Transplanting Autoimmune Research

Blog Post by Jonathan Kimmelman, Assistant Professor, Biomedical Ethics Unit/Social Studies of Medicine, McGill University, Quebec, Canada

What’s the difference between testing a typical small molecule drug, and testing a novel cell therapy strategy? And where might the latter raise ethical challenges that the former doesn’t? These questions are extensively discussed in my book, and given human drama in a recent story by Jennifer Couzin-Frankel in the Feb 12, 2010 issue of Science (“Replacing an Immune System Gone Haywire“).

Remembrance of Things Past: Revisiting Ethics in New Fetal Tissue Transplant Studies

Blog post by Jonathan Kimmelman, Assistant Professor, Biomedical Ethics Unit/Social Studies of Medicine, McGill University, Quebec, Canada

In a recent article in Science magazine, Constance Holden reports that European researchers are contemplating a revival of fetal tissue transplantation for the treatment of Parkinson’s disease. As the article recounts, fetal transplants were subjected to sham controlled studies in the late 1990s; none performed better than sham, and several caused disabling dyskinesias. So should fetal tissue transplantation be revived, and if so, how?
The challenges seem all the more formidable today. We now understand that Parkinson’s disease is not restricted to the dopaminergic neurons in the basal ganglia, but instead involves diffuse pathology. And yet, studies will not involve implantation of tissues throughout the brain. As Holden’s article points out, previous fetal transplant studies revealed that brain pathology spreads to implanted tissues, suggesting that permanent responses may be difficult to achieve.

GUT decision-making

Blog Post by Alan Schwartz, Associate Professor of Medical Education and Pediatrics, University of Illinois at Chicago College of Medicine (reposted from Prof. Schwartz’s Making Medical Decisions blog)

I was recently at a workshop for National Science Foundation Principal Investigators focused on how to communicate research to the public and the media. One of the suggestions was to develop a three-word summary of the principle message of your research work. This is hard. After thinking about it for a while, though, I realized that medical decision science (at least as I practice it) is primarily about helping physicians and patients to do three key things:

• know your goals
• understand uncertainty
• pay attention to trade-offs