Living in the Biotech Century -- May 2, 2006

“You would be dismayed at how political the process [of defining psychiatric disorders] can be.”

“Every psychiatric expert involved in writing the standard diagnostic criteria for disorders such as depression and schizophrenia has had financial ties to drug companies that sell medications for those illnesses, a new analysis has found.

“Of the 170 experts in all who contributed to the manual that defines disorders from personality problems to drug addiction, more than half had such ties, including 100 percent of the experts who served on work groups on mood disorders and psychotic disorders. The analysis did not reveal the extent of their relationships with industry or whether those ties preceded or followed their work on the manual.

“‘I don’t think the public is aware of how egregious the financial ties are in the field of psychiatry,’ said Lisa Cosgrove, a clinical psychologist at the University of Massachusetts in Boston, who is publishing her analysis today in the peer-reviewed journal Psychotherapy and Psychosomatics.

“The analysis comes at a time of growing debate over the rising use of medication as the primary or sole treatment for many psychiatric disorders, a trend driven in part by definitions of mental disorders in the psychiatric manual....”

“...Today most Americans have their tissue on file somewhere. In 1999 the RAND Corporation published a report (the first and, so far, the last of its kind) with what it called a ‘conservative estimate’ that more than 307 million tissue samples from more than 178 million people were stored in the United States. This number, the report said, was increasing by more than 20 million samples each year. These samples come from routine medical tests, operations, clinical trials and research donations. They sit in lab freezers, on shelves or in industrial vats of liquid nitrogen. They’re stored at military facilities, the F.B.I. and the National Institutes of Health. They’re in biotech companies and most hospitals. Biobanks store everything from appendixes, ovaries and skin to sphincters, testicles and fat. Not to mention blood samples taken from most children born in the United States since the late 60’s, when states started mandating screening newborns for genetic diseases.

“Scientists and surgeons use these tissues to develop everything from flu vaccines to penis-enlargement products. They put cells in culture dishes and expose them to radiation, drugs, cosmetics, viruses, household chemicals and biological weapons and then study their responses. They remove DNA to examine it—and therefore the person it came from—gene by gene. Without those tissues, we would have no tests for diseases like hepatitis and H.I.V.; no vaccines for polio, smallpox, measles; none of the new promising drugs for leukemia, breast cancer, colon cancer. And without tissue samples, the developers of those products would be out billions of dollars....”

Rising demand has created a thriving market for human body parts—and not all of it above ground.

ZUMA Press

“For 58 years, Alistair Cooke enchanted his radio audience. A Brit who lived in New York, Cooke regaled listeners in the UK with stories about Americans and was honored for bridging the distance between the countries.

“In March 2004, one week after he announced his last broadcast, Cooke died of lung cancer in his New York home. He was 95. As his listeners mourned, his family sent his body to be cremated at a local funeral home.

“In December 2005, Cooke’s family learned that his body had been surgically plundered and the pieces sold to different bidders. A body brokerage company had harvested his bones, falsified his medical records—claiming he had died at 85 of a heart attack—to make them more marketable, and then sold them to at least two tissue banks.

“Cooke’s was one of more than 1,000 bodies allegedly stolen by the company, New Jersey–based Biomedical Tissue Services. Prosecutors say the company and the funeral home, Daniel George & Son, made millions of dollars harvesting pieces of the cadavers, instead stuffing bodies for burial with broomsticks and piping. An investigation is ongoing....”

“The French woman who received the world’s first partial face transplant has complete feeling in the new tissue five months after the operation, she told a Sunday newspaper.

“Isabelle Dinoire, 38, also told the newspaper Le Journal du Dimanche that the hardest part of her recovery appears to be getting to know herself again. When asked if she has accepted her new face, she responded: ‘It’s too difficult to explain.’

“She takes out old photos and, shocked at the difference between her former face and her new one, tells herself that she simply has aged, she said.

“Dinoire said her speech has improved as she has gained more facial mobility....”

“...‘Somewhere on the streets of New York there’s an 8-year-old girl who has absolutely no idea what she’s done for me,’ said Mr. [Stephen] Sprague, 58, all of whose blood cells are now female. Mr. Sprague, who works for the New York Blood Center’s National Cord Blood Program, expects a bright future for cord blood transplants even though so many logistical and technical obstacles remain before it can be widely used.

“Most people, and even many doctors, are unaware of the tremendous strides that have been made in the field of bone marrow transplants. They also don’t realize that today it can be much easier to be a donor. No longer is it necessary to be anesthetized and have bone marrow extracted from your hips. Now blood stem cells can be removed from your blood with minimal risk to the donor. And when mothers-to-be choose to donate umbilical cord blood at a hospital equipped to process it, there is no risk at all to the donor....”

A CAT scan showing the back of an unnamed 12-year-old patient of Dr. Frederick Kaplan—the bone formation typical of FOP. (AP Photo/University of Pennsylvania and Nature Genetics)

“Scientists have discovered a mutant gene that triggers the body to form a second, renegade skeleton, solving the mystery of a rare disease called FOP that imprisons children in bone for life.

“The finding, reported Sunday, may one day lead to development of a drug, not only to treat the rare bone disorder, but more common bone buildup related to head and spine trauma, and even sports injuries, the researchers said.

“‘We’ve reached the summit,’ said Dr. Frederick Kaplan, an orthopedist whose team at the University of Pennsylvania School of Medicine pinpointed the cause of FOP, or fibrodysplasia ossificans progressiva. The disease is believed to afflict only 2,500 people worldwide....”

“Every time I turn around I seem to read about some paralyzed person who’s traveled to a far-flung country for a miracle treatment not available in the United States. ‘I can now wiggle a toe! I’m improving!’ they exclaim.

“Meanwhile, I stay put in my wheelchair, albeit restlessly, in Charleston. Having been paralyzed from the shoulders down since suffering a C3 contusion injury to my neck in 1996, you might ask what the heck I’m waiting for. Am I a masochist? Possibly. But have you ever read a follow-up story about long-term functional gains achieved by one of these treatments? If none come to mind, it’s not because you have a bad memory.

“A recent article in Neurorehabilitation and Neural Repair offers a sobering explanation. The study examined the results of seven surgeries performed by Hongyun Huang, a doctor in Beijing who treats spinal cord injury patients with cells taken from the olfactory bulb (found inside the nose) of aborted fetuses. Previous anecdotal reports from some of the 600 patients that Dr. Hongyun Huang says he’s treated were positive, but had a twinge of irrational exuberance.

“Now, the authors of one of only three papers attempting to quantify Huang’s results (none of them by Huang) say that ‘no clinically significant ... improvements were found....’”

Male hormonal contraception can be reversed within a few months, a study has found.

“Researchers looked at data on more than 1,500 men around the world who had taken part in tests of some form of hormonal contraception.

“On average, men took three to four months to recover full fertility, according to a paper in the Lancet.

“Experts say the research offers men reassurance that their fertility can be restored.

“Existing methods of contraception for men—condoms and vasectomy—may be unacceptable to some couples because they are not sufficiently reliable or not easily reversible.

“Male hormonal contraception methods work in a similar way to those used by women.

“While female treatments suppress ovulation, sperm production can be prevented by giving the male hormones androgen and progestagen....”

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Assistant D.A. Josh Hanshaft shows an X-ray of a person’s pelvic area with PVC plumbing pipe where bones should be.

“At least a dozen people who had routine operations say they caught deadly viruses and other germs from body parts stolen from corpses in a ghoulish scandal that has sent hundreds of people for tests.

“The patients tested positive for germs that cause AIDS, hepatitis or syphilis after receiving tissue transplants, according to their attorneys and court records.

“Lawsuits have been filed for two men, one in Nebraska and one in Ohio. Each contends he caught a hepatitis virus from tissue implanted in back and spine operations—an assertion that lawyers acknowledge will be difficult to prove.

“A New Jersey company, Biomedical Tissue Services, is accused of failing to gain consent to take bones, tendons, ligaments, skin and other tissue from cadavers. The most famous example involved the corpse of Alistair Cooke, the longtime host of the PBS series ‘Masterpiece Theater.’ Cooke died of cancer at age 95, and his leg bones were removed and shipped to tissue processors for use in medical procedures....”

“...The mad scientist, as we all know, sits in his laboratory developing the ultimate weapon to blow up the world or the ultimate superman to rule it, and is set apart from the ordinary sane multitudes who go about their business innocuous and unsuspecting. Other cultures than our own might properly express their criticism of the sin of curiositas in this way; but our own culture is one in which curiositas has become a sin of the masses. All the innovations in medical technique which we have to discuss have been surrounded by a high level of publicity; none has been met with public anger, and one at least has encountered unaffected public satisfaction. The liberal revolution arose, and will continue to evolve, in answer to a mass desire of Western civilization, in which we all participate, and not at the behest of a few scientists. The pioneers of research give authentic expression to our society’s soul, and we cannot be permitted to disown them.

“The medical practitioner, then, finds himself an agent in the midst of a mass activity, and of course he can have no independence of action to speak of. If a certain medical technology has been developed, it is expected by society that he will facilitate his patients’ access to it. To act in this sphere is to participate with the community’s common action, which has very well defined and unnegotiable purposes. The paradox is that the community’s goal is freedom; but such freedom clearly cannot include freedom of action which might frustrate communal action. It follows that we conceive our freedom passively, as a freedom not to suffer, not to be imposed upon. It is the freedom of consumers, rather than participants. It is a freedom to exist unmolested and unthreatened in the private realm, without interference in one’s family, one’s sexual relations, one’s religion, one’s eating and drinking—and, of course, the expression of one’s opinion, for in a society in which politics is managed by technique, opinions are no longer potent in the public realm. The freedom of conscience on which liberal society prides itself is only a private freedom. As soon as one intends to act in public, by being a physician, a lawyer, or a journalist, one is constrained. To presume to exercise freedom of conscience in one’s public dealings is, as we say, ‘thrusting your private convictions down other people’s throats’, that is to say, bringing them out of the private realm into the public forum where they might challenge community policy. We call ourselves, self-deprecatingly, a ‘consumer society’, and chide ourselves for the greed which makes it so. Even the practice of medicine, it is often said, is seen increasingly as a kind of retail trade, marketing health-care to consumers. I do not think that this shift of perspective has primarily to do with an increase of greed or selfishness (though no doubt these are implied by it), but with our cultural conception of freedom as the freedom not to suffer. From such a conception it must follow that the freedom is all the patient’s and the responsibility all the doctor’s, and that is what evokes the analogy with the retail trades. The old conception of medicine as a collaborative enterprise, in which doctor and patient each have freedoms and responsibilities, can no longer be sustained....”

“Medicine and the Liberal Revolution” is Chapter 1 of Begotten or Made, by Oliver O’Donovan. Begotten or Made was published in 1984 by Oxford University Press (excerpt is from pages 9 and 10). Oliver O’Donovan is currently Regius Professor of Moral and Pastoral Theology at the University of Oxford and Canon of Christ Church, Oxford. In September 2006 he will assume the Chair of Christian Ethics and Practical Theology at the University of Edinburgh School of Divinity.

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