Monday, April 27, 2009

Appalling: NHS Hospital used wrong sperm to fertilise eggs -- kills embryos

The usual bureaucratic carelessness

WOMEN undergoing fertility treatment have had their eggs fertilised with the wrong sperm in a series of mix-ups at one of Britain’s most famous hospitals. Embryos belonging to three couples had to be destroyed and their cycles of treatment abandoned after the errors were discovered at Guy’s and St Thomas’ hospital in London earlier this year. In a separate blunder, a woman had the wrong embryo implanted at the same hospital in 2007.

Fertility experts say the errors, along with similar mistakes at other hospitals, raise serious concerns about the way IVF clinics are regulated. They believe the Human Fertilisation and Embryology Authority (HFEA), the watchdog, is failing to deal with serious problems. [That's because they are too busy persecuting Dr Taranissi, Britain's most successful IVF practitioner, who is, unforgiveably, a PRIVATE doctor]

The mistakes have raised concerns about a “casual approach” to the 37,000 British couples who seek fertility treatment every year. Critics point out that inspection reports from 2007 and 2008 warned that Guy’s and St Thomas’ was carrying out “risky” procedures in the preparation of sperm samples for fertilisation.

A February 2007 report by the HFEA warned that embryologists at the hospital were running the risk of confusing sperm samples from different men by preparing them in the same container. Yet errors were still being made earlier this year.

One of the recent cases was discovered when the embryologist realised she had used a sample from the wrong man to fertilise a patient’s eggs. Within days of this mistake, scientists carrying out tests designed to ensure that babies are free of hereditary diseases found genes showing that the embryos could not belong to the parents they had believed to be the owners.

In 2007 a patient at Guy’s had been implanted with the wrong embryo. The treatment failed to result in a birth and embryologists later discovered that they had put back a weak embryo – despite the patient having created a stronger one that had a greater chance of developing into a baby.

Documents seen by The Sunday Times show a series of mistakes at other clinics that led to general warnings being issued. In one incident, a surrogate mother was given embryos from a couple who had a similar-sounding surname to the couple who had hired her. The surrogate did not become pregnant. The HFEA warned clinics about the mistake in March 2007, but the incident was not made public.

At another unidentified clinic, a woman became pregnant after she was implanted with embryos belonging to another couple with the same surname. The HFEA told clinics about the mix-up in May 2007 but the public was again not informed. The pregnancy ended in miscarriage. At about the same time, treatment for two other couples had to be abandoned after their embryos were mixed-up.

Josephine Quintavalle of the campaign group Comment on Reproductive Ethics, said: “It is horrifying that this information is not available to the public. I didn’t realise the extent of this. The casualness is just dreadful.”

Sue Avery, consultant embryologist at Birmingham women’s hospital and a former chairwoman of the Association of Clinical Embryologists, said the sperm mix-ups at Guy’s were “very serious”. She said it was disappointing that clinics had not learnt lessons from the mistakes that had led to the birth of black twins to a white couple in Leeds in 2002.

Despite the repeated mistakes at Guy’s and St Thomas’ hospital, the HFEA has not carried out an investigation. Avery said: “We would expect in the case of repetition that the HFEA might want to investigate unless they can be thoroughly satisfied that the centre has taken sufficient action.”

The assisted conception unit at Guy’s and St Thomas’ hospital said a thorough internal investigation had been carried out and the HFEA was informed of the mistakes.

The HFEA said that while IVF was a delicate procedure and it was impossible to eliminate human error, only 0.5% of treatments resulted in problems. It added: “The HFEA takes incidents very seriously. When incidents are reported to us, we will investigate and take action where necessary. The risk of mix-ups is a serious concern for patients, clinics and the HFEA.”


Obama policies must lead to severe health care rationing

Charles Krauthammer

In the service of his ultimate mission -- the leveling of social inequalities -- President Obama offers a tripartite social democratic agenda: nationalized health care, federalized education (ultimately guaranteed through college) and a cash-cow carbon tax (or its equivalent) to subsidize the other two.

Problem is, the math doesn't add up. Not even a carbon tax would pay for Obama's vastly expanded welfare state. Nor will Midwest Democrats stand for a tax that would devastate their already crumbling region. What is obviously required is entitlement reform, meaning Social Security and Medicare/Medicaid. That's where the real money is -- trillions saved that could not only fund hugely expensive health and education programs but also restore budgetary balance. Except that Obama has offered no real entitlement reform. His universal health care proposal would increase costs by perhaps $1 trillion. Medicare/Medicaid reform is supposed to decrease costs.

Obama's own budget projections show staggering budget deficits going out to 2019. If he knows his social agenda is going to drown us in debt, what's he up to? He has an idea. But he dare not speak of it yet. He has only hinted. When asked in his March 24 news conference about the huge debt he's incurring, Obama spoke vaguely of "additional adjustments" that will be unfolding in future budgets.

Rarely have two more anodyne words carried such import. "Additional adjustments" equals major cuts in Social Security and Medicare/Medicaid. Social Security is relatively easy. A bipartisan commission (like the 1983 Alan Greenspan commission) recommends some combination of means testing for richer people, increasing the retirement age, and a technical change in the inflation measure (indexing benefits to prices instead of wages). The proposal is brought to Congress for a no-amendment up-or-down vote. Done.

The hard part is Medicare and Medicaid. In an aging population, how do you keep them from blowing up the budget? There is only one answer: rationing. Why do you think the stimulus package pours $1.1 billion into medical "comparative effectiveness research"? It is the perfect setup for rationing. Once you establish what is "best practice" for expensive operations, medical tests and aggressive therapies, you've laid the premise for funding some and denying others.

It is estimated that a third to a half of one's lifetime health costs are consumed in the last six months of life. Accordingly, Britain's National Health Service can deny treatments it deems not cost-effective -- and if you're old and infirm, the cost-effectiveness of treating you plummets. In Canada, they ration by queuing. You can wait forever for so-called elective procedures like hip replacements.

Rationing is not quite as alien to America as we think. We already ration kidneys and hearts for transplant according to survivability criteria as well as by queuing. A nationalized health insurance system would ration everything from MRIs to intensive care by a myriad of similar criteria.

The more acute thinkers on the left can see rationing coming, provoking Slate blogger Mickey Kaus to warn of the political danger. "Isn't it an epic mistake to try to sell Democratic health care reform on this basis? Possible sales pitch: 'Our plan will deny you unnecessary treatments!' ... Is that really why the middle class will sign on to a revolutionary multitrillion-dollar shift in spending -- so the government can decide their life or health 'is not worth the price'?"

My own preference is for a highly competitive, privatized health insurance system with a government-subsidized transition to portability, breaking the absurd and ruinous link between health insurance and employment. But if you believe that health care is a public good to be guaranteed by the state, then a single-payer system is the next best alternative. Unfortunately, it is fiscally unsustainable without rationing.

Social Security used to be the third rail of American politics. Not anymore. Health care rationing is taking its place -- which is why Obama, the consummate politician, knows to offer the candy (universality) today before serving the spinach (rationing) tomorrow.

Taken as a whole, Obama's social democratic agenda is breathtaking. And the rollout has thus far been brilliant. It follows Kaus' advice to "give pandering a chance" and adheres to the Democratic tradition of being the party that gives things away, while leaving the green-eyeshade stinginess to those heartless Republicans. It will work for a while, but there is no escaping rationing. In the end, the spinach must be served.


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