Difficult questions still remain to be answered

Two areas in particular are likely to spark controversy in the Adelaide Hospital Society's policy submission to the Commission…

Two areas in particular are likely to spark controversy in the Adelaide Hospital Society's policy submission to the Commission on Assisted Human Reproduction. They relate to research carried out on embryos and to the screening of embryos for genetic diseases.

There is a number of medical terms used to describe the stages of human development after conception, but these mean little to most people. For this reason the term "embryo" is often used to cover the growth phase from conception on through to when the bundle of cells in the womb begins to take on crude human form.

Conception occurs when the egg and sperm cells fuse together. This combination then divides to become two cells, divides again to form four, then eight then 16 cells and so on as the embryo continues to grow. This is a key time in human development before any of these early cells have taken on a specific role, for example to become a kidney or skin or bone cell. Each of these early cells or stem cells holds the potential to become any tissue type in the body.

It is this possibility of becoming any type of cell which so interests medical researchers. They hope to learn what controls the change from embryonic stem cell to specific tissue types and then use this knowledge to develop radical new tissue replacement therapies to overcome nerve damage or diseases such as Parkinson's.

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The submission says research on human embryos up to 14 days old could be "of considerable medical value", for example in stem-cell studies, and argues this should be permissible "under strict licensing". Researchers in Britain work under a similar 14- day limit, after which time embryos must be destroyed.

Anti-abortion groups argue however that life begins not at 14 days but at the very moment of conception. For them, this represents experimentation on human life.

The 14-day limit would also run counter to Government thinking. Its constitutional proposals afford legal protection for the embryo only from the moment it implants itself in the womb, which occurs much sooner than 14 days.

Genetic screening of embryos is also controversial. Increasing knowledge of the human genetic blueprint has allowed us to identify errors in it which can lead to disease and disability. Soon after conception, cells can be recovered from a living implanted embryo and screened for these genetic errors.

The submission says parents "are entitled to the fullest possible information" about known genetic conditions. It says screening "under regulated conditions" is necessary for this purpose.

Deep moral issues arise, however, once this information becomes available. If you know the developing child carries an irreversible disease which could blight its life, do you intervene to halt that life or allow it to continue? Having access to such information might encourage more women to pursue abortions to avoid having children with genetic diseases.

There is also the question of who subsequently should have access to the information. Some genetic diseases do not manifest themselves for many years. If you knew you carried a genetic disease, should you be required to inform your insurance company?

Embryo research also raises other difficult issues, such as the source of the embryos. Some in the US and Britain are collected from abortion clinics. Others are donated by people who have "left-over" frozen embryos after successful in-vitro fertilisation treatments.

One company in the US seeks donors for eggs which are then fertilised and made available for approved clinical research.