Still in the Stone Age down under

Debate is heating up in Australia about the use of mifepristone (RU-486) for medical (as opposed to surgical) abortions. Tony Abbott, who is clearly highly qualified to have an opinion about (a) medicine (he has an Economics/Law double degree) and (b) women (he quite obviously isn't one), has decided that he should be more cautious than the Australian Medical Association, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, and the World Health Organization and keep mifepristone off the shelves in Australia. Well, that's his story, anyway. Unfortunately for Mr Abbott, people aren't stupid and are quite able to see that his views on mifepristone are just thinly veiled anti-abortion views (which go hand in hand with his anti-stem cell research views).

All research and medical opinion points to mifepristone's safety and efficacy in inducing termination, when combined with a prostaglandin analogue such as misoprostol (which is already available in Australia for other uses). From the reading I've done, I can't see how medical abortion is any less safe than a spontaneous abortion. Both can lead to complications, such as incomplete abortion, which can be taken care of with medical help.

It's insulting to doctors for Abbott to suggest that they would not be able to deal with the complications that can arise. If they can deal with a miscarriage, they can deal with a medical abortion too. And it's insulting to suggest that they would prescribe mifepristone unwisely. Any doctor prescribing it would, of course, be there to deal with any adverse effects, same as they would be for any medication they prescribed. Rural doctors, in particular, should be offended at the implication that they can't handle complications of pregnancy, when they can probably deal with them better than some over-specialised urban doctors. Should they be recommending that all female regional inhabitants relocate to cities for pregnancy care?

Abortion isn't nice or pleasant but it's a reality that some women find themselves facing for a variety of reasons. Whether the underlying cause is their own stupidity or the cruelty of rape, no woman should find herself facing the alternative of an unsafe abortion, or an unwanted pregnancy that will produce an unwanted child, who might never receive adequate care or love. And medical abortion makes it easier -- some might say too easy, but I feel that the option needs to be there for women in remote areas, or from communities where abortion is not acceptable, and going to the doctor for a pill and pretending that you've had a miscarriage might be your only option.

It's just mind-boggling that this decision is in the hands of one man who's clearly biased, rather than where it belongs: in the hands of each individual woman.

Forward, march

It's always tempting to do a 'year in review' type of article at this time of year. It's not hard (especially after every other publication has done theirs). For example, science in 2005 can be summed up thus: embarrassing NASA failures; freakish meteorology; bird flu fears and cover-ups; evangelism masquerading as science; the rise, rise and fall of Woo Suk Hwang and his therapeutic cloning; and perhaps the only proud moment: the completion of the chimp genome.

Too easy. So of course I'll have to put my foot in it and hazard a guess as to what might be the 'year in review' for 2006. Some of it's easy because it's just more of the same, really. Bird flu is only going to become a bigger problem, as is climate change. It would be nice to see some successes in space exploration. (It would be even nicer to put that kind of money into feeding the starving and AIDS prevention [for example], but you can't have everything.) Physicists will keep nattering on about string and other things that I don't pretend to understand (anyone care to calculate the trajectory of physics wooshing over my head?).

Apart from bird flu, obesity will probably be the most important health issue (unless there's some other awful pandemic). Genomes, which are just so last century really, will continue to be superseded by proteomes and epigenomes. But I think there's a very big missing link between genotype and phenotype that we're just not getting, sort of like the dark matter of biology -- the setbacks with cloning and the final figure of 96% similarity between the human and chimp genomes point to that. I'll be surprised if 2006 is the year that solves that mystery, though. And I'm going to be optimistic and hope for a new stem cell hero.

I'm not particularly optimistic about climate. There are so many pitfalls to all the alternatives to oil (the destruction of forests in developing countries for biofuels, for example) that I think headway will only be made when it's too late. It's already too late, really.

Technology will probably keep moving along the lines of smaller, faster, and cuter, and as usual not spend too much time on actually being helpful.

Not too cheery overall. But one thing I can predict with confidence: like every year, there will be good bits and bad bits. Is the ratio even up to us? Who knows?