BEFORE I WAS AN EMBRYO,I WAS A PRE-EMBRYO: OR WAS I?

Issues surrounding human embryos are poignant and profound. Should research be conducted on them? Should they be discarded? Should they be donated to infertile couples? The Warnock Report was a landmark in providing guidelines limiting experimentation on human embryos to the first 14 days after fertilization, at which time implantation of the embryo is complete and the primitive streak has appeared.² However, these embryological features were not considered sufficiently distinctive to bestow upon this 14-day period a separate classification. This situation changed when, in 1986, Anne McLaren suggested the use of the terms ‘pre-embryo’ or ‘conceptus' to designate “the entire product of the fertilized egg up to the end of the implantation stage” and the term ’embryo‘ for “that small part of the pre-embryo or conceptus, first distinguishable at the primitive streak stage, that later develops into the foetus.”³ In this paper we look critically at the term ‘pre-embryo’, and we shall present the case for an alternative set of terms, namely, embryo-placenta and embryo-fetus. We consider this latter to be biologically-based terminology, that does not have any connotation of restricted moral value as the term pre-embryo does for some.     

WHO ARE THE WHALES?

ABSTRACT

Whales, dolphins and porpoises, 80 species of entirely aquatic mammals, constitute the order Cetacea. In the early Eocene, about 55 to 60 million years ago according to paleontologists, distant ancestors of modern cetaceans left land for aquatic life. Cetaceans are diverse; average adult size of cetacean species varies by 1000 to 2000 times. Small and large species occupy all oceans from the equator to the polar seas, some forms inhabit rivers and four species live only in fresh water.

Cetaceans are born in water and spend their entire lives in the aquatic medium. There is a great gap in knowledge about hearing in most cetacean species and especially about how noise and high-intensity sound may affect all cetaceans and other mammals underwater. Studies of temporary threshold shift (TTS) and occupational noise exposure in human divers suggest a cautious approach to cetacean noise exposure until data on cetacean TTS can give us some idea of the dynamic range of cetacean ears.     

WHO ARE PROSPECTIVE NEUROTICS?

Emotions of any kind and experienced at any age are etiologic factors of neuroses only in predisposed persons.Predisposed persons are those of neuropathic and psychoneuropathic constitution. This is characterized by excessive excitability and abnormal reactivity of the nervous system. This involves, in various degree and proportion, the autonomic nervous system as well as the higher cerebral functions including associative and emotional mental reactions.Objective signs of autonomic nervous imbalance can be detected by physical examination. In the mental sphere, psychoneurotic constitution can be recognized by emotional imbalance, excessive, inadequate, untimely reactions (“psychic dysmetry”).Neuropathic and psychoneuropathic constitution per se is compatible with perfect health. It deserves attention, however, in that its carriers may play an important role in cultural and social life and so exert a great suggestive influence on the mass of people.The type of neurosis or psychoneurosis and the symptoms of it depend chiefly on the constitutional morbid predisposition (constitutional biologic inferiority) of certain organs or organ systems and on the kind of emotional situations which the patient is unable to cope with.The great number of neuroses, psychoneuroses and psychosomatic diseases among patients consulting them makes it imperative that internists and general practitioners be capable of making the correct diagnosis and of carrying out the indicated treatments by “minor psychotherapy.”     

WHO ARE THE BENEFICIARIES?

Is it defensible that society spends money on medical or research projects intended to help people solve their fertility problems? Suppose that we want to answer this question from the point of view of a utilitarian cost-benefit analysis. The answer to the question then depends, of course, on how expensive these projects turn out to be, relative to the costs of other possible projects. But it depends also on how we assess the benefits of these projects. To whom do they accrue? Who are the beneficiaries of these projects?     

WHO fellowships--what do they achieve?

Training health professionals is one of WHO''s major strategies for improving health care in the developing world. The aim, to strengthen a country''s own capacity rather than injecting expertise from outside, is in the best tradition of sustainable development. But how effective is this so called "capacity building in human resources"? Since it accounted for $43m of WHO''s budget in 1992-3 and is considered by WHO to be a major contribution to health in individual countries, it deserves detailed examination.