A Moratorium on Heritable Human Genome Editing: Illusory or Real?

Blog, Emerging Technologies, Engineering Humans, Genomic & Genetics Issues / /

D. Joy Riley, M.D., M.A. Executive Director

In March, 2019, Nature published a commentary penned by Eric Lander, Françoise Baylis, Feng Zhang, Emmanuelle Charpentier, and Paul Berg, and signed by 13 other notables. The name of the commentary is “Adopt a moratorium on heritable genome editing.” This document requires analysis.

First, some definitions are needed. A moratorium is defined as a “suspension of activity,” or “an authorized period of delay or waiting.” Heritable means “capable of being passed from one generation to the next.” Additionally, clinical can refer to a “scientifically detached” attitude or “the observation and treatment of patients directly.” Each of ...read more

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Transgenic Monkeys: Coming to a Lab Near You?

Blog, China, Emerging Technologies, Genomic & Genetics Issues, United States / /

D. Joy Riley, M.D., M.A. Executive Director

The initial draft sequence of the chimpanzee genome was published in September 2005 – in comparison with the human genome. A few months later, geneticist James M. Sikela wrote in PLOS Genetics, “the genes and genetic changes that are responsible for making the human brain what it is and for allowing it to do what it uniquely does, have long been among the most prized jewels of our genome.” In that paper, Sikela considered how one could locate the changes in the genome that account for “human-specific cognitive abilities.” How could one prove that a ...read more

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A Book for (Y)our Time – A Review

Blog, Book Reviews / /

D. Joy Riley, M.D., M.A. Executive Director

Reading Siddhartha Mukherjee’s The Gene: An Intimate History (NY, NY: Scribner, 2016; paperback, 2017) is to take a 150+ year print journey with an English-speaking physician and scientist, who is also a renaissance man. Mukherjee, an assistant professor of medicine at Columbia University, won the Pulitzer Prize in 2011 for his non-fiction work, The Emperor of All Maladies: A Biography of Cancer. I have not read that earlier work, but have spent time delving into The Gene.

The Gene: An Intimate History begins with the author’s 2012 trip to Calcutta with his father to visit a ...read more

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The Rubicon

Blog, End of Life, Medicine & Health, Resource Room, United States / /

D. Joy Riley, M.D., M.A. Executive Director

The law in the Roman Republic in 49 B.C. was very clear about an army crossing a small stream outside Rome: it was considered an act of war. Julius Caesar knew this, and led his 13th Legion across that stream, declaring, in the historian Suetonius’ words, “The die is cast!” Caesar and his army did not turn back, but continued on to war, and ultimately defeated Pompey the Great. This turning point in history is referenced whenever we talk about approaching a point of no return and utter the phrase, “crossing the Rubicon.”

“The Rubicon” sculpture ...read more

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Medicine’s Schizophrenic Approach to Suicide

Blog, Medicine & Health, Resource Room / /

D. Joy Riley, M.D., M.A. Executive Director

On 10 May 2018, Medscape Medical News published an article about the recent suicides — five days apart — of an NYU psychiatry resident and a medical student. Marcia Frellick, reporting for Medscape, wrote

The university confirmed the deaths to Medscape Medical News in a statement: “We were saddened to learn of the recent deaths of one of our medical students and one of our psychiatry residents, both by suicide. Counseling and support services are being offered to students, faculty, and staff. On behalf of the institution, we extend our deepest condolences to their families, friends, ...read more

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The ACP Releases a Position Paper on Physician-Assisted Suicide

Blog, End of Life, United States / /

D. Joy Riley, M.D., M.A. Executive Director

On 19 September 2017, the Ethics, Professionalism and Human Rights Committee of the American College of Physicians released their position paper on physician-assisted suicide (P-AS). A brief synopsis of it follows…

Re: Ethics and the Legalization of Physician-Assisted Suicide: An American College of Physicians Position Paper

The statement released last week builds on previous work:

1997 report by the Institute of Medicine (IOM), Approaching Death: Improving Care at the End of Life, which cited “inadequate end-of-life care” in the U.S. 2001 statement by the American College of Physicians, in which the ACP did not support the legalization of P-AS. ...read more

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First Human Embryos Edited in U.S.: A Bright Red Line Is Crossed

Blog, Emerging Technologies, Genomic & Genetics Issues, Medicine & Health, uncategorized, United States / /

D. Joy Riley, M.D., M.A. Executive Director

“Sooner than we expected”: A friend – a scientist steeped in the bioethics realm – wrote to me of her surprise at the announcement of the first embryonic humans edited in the United States. Steve Connor, writing in the MIT Technology Review, reported the work on 26 July 2017.  Doubtless, the publication of the work in a scientific journal will follow.

The article, “First human embryos edited in U.S.” by Steve Connor, describes the process thusly: “A person familiar with the research says ‘many tens’ of human IVF embryos were created for the experiment using the ...read more

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Helping Patients Live vs. Helping Them Die

Blog, End of Life, Hot Topics, Medicine & Health, United States / /

D. Joy Riley, M.D., M.A. Executive Director

Cultural Suicide On Sunday, 28 May 2017, The Tennessean published a full page set of articles on the problem of suicide amongst the armed forces in our nation. The year 2012 saw a peak of 22 U.S. veterans killing themselves per day (Jake Lowary, “‘I can’t do barbecues:’ Veteran says“). The Department of Veterans Affairs plans a 7.5 percent budget increase to $186.1 million in 2018 — all to address suicide prevention, the department’s “highest clinical priority” (Jake Lowary, “Suicide rising in the military, but some programs give veterans hope“).

In light of these sobering statistics, it ...read more

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What Is a SHEEF, and Why Should We Care?

Blog, Emerging Technologies, Stem Cell Research, United States / /

D. Joy Riley, M.D., M.A. Executive Director

Human embryo research has long been guided by what is known as the “14-day rule.” That is, various nations have allowed research on embryos up to 14 days post fertilization. The 14-day rule was put in place ostensibly in order to avoid causing pain for the developing embryo. The primitive streak — the first visible evidence of gastrulation and the formation of differentiated tissues in the embryo — appears at about day 15 after fertilization. (See video at the bottom of this post for more information.)

When the 14-day rule was put in place, laboratories were ...read more

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It Has Arrived: Gene Editing Recommendations Published

Blog, Emerging Technologies, Engineering Humans, Genomic & Genetics Issues, United States / /

D. Joy Riley, M.D., M.A. Executive Director

The committee appointed to advise our government regarding the editing of genes, including editing the genes of the human embryo, has published a draft report (see the title page screen shot above). We at The Tennessee Center for Bioethics & Culture are studying the document’s 261 pages, and have a few caveats to share with our readers. Germline gene editing was given cautious approval by the committee:

Heritable germline genome editing trials must be approached with caution, but caution does not mean they must be prohibited. (p. 102)

and

If the technical challenges are ...read more

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