Sunday, November 20, 2005

Fantastic ethical news - Guardian reports world's first blood vessels grown from patient's skin and trials into using new blood vessels to treat heart patients in Cambridge..... so why are scientists, reported by the Sunday Telegraph, still sidestepping UK law and planning to import embryonic stem cells?

Fantastic news reported in the Guardian (16/11/05) that kidney patients have successfully been treated for the first time with new blood vessels created from their own skin cells! The research was reported to the annual conference of the American Heart Association and proves yet again that adult stem cells provide an ethical alternative to the hypothetical and much-hyped sensationalism surrounding embryonic stem cells. The blood vessels breakthrough is particularly exciting because this technique could also be used to treat patients with heart damage and to treat diabetics as an alternative to limb amputation, as well as treating children with congenital heart defects which would mean that the blood vessels would grow naturally with the child rather than requiring further surgery. The Guardian reports that British trials will be taking place at Papworth hospital in Cambridge to treat heart bypass surgery patients with lab grown blood vessels which will avoid requiring blood vessels from the patients' legs. All credit to the science correspondent on the Guardian for this particular report, but the impression still prevails that embryonic stem cells are necessary.

Only three days before the Guardian report of this world first, the Observer included a wideranging piece about future controversial manipulations of science in which embryonic stem cells were casually referred to. References to curing parkinsons and diabetes were casually tossed around, no mention of the real progress being made with adult stem cells into the treatment of over 60 different conditions. The article concluded with "Milestones in human biology" which mentioned Dolly the sheep and the first cloning licence issued in the UK, despite the fact that the cloning licence isn't a milestone, it's only a licence and (again not mentioned) is under legal challenge for being unnecessary and unlawful because alternative avenues of research exist.

Here for example are some real breakthroughs that merited a mention from the news updates on the CORE website:

Bone marrow stem cells improves heart's efficiency (14th November 2005)

Commercial umbilical cord stem cell bank possible in Cambridge,UK (26th October 2005)

Spina bifida may be cured using amniotic stem cells (11th October 2005)

Fast and efficient technique to reproduce cord blood stem cells (10th October 2005)

Vacanti brothers quietly pioneering adult stem cell treatments for diabetes and paralysis (8th October 2005)

London: Liver failure patients treated using bone marrow stem cells extracted from blood (6th October 2005)

A cure for baldness (3rd October 2005)

Major advantages of placental stem cells (27th September 2005)

Only 1 out of 96 New Jersey research proposals involves Embryonic stem cells (22nd September 2005)

World's largest umbilical cord bank to be set up in India, to provide stem cells for transplant surgeons globally (12th September 2005)

Nature Genetics: Embryonic Stem Cells produce cancerous mutations (4th September)

Embryonic stem cells trigger immune rejection (29th August)

First real progress in acute renal failure: bone marrow stem cells "fast direct improvement" (16th August)

Placenta contains 300 million amniotic epithelial cells (5th August)

Adult stem cells could help tens of millions of heart patients each year (2nd August)

And then in the Sunday Telegraph on the 20th November it was reported that two fertility specialists plan to sidestep UK law and import embryonic stem cells. Again readers were informed that "Stem cells are gathered from embryos at an early stage of development..[and] can grow into any of the 220 types of tissue in the body, offering scientists the best hope of cures for many disorders." - no mention of the complete pointlessness of this when countries around the world are setting up banks of umbilical cord stem cells and having real success using stem cells collected from ethical sources.

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Wednesday, November 02, 2005

British Medical Journal research paper on abortion and depression should not have been represented by news outlets as conclusive proof of anything

see also: University of Oslo researchers find that abortion causes more longer term anguish than miscarriage (12th Dec)

Anyone who saw the cavalier and misleading news reports last week which made sweeping overgeneralisations that abortion is not linked to depression should read David Reardon’s comprehensive online rebuttal of Nancy Russo’s research in the rapid responses to the British Medical Journal article (see Study Fails to Address Our Previous Findings and Subject to Misleading Interpretations (Rapid response, David Reardon, 1/11/05). David Reardon has published extensively about the increased rate of depression following abortion in the BMJ in 2002 and in the Canadian Medical Association Journal in 2003, which found that 6.5 per 1000 women were admitted for the first time to a psychiatric unit within 4 years of a live birth, compared with 12.9 per 1000 women admitted within 4 years of an abortion.

Russo's research paper criticised Reardon's conclusions but also failed to note, as Reardon pointed out, how extensive the literature is on the link between on abortion and depression by concentrating only in critiquing Reardon's work and not mentioning the literature, which include a paper by Russo herself which revealed significant increases in depression, suicidal ideation, and lower life satisfaction, even though Russo hypothised that this is due to factors other than abortion. It is a pity that the mainstream media are unlikely to report Reardon's objections in full and that the misleading impression generated by Russo's paper is allowed to stick.

The immediate flaw that jumped out at me when I looked at the research by
Russo in the BMJ online first
, which was reported by BBC Newsonline as
“Abortion depression link queried” and by the Times as “First abortion 'not linked to depression'” was that these headlines were too sweeping and inaccurate given that Russo’s study explicitly stated that they had deliberately left out cases involving women who underwent abortions in which the pregnancy was wanted, even though these women are the most at risk of
suffering from depression. Far from proving that abortion in general does not cause depression, if Russo’s research was to be believed it is only applicable to pregnancies women classify as “ unwanted”, and even then the conclusions can be challenged. So far from disproving earlier findings, Russo's research simply ignored them. As David Reardon says in his rapid response "their results do not contradict ours" as they "can easily be reconciled with our own findings" - any differences in results “can primarily be explained by differences in coding of key variables and sample selection.”

Reardon's says "Ambivalence about pregnancy and abortion is common. I do not doubt that there was a group of women who
had swings in “wanting” their pregnancies, which ended in a decision against keeping the pregnancy. Indeed, ambivalent swings from wanting to unwanting a pregnancy is a well-known risk factor for emotional turmoil after an abortion.For example, research by Husfeldt and colleagues found that 44% of participants experienced doubts about a decision to abort upon
confirmation of their pregnancies, while 30% continued to have doubts on the day of their abortions. Eliminating this subset of women may significantly bias the analysis by eliminating a class of women who have abortions who may be at highest risk of post-abortion depression.

Not only does the selection of women in the abortion sample skew the findings but somewhat strangely the researchers also included women who went on to have an abortion in the control group. The control group should have consisted only of women who gave birth following unintended pregnancy in order to avoid introducing a bias, but instead it included women who had abortions too and therefore means that the depression scores for the control group could have been high due to subsequent abortions, not due, as the researchers concluded, to giving birth. Indeed, Reardon points out that there is some evidence that women who have given birth who go on to have an abortion are at a greater risk of emotional sequelae. As the time lapse under analysis is eight years after the first pregnancy, it is even more likely that the depression score may be due to the subsequent abortion and not the original pregnancy that went to term. By including women who had abortions in the control group, it lessens the chance of being able to detect any statistical difference between the delivery group and the abortion group. Reardon also notes that Russo's study does not involve any control variables for women who gave birth, and does not include any consideration of concealed abortions which is thought to be as high as 60% (compared with national averages, only 40% of the expected number of abortions are reported) which means that another confounding effect in the control group may result from the inclusion of minors who became pregnant with two years of an abortion where the abortion is not recorded. Reardon concludes that there needs to be more research not less in this area.

Proabortionists are typically dismissive of the link between abortion and depression. Nancy Russo was quoted in January 2004 by a science reporter from the Toledo Blade newspaper saying "As far as I'm concerned, whether or not an abortion creates psychological difficulties is not means you give proper informed consent and you deal with it". Perhaps unsurprisingly, given her membership of the proabortion board of the UK Prochoice forum she also uses her research to promote abortion as a way of lowering the risk of depression, when she is quoted in The Times saying that "research should focus on how to prevent and ameliorate the effect of unwanted childbearing, particularly for younger women", a conclusion which is obviously contradictory to the vast body of research studies cited by Reardon.

Abortion agencies that carry out abortions like the British Pregnancy Advisory Service and have an ideological commitment to abortion on demand for any reason up to and including birth were quoted in the Times saying that few women return for post abortion counselling. Given that proabortionists regularly say "few" abortions are carried out past 20 weeks, even though there are over 3,000 abortions carried out on babies over 20 weeks gestation, the word "few" could really mean anything. But even if few women do go back to BPAS, is it really surprising given that this is the organisation that carried out the abortion in the first place?

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