Biotechnology Fever

Since the 1980 law enabling universities and hospitals to profit from research through licensing new drugs, biotechnology has had an increased need for ethical surveillance. Given our capitalist market economy, it is unsurprising that this financial incentive for academic institutions has generated more momentum in the biotechnology industry. I would even argue that this intersection of academic and business medicine is ultimately beneficial for more aggressive, albeit money-driven, research & development. The qualm I have on this academic-industrial relationship, especially from reading of cases like that of Jesse Gelsinger and U. Penn. (1999), is the impact for patients in the clinical setting. This issue coincides in part with our discussions on the relationships of doctors with pharmaceutical companies. In that case, I argued that hospitals take greater control over checking and balancing this relationship. In this case, however, I wonder how efficient more communications and awareness-training for physicians, especially younger ones in training, at the individual level would be. More fast-acting structural changes might be needed, however, since currently, it is the older, more powerful physicians in the hospital or research administrations that might be heavily influencing choices on trials for patients.

At the more microscopic level, in the article “The Biotechnical Embrace”, Good argues: “Enthusiasm for medicine’s possibilities arises not necessarily from material products with therapeutic efficacy but through the production of ideas, with potential although not yet proven therapeutic efficacy.” Good goes on to argue that patients tend to invest in this “medical imaginary” enterprise—culturally, emotionally, and financially. As doctors invested in our patients’ health, I think that we need to be cognizant of the fact that conversations involving biotechnology-trials can have a sentimental effect, which in turn, can significantly affect life-altering decisions. However, I would argue that for many patients, hope is urgently needed in battling disease, and that this hope is sometimes simply clothed in the form of hope in the promising future of biotechnology. As discerning doctors, then, our job might be to recognize and continue to foster this need for hope, but not let it coincide 100% with a trust in the “medical imaginary.”