Commentary on Pollard

- Jayapaul Azariah

Professor of Zoology, University of Madras - Guindy Campus,
Madras 600025, INDIA

Eubios Journal of Asian and International Bioethics 6 (1996), 7-8.
It is time for action. The contribution of Dr. Irina Pollard is delightful and frightening. It is delightful because it is a coherent compendium of vital and less known information on psychotropic drugs that are known to cause distinct behavioral abnormalities. It is frightening because we are ignorant of their teratogenicity and chronic ill effects both physical and gross anatomical. Drinking and smoking are bad habits and coffee drinking is a cultural lifestyle related habit.

The early intra uterine occupant-phase of human life span is fragmented into (i) the preimplantation stage - time between fertilization of the oocytes and implantation in the endometrium (about 6 days) and (ii) organogenesis stage (8-14 days). Macer (1990) has summarized the important stages in Human Embryo Development. At 2-3 day (8 cell stage) period probably every cell is totipotent and in the in-utero drug rich environment these embryonic cells are prone to drastic defects. Much of the deleterious effects can be doused by the pristine quality of fetus to heal a wound without producing a scar. If the individual effects of the drugs are dreadful then their synergistic (combined) effects are even more dangerous: " The combination of smoking and drinking more than four cups of coffee a day significantly decreases sperm motility, reduces sperm density and increases the percentage of dead sperms " (Section 3.2).

In this well documented article the author has raised an issue vital on our present day needs. With global programs on "Health for all by 2000 AD" one should naturally wonder as to how we are going to ensure health for all these people (yet to be born persons) who'd live beyond then. In the review, the author has outlined the adverse effects of three preventable habits of the present day society (smoking, drinking alcohol and coffee). It is surprising that intake of drugs (preventable) during pregnancy has not been considered at all by us. Will the present day attitude of "pop a pill for every problem" work?. Does it need another thalidomide-tragedy to bring to light the vulnerability of the intra-uterine occupant to such xenobiotics. The question as to what the medical and pharmaceutical community are going to do about it deserves probing since it is frightening to read the ill effects of such bioactive compounds like ethanol, nicotine and caffeine. The fact that our "ignorance of lifestyle-effects can be responsible for handicapping potentially healthy individuals" must be brought to the common knowledge of the common people. She has rightly pointed out that for married couples " reproduction under good conditions creates a positive force in shaping human identity ". But the history of drug exposure is detrimental to this pristine positive force. It may be recalled any toxic bioactive compound in very low dose can exert a positive influence while at a critical and higher concentration it exhibits lethal effect (Azariah, et al 1989).

While considering the social stress that a mentally ill-developed subject is going to face, the importance of fetal mortality and psycho-teratogenicity get reversed. Due emphasis should be given to this aspect since instead of being an added asset to the society, these unfortunate fetuses, victims of not their own mistakes, eventually are considered as a liability to the family as well as to society, both on the psychological as well as economic front. Her comment that savings through prevention of low birth- weight may, in the long term, significantly offset the additional cost of prevention- programs should be underscored. It remains to be seen as to what our economy-budget- based-policy makers are going to do about it.

The mentioned that " Women would be wise to abstain completely from drinking during pregnancy and whilst attempting to conceive ". The question is, will it suffice if one abstains from these drugs only until delivery. Wouldn't it be advisable if such restriction is extended post-partum too, because as the author herself has pointed that significant exposure could occur through breast-feeding.

In her reference to studies in those who quit smoking, it is not mentioned whether the "quitting" was once for all or until delivery. Once a smoker need not always be smoker. If it was until delivery, what was the effect of the post-natal smoke-filled environment to which the fetus will be subjected to? It is interesting to note "single women smoke more often than women living with a partner" It is ethical to encourage married couples to stay married. It may that if there is a harmonious relationship between two life partners then there may be easy quitting of this bad habit. Since "... quitting is a complex undertaking which requires will-power and specific knowledge..." there should be more of counseling sessions. We should produce more of good counselors in this specific area.

It may be recalled that Adam and Eve had a problem of deficiency in body. To meet it they used a technological device- " they sewed fig leaves together and made themselves aprons" (Gen. 3:7b). Their technology was wrong in the sight of LORD God who "made for Adam and for his wife garments of skins and clothed them" (V.21). Both Bible and Science confirm the undeniable relationship between bad habits and ill health. The prophet Ezekiel (BC 593-586) quoted a common proverb of Israel: " The fathers have eaten sour grapes and the children's teeth are set on edge " (Ezk.18.2) which indicates the biblical affirmation of the above scientific theme. The prophet Jeremiah (BC 626-586) also affirmed the above relationship: " Our fathers sinned, and are no more; and we bear their iniquities "(Jer. 5:7). The problem is severe and critical. A technological quick fix does not work. An ethical solution from a spiritual base can work. For the prophet Jeremiah affirms that such relationships can be reversed from a spiritual base (Jer. 31: 28b-29a).

Among the Man-made resources, education, as the author rightly pointed out, will work to produce a desirable social and cultural change. Therefore, I take this opportunity to suggest that it is time to form an international working group to frame an ethically based curriculum and to produce internationally acceptable standard text books to save our children, both preconceptual and prenatal. It is time to care of our children from drug-induced disabilities "from an ethical stand point". Such an attempt should start at the age of seven since the sexual activity of children in the West starts at about 10 years of age. To the question "Who would educate?", conducting training workshop for teachers is the answer. Where there is no vision (prophecy = forth telling) the people perish (Prov. 19:18).

1. Azariah, J. H.Azariah, S. Mallikesan, M.V. Sumathi and C. Sundarajan. 1987 Toxicology of the plant Calotropis gigantea. Progress in Venom and Toxin Research Ed. P. Gopalakrishnakopne and C.K. Tan. National University of Singapore. pp. 633-641
2. Macer, D.R.J., 1990 Shaping Genes. Eubios Ethics Institute, Christchurch, N.Z. pp 63-95.

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