells are regressed into an embryonic-stem-cell-like state). Despite the controversy around embryonic stem cells, stem cells generally (including, but not limited to, the embryonic kind) offer enormous potential for radical treatments.

Still, many of these treatments are in the research phase, and the Food and Drug Administration (FDA) recently issued some warnings about stem cells. Essentially, the FDA warns that stem cell treatments are still being approved, and consumers ought to be wary when approached with information about radical stem cell cures; these pitches are often just scams designed to bilk desperate patients and their families out of money. On the other hand, some tech companies prefer to operate overseas because of the regulatory morass imposed by the FDA here in the United States; while the regulations are well intentioned to ensure patient safety (to give the FDA the benefit of the doubt) they frustrate companies that want to get cures to patients as quickly as possible. I’ll outline some of the proposed treatments below:

Researchers in London are conducting clinical trials where stem cells are introduced into the retina of patients that suffer from blindness-causing diseases.  Concurrently, researchers at UCLA are reporting early success with the procedure. Through the first four months, the treatment appears successful and safe. However, “many more years” of trials are needed to further confirm the initial results. Additionally, the trial offered only slight improvement to vision, though curing the disease doesn’t seem to have been the point of the trial.

An article from NPR offers more information about the same experiment, including that the experiment was the first time that humans were helped by stem cells. This article also describes in more detail the improvement made by the test subjects; the improvement seems to be substantial. Scientists in both articles are very careful to reiterate that this should not be touted as a cure for blindness, but only encouraging initial results. Thus far, however, the results seem very impressive indeed.

I’m a little confused by the implication that the previous article makes that the research was the first time that stem cells were used to help humans because this video claims that scientists have used stem cells to grow a new trachea (wind pipe) for patients. The video is a little dry, but I include it below in its entirety for you to judge:

In other experiments, scientists are researching ways to cure Alzheimer’s Disease and regenerating muscle tissue that forms vascular walls. The first set of research ought to eventually allow doctors to introduce healthy neurons into the brains of people afflicted with Alzheimer’s Disease, essentially curing the disease (especially if they can also remove the defective or dead cells; another project Aubrey DeGray and crew are making headway on.) Stem cells have also been introduced into mice and seems to help them live longer, healthier lives. Aubrey DeGray generally predicts that 10-15 years after scientists are able to double the lifespan of mice, they ought to be able to do the same for humans. This research suggests that the mouse-lifespan threshold may soon be met.

In sum, the FDA is right that currently much of the work being done with stem cells is research based or otherwise preliminary, and patients should be wary of supposed stem cell treatments for almost any condition. However, just because the treatments aren’t here yet doesn’t mean that they won’t be soon, and current research suggests that within the next several years stem cell treatments will move from hoax to fact.

Artificially intelligent cars have received a lot of press lately, so look out for my article about them in the next few days.

Categories: legal issues Tags: , , ,

Weekend Edition: Heathcare News

January 7, 2012 1 comment

It’s been a busy few days in health technology news.

First, CTV (via fight aging!) reports that Canadian researchers have discovered stem cells within the eyes of adults that can be used to help cure age-related macular degeneration (AMD) – the leading cause of vision loss in people over 60. Apparently these cells form within the eye during the embryonic stage, and remain dormant (sometimes up to 100 years) in our eyes. By removing the cells and growing them in a culture, scientists can (in theory) restore vision by replacing dysfunctional cells. Further, these stem cells seem to be pluripotent, meaning that the scientists can turn them into other types of cells and thus, to treatments for other diseases. Here’s a quote from the article:

“In culture dishes in the lab, the researchers were able to coax about 10 per cent of the RPE-derived stem cells to grow in the lab. Further prodding caused the cells to differentiate into, or give rise to, a variety of cell types — those that make bone, fat or cartilage.

Temple said her team also generated a progenitor cell that carries some characteristics of one type of nervous system cell, although it was not fully differentiated.

‘But the fact that we could make these cells that were part-way, that were immature, indicates to us that if we keep on manipulating them, going forward in the future, we should be able to find ways to create other types of central nervous system cells,’ she said.

One goal would be to produce neurons, the electrical-signalling cells in the brain and other parts of the central nervous system. That would mark a major step towards the holy grail of regenerative medicine: the ability to repair spinal cord injuries and brain damage caused by such diseases as Alzheimer’s or Parkinson’s.

‘And a really important cell type that we’d love to see if we can make would be the retinal cells, the neural retinal cells like the photoreceptors that are in the eye,” said Temple. “So if we could help make new photoreceptors as well as the RPE — which we’ve already shown we can make — then we would be making two really valuable cell types for age-related macular degeneration.'”

Second, USA Today (via Transhumanic) reports that yet another artificial organ, this time the pancreas, has entered clinical trials. Unfortunately, this organ isn’t exactly like the rest of your organs; it’s a small machine worn outside the body rather than being implanted inside the body where the old pancreas used to go. Nevertheless, it’s seemingly effective at monitoring glucose levels in the blood and calculating how much insulin needs to be injected to bring the blood levels back to normal, and then it injects that amount of insulin. Approval for the device is expected in the next three to five years.

Speaking of clinical trials, however, all is not rosy in the world of academic publishing. Discover Magazine reports on a study conducted by scientists showing that 30 months after clinical trials had been completed, better than half had not been published. After more than four years, one-third of the results from clinical trials remained unpublished. This is problematic for two reasons. First, publishing is a condition of receiving a grant from the National Institute of Health (NIH). Thus, better than half of funded groups breach their funding agreement. Second, and perhaps more importantly, by not publishing their results, these scientists deprive the rest of the scientific community of valuable information; information the scientists conducting this study argue could change the conclusions of researchers based on published work.

“’Overall, addition of unpublished FDA trial data caused 46% (19/41) of the summary estimates from the meta-analyses to show lower efficacy of the drug, 7% (3/41) to show identical efficacy, and 46% (19/41) to show greater efficacy.’ That means that when scientists try to study those FDA-approved drugs, they may not realize that they work less well than published papers indicate (or better, as the case may be).”

This is a trend that needs to stop, especially given the exponential increases in technology and the vast amount of advancement coming yearly; up-to-date results are a must.

Going back to diabetes for a moment, a new study reported by eurekalert shows that poor maternal diet can increase the odds of diabetes in the child. Scientists from Cambridge and Leicester have linked poor maternal diet while pregnant to the fetus’ inability to correctly manage fat cells later in life. “Storing fats in the right areas of the body is important because otherwise they can accumulate in places like the liver and muscle where they are more likely to lead to disease.” The pregnant rats in the study were fed low-protein diets, which led to the unborn rats later being unable to process fat correctly and increased their chances of developing type-2 diabetes. This deficiency caused the now-born rats to look slimmer (because they stored less fat) but nevertheless be more likely to develop diabetes. Similar results were shown in humans with low birth weights.

In a world of increasing medical apps and patient-driven medical data, reports on the the thoughts of cardiologist Eric Topol, who seems to agree with SingularityU chair Daniel Kraft that this increasing data will revolutionize medicine. The article indicates, however, that there is reason to question whether or not all this additional data is really helpful. In no case does the additional information seem to have hurt (that is, patients did not receive worse care for the abundance of information) but neither did the outcome always improve. What the article does not seem to question, however, is that quite soon there will be a deluge of additional patient information available, first through cell phone apps and the federally funded switch to electronic patient records records, and later through more advanced sensors like nanobots swimming around in the bloodstream. For my money, I suggest that if the patient data isn’t helping to increase patient care, then it’s because the data is not being used correctly. Certainly no doctor can keep track of hundreds or thousands of patients whose information is being updated daily or even weekly, but some sort of computer within a hospital with correctly coded software (or perhaps even a Watson-style supercomputer) easily could, and then could alert the doctor to only the most important cases.

Finally, my law school pal Micah linked me to an article from the BBC, reporting on the first chimera-monkey; a monkey created from several different embryos. Essentially, the scientists took DNA from up to six different embryos, mixed them together into three monkey embryos, and out came apparently healthy monkeys Chimero, Hex, and Roku. The study also found that (somewhat unsurprisingly) stem cells didn’t work the same way in mice as they did in primates, which suggests that perhaps all the backward-engineering we’re doing to revert normal cells into a pluripotent stage might not be effective in humans like it is in mice. That is, there still may be a need for embryonic stem cells. Micah asked whether this experiment might have an impact on our notions of family, in addition to our ideas about personhood.

For a couple of reasons, I think this experiment in particular probably won’t. The only thing different about these monkeys and any other monkeys of the same type is that these were artificially created and had a mixture of several strands of DNA. On one hand, that probably means that there is no clear mother or father; when the DNA of six monkeys is mixed together, who’s the biological parent? On the other hand, a monkey (or a human, for that matter) who receives a transplanted organ now has DNA from at least three different people (both biological parents, plus the donor) and maybe four (if you count the two different DNA-strands that make up the donors’ DNA) different sources. With more transplants comes more DNA; it’s not inconceivable that a human could have a kidney from one donor, a lung from another, and a heart from yet a third; making at least five distinct DNA strands within the same human. Also, in the sense that ‘chimera’ just means composed of different DNA strands, then anyone who already has a transplant is a chimera. so for that reason, I don’t think that a human created this way (as unlikely as it is, given human-experimentation laws) would be any less of a person than a more traditionally-created human.

But speaking of created humans, through various fertility treatments, and including even surrogate mothers (or fathers) and whatnot, our notions of family are becoming less tied to the make-up of our DNA. Even simple adoption shows that a family unit can include members with different DNA without trouble. So the fact that these monkeys are made up of several DNA strands probably shouldn’t start affecting out ideas about family, though in humans they could lead to some hilarious Maury Povich episodes. Also, the fact that a human is created through artificial means hasn’t yet stopped them from being a person in the traditional sense, and so I don’t think it would have any effect on monkeys (though they’re not legally persons, and this is unlikely to change that.)

Something that might make us reconsider our notions of personhood and family is a chimera made of different species; part monkey, part reptile combinations, for example. There, a whole new species is being creates and the being becomes further removed from parents. Because family is more of a social construct now than a DNA-matched set (consider how many people seriously consider their dog / cat / goldfish to be part of their family) even this radical form of chimera might not shake our notions of family. But personhood … that’s something I’ll have to think more about.

Stay tuned for some news about robotics tomorrow; I wanted to make separate posts to keep this one from becoming even more unwieldy than it already is.

The Appeal of Stem Cells

Okay, that was a terrible pun.

A few weeks ago, an appellate court overturned the ban on the testing of some human embryonic stem cells. The appellate court reasoned that the trial court analyzed one factor related to the permissibility of an injunction incorrectly when the trial court decided that a stay on stem cell research would not seriously affect researchers. The appellate court instead held that by enjoining research on stem cells, the researcher’s loss of staff jobs and loss of investments in research and equipment caused “certain and substantial” harm. In addition, the appellate court found that the trial court misapplied an amendment to the 2009 federal budget. The Dickey-Wicker Amendment, in addition to being tremendously fun to say, prevents the allotment of funds from fiscal year 2009 from being used to support either the creation or (somewhat more nuanced) destruction of human embryos for research. The Amendment does not, according to the appellate court, bar the allotment funds from fiscal year 2009 for research using embryonic stem cells obtained in other ways.

Now that the appellate court has ruled, the case will move back to the trial court for more arguments and a consistent verdict. which is not to say that the defendant researchers’ victory is assured, only that the verdict cannot contradict the findings of the appellate court. Whatever the ruling, I don’t think the issue will be particularly controversial going forward for two reasons.

First, the Dickey-Wicker Amendment only constrained funds for FY2009, and money from 2009 is unlikely to still be lurking about. However, any future budget could contain a similar amendment, in which case more suits would almost certainly challenge the use of that money for stem cell research.

Second, and more importantly, the need for embryonic stem cells seems to be declining, and the moral bickering that accompanies embryonic stem cell research seems largely absent from adult stem cell research.

Embryonic stem cells are valuable because they are “pluripotent,” which means that they can become any type of cell. At conception, two cells merge and from that comes the entire complexity of human beings. As people age, however, cells become more specialized and reproduce only the same kind of cell: this helps to ensure that we don’t grow an eyeball in our esophagus. Using some scientific magic, however, researchers have found a way to regress an adult cell back into a pluripotent cell that can then, with some additional tinkering, become whatever sort of cell scientists desire. Just yesterday, GEN reported that human liver cells derived from other adult cells suffered no loss of functionality as compared to embryonic stem cells when grafted onto mice. Importantly, the research showed no signs of tumor, and thus cancer, over the life of the experiment. Although more research needs to be done, it seems that the initial indications suggest embryonic stem cells will not be needed much longer.

Why use stem cells, embryonic or otherwise, at all? There are several excellent reasons. Because stem cells are pluripotent, they (and other cells regressed into that state) can rejuvenate already existing organs. Where an individual with severe heart problems now needs to wait for a donor and hope that the heart doesn’t trigger an adverse immune reaction, stem cells and created pluripotent cells offer the same individual the opportunity to get a heart made from their own cells. Because the heart will be created with the patient’s own cells, the patient’s body will not reject the new organ. Further, when adult cells can be reliably turned into whatever sort of cell is needed, the patient need only have enough cells excised from a convenient part of their body to create the new pluripotent cells – no one else need give up their heart, and the wait list experience could be more like ordering a custom car and less like hoping some poor sap with a compatible heart kicks the bucket. Plainly, stem cells save lives and reduce scarcity – two very important goals.

Potentially, the same effect could be obtained mechanically through an artificial heart rather than a heart created biologically from other cells. Despite that, there are excellent reasons for continuing stem cell research. For large organs, such mechanical replacement probably works out fine, although if the choice is available some people would probably prefer to remain (quasi)au-natural. Even for a large organ like skin, however, mechanical replacement can pose some problems. First, there are few synthetic skins available, and none of them are as good as human skin or have a proven ability to integrate with human skin. The closest that I’ve found is a synthetic skin designed for use with robots. This seems to be an all or nothing proposition, however: either all of the skin is replaced, or none of it is (if it can even work well on a human at all.) Even if a synthetic skin is invented that can integrate with human skin, it will need to look very much like human skin (and, particularly, the skin of the human to whom it is attached) to gain widespread acceptance: No one wants to look like a patchwork quilt if they can avoid it. For other types of cells; neurons and nervous system cells included, there is, as yet, no mechanical substitute.

Eventually mechanical engineering will overtake biological engineering. Cells have been created over millions of years through a painstakingly slow process with only a few dozen raw materials to choose from. Everything is carbon based because carbon is extremely adaptable. However, synthetic polymers, alloys, and substrates ought to provide many more choices in crafting future organs, and human experimentation means that changes that either are not conducive to survival (say, the purely cosmetic) and so not available via evolution, or else not made of materials to which evolution has access can be used to create organs with features designed by and for the user. It’s very nice (and much appreciated) that our skin holds our insides in and provides us with tactile sensory information, but wouldn’t it be nice if it was more resistant to wear (with, say, properties similar to Kevlar) or could maintain its shape without suffering for cellular decay and loss of elasticity that leads to wrinkles? Perhaps we could imbue skin biologically with chameleon-like qualities, but wouldn’t it be better if skin could displace light entirely, or if we could moderate pain sensations in a modular way, such that a cut that has been noticed could stop hurting while we repair it? People will largely choose mechanical engineering over biology for the same reasons that people use hearing aids and contact lenses: more functionality is better.

The benefits of mechanical engineering aside, biological engineering is largely more attainable at the moment. Even if mechanical engineering was up to par, because some people will choose to remain quasi-natural (i.e., biological) instead of becoming a hybrid or a fully mechanical being. For that reason alone, stem cell research is worth pursuing: more options are always better.

On deck for Monday: Mechanical Cars.