Controversial Bioethicist Resigns From Celltex

ananyo writes "Bioethicist Glenn McGee has resigned his position as president of ethics and strategic initiatives at the stem-cell firm Celltex Therapeutics in Houston, Texas. Yesterday, Slashdot posted a story that suggested Celltex may have administered unproven treatments to several patients. The move comes at the end of a turbulent three months, which has seen McGee blasted by other bioethicists for working at the controversial stem-cell company while also holding the post of editor-in-chief of the American Journal of Bioethics, the most cited bioethics journal in the world. McGee announced that he had resigned, effective 28 February, on Twitter last night — the move came just two weeks after the 13 February press release by Celltex announcing that he would take the position."

Comments

Well... how else are you gona prove them?

[Kenja]

Frankly, I dont see the issue with administering unproven treatments to people who would otherwise suffer and die. So long as the risks are made clear to them. The idea of being told I'm going to die in a month, but they cant try a treatment that could cure me because it could kill me is silly.

Re:Well... how else are you gona prove them?

[Demonantis]

There many instances of the doctor writing the individual off as almost dead when they live for years afterwards. Doctors currently can't predict how long you are going to live accurately enough to legitimize allowing them to give experimental treatment to people they think have a month to live.

Re:Well... how else are you gona prove them?

[Misanthrope]

If it's unproven, your insurance company isn't going to cover it, period. So these types of companies are emotionally extorting people by charging high fees in addition to using you as a guinea pig. If the treatment was given for free, as it usually is in proper medical trials it would be a different matter.

Re:Well... how else are you gona prove them?

[Baloroth]

That wasn't the problem, actually. The problem was he held a position at the company simultaneous with holding a position (as editor-in-chief) with a highly regarded and influential bioethics magazine. The result was a conflict of interest: the company pushes to perform unproven operations, and it is the job of bioethics to make sure they don't go into an ethical violation with the treatments. If one person is involved in both, the safeguards against unethical behavior are called into question, whether or not ethical violations actually take place. From the second linked article:

They argue that in holding both posts, McGee has a conflict of interest between his responsibilities to the journal [of Bioethics] and his new employer’s desire to promote the clinical application of stem-cell treatments that are not approved by the US Food and Drug Administration.

Re:Well... how else are you gona prove them?

[ColdWetDog]

There many instances of the doctor writing the individual off as almost dead when they live for years afterwards.

True enough, but it's the best information we have.

Doctors currently can't predict how long you are going to live accurately enough to legitimize allowing them to give experimental treatment to people they think have a month to live.

I would disagree. The key is informed consent. Do you carefully explain all of the relevant information? Do you explain where you could be wrong? Do you give an accurate accounting of potential benefits and potential harms? Can the patient understand all of that?

Informed consent is hard to do, but lacking every potential bit of information is not an absolute barrier.

Re:Well... how else are you gona prove them?

[edelbrp]

There's a certain element of quality of life to be taken into consideration, too. My father died of brain cancer but participated in a study to see if an unusually higher use of chemo might improve the odds of survival. It's hard to say if the cancer or the drugs were what caused more suffering. Being really, really sick can sometimes be worse than death I would have to believe, especially if the odds for recovery are slim. So while the "why not give it a shot?" attitude has a certain bit of logic to it, it still gets a bit more complicated than that from an ethical point of view.

Re:Well... how else are you gona prove them?

[jhoegl]

Informed consent is hard to do, but lacking every potential bit of information is not an absolute barrier.
Tell that to Vietnam war veterans.

Re:Well... how else are you gona prove them?

[Dishevel]

Here is a blanket statement. I would think that all people when they are the ones who are sick would want the choice to be theirs not the governments.

Re:Well... how else are you gona prove them?

[Frnknstn]

True enough, but it's the best information we have.

Exactly, and in this case the best we have isn't good enough, therefore administering untested treatments remains unethical.

If the doctors themselves are not adequately informed about a patient, how could a patient ever give informed consent?

Re:Well... how else are you gona prove them?

[nbauman]

There's no evidence for that and some evidence to the contrary. Jessie Gruman, who interviewed 200 patients about the way they make medical decisions, said that most patients can't and don't want to make their own decisions about health care. http://en.wikipedia.org/wiki/Consumer-driven_health_care

Those patients want their doctors to make the decisions. Most patients also want government regulations to protect them against bad decisions. They are surprised to find out when they get a bad result from a "dietary supplement" that dietary supplements are not regulated.

In many countries, doctors are paid by the government and follow government guidelines, and most patients prefer it that way. If you live in the U.K., and your doctor follows NICE guidelines, you'll get pretty close to the best medical decisions in the world.

In health care, the governments of developed countries usually make the best decisions. The U.S. federal government usually makes the best decisions, except for those times when they're under pressure from the health care industry. Best example: If you get a head injury in Iraq or Afghanistan, military medicine will give you the best chance of getting home alive and with the least cognitive damage that you could get anywhere in the world. I've looked up some of the studies of results of major surgery, and the Veterans Affairs hospitals have some of the best outcomes in the country and the world.

Ouch...

[SomePgmr]

So he took the position there just in time to find out the place is shady, take a bunch of heat, and resign?

That sucks.

Re:Ethicist

[ColdWetDog]

It's 'religious' in that it relies on system of beliefs rather than facts and experiment, but it it's important anyway. Not everything can be reduced to logic.

Codifying something, be it religious, scientific, engineering or what have you has validity. It's how you start a framework for discussion.

My karma ran over your dogma, as it were.

With clinical trials

[pavon]

You prove that this works through clinical trials. But Celltex Therapeutics isn't conducting any such trials. They have made vague comments about starting some trials sometime in the future, but that's it. They don't have any control subjects. They don't have any animal test results on which they are basing their human predictions on. They haven't even identified what ailments they are going to be testing their treatment for!

In the meanwhile they are happy to inject anyone willing to pay the $7k+ per injection, for whatever ailment they complain about, regardless of whether there is any reason to think the treatment would help, or whether the patient would otherwise suffer and die.

Re:With clinical trials

[ananyo]

Yep exactly. There are two problems here.
1. Celltex hasn't done any clinical trials of any sort. To prove a treatment works you need a double-blind trial at least - administer placebo to one group, and the cells to another and make sure the physician in charge doesn't know which one is being given to which patient. Then when you 'unblind' the trial and reveal which patient got what - that's when (if it's worked) you start charging. In the trial phase, a company should be providing the treatment free with placebo and working with the FDA. They shouldn't be charging for voodoo treatments/homeopathy.
2. Big conflict of interest for McGee from the start - it's difficult to claim you can independently assess papers on bioethics, when many of the papers are likely to be about stem cells and trials but you're being paid by a firm that is growing stem cells.

As the (accidentally unlinked when I submitted) Nature story says, McGee claimed he hoped by being inside the company, he could push them to do trials properly. When it became clear they were already treating patients and probably weren't too interested in testing the treatments, he quit. At least, that's one interpretation....

Way to go.

[subreality]

blasted by other bioethicists for working at the controversial stem-cell company

Fail. This is exactly the kind of company that we want a bioethicist working for.