September 4, 2006
- Day 6 - Week 22 - Labor Day: An Appropriate Story
Greetings, friends and family of Peter and Katy! I'm
hoping that all of you are enjoying a few days
respite from the treadmill of life-----taking the
opportunity to bid summer adieu and to get set for
the frenzy of fall activity. Twas a memorable
weekend at this end of the country. By my
calculation, my brother and sister and I shared our
birthdays jointly for the first time in over forty
years! I'm especially pleased to report that my
brother, Barry, seems to be on top of the world
these days. His dear friend, Carol, sold her house,
packed her things, and was on the road to
Albuquerque this weekend. The forthcoming chapter in
his life is about to take a dramatic new turn, and
Barry seems almost giddy at the prospect. For the
moment, the upcoming post-operation battle with
cancer is on the back burner, and all seems well
with Barry's world.
On the airplane back to Los Angeles yesterday, I
indulged my passion for the New York Times and was
fascinated by the front page article by Amy Harmon
on "preimplantation genetic diagnosis" (PGD) as
applied to couples seeking to screen their embryos
for predisposition to various forms of cancer. The
article outlines a process by which couples must
choose to undergo an in vitro fertilization process
in which eggs are extracted from the mother and
fertilized with the father's sperm. When the
resulting embryos are three days old, doctors remove
a cell from the embryo and examine its DNA
structure. The article states that "only embryos
without the defective gene are then considered
candidates to implant in the mother's uterus."
Obviously, the process raises a host of moral issues
and choices, most of which are contentious, and all
of which I would find challenging. I'm not well
educated about medical things, but I wonder if,
having examined the DNA structure of such an embryo,
could science manipulate DNA structure these days in
ways that could repair or eliminate the "defective
gene"? Perhaps this lies at the heart of the "stem
cell research" controversy, and I simply have not
made the connection. If it IS possible to manipulate
genetic structure in an embryo, I can't begin to
imagine how much human suffering, including cancer,
could cease to exist! The article, however, does not
answer my question about DNA manipulation. It simply
suggests that the choice for the mother and father
at that point is to implant only embryos without a
defective gene in the mother's uterus and proceed
from there.
Such procedures are extremely expensive, of course,
raising an important moral question about equity.
Out of pocket expenses, the article states, often
exceed $25,000. By definition, therefore, those
couples seeking to minimize the risk of cancer for
their children must have access to large bank
accounts. Poor folks aren't likely to qualify.
Others are concerned that the process could be used
to develop "designer children", raising spectres of
genetic manipulation that hearken back to Hitler.
Not a pretty thought.
People know more about our genetic profile these
days, however, and not surprisingly, we're inclined
to want to know about our children, particularly if
there are ways to prevent genetic disabilities and
susceptibilities. The article cites one woman's
anger that she had not been advised regarding the
PGD procedure when she came to understand that her
own genetic makeup made it five times more likely
that her 4 year old daughter would develop breast
cancer. Many medical professionals, on the other
hand, point to advances in prevention and treatment
as preferable options to PGD that enable parents to
avoid difficult moral choices. Others look at the
matter as a form of "eugenics" where decisions are
made that might mean that "you" never existed.
Social activists are concerned that PGD could be
used against certain groups, including homosexuals,
females, or people with disabilities. I think you
can see how complicated the discussion about PGD can
get!
The article cited a particular cancer case that I
found which illuminates the dilemma. Danielle Jamond
carries a severe form of inherited colon cancer. She
herself underwent a major operation to remove her
large intestine as a preventive measure for the
cancer she was advised she was highly likely to get.
She and her husband, consequently, chose to undergo
the PGD procedure for their children. Four embryos
were created from her 12 eggs; three did not have
the colon cancer genetic mutation. One of those
died, and the other two were implanted. Of those
two, one embryo survived and is now in its sixth
month. For those who believe that human life begins
at conception, the choice that the couple made was
tantamount to abortion and, the article states,
"pernicious, because it is psychologically less
burdensome". On the other hand, the article points
out that parents could avoid that question by
freezing the unused embryos indefinitely-----leaving
the question as to their future undefined for an
indefinite future.
I think that summary captures the essence of the
article.....a slant on cancer "prevention" that I
wasn't familiar with. I recommend that you track
down the article. "Couples Cull Embryos to Halt
Heritage of Cancer" on the front page of the New
York Times of September 3. Perhaps our wizard web
master can provide a link for all of you to use.
When I looked up from the newspaper and reflected a
bit, I began to wonder about that perennial "nature
vs. nurture" debate regarding the causes of cancer.
The answer is clearly both. Typically, those of us
concerned with humanity's inhumanity to the
environment tend to focus on our surroudings as the
culprit. The article in the Times reminds me that we
should not ignore our own genetic heritage and its
potential for success in the war against cancer as
well. Abrazos. Wayne
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