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GRESHAM LECTURE I

GRESHAM LECTURE I. Reproductive Technologies and the birth of Regulation. A UK First. The First IVF Baby. Born in England 1978 Sparked off global debate Became a nursery nurse Has her own child. In vitro fertilisation. The Warnock Report. 1984: people need principles Moral consensus

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GRESHAM LECTURE I

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  1. GRESHAM LECTURE I Reproductive Technologies and the birth of Regulation

  2. A UK First

  3. The First IVF Baby • Born in England 1978 • Sparked off global debate • Became a nursery nurse • Has her own child

  4. In vitro fertilisation

  5. The Warnock Report • 1984: people need principles • Moral consensus • Regulate

  6. Human Fertilistion & Embryology Authority UK • Established by 1990 Act • Licences and monitors clinics and laboratories, IVF and embryo research • 21 members appointed after advertisement

  7. Benefits of regulation • Protection of the embryo • Welfare of the child • Record of treatments and donors • Control of market forces • Answerable and representative • Looking ahead

  8. The Realities of Regulation • The constraints of the legal framework • Resources need to enforce and defend in court • The power of the media and images • The pressure from politicians

  9. Fertility For Ever • Frozen eggs give hope to young cancer patients

  10. As Fertile as a Man • Career women can put their eggs on ice until the time and the man are right

  11. ICSI • Cure for male infertility – 50% of cases

  12. Preimplantation genetic diagnosis • Unite sperm and egg in the laboratory • Fertilised egg grows to 8 cell size • Remove 1 cell and test for disease • Test also for compatibility (HLA)

  13. PGD

  14. Cloning Dolly

  15. Cloning

  16. Human cloning

  17. USA • Anti-regulation and federal control • No federal funds for new stem cell lines • Private clinics uncontrolled • Council on Bioethics • Democrat-Republican differences

  18. California • Proposition 71, 2004, state funding for stem cell research • California Institute for Regenerative Medicine • Independent Citizens’ Oversight Committee

  19. Categories of Regulation • I Prohibition of all human embryo research • II Use of stem cell lines already in existence • III Use of embryos surplus to IVF for stem cell research • IV Allow creation of embryos for stem cell research

  20. Procedural Safeguards • Health monitoring and risk warnings • Integrity of statistics • Secure database • Information for patients • Limits on the number of embryos used • Length of storage • Disposition of embryos on divorce • Regulation, licences and sanctions

  21. A Legislative Minimum • Prohibitions on cloning, experiments in the womb, genetic manipulation • Inspection of clinics and laboratories • 14-day rule for keeping embryos • Commerce in gametes • Control patenting

  22. Animal-human embryos for research

  23. The Future • Artificial wombs from week 2 to 26 or longer

  24. What are Stem Cells? • Derived from early human embryos of a few days’ growth • Adult stem cells derived from bone marrow, skin, umbilical cord, blood • They are the origin of all our cells • Will help us to understand disease • Might make cells and tissue for transplantation and renewal

  25. Therapeutic cloning

  26. Stem Cells and Cures • Nerve cells might cure Parkinson’s, Alzheimer’s, spinal cord injury, stroke • Embryo cells might help infertility • Heart muscle cells for heart disease • Blood cells for cancer, leukaemia • Skin cells for burns and wounds • Bone cells for osteoporosis

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