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Embryos, the law and medical advances in 2004

20 December 2004
By Dr Jess Buxton
genetics editor, BioNews
Appeared in BioNews 289
Scientists, mindful of raising false hopes, usually hesitate to use the word 'breakthrough' in medical research. But the beginning of this year saw the publication of work that was truly ground-breaking. The achievement of a team of South Korean scientists, who managed to create cloned human embryo stem cells (ES cells), was hailed as a 'landmark paper' by other scientists. Their work will pave the way for research into 'therapeutic cloning', the proposed use of cloned ES cells to develop tissue-matched cell therapies for a range of diseases. Much work remains to be done, but, as US stem cell researcher Robert Lanza pointed out, scientists now have a publicly-available 'cookbook' to work with. In the UK, scientists at Newcastle University are now hoping to repeat the Korean team's success, after receiving the first UK licence to do so in August.

But the stem cell advance also showed that it takes more than scientific breakthroughs to develop new medical therapies - a supportive regulatory framework and public backing are also crucial for such work. Recognising this fact, France and Canada both passed legislation this year allowing ES cell research to take place. In the US, many government-funded stem cell researchers, banned from working with ES cells created after 9 August 2001, are now hoping that other states will follow California's lead: on the same day that George Bush returned to the White House for a second term, Californians voted to provide $3 billion of public money for ES cell research. Sadly, Christopher Reeve, who campaigned tirelessly for the stem cell cause, died a few weeks before this unequivocal display of public support for such work.

Embryo research and assisted reproduction technologies continue to present policy and regulatory challenges to governments around the world. Different countries approach these challenges in very different ways, a fact highlighted by the repeated failure of the United Nations (UN) to agree upon an international cloning convention. Finally, in November, its legal committee abandoned attempts to find common ground on the issue of therapeutic cloning in favour of a non-binding UN declaration against reproductive cloning only.

Meanwhile, in Italy, new restrictive laws governing assisted reproduction, passed in February continue to cause controversy. With its emphasis on protecting embryos at the expense of women's health, the legislation states that no more than three eggs can be fertilised at any one time, and that all resulting embryos must be returned to the womb. This has already resulted in at least one triplet pregnancy that endangered the health of the mother.

In the UK, the 14-year old Human Fertilisation and Embryology Act that governs assisted reproduction and embryo research has faced its own regulatory challenges. In particular, the issue of 'saviour siblings' - babies conceived to provide tissue-matched cord blood stem cells for sick children - has vexed policy-makers. In September, the Fletcher family became the first  to benefit from a change of heart by the Human Fertilisation and Embryology Authority (HFEA). Julie Fletcher is now reported to be pregnant with a baby whose cord blood could help treat their son Joshua, who has Diamond Blackfan anaemia (DBA). Earlier in the year came the good news that a British child Charlie Whitaker, who also has DBA, is now 'effectively cured' of his condition. Charlie received a cord blood transplant from his brother James, who was born after the Whitakers travelled to Chicago for treatment that was previously banned by the HFEA.

The confusion over saviour siblings, which involves a medical procedure not predicted at the time the HFE Act was drawn up, is perhaps one of the reasons for next year's planned overhaul of this legislation. The House of Commons Science and Technology Committee is in the final stages of gathering evidence for its review of the Act, and is due to report its findings next spring. This will be followed by a Department of Health (DH) review, culminating in a reconsideration of the Act by parliament.

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