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A
lesson while dying
The dying young
men of Johnson City, Tenn., taught Abraham Verghese, M.D.,
something about the meaning of life. A professor of medicine
at Texas Tech University in El Paso and a contributor to The
New Yorker, Verghese is the author of the award-winning My
Own Country, his account of treating men who returned from
large cities to their Tennessee homes after contracting HIV.
Speaking at medical grand rounds in November, Verghese said that
as his patients faced death, they told him that wealth, power
and appearance mattered little. “Instead, they found that
meaning consistently resided in the successful relationships
that they had negotiated over a lifetime, particularly with parents.”
—Cathy
Shufro |
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Clinical
research “riddled with conflicts”
Protection of
human subjects and the integrity of clinical trials are in jeopardy
from the new economics of drug development, according to Marcia
Angell, M.D., a lecturer on medical ethics at Harvard Medical
School and a former editor of the New England Journal of Medicine.
While editor of the journal, she issued an apology to readers
for 19 instances in which the journal had published reviews of
treatments even though the review authors had informed the editors
of financial connections to drug companies. The editors admitted
failing to apply journal policy, which prohibits review authors
from having a financial interest in a company that makes a product
discussed in the article.
As more scientists
and institutions have financial stakes in research, she told
faculty and students at a meeting of the Medical School Council
in February, the drug approval system has become “riddled
with financial conflicts of interest.” She suggests making
drug company funding, clinical testing and ethical oversight
independent of each other. “The result would be a system
of checks and balances in which the influence of industry funding
would be minimized,” she said.
—John
Curtis |
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The
ethics of stem cell research
In 1838, before
publishing his theory that tissue is made up of tiny particles
he called cells, German physiologist Theodor Schwann sought permission
outside the realm of science. “He asked the religious authorities
whether it was OK,” said Ronald D.G. McKay, Ph.D.,
chief of the laboratory of molecular biology at the National
Institute of Neurological Disorders and Stroke, where he studies
stem cell differentiation. “The current controversy over
stem cells,” said McKay at a meeting of the Medical School
Council last fall, “is nothing new.” Embryonic stem
cells offer the promise of cures for such diseases as Alzheimer’s
and Parkinson’s, but they must be extracted from embryos
that are destroyed in the process. “For certain people,”
said McKay, “if you take cells out of an early embryo you
commit an act of ethical impropriety. We have people who might
benefit from these cells, and that is another moral issue. There
is no way of moving forward without making ethical decisions.”
—John
Curtis |
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The
healing power of music
Twenty-five
years ago, Oliver Sacks, M.D., tore off his left quadriceps while
mountaineering in Norway and was saved by reindeer hunters. Following
the accident, “the clumsy limb didn’t seem to be mine.
It was as if I had no internal sense of pacing,” he said
last fall during “Neurotherapeutic Effects of Music,”
a symposium at the School of Medicine that explored the effectiveness
of music in treating neurological disorders. Music, he said,
helped him recover his “kinetic melody” and walk again.
“Suddenly … Mendelssohn started playing in my mind
and in some unconscious way I found myself walking to it.”
Sacks, a neurologist and the author of Awakenings and
other books, was experiencing the connection between music and
healing that he had observed among patients with Parkinson’s
disease. Although they could not initiate speech or walk, some
were able to sing or dance when music was played. One patient
stayed absolutely still with a finger on her eyeglass for most
of the day, but came alive playing Chopin on the piano. Said
Sacks: “I saw music as a mysterious, liberating power with
these people who were otherwise virtually inaccessible.”
—Rachel
Engers |
