[CRISPR babies: technology and transgression]. / Bébés CRISPR - Anatomie d'une transgression.

Analysing the data recently presented by Jiankui He and assuming that it is authentic shows that the goal of abolishing the expression of CCR5 may have been reached for one of the resulting twins, although this remains to be proven. However, the canonical delta32 mutation has not been achieved. The various preliminary experiments and controls give some confidence that major off-target modifications have not occurred; again, this is difficult to exclude. Clearly, the requirements of perfect technical mastery of the process have not been met, to say nothing of the requirements for complete transparency and full societal approval.

Unexpected Creatures: Procreative Liberty and the Frankenstein Ballet.

One of the most recent and original adaptations of Mary Wollstonecraft (Godwin) Shelley's Frankenstein; or, The Modern Prometheus (1818) is the ballet version choreographed by Liam Scarlett and performed by the Royal Ballet in 2016 and the San Francisco Ballet in 2017 and 2018. What emerges from this translation is an economical, emotionally wrenching, and visually elegant drama of family tragedy from which we can draw a cautionary tale about contemporary bioethical dilemmas in family making that new and forthcoming biomedical technologies present. This performance of bodies interacting suggests the need for an ethics of acceptance and recognition as people navigate complex familial relationships involving procreative liberty, questions of moral personhood, and parental obligation. In the Frankenstein ballet, the narrative genre of dance-what I'll call "story in the flesh"-invites viewers to identify with the characters and enter into the complexity of interpersonal relations. The ballet becomes a compelling testimony about possible unintended outcomes set in motion by well-intended fallible humans like themselves.

On Cute Monkeys and Repulsive Monsters.

When I heard that a laboratory in China had cloned two long-tailed macaques, I thought of Mary Shelley's novel Frankenstein. When academics write about the novel, many point out that the reason the creature becomes a "monster" is not that he has any inherently evil qualities but that Victor Frankenstein, the creature's "mother," immediately rejects him. All later problems can be traced to the fact that Frankenstein does not take responsibility for his creation. While I do not disagree with this, we need to think beyond (or before) Frankenstein's rejection to the reason he rejects it. I would like to suggest that this reason reveals something about how bioethics judges new biological technologies. I suggest that what causes Frankenstein to feel revulsion toward his creation is its unsettling mix of the beautiful and the ugly.

Rereading Frankenstein: What If Victor Frankenstein Had Actually Been Evil?

As we reread Mary Shelley's Frankenstein at two hundred years, it is evident that Victor Frankenstein is both a mad scientist (fevered, obsessive) and a bad scientist (secretive, hubristic, irresponsible). He's also not a very nice person. He's a narcissist, a liar, and a bad "parent." But he is not genuinely evil. And yet when we reimagine him as evil-as an evil scientist and as an evil person-we can learn some important lessons about science and technology, our contemporary society, and ourselves.

Potential of human twin embryos generated by embryo splitting in assisted reproduction and research.

BACKGROUND: Embryo splitting or twinning has been widely used in veterinary medicine over 20 years to generate monozygotic twins with desirable genetic characteristics. The first human embryo splitting, reported in 1993, triggered fierce ethical debate on human embryo cloning. Since Dolly the sheep was born in 1997, the international community has acknowledged the complexity of the moral arguments related to this research and has expressed concerns about the potential for reproductive cloning in humans. A number of countries have formulated bans either through laws, decrees or official statements. However, in general, these laws specifically define cloning as an embryo that is generated via nuclear transfer (NT) and do not mention embryo splitting. Only the UK includes under cloning both embryo splitting and NT in the same legislation. On the contrary, the Ethics Committee of the American Society for Reproductive Medicine does not have a major ethical objection to transferring two or more artificially created embryos with the same genome with the aim of producing a single pregnancy, stating that 'since embryo splitting has the potential to improve the efficacy of IVF treatments for infertility, research to investigate the technique is ethically acceptable'. OBJECTIVE AND RATIONALE: Embryo splitting has been introduced successfully to the veterinary medicine several decades ago and today is a part of standard practice. We present here an overview of embryo splitting experiments in humans and non-human primates and discuss the potential of this technology in assisted reproduction and research. SEARCH METHODS: A comprehensive literature search was carried out using PUBMED and Google Scholar databases to identify studies on embryo splitting in humans and non-human primates. 'Embryo splitting' and 'embryo twinning' were used as the keywords, alone or in combination with other search phrases relevant to the topics of biology of preimplantation embryos. OUTCOMES: A very limited number of studies have been conducted in humans and non-human primates. The published material, especially the studies with human embryos, is controversial. Some reports suggest that twinning technology will find clinical use in reproductive medicine in the future, whereas others conclude the opposite that human twin embryos created in vitro are unsuitable not only for clinical, but also for research, purposes. WIDER IMPLICATIONS: The blastomere biopsy technique of embryo splitting seems to be unsuitable for either clinical or research purposes; however, embryo bisection, a preferable method of cloning in veterinary medicine, has not yet been tested on human embryos.

Algunas consideraciones sobre la transferencia mitocondrial: ¿un nuevo problema para la bioética? / Some thoughts on the mitochondrial transfer: a new issue for bioethics? / Algumas considerações sobre a transferência mitocondrial: um novo problema para a bioética?

En febrero de 2015 el Reino Unido dio el primer paso para la aprobación de la transferencia mitocondrial como técnica terapéutica. Teóricamente, gracias a eso será posible para muchas mujeres engendrar descendencia libre de patologías asociadas a defectos mitocondriales. Sin embargo, esta práctica enfrenta severas dudas desde un punto de vista ético. Entre las objeciones destacan: su estrecha vinculación con la clonación humana; la alteración de los genes de la línea germinal; la modificación de la identidad del ser humano al que dará lugar; la destrucción de embriones humanos que envuelve, o el elevado riesgo que encierra para la salud del ser humano resultante. En este texto se analiza la solvencia de todas estas objeciones de forma crítica, resaltando las fortalezas de algunas de ellas. En particular, se aboga por una restricción cuidadosa del uso de esta técnica, que promueva el empleo de alternativas más respetuosas con la salud del futuro ser humano.

In February 2015 the United Kingdom took the first step towards the adoption of mitochondrial transfer as a therapeutic technique. Theoretically, it will make it possible for many women to get rid of pathologies associated with mitochondrial defects. However, this practice has been subjected to severe doubts from an ethical standpoint. Among these objections, we could highlight the following: its close association with human cloning; the alteration of the germline genes; the modification in the identity of the human being involved; the destruction of human embryos; or the high risk to the health of the human being. In this text we will analyze these objections critically, highlighting the strength of all of them. As a result, we will call for a careful restriction of the use of this technique, and the promotion of the use of alternative options much more respectful of the human future.

Em fevereiro de 2015 o Reino Unido deu o primeiro passo para a aprovação da transferência mitocondrial como técnica terapêutica. Teoricamente, graças a isso será possível a muitas mulheres engendrar descendência livre de patologias associadas a defeitos mitocondriais. No entanto, esta prática enfrenta severas dúvidas a partir de um ponto de vista ético. Entre as objeções destacam: sua estreita vinculação com a clonagem humana; a alteração dos genes da linha germinal; a modificação da identidade do ser humano ao qual dará lugar; a destruição de embriões humanos que envolve, ou o elevado risco que encerra para a saúde do ser humano resultante. Neste texto se analisa a solvência de todas estas objeções de forma crítica, ressaltando as fortalezas de algumas delas. Em particular, se advoga por uma restrição cuidadosa do uso desta técnica, que se promova o emprego de alternativas mais respeitosas com a saúde do futuro ser humano.

New technologies in biomedicine. Opinions of young Romanian physicians / Nuevas tecnologías en biomedicina. Opiniones de médicos jóvenes de Rumania / Novas tecnologias em biomedicina. Opiniões de jovens médicos romenos

Aim. The purpose of this article is to summarize the way young medical professionals view these modern biomedical procedures and their moral acceptability. Materials and methods. A survey, filled in online, analyzing items in four main areas: genetic techniques, cloning, stem cell research, and assisted reproduction. Results. Genetics related items. Most subjects agreed that the right to the genetic material should be a fundamental human right and that genetic engineering should be used if it could lead to the elimination os severe genetic diseases like cystic fibrosis and thalassemia. The least acceptance rate was obtained for techniques that would either change physical traits (like eye or hair color) or augment them. Assisted reproductive techniques. Most subjects agreed that the prenatal screening should be mandatory, and if the screening detects a severe congenital malformation the physician should recommend therapeutic abortion. Cloning. Most subjects disagreed that cloning of any type, either therapeutic or reproductive, using human, animal, or vegetal genetic material. Stem cell research. Most subjects agreed with the collection and storage of cord blood stem cells and the use of adult stem cells, and most of them disagreed with the creation of embryos specifically for obtaining stem cells. Conclusions. Even if the national legislation in this area is very scarce, the responses have usually identified the highly controversial techniques. If however the national legislation has elements similar to the items from the survey, they tended to take the respective items as morally acceptable without trying to analyze them critically.

Objetivo. El propósito de este artículo es recoger la forma en que jóvenes profesionales médicos ven los procedimientos biomédicos modernos y su aceptabilidad moral. Materiales y métodos: Una encuesta, rellenada online, que analiza elementos en cuatro áreas principales: técnicas genéticas, clonación, investigación con células madre y reproducción asistida. Resultados: Elementos relacionados con la genética: La mayoría de los sujetos acepta que el derecho a material genético debería ser un derecho humano fundamental y que la ingeniería genética debería usarse si pudiese eliminar enfermedades genéticas severas como la fibrosis quística y la talasemia. Se obtuvo una frecuencia de aceptación menor para técnicas que pudieran o cambiar características físicas (como el color de los ojos o del pelo) o aumentarlas. Técnicas de reproducción asistida: La mayoría de los sujetos acepta que el examen de detección prenatal debiera ser mandatorio y si se detecta una deformación congénita severa, el médico debería recomendar aborto terapéutico. Clonación: La mayoría de los sujetos no acepta clonación de ningún tipo, terapéutica o reproductiva, usando material genético humano, animal o vegetal. Investigación con células madre: La mayoría de los sujetos acepta recoger y almacenar células madre del cordón umbilical y el uso de células madre adultas y está en desacuerdo con la creación de embriones específicamente para obtener células madre. Conclusiones: aunque la legislación nacional en esta área es muy escasa, las respuestas por lo general han identificado las técnicas altamente controversiales. Sin embargo, si la legislación nacional tiene elementos similares a los temas de la encuesta, se tiende a tomarlos respectivamente como moralmente aceptables sin tratar de analizarlos críticamente.

Objetivo. A proposta deste artigo é sumarizar o modo de ver dos jovens profissionais médicos sobre procedimentos biomédicos modernos e sua aceitação moral. Materiais e métodos. Uma pesquisa de opinião realizada online, analisou ítens de quatro principais áreas: técnicas genéticas, clonagem, pesquisa com células-tronco, e reprodução assistida. Resultados. Itens relacionados à Genética. A maioria dos sujeitos concordaram que o direito ao material genético deveria ser um direito humano fundamental e que a engenharia genética poderia ser usada se puder levar à eliminação de doenças genéticas severas como a fibrose cística e a talassemia. A menor taxa de aceitação foi obtida para técnicas que pudessem modificar o aspecto físico individual (como olho e cor do cabelo) ou aumentá-los. Técnicas de reprodução assistida. A maioria dos sujeitos concordaram que a seleção pré-natal (screening) deverá ser impositiva, e que se o "screening" detetar uma severa malformação congênita o médico deveria recomendar o aborto terapêutico. Clonagem. A maioria dos sujeitos discordaram da clonagem de qualquer tipo, terapêutica ou reprodutiva, com material genético de uso humano, animal, ou vegetal. Pesquisa com células-tronco. A maioria dos sujeitos concordaram com a obtenção e estocagem de células-tronco de sangue do cordão umbilical e a utilização de células-tronco adultas , e a maioria deles discordaram da criação de embriões especificamente para a obtenção de células-tronco. Conclusões. Mesmo que a legislação nacional na área seja muito escassa, as respostas usualmente identificaram as técnicas como altamente controversas. Quando a legislação nacional oferece elementos semelhantes aos ítens obtidos pela pesquisa de opinião, eles tenderiam a tomar os respectivos ítens como moralmente aceitáveis sem tentar analisá-los criticamente.

[The embryonic stem cells research. Example of biotechnology progress under extra-scientific pressure]. / La Investigación con Células Troncales Embrionarias. Ejemplo de Progreso Biotecnológico bajo Presiones Extracientíficas.

The possibility to isolate, cultivate, preserve, characterize and differentiate Human Embryonic Stem Cells (ES) discovered by James Thomson and his colleagues in 1998 was a milestone in the history of Stem Cell Research. Immediately after this discovery many speculations were made about the therapeutic possibilities of ES, motivated by ideological, political and economic aspects. The episode made clear the lack of scientific rationality and ethics when assessing realities as meaningful as those of human embryos obtained by in vitro fertilization techniques (IVF) or human eggs. Therapeutic Cloning as a promise to produce ″tailored″ Stem Cells reported by Hwang and his team in 2004, ended up being a scandal within the scientific community. The technical difficulties and ethical controversies that arose from obtaining ES were insurmountable. In 2010 only two clinical trials were reported using these cells. Those trials were abandoned in late 2011 arguing financial reasons. The discovery of Induced Pluripotent Stem Cell (iPS) in 2006 in mice and in 2007 in humans, represented the possibility of obtaining pluripotent stem cells without the need to destroy embryos. Today, the absence of clinical trials using ES, caused by financial difficulties as a result of its ineffectiveness, anticipates that the use of ES will be limited to certain experimental controls. Probably, the main contribution of Embryonic Stem Cells will be the understanding that biomedical research should follow an ethically and rationally based rigorous method that cannot be ignore.

Stem cells: research tools and clinical treatments.

The term 'stem cell' most commonly refers to embryonic stem cells, particularly in the lay media; however, it also describes other cell types. A stem cell represents a cell of multi-lineage potential with the ability for self-renewal. It is now clear that the plasticity and immortality of a given stem cell will depend on what type of stem cell it is, whether an embryonic stem cell, a fetal-placental stem cell or an adult stem cell. Stem cells offer great promise as cell-based therapies for the future. With evolving technology, much of the socio-political debate regarding stem cells can now be avoided.

Human procreation in unchartered territory: new twists in ethical discussions.

Since their validation in mammals, there have been profound ethical discussions on the possible applications of somatic cell nuclear transfer, human embryonic stem cells and induced pluripotent stem cells to reproductive medicine. This has been the case whether these technologies were considered as direct (i.e. when procreation is the ultimate goal) or indirect applications. In most countries, the majority of these approaches have been either stringently regulated, or regulation has been strongly and consensually suggested. However, this is not necessarily the case for possibilities such as same-sex chimaeras or the direct differentiation of gametes from somatic cells, skipping a pluripotent cell intermediate. The author suggests that the field of reproductive medicine should be more proactive in discussing both current and emerging developments with possible implications for human reproduction, even those reaching beyond current paradigms.

Posicionamento ético de acadêmicos de Enfermagem acerca das situaçõesdilemáticas em saúde / Nursing students ethical positioning on dilemmatic situations in health

Este artigo apresenta o posicionamento ético de acadêmicos de Enfermagem frente às situações dilemáticas em saúde, tomando como base o princípio da sacralidade da vida (PSV) e o princípio da qualidade de vida (PQV). A análise é baseada em dados levantados em estudodescritivo, exploratório, de abordagem quantitativa sobre temas bioéticos, realizado em universo de 70 por cento dos alunos do curso de Enfermagem em uma universidade pública federal no ano de 2010. Os resultados apontam para posições voltadas ao PSV em relação ao aborto (69,29 por cento), à eutanásia (63,58por cento), ao suicídio assistido (57,86 por cento) e à ortotanásia (65 por cento). Em relação à engenharia genética (62,85 por cento), técnicas de clonagem (58,57 por cento) e reprodução humana assistida (92,14 por cento) ressaltaram a importância da qualidade de vida dos sujeitos. A discussão destaca a influência da questão religiosa no posicionamento dos discentes. As considerações finais apontam a importância de estabelecer ou consolidar espaços para a discussão sobre conflitos bioéticos, voltados ao estímulo da reflexão e do diálogo.

Notas sobre judaísmo y bioética / Notes about judaism and bioethics / Notas sobre judaísmo e bioética

El presente artículo revisa algunos temas tradicionales de bioética desde la perspectiva del Judaísmo, refiere respuestas desde las fuentes originales, sus sucesivas exégesis y la legislación judía (Halajá), y revela la relación entre ciencia, fe y defensa de la vida en esta visión religiosa.

The present article reviews some traditional bioethical topics from Jewish perspective, it gives answers derived from original sources, their subsequent exegesis and from Jewish legislation (Halajá), and it unveils relations among science, faith and defense of life according to this religious view.

O presente artigo revisa alguns temas tradicionais de bioética a partir da perspectiva do Judaísmo, em busca de respostas, com base nas fontes originais, nas sucessivas exegeses e na legislação judaica (Halajá), e revela a relação entre ciência, fé e defesa da vida nessa visão religiosa.

Stem cells, nuclear transfer and respect for embryos.

Harvesting human embryonic stem (hES) cells is a highly controversial field of research because it rests on the destruction of human embryos. Altering the procedure of nuclear transfer (NT) is suggested to generate hES cell lines without ethical obstacles by claiming that no embryo would be involved. While discussing the nature of an embryo and related central questions concerning their moral status and the respect they deserve, this paper argues that the entity created by somatic cell nuclear transfer (SCNT) or altered nuclear transfer (ANT) is an embryo and has the same moral status as a natural embryo. Respect for the embryo is expressed by the ethical principles of proportionality, probability and subsidiarity. This paper argues that the human embryo should only be taken for research with high ranking goals, which are proven in animal experimentation and for which there are no alternatives. This makes ANT obsolete and shows that SCNT to produce hES cells is premature at the present time.