False hope for real money
Internet sites for clinics all around the world—including the US, but especially in China, India, the Caribbean, Latin America, and nations of the former Soviet Union—offer stem-cell-based treatments for people suffering from a dizzying array of serious conditions.
Never mind that cancer is the only disease category for which there is published, scientifically valid evidence showing that stem cell therapy may help. Thousands, if not tens of thousands, of desperate people are flocking to clinics that charge tens of thousands of dollars for every unproven treatment.
Traveling for therapy, or “stem cell tourism,” was the subject of a panel discussion titled “Stem Cell Therapy and Medical Tourism: Of Promise and Peril?” arranged by HSCI in collaboration with the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics.
Brock Reeve, HSCI executive director, introduced the topic by pointing out that there are positive and negative aspects to medical tourism. For example, patients flock from all over the world to the Harvard-affiliated Massachusetts General Hospital, Brigham and Women’s Hospital, Dana-Farber Center Institute, and other Boston research hospitals for cutting-edge, scientifically validated treatments for a host of diseases.
But then there is the other kind of medical tourism, and every member of the panel agreed with speaker Timothy A. Caulfield, LL.M, the Canada Research chair in health, law, and policy at the University of Alberta, when he said that the stem cell tourism phenomenon “hurts the legitimacy of the entire field” of stem cell science and medicine.
While adult stem cells have been used for decades to treat a number of malignancies—bone marrow transplants are, in fact, are the only stem cell treatments that are not experimental.
George Daley, MD, PhD, a member of the Harvard Stem Cell Institute’s executive committee and past president of the International Society for Stem Cell Research, added that “we are seeing a growing number [of legitimate clinical trials] but all such uses are experimental ... and there is great skepticism as to whether we have” the scientific knowledge and basis even to “predict that these will be effective.” “It may,” he said, “take decades before there is certainty.” “The only stem cell therapies that have been proven safe and effective,” he said, “are those constituting what is known as bone marrow transplantation for treatment of some cancers.”
But the clinics selling stem cell therapy for a sweeping catalog of diseases aren’t offering patients places in clinical trials. They are touting what they claim are established treatments, with proven results. Caulfield said a number of his studies demonstrate that treatments are offered as safe, routine, and effective, but “none of what is being offered matched what the scientific literature said.” He accused the clinics of “financial exploitation” of desperate people, and said those who raise money to finance pilgrimages to them are “raising money to turn over to a fraud.”
I. Glenn Cohen, JD, professor at Harvard Law School and co-director of the Petrie-Flom Center, suggested that one way to slow stem cell tourism could be to prosecute for child abuse when the treatment involves minors. Cohen said that though he is sympathetic with parents seeking help for their ill children, “this falls under existing child-abuse and neglect statutes.”
Jill Lepore, PhD, chair of Harvard’s History and Literature Program, came at the issues from a very different perspective. “I don’t have patients,” Lepore said, “I have characters.” She said there is a kind of “faith in science that draws” some people to any promise of a cure for disease, no matter how specious. What fuels this false hope, she said, is “one of the most dangerous elements of our culture: that we have forgotten how to die.”