Thursday 30th June 2016- The Guardian: Couple win legal battle against ruling on dead daughter’s eggs

‘A 60-year-old woman who wants to use her dead daughter’s frozen eggs to give birth to a grandchild has won a legal battle over what constitutes medical consent.

The court of appeal has ordered the Human Fertilisation and Embryology Authority (HFEA) to reconsider the application, opening the way for fertility treatment in the United States.

The woman, whose daughter died of bowel cancer in 2011, had asked three judges to allow her to carry out the dying wishes of her “much-loved and only child”. The family have remained anonymous; the court identified the mother as Mrs M.

Her daughter, who was 28 when she died, spent most of the last five years of her life in hospital. She wanted to have IVF treatment but became too ill. At one stage, she suggested having her ovaries transplanted into her mother. Three eggs were eventually removed and stored.

The legal problem the HFEA confronted, the judgment explained, “was that while [the daughter] consented to treatment for egg removal and storage (including storage after her death) and also to the use (other than for research purposes) of her eggs after her death, she never completed any form giving details of the precise use that is now proposed”.

Lawyers for the mother and her husband, referred to only as Mr M, said that if they did not overturn the refusal for treatment, the eggs would be allowed to perish.

Giving judgment, Sir James Munby, who is president of the family division of the high court, Lady Justice Arden and Lord Justice Burnett granted the parents’ appeal. Neither Mr or Mrs M were in court for the ruling.’

‘The judges heard that the daughter, referred to only as A, was desperate to have children and asked her mother to “carry my babies”. Her parents launched legal action against the HFEA’s refusal in September 2014 to allow them to take their daughter’s eggs to a US fertility treatment clinic to be used with donor sperm.’

‘The court’s role, however, was not to decide whether it would have permitted the mother to undergo fertility treatment using her deceased daughter’s eggs and donated sperm.

Its task was to determine whether Mr Justice Ouseley erred in concluding that the HFEA’s statutory approvals committee acted lawfully and rationally in exercising its broad discretion to refuse to authorise export of the frozen eggs.

Giving the court’s ruling, Lady Justice Arden said the challenge succeeded at three levels: “First, there was on the face of it the misstatement of certain of the evidence about [the daughter’s] consent by the [HFEA] committee.

“Second, even if what the committee meant was that there was a lack of effective consent because the appellants could not show that [the daughter] received information on certain matters, the decision was flawed because the committee pointed to the lack of certain evidence without explaining why [she] needed to receive that information and give that consent.

“The third level is that the committee did not ask the prior question of what information the Human Fertilisation and Embryology Act required to be given to [the daughter] in the circumstances of her case.”

The judge said the decision must be set aside and remitted to the statutory approvals committee of the HFEA for further consideration of the export application.’

Related Articles:

Couple win legal battle against ruling on dead daughter’s eggs- The Guardian

Woman wins appeal to use dead daughter’s eggs- BBC News

 

Monday 9th May 2016- The Guardian: London HIV clinic fined £180,000 for revealing service users’ names

‘An NHS clinic in London has been fined £180,000 for a serious breach of the privacy of more than 700 users of an HIV service.

Patients and service users who were on the HIV clinic email list of 56 Dean Street, a Soho-based sexual health clinic, said at the time of the breach they were terrified it could leave them open to blackmail or public outing.

A staff error meant anyone receiving the September newsletter from the service could see the email addresses of all the other recipients.

Addresses had been wrongly entered into the “to” field instead of the “bcc” field, and 730 of the 781 email addresses contained recipients’ full names. Most of the recipients were HIV positive though a small number were not.

Chelsea and Westminster hospital NHS foundation trust, which runs the clinic, has been fined £180,000 after the Information Commissioner’s Office (ICO) found there had been a serious breach of the Data Protection Act, likely to have caused substantial distress.

The information commissioner, Christopher Graham, said it was “clear that this breach caused a great deal of upset to the people affected”.

Graham said the investigation revealed many people recognised other names on the list of recipients, because the clinic served a small area of London, and feared their own name would be recognised too.

The ICO investigation found the trust had previously made a similar error in March 2010, when a member of staff in the pharmacy department sent a questionnaire to 17 patients in relation to their HIV treatment. After the mistake, extra measures were put in place but no specialist training was implemented, the ICO found.

“The trust was quick to apologise for their mistake, and has undertaken substantial remedial work since the breach,” Graham said. “Nevertheless, it is crucial that the senior managers at NHS trusts understand the requirements of data protection law, and the serious consequences that follow when that law is broken.”’

Related Articles:

London HIV clinic fined £180,000 for revealing service users’ names

NHS trust fined for 56 Dean Street HIV status leak- BBC News

Saturday 27th February 2016- The Guardian: Decayed teeth removed from 128,000 children in England since 2011

‘Tens of thousands of children have had decaying teeth removed in hospitals in England, according to the latest figures, which show an increase for the fourth year in a row.

There has been a rise of almost 10% in child hospital admissions for severe tooth decay in England over a four-year period, with the report’s authors pointing out “a strong correlation between area deprivation and the rate of tooth extraction”.

More than 128,000 children aged 10 and under have needed at least one removed since 2011, often in cases where the decay may have been preventable.

There were 14,445 admissions of children aged five and under between April 2014 and March the following year, and a further 19,336 cases of six- to10-year-olds having teeth taken out in hospital in the same period. More boys than girls were likely to have suffered from severe tooth decay.

The rate of tooth extraction among the most deprived children is almost five times that for those from the least deprived decile, according to the statistics analysed by the Health and Social Care Information Centre.

In Yorkshire and the Humber, the tooth extraction rate was more than five times that for the east of England. London had the most children who needed to be admitted to hospital for severe tooth decay, with 8,362 having teeth removed.

Prof Nigel Hunt, the dean of the dental surgery faculty at the Royal College of Surgeons, said the 9.81% increase was unacceptable.

“Not only is tooth decay distressing to children and parents, it has serious social and financial implications,” he said. “The need for tooth extraction continues to be the number one reason why five- to nine-year-old children are admitted to hospital. This issue urgently needs to be addressed, especially since 90% of tooth decay is preventable.”

Related Articles:

Decayed teeth removed from 128,000 children in England since 2011

Tooth decay still on the rise among English children- BBC News

Thursday 25th February 2016- The Guardian: Lab-created sperm breeds healthy mice, raising hopes for end to male infertility

‘A handful of healthy mice made from sperm cells created in the lab have been hailed as a milestone in research that could ultimately provide new treatments for male infertility.

Scientists in China created the mice by fertilising normal mouse eggs with early-stage sperm cells that were manufactured from embryonic stem cells plucked from the animals.

To make the sperm, the team nudged mouse stem cells through a complex series of steps known as meiosis that must be performed with extreme care to ensure the sperm develop properly.

Despite years of work, scientists have never managed to pull off the same trick with human stem cells, but the latest study could provide fresh impetus to the effort, said Jiahao Sha, director of the Laboratory of Reproductive Medicine at Nanjing Medical University in China.

The creation of sperm and eggs – known as germ cells – for use in IVF raises particular safety issues, because any faults in their genetic material could harm not only the children born from the treatment, but all their future descendants.

“If it works, human germ cells could possibly be produced. However, in the current stage, ethics should be concerned, and any possible risks ruled out,” said Sha, who led the team

The scientists believe that the cautious, stepwise production of the sperm cells was crucial for the mice to be born healthy and fertile. The mice went on to mate and have fertile offspring of their own, Sha said.’

‘Independent scientists welcomed the landmark achievement but cautioned that the creation of human sperm to treat infertile men was a distant prospect fraught with concerns over safety, ethics and legality.’

Related Articles:

Lab-created sperm breeds healthy mice, raising hopes for end to male infertility

Toward Making Sperm in the Lab- The Scientist

Lab-grown sperm makes healthy offspring- BBC News

Sperm grown in lab could allow infertile men to have children- The Telegraph

Wednesday 24th February 2016- The Guardian: Radical cancer treatment seeks to control rather than destroy tumours

‘A radical approach to cancer treatment which keeps tumours under control rather than destroying them completely may be more effective than conventional therapies, scientists say.

The idea draws on Charles Darwin’s 150-year-old theory of evolution and recasts tumours as diverse ecosystems of cells which can be manipulated to prevent them from growing out of control.

The strategy is highly experimental and has only been tested in mice, but successful trials in humans could usher in a transformation in cancer care, where patients live healthy lives with tumours that are constantly kept in check by low doses of medicine.

Routine cancer treatment assumes that patients do best when a therapy kills off the maximum number of malignant cells in their bodies. But tumours are collections of different cells and some are more resistant to drugs than others. A dose of chemotherapy will typically leave drug-resistant cells behind. Unencumbered by their neighbours, they can rapidly grow back when the treatment stops.

Scientists in the US wondered what would happen if anticancer drugs were used to shrink tumours without destroying the diversity of cells inside them. They hoped that the surviving cancer cells would stop more aggressive, drug-resistant ones from taking over, just as grass can prevent moss running wild in a garden.

Writing in the journal Science Translational Medicine, Robert Gatenby at the H. Lee Moffitt Cancer Center in Tampa, Florida, describes how his team tested the idea with the chemotherapy drug paclitaxel (or taxol) in mice with two different forms of breast cancer.

When the mice were given standard chemotherapy, their tumours shrank, but grew back as soon as the treatment ended. For the new therapy, mice were given initially high doses of drugs followed by ever lower doses. The strategy appeared to be more effective than standard treatment. Giannoula Klement, a cancer specialist at Tufts University School of Medicine in Boston, who was not involved in the work, said that in about 60% of the mice, the cancer treatment could be withdrawn completely with no further growth of the tumours.

In an accompanying article, Klement argues that to beat cancer, it must be considered as an ecosystem of different cells. “The likelihood that a ‘magic bullet’ against cancer is going to be found is nil. If we have learned anything from the eco-evolutionary model it is that unless we respect these eco-evolutionary laws, we will continue to play a cat and mouse game with cancer,” she writes.

Instead of eradicating cancer, the new goal for doctors needs to be prevention of cancer disease, she adds. “We need to stabilise tumour growth and enable gradual, controlled regression over time.”’

Related Articles:

Radical cancer treatment seeks to control rather than destroy tumours

Don’t kill cancer, learn to live with it, say scientists- The Telegraph

Thursday 4th February 2016- The Guardian: Spain reports first known European case of Zika-infected pregnant woman

‘The health ministry in Spain said a pregnant woman who had returned from Colombia had been diagnosed with the Zika virus, Europe’s first known case of the mosquito-born virus this week declared a global health emergency by the World Health Organisation.

“One of the patients diagnosed in [the northeastern region of] Catalonia is a pregnant woman, who showed symptoms after having travelled to Colombia,” the health ministry announced on Thursday, adding she is one of seven cases in Spain and all are in good condition.

News of the virus, thought to cause birth defects, first emerged in Brazil last year, and health authorities have warned the disease could infect up to 4 million people in the Americas and spread worldwide.

The fever starts with a mosquito bite and normally causes little more than a fever and rash. But since October, Brazil has reported 404 confirmed cases of microcephaly, where the baby’s head is abnormally small – up from 147 in 2014 – plus 3,670 suspected cases.

The timing has fuelled strong suspicions that Zika is causing the birth defect. The virus has also been linked to a potentially paralysing nerve disorder called Guillain-Barre syndrome in some patients.’

Related Articles:

Spain reports first known European case of Zika-infected pregnant woman

Zika virus pregnancy case confirmed in Spain – first in Europe- BBC News

Zika: Spanish officials confirm pregnant woman in Catalonia infected with virus- The Independent

Wednesday 3rd February 2016- The Guardian: NHS stops people who have visited areas hit by Zika virus giving blood

‘People who have travelled to countries affected by the Zika virus will not be allowed to donate blood for four weeks after returning home, the NHS has said.

Zika has prompted the World Health Organisation to declare a public health emergency of international concern. It is spread by mosquitoes but there have been a handful of cases where the virus is believed to have been sexually transmitted, the most recent in Texas.

Amid fears that it is linked to thousands of cases in Brazil of the foetal deformation microcephaly, which causes babies to be born with smaller than normal brains, NHS Blood and Transplant (NHSBT) announced on Wednesday that it was implementing “precautionary measures”.

A spokeswoman said: “The safety of the blood supply is paramount and it is important we implement any precautionary blood safety measures agreed here as a result of an increasing prevalence of infectious diseases found around the globe.

“From 4 February 2016, we will have a 28-day blood donation deferral for people looking to donate blood in England and north Wales who have travelled to countries where the Zika virus is endemic.’

Related Articles:

NHS stops people who have visited areas hit by Zika virus giving blood

Zika outbreak: NHS bans blood donations for 28 days after travel- The Telegraph

WHO warns against blood donations from people returning from Zika regions- The Guardian

Monday 1st February 2016- The Guardian: British researchers get green light to genetically modify human embryos

‘Britain’s first genetically modified human embryos could be created within months, after scientists were granted permission to carry out the controversial procedure in a landmark decision by the fertility regulator.

The Human Fertilisation and Embryology Authority (HFEA) regulator approved a licence application by Kathy Niakan, a stem cell scientist at the Francis Crick Institute in London, to perform so-called genome editing on human embryos.

The decision permits Niakan to study the embryos for 14 days for research purposes only. It does not permit them to be implanted into women. Niakan’s research is aimed at finding the genes at play in the early days of human fertilisation.

The decision was hailed by the Francis Crick Institute and British scientists but will be met with disquiet by those concerned that rapid advances in the field of genome editing is precluding proper consideration of the ethical implications.’

‘The work, using embryos donated by couples with a surplus after IVF treatment, will look at the fertilised egg’s development from a single cell to around 250 cells. The basic research could help scientists understand why some women lose their babies before term and provide better clinical treatments for infertility, using conventional medical methods.

Niakan will use a powerful genome editing procedure called Crispr-Cas9 to switch genes on and off in early stage human embryos. She will then look for the effects the modifications have on the development of the cells that go on to form the placenta.

Crispr-Cas9 has revolutionised biomedical research since its invention three years ago. It allows scientists to make precise changes to DNA, and has the potential to transform the treatment of genetic disorders by correcting faulty genes.’

Related Articles:

British researchers get green light to genetically modify human embryos

Scientists get ‘gene editing’ go-ahead- BBC News

Scientists in UK get approval for ‘gene editing’- BBC News (video)

British scientists granted permission to genetically modify human embryos- The Telegraph

 

Monday 1st February 2016- The Guardian: World Health Organisation declares Zika virus public health emergency

‘The World Health Organisation has declared that the clusters of brain-damaged babies born in Brazil – linked to but not proven to be caused by the Zika virus – constitute a public health emergency of international concern.

The declaration, made by the WHO director Margaret Chan, will trigger funding for research to try to establish whether the Zika virus, spread by mosquitoes, is responsible for the large numbers of babies born with abnormally small heads in Brazil. It will also put resources behind a massive effort to prevent pregnant women becoming infected and, through mosquito control, stop the virus spreading.

Chan called the birth of thousands of babies with microcephaly “an extraordinary event and a public health threat to other parts of the world”. She was speaking following a meeting of the WHO’s international health regulations emergency committee, summoned to advise the director general on whether to make the declaration, which calls in international resources and expertise.’

‘“Members of the committee agreed that the situation meets the conditions for a public health emergency of international concern. I have accepted this advice,” she said.

Chan, who was criticised for being slow to make a similar declaration while Ebola spread across west Africa, sidestepped the question when asked if she felt that was a factor in the response to the Zika crisis in Brazil.

“It is important to realise that when the evidence first becomes available of such a serious condition like microcephaly and other congenital abnormalities, we need to take action, including precautionary measures,” she said.’

‘Tropical disease experts involved in the Ebola epidemic applauded the declaration. “The WHO faced heavy criticism for waiting too long to declare the Ebola outbreak a public health emergency and they should be congratulated for being far more proactive this time,” said Dr Jeremy Farrar, director of the Wellcome Trust. “Today’s declaration will give the WHO the authority and resources it needs to lead the international response to Zika.”

Chan called for countries to refrain from imposing any sort of travel restrictions on those Latin American countries where the Zika virus is spreading.’

Related Articles:

World Health Organisation declares Zika virus public health emergency

WHO chief declares Zika virus as public health emergency – video- The Guardian

WHO Director-General summarizes the outcome of the Emergency Committee regarding clusters of microcephaly and Guillain-Barré syndrome- The World Health Organisation

 

 

Tuesday 26th January 2016- The Guardian: Hunt apologises to family of dead boy over NHS sepsis failings

‘Jeremy Hunt has accepted the recommendations of a damning NHS report which found that doctors and the NHS helpline missed four opportunities to save the life of a one-year-old boy.

The health secretary offered a public apology to the family of William Mead, who died in September 2014 of the common sepsis bug, which went undetected despite repeated visits to the GP and a call to the NHS 111 helpline hours before his death.

Speaking in the Commons, Hunt said: “Whilst any health system will inevitably suffer some tragedies, the issues raised in this case have significant implications for the rest of the NHS which I’m determined we should learn from.”’

‘William’s mother Melissa – who has chronicled the family’s campaign for better awareness about sepsis on a blog – welcomed the apology and said that she hoped that a report into the 12-month-old’s death would have far-reaching implications across the health service.’

‘The report found that 16 mistakes had contributed to William’s death. It said the “tickbox” system used by helpline call handlers failed to include “sepsis red flags” despite the fact that it is one of the most common causes of death among children.’

Related Articles:

Hunt apologises to family of dead boy over NHS sepsis failings

Mother tells how NHS 111 helpline failed to save son – video- The Guardian

Jeremy Hunt: we let William Meade down in worst possible way – video- The Guardian

NHS 111 helpline ‘broken’, says mother of baby who died of sepsis- The Guardian

Hunt apologises for NHS failings over baby death- BBC News

William Mead’s ‘fate was sealed’ after NHS 111 call handlers failed to identify his deadly illness, says mother- The Independent

NHS 111 helpline missed chances to save baby William Mead’s life and is ‘unable to detect deadly child illnesses’- The Telegraph