HEALTH & HUMAN GENETICS (Mini-articles) Index

Children do no retain their innocence for long any more. They are subjected to all sorts of influences from television and the media, and when families break up or there are pressures at home, many children have to assume an adult role.

Record numbers of children under the age of 10 are being treated in hospital for mental illness caused by family break-ups, poor parenting and increased pressures at school. New Health Department figures reveal that the number of children below 10 admitted to hospital for mental illness has leapt by 50 per cent in three years. There are now more than 1,000 being treated for psychoses, severe depression and eating disorders. The rise among children aged 10 to 14 has been almost as steep. Since the mid-1 980s, numbers have increased by a third to about 1,200, alarming psychologists who blame the increased emotional and social demands placed on children at a younger age.

The lack of communication at home, where conversation and play between parents and children has been killed off by television, has contributed enormously to children's isolation, psychologists say. Ian Goodyear, of the Child and Adolescent Psychiatry Department at Cambridge University, estimated that as many as 3 per cent, or 20,000 children of school age, are suffering from a serious depressive disorder and will carry severe problems of behaviour into adult life.

Richard Harrington is a Professor of Child Care at the University of Manchester. Report March 1995

The cause of euthanasia has been gathering strength for many years now. The age group that thinks most about this are in their fifties. This is a mature generation which has watched, or is still caring for, their parents' generation -- perhaps losing their dignity, and sometimes their personality and composure, as they become infirm. As this middle generation whether they want to live like this in 20 or 30 years' time and they will reply with a vigorous No.

Generally, governments have been slow to respond to this public feeling. But,at last, in the UK, the government is considing giving legal status to Living Wills--documents in which people declare, in advance of any later mental incapacity, their wish to refuse medical treatment. Euthanasia campaigners have long fought for the right to set down in advance that, should they be unable to live without a life-support machine and are incapable of making their feelings known at that time, they would prefer to die. At present, Living Wills have no legal staus and doctors and relatives are free to ignore their statements. Last month, a BBC documentary, which showed a Dutch doctor giving a lethal injection to a terminally-ill patient with motor neurone disease had great public support. Only a small minority of MPs would oppose Living Wills and it is to be hoped that the Government will not be inhibited by these backwoodsmen.

Newsletter, Job Society, April 1995

Eugenics is beginning to rear its head again as scientists discover more about faulty human genes, such as 'cryptic' rearrangements of genetic material at the tips of chromosomes which they think can result in half of children born with serious mental handicap -- about one and a half of all children.

China is already moving to ban babies with defects. From 1 June, marriages between couples likely to pass on genetic deficiencies preventing "the victim from living independently" will be banned. Pregnant women will be required to undergo testing and advised to abort unborn children with serious abnormalities.

Western critics say the policy is dangerous. "Ideas of selective breeding and deciding who is fit and who unfit to reproduce go back to the 1920s and have simply been shown not to work," said Frank Dikotter of London University. "You can't engineer a population to get rid of deleterious features." However, other experts agree with the Chinese and say it is perfectly possible to screen out some genetically-based diseases.

The new Chinese law also forbids marriages between people with illnesses which would have "adverse effects", such as Aids, gonorrhoea, syphyllis and leprosy. There are considered to be 300,000 to 400,000 children born each year with congential diseases, and the new law, which passed last October, has stirred little reaction among the population.

From an article in The Independent, 31 January 1995

The number of known cancer genes has been increasing exponentially since the original one was identified 20 years ago. The past year's bumper crop of discoveries, including the first breast cancer gene, BRCA1, brings the tally of genes implicated in human cancer to about 50.

They fall into two categories: (a) 'Oncogenes' are natural molecular accelerators in which mutations cause runaway cell growth; (b) 'Tumour suppressor genes' normally put the brakes on excessive proliferation_when mutations put them out of action, cancer can get started.

All the new information will make it possible to screen people for genetic predisposition to a wide range of cancers. Researchers estimate that roughly 5 to 10 per cent of common cancers are triggered by inherited mutations; the remainder result from genetic changes in the course of the individual's lifetime, caused by environmental factors and random changes during cell division. No cancer gene tests are yet in routine clinical use, however, and--despite much recent publicity about their implications--researchers say several important issues will have to be addressed before widespread genetic screening can be introduced. Some are technical problems about developing simple and accurate tests. Others are social and political, including the risk of 'genetic discrimination' by insurers and employers.

From an article in the Financial Times, 24 January 1995

All is far from well in the medical profession. The first big government investigation into routine surgery questions the 'cure rates' of operations and reveals dramatic variations around the country with some scalpel-happy surgeons 20 times more likely to operate than others. The chances of a patient dying in hospital could vary up to five times, depending on which hospital is providing the treatment. Almost three-quarters of hospital operations may be unnecessary. One woman, Sandra Simkin, 51, from Wokin g, Surrey, is planning legal action after being talked into having an operation to remove a non-existent malignancy. 'This area is known as "wombless Woking" because there are too many gynaecologists,' she said.

According to Iain Chalmers, who heads the UK Cochraine Centre in Oxford, which evaluates medical research, many people die every year because doctors rely on 'lethal' outdated textbooks and by giving outmoded treatments after they have beeen found ineffective or even dangerous. This has been admitted by many doctors. One disease expert said he had killed infants suffering from viral infections by following inaccurate textbook advice not to give antibiotics. Another described how heart patients died bec ause of failure to give readily available drugs to dissolve clots.

From an article in The Sunday Times, 27 November 1994

The UK's only company specialising in human gene therapy, Therexsys, has developed a new method of replacing faulty genes with new ones -- and the right place in the body.

There are two existing methods of trying to insert a therapeutic gene into humans. One involves putting the gene into a virus. Viruses survive by getting into the cells of a host and taking over the genetic machinery in order to reproduce themselves. In gene therapy, the viruses are disabled so they cannot replicate but still have the ability to slot the therapeutic gene into the cell nucleaus. The worry is that the viruses could regain the ability to replicate, causing serious infections.

A second, less risky, method involves wrapping the genes in envelopes of fatty material called liposomes, which dissolve inside the body. The problem is that there is no way of targeting liposomes to the cells where the gene is needed.

Therexsys's approach, based on a string of genes called a local control region (LCR), avoids these pitfalls. Each type of cell has a characteristic locus control region, which is responsible for switching on other genes. The therapeutic gene is attached to the LCR of the target cell type and will only be switched on in these cells. Therxsys is also developing delivery systems based on proteins rather than viruses, to get the package of LCR and its attached gene into the cell.

Newsletter, Job Society, March 95

MPs will urge the government this week to regulate companies offering controversial tests by post that tell people whether they carry genes that put them at greater risk of hereditary disease. An advertisement by University Diagnostics tells readers of a women's magazine that they may be among the 2 million people in this country who carry the gene for cystic fibrosis, a chronic disorder of the lungs and digestive system. If both parents are carriers, their children may develop the disease as a result of "quirks of inheritance", readers are told.

Several American companies that alrerady offer screening for a variety of inherited conditions are planning to offer predictive tests in Europe for enhanced risks of cancers of the breast, skin and colon. While some tests will offer valuable early warning of illnesses that may be prevented by early treatment of changes in lifestyle, doctors say they will alwso create anxiety. A future test for Alzheimer's disease. for example, would offer purchasers the uncomfortable prospect that they face senile dementia while at the same time being unable to do anything about it.

The prospect of such tests has alarmed members of the House of Commons select committee on science and technology and if their recommendations are accepted by the government, comoanies will be subjected to checks on the accuracy of their tests and will be required to provide counselling for those receiving what some critics describe as a possible death sentence by mail-order. The committee warns that genetic testing may become a free-for-all, and want to prevent the growth of "half-baked eugenics", and it also warns of the need to tackle the porblem of a future"genetic underclass" left uninsurable and unemployable by circulation of genetic information about their propensity to certain diseases, and even intelligence and traits of personality. It will also put forward guidelines to control the use of genetic information to determine whether or not an unborn child should be aborted.

From the Sunday Times, 16 July 1995