Academic journal article The Hastings Center Report

Research Using Brain Dead and Nearly Dead Patients

Academic journal article The Hastings Center Report

Research Using Brain Dead and Nearly Dead Patients

Article excerpt

Researchers at the MD Anderson Cancer Center in Houston, Texas, have published the results of a ground-breaking study using brain dead and nearly brain dead patients (W. Arap et al., "Steps toward Mapping the Human Vasculature by Phage Display," Nature Medicine 8, no. 2). The work is pioneering, in at least two ways. It could lead to the development of targeted cancer drugs. It also sets the stage for other research utilizing dead and nearly dead patients.

The study involved infusing roughly 200 million different peptides (strings of amino acids) into a brain dead or nearly dead subject and then performing multiple invasive biopsies--of skin, muscle, bone marrow, prostate, fat, and liver--to determine where the peptides end up. The results have been hailed as very promising ("Study of Brain Dead Sparks Debate," Science 295, no. 5558).

So what's the prolem? After all, brain dead and nearly dead human subjects can feel no pain and cannot be "harmed" by the biopsies. For some, the clinical ethicists at MD Anderson among them, the benefits are substantial and the ethical "qualms" can be overcome. The ethicists set strict rules for obtaining informed consent, including a requirement that researchers could not discuss the research with families unless the families had already raised the issue of organ donation or research.

Still, the leap from brain dead patients to nearly dead patients, assuming that we can even adequately define that category, is problematic. Anyone impressed by "slippery slope" concerns will probably find it unjustifiable. The research is undeniably valuable, but where will we stop? If we start with the already dead patient and move to the nearly dead patient, who will be next? Proponents will argue that there is a clear distinction between subjects who are dead and nearly dead, who cannot feel pain, and subjects who can feel pain. …

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