December 10, 2023

Can it happen again?


The word bioethics seldom crops up in Google News searches, but this week it was in flashing lights. The US Presidential Commission for the Study of Bioethical Issues had released a preliminary report into abuses by American public health doctors in Guatemala in the late 1940s. The shocking story was came to light last year: doctors deliberately infected hundreds of soldiers and psychiatric patients and others with venereal diseases without their consent. Some died.

How could this have happened? It took place only a few years after Nazi doctors were tried for similar offences, so there was no excuse for ignorance of the notion of “informed consent”. “The attitude toward the Guatemalan people was pretty much what you’d expect if they were doing research on rabbits,” says John Arras, of the University of Virginia, a bioethicist on the Commission.

Could such abuses happen again? That’s the big question. In one sense, the field of bioethics exists to ensure that it won’t. There are allegations that clinical trials are outsourced to the developing world to escape strict protocols for informed consent. A film has even been made about this – The Constant Gardener. These need to be investigated.

But one area that gets very little attention is the ethics of assisted reproduction. Below you will find news about egg freezing, which the British Fertility Society regards as ethical. But have its effects on children been tested? Surely these have to be considered, not just its effects upon women. Intracytoplasmic sperm injection is a technique which has become a mainstay of IVF. Yet it was never clinically trialled. Now it appears that there is a higher incidence of birth defects in ICSI babies. A generation hence, will people be talking about experiments on rabbits? What do you think?

Michael Cook