The "baby drug" hoax

Natalia López Moratalla.
Professor of Biochemistry and Molecular Biology at the University of Navarra.
Opinion article published in La Estafeta de Navarra, 30-V-04, p. 31.

It is very, very unfair to create false expectations for the parents of a seriously ill child. It is very easy to induce a compulsion to do everything they can to parents who see their child suffering from severe forms of leukaemia.

There is a modern, modern medicine that is a true medical art; it always seeks to ensure that the patient overcomes the illness and to do this financial aid to strengthen their own resources, which are not few; when necessary, it removes something that is causing incorrigible damage. Sometimes he has to provide an organ, blood, or even cells from a donor to whom he does no harm. If the donor is a corpse, it ensures that he is dead and does not shy away from the logical control of the competent body (the National Transplant Centre), while encouraging free, voluntary and generous donation. Medicine has no place for the concept of a "medicine baby".

With the "test-tube babies" a substitute for medicine was born: Assisted Human Reproduction Techniques. The medical art renounced curing sterility, diagnosing it and remedying it, and therefore became a technical art that is only capable of substituting a man and a woman in the transmission of life. Success does not consist in curing but in achieving the fertilisation of the gametes and placing the "test-tube baby" in the mother's womb. In its beginnings it was proposed as an extreme and temporary solution, while sterility could not be cured, but it quickly became a good business. Clinics (mainly private) emerged, offering couples and couples to make children at reasonable prices. The advertising campaign started with the pain of childless couples, and continued without a modesty that respects this pain, because it neither respects nor empowers, nor seeks research to cure them. The skill by the client brings the transmission of human life fully into the logic of production: choice of conditions (if it is easier and more comfortable, 10 or 12 are made and those left over are kept frozen in case they are needed later), choice of the number of children and the time and health conditions; and a biological quality control that eliminates any baby that carries any subject of defect. Thus is born the "baby à la carte" and with it the "frozen surplus embryo". And if the age of the mother, or a genetic deficiency of one of the parents, makes the couple's gametes unsuitable, they are offered sperm from the bank or eggs from young university students. The baby a la carte also becomes an "adulterous baby". The obligation to give the couple a child is born, whatever the cost. Technology makes everything possible; there is no need for a cure.

Just over five years ago, another "boom" was born: stem cells are going to cure all degenerative diseases. Great expectations, groups of patients on the move, and biotech companies on the prowl. With unscientific competition, public opinion and research are divided. Regenerative medicine focuses its efforts on curing the patient with its own resources: its own stem cells. And it achieves spectacular successes that are all too rarely reported in the media and often under the suspicion of "who knows what they are doing" so that, despite everything, the patients they treat do not die. On the other hand, the medical sector, intimately associated with in vitro fertilisation clinics, is launching itself with great fanfare in the direction of its own logic of power over human life and its transmission: using the embryos they have been storing for years to obtain stem cells. The sick (the campaigns insist) will be cured with the cells we prepare for them from the stem cells in the five-day-old embryos: we have hundreds of thousands left over in the freezers. The idea is therefore that, since we are not going to allow them to develop and live, they should live to their fifth day and have the noble utility of becoming "embryo medicine"; it is recognised that "perhaps" they will never be able to serve as a remedy for diseases, but they will certainly serve as research material. The laws must be changed to allow legal research by destroying human embryos.

But "medicine embryos" are useless for curing: they have such an excess of vital potency that their cells are wildly out of control and instead of curing, they produce tumours. The ineffectiveness to cure cannot be hidden under the campaign that the cause of the delay is the prejudices of some; and when it is obvious, and no longer concealable, that therapeutic donation is a trap with no scientific basis and does not work; and when it is obvious that reproductive cloning is science fiction ... etc., the "medicine baby" compatible with the sick sibling comes out, as a new progress of in vitro fertilisation. It is very, very, unfair to create false expectations for the parents of a seriously ill child. It is very easy to induce a compulsion to do whatever they can to parents who see a child suffering from severe forms of leukaemia or anaemia. It is quite possible that the parents do not know exactly what they are asking for or what is being offered; even the jargon of so much "surname" of embryos and babies creates euphemisms and confuses. I think that as hard as it may be, it is necessary to know what it means to select an embryo so that, when it is born, it will be a donor of its umbilical cord blood or part of its bone marrow to a sick sibling with whom it is immunologically compatible.

What does it mean for the sibling of the sick child to come into the world as a "medicine baby"? I am not going to go into the serious human issues of bringing him into the world "to" suck out his marrow. I limit myself only to the cruelty to which he must be subjected for the sake of others. The possibility of selecting requires multiple siblings and for this, starting from 10 or 20 eggs that will necessarily be more immature and worse than those produced by the mother, with its consequences for the child. When the embryo is an 8-cell embryo, two of its cells will be removed to check its quality as a potential donor; if it survives, it will carry the possible consequences of that certain deficit. While the genetic analysis is being carried out on his two cells, he will be at laboratory without receiving from his mother what he needs to start his life with strength; therefore, with greater probability than those born after having been engendered in his mother, he may suffer rare and serious illnesses (those that we call linked to the imprinting) that have no solution. And if it is born, will the sick sibling be able to wait until it grows a little before starting to take the marrow out of its bones? If there is a guarantee of cure with cells from a compatible donor sibling, the logical thing to do is to look for donors in the family.

It should be known that there is no guarantee of efficacy, even in achieving such a compatible sibling. There is only one study (published on 5 May in JAMA volume 291, page 2079) and it is very discouraging. Out of 199 embryos from 13 couples, 45 were selected and only 5 children were born. But above all, what must no longer be hidden is that umbilical cord blood cells do not cause rejection and neither do at least some of the stem cells from donor bone marrow. Once again, we must demand from medical science solutions for the illness of a child, which do not bring the parents even more suffering! It is the right of the sick and the duty of medicine and the scientific community.