Sunday, January 16, 2011

Mordac, the Preventer of Medical Research

Here's a depressing story. It's depressing because it involves an ethics committee. Ethics committees are one of those things that are a great idea in principle but have a lot of downsides in practice. For all that we wouldn't want to go back to the old days of researchers finding out what mercury does to the human body by eating some, or testing the effects of radiation on humans by rounding up some darkies and irradiating them, we seem to have gone over to a level of caution that's indistinguishable from paralysis. Mordac, the Preventer of Information Services, who appears occasionally in Dilbert cartoons, is the apparent model for current ethics committees, which seem to exist mainly for the prevention of research.

In this instance, we have a chap in a wheelchair, Robert Stubbs, and some researchers who'd like to find out whether adult stem cells could mitigate to some extent the damage from his spinal injury. Apparently, stem cell researchers and various medical professionals consider this highly unlikely. Mr Stubbs would like to find out whether they're actually correct about that, as he doesn't much enjoy life in a wheelchair (duh-uh - for all that a significant number of hand-wringers would like us all just to pretend that being blind, or deaf, or paralyzed from the waist down are merely a "difference" from the majority rather than a debilitating handicap, most of us are actually capable of recognising reality when it kicks us in the bollocks). You can easily sympathise with Mr Stubbs - if it was me, I'd be sticking my hand up too for experiments that might bring about progress in this area.

Enter the ethics committee. The ethics committee's view of people like Mr Stubbs is well summed up by Dr Rick Acland of the Medical Council: "This is a vulnerable group of people and some are desperate for a cure so will take risks." In other words, "Hush dear, the grown-ups are talking." Mr Stubbs, as an interested party, must be considered "vulnerable" and be protected by wiser and more knowledgeable parties like Dr Acland from making decisions about his treatment.* Above all, he must be prevented from taking risks in an effort to advance medical treatment of his condition. (After all, taking risks never got anyone anywhere. /sarcasm)

I'm not qualified to express an opinion either way on the likelihood of this experiment contributing greatly to what we know about spinal injury and the usefulness of stem cells for treating it. However, I'm as qualified to express an opinion on ethics as anyone else, and as long as there's fully informed consent, I'm failing to see what the ethical issue here is.

For a laugh, check out the gaping logical flaws in these two quotes:

1. Dr Acland on why this group should be prevented from carrying out a clinical trial of adult stem cell treatment:

"...sadly, there have been very few world clinical trials of any repute. There has been no clinical evidence forthcoming to show improvement in spinal cord injury outcomes."

2. Kim Hudson, a wheelchair-bound ex-service co-ordinator from the Otara Spinal Unit, on why Stubbs should be prevented from taking part in this:

"It would take someone having a full recovery before I would take part..."

*Excessive bitterness in this paragraph due to having spent years seeing diabetics also patted on the head and told they must be protected by wiser ethics committee members from their willingness to undergo a small level of risk if it might advance the treatment of diabetes.


MacDoctor said...

This attitude of severe aversion to risk is pervasive in all of Western medicine. It accounts for our slavish devotion to clinical trials, our tedious desire to write notes on everything and our reluctance to do anything useful without filling in millions of forms.

I could go on, but you get the point, I'm sure. Mr. Stubbs best chance of getting stem cells is in China or Mexico where they are not quite so risk averse.

Anonymous said...

Ethics is the science of determining the correct action.
Morally I guess.
So I would say that the morality of the modern ethicist is a bit screwy and they seem more concerned with determining the correct inaction.

Psycho Milt said...

Mr. Stubbs best chance of getting stem cells is in China or Mexico where they are not quite so risk averse.

Yes. Personally, I think that there's a distinct ethical shortfall in Acland and Hudson wanting to prevent testing of this kind of thing in NZ until success has been proven (or ruled out) by risk-takers in third-world countries. But then, I lack the wisdom and knowledge of an ethics committee member...

Adolf Fiinkensein said...

What these people really are doing is covering the arses of their medical colleagues in the event there is a problem. They are in the business of risk mitigation - the risk of being sued.

Yes Milt, you've put your finger on it. Let's not take any risks with NZers. Lets go round up a few darkies and see if it works on them first.

Adolf Fiinkensein said...

What's the betting the good doctor and his mates are all socialists?

Paid up members of the 'we know best' brigade.

ISeeRed said...

If "my body, my choice" is good enough for women with regard to abortion, it should be good enough for Robert Stubbs if he's also willing to accept the risks and potential averse effects. This "healthier than thou" medical ethics committee makes me sick (pun intended).