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Kawam O, Zhu X, Eton DT, Martin-Lillie C, Finney Rutten LJ, Shapiro S, Tilburt JC, Master Z. Designing persuasive health education for patients seeking unproven stem cell interventions. Stem Cell Reports 2023; 18:1549-1554. [PMID: 37557072 PMCID: PMC10444566 DOI: 10.1016/j.stemcr.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 06/07/2023] [Accepted: 06/07/2023] [Indexed: 08/11/2023] Open
Abstract
Misinformation among clinics advertising unproven stem cell interventions (SCIs) is pervasive and has resulted in patient and societal harms. Most bioethics commentaries have centered on advancing regulatory approaches to curtail the supply side of the market, but insufficient attention has been paid to considering strategies influencing patient demand. In this article, we offer an ethical justification for the design and deployment of persuasive patient education on unproven SCIs and distinguish it from didactic and manipulative education frames. Persuasive education should aim to correct and inoculate against misinformation about unproven SCIs and instill a sense of caution among patients considering experimental interventions outside of a clinical trial. We outline various communication strategies to effectively correct or inoculate against SCI misinformation. The stem cell community needs to invest in understanding patients' informational sources, attitudes, and beliefs about SCIs to develop and implement evidence-based persuasive education to promote informed decision-making about these therapies.
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Affiliation(s)
- Omar Kawam
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA
| | - Xuan Zhu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - David T Eton
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | | | | | - Shane Shapiro
- Center for Regenerative Biotherapeutics, Mayo Clinic, Rochester, MN, USA; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA
| | - Jon C Tilburt
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA; Division of General Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Zubin Master
- Biomedical Ethics Research Program, Mayo Clinic, Rochester, MN, USA; Center for Regenerative Biotherapeutics, Mayo Clinic, Rochester, MN, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
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2
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Lyu B, Yi R, Fan G, Zhang Y. Stakeholder network for developing open innovation practice of China's manufacturing enterprises. Heliyon 2023; 9:e13192. [DOI: https:/doi.org/10.1016/j.heliyon.2023.e13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023] Open
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3
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Lyu B, Yi R, Fan G, Zhang Y. Stakeholder network for developing open innovation practice of China's manufacturing enterprises. Heliyon 2023; 9:e13192. [PMID: 37101472 PMCID: PMC10123074 DOI: 10.1016/j.heliyon.2023.e13192] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/20/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
The study aims to investigate the impact of stakeholder network characteristics on a company's open innovation performance. To investigate the innovation performance of a company. This study not only demonstrates the impact of stakeholder network characteristics on a firm's open innovation performance but also provides empirical evidence for accelerating the construction of an innovation ecology at the national and industry levels and using innovation networks to promote firm innovation performance. Panel data from 1507 listed manufacturing firms in China from 2008 to 2018 are used. A particular focus is on the role of absorptive capacity in the relationship. The results show that centrality, stability, and stakeholder network size are positively correlated or have an inverted U-shaped relationship with the firm's open innovation performance. The results show that the centrality, stability and stakeholder network size are positively correlated or have an inverse U-shaped relationship with the firm's open innovation performance, while the effects of stakeholder network density on the firm's open innovation performance are not significant. Furthermore, absorptive capacity is found to play a moderating role in the inverted U-shaped relationship between the former two factors, and the inverted U-shaped relationship between stakeholder network characteristics and a firm's open innovation performance is also significant under the conditions of different technology levels and different types of firms.
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Affiliation(s)
- Bei Lyu
- Business School, Henan University, Kaifeng, China
- School of Economics and Management, Huaibei Normal University, Huaibei, China
- Chinese Gradate School, Panyapiwat Institute of Management, Thailand
- Corresponding author.School of Economics and Management, Huaibei Normal University, No. 100, Dongshan Road, Xiangshan District, Huaibei, Anhui Province, 235000 China.
| | - Rui Yi
- Business School, Xiangtan University, Xiangtan, China
| | - Guangcan Fan
- Business School, Xiangtan University, Xiangtan, China
| | - Yuezhou Zhang
- Business School, Xiangtan University, Xiangtan, China
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4
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Lysaght T, Schaefer GO, Voo TC, Wee HL, Joseph R. Professional Oversight of Emergency-Use Interventions and Monitoring Systems: Ethical Guidance From the Singapore Experience of COVID-19. JOURNAL OF BIOETHICAL INQUIRY 2022; 19:327-339. [PMID: 35420376 PMCID: PMC9008394 DOI: 10.1007/s11673-022-10171-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/10/2022] [Indexed: 06/14/2023]
Abstract
High degrees of uncertainty and a lack of effective therapeutic treatments have characterized the COVID-19 pandemic and the provision of drug products outside research settings has been controversial. International guidelines for providing patients with experimental interventions to treat infectious diseases outside of clinical trials exist but it is unclear if or how they should apply in settings where clinical trials and research are strongly regulated. We propose the Professional Oversight of Emergency-Use Interventions and Monitoring System (POEIMS) as an alternative pathway based on guidance developed for the ethical provision of experimental interventions to treat COVID-19 in Singapore. We support our proposal with justifications that establish moral duties for physicians to record outcomes data and for institutions to establish monitoring systems for reporting information on safety and effectiveness to the relevant authorities. Institutions also have a duty to support generation of evidence for what constitutes good clinical practice and so should ensure the unproven intervention is made the subject of research studies that can contribute to generalizable knowledge as soon as practical and that physicians remain committed to supporting learning health systems. We outline key differences between POEIMS and other pathways for the provision of experimental interventions in public health emergencies.
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Affiliation(s)
- Tamra Lysaght
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
| | - Gerald Owen Schaefer
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
| | - Teck Chuan Voo
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
| | - Hwee Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Roy Joseph
- Centre for Biomedical Ethics, Yong Yoo Lin School of Medicine, Clinical Research Centre MD 11 #02-03, National University of Singapore, 10 Medical Drive, Singapore, Singapore
- Department of Paediatrics, National University Hospital, Singapore, Singapore
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5
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Framing regenerative medicine: culturally specific stories of an emerging technoscience. BIOSOCIETIES 2021. [DOI: 10.1057/s41292-021-00236-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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6
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Master Z, Matthews KRW, Abou-El-Enein M. Unproven stem cell interventions: A global public health problem requiring global deliberation. Stem Cell Reports 2021; 16:1435-1445. [PMID: 34107243 PMCID: PMC8190665 DOI: 10.1016/j.stemcr.2021.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/12/2022] Open
Abstract
The unproven stem cell intervention (SCI) industry is a global health problem. Despite efforts of some nations, the industry continues to flourish. In this paper, we call for a global approach and the establishment of a World Health Organization (WHO) Expert Advisory Committee on Regenerative Medicine to tackle this issue and provide guidance. The WHO committee can harmonize national regulations; promote regulatory approaches responsive to unmet patient needs; and formulate an education campaign against misinformation. Fostering an international dialog and developing recommendations that can be adopted by member states would effectively address the global market of unproven SCIs.
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Affiliation(s)
- Zubin Master
- Biomedical Ethics Research Program and the Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Kirstin R W Matthews
- Baker Institute for Public Policy Center for Health and Biosciences, Rice University, Houston, TX, USA
| | - Mohamed Abou-El-Enein
- Division of Medical Oncology, Department of Medicine, and Department of Stem Cell Biology and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Joint USC/CHLA Cell Therapy Program, University of Southern California, and Children Hospital Los Angeles, Los Angeles, CA, USA.
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7
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Development and Regulation of Gene and Cell-Based Therapies in Europe: A Quantification and Reflection. Trends Pharmacol Sci 2020; 41:67-71. [DOI: 10.1016/j.tips.2019.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/12/2019] [Accepted: 11/27/2019] [Indexed: 11/18/2022]
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8
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Petersen A, Tanner C, Munsie M. Navigating the cartographies of trust: how patients and carers establish the credibility of online treatment claims. SOCIOLOGY OF HEALTH & ILLNESS 2019; 41 Suppl 1:50-64. [PMID: 31599982 DOI: 10.1111/1467-9566.12872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Digital media offer citizens novel ways of 'enacting' health and illness, and treatment and care. However, while digital media may so 'empower' citizens, those searching for credible information will be confronted with various, often-conflicting claims that may have 'disempowering' effects. This article uses Gieryn's concept of the 'cultural cartography' to explore the criteria that patients and carers employ in establishing the credibility of information on alleged treatments. Drawing on data from interviews with Australian patients and carers who have travelled or considered travelling abroad for unproven commercial stem cell treatments, the article examines how individuals assess rival sources of epistemic authority - science-based and non-science-based - as they search for credible information. As we argue, in a context where conventional treatment options are perceived to be limited or non-existent - which is likely to be the case with those suffering severe, life-limiting conditions - and the credibility of sources uncertain, matters of opinion and belief are prone to being interpreted as matters of fact, with potentially far-reaching implications for citizens' health. Revealing the mechanisms by which individuals ascribe credibility to health information, we conclude, has become crucial as digital media assume a growing role in health and healthcare and governments encourage citizens to become 'digitally literate'.
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Affiliation(s)
- Alan Petersen
- Sociology and Gender Studies, School of Social Sciences, Monash University, Melbourne, Vic, Australia
| | - Claire Tanner
- Department of Anatomy and Neuroscience, Centre for Stem Cell Systems, School of Biomedical Sciences, University of Melbourne, Melbourne, Vic, Australia
| | - Megan Munsie
- Department of Anatomy and Neuroscience, Centre for Stem Cell Systems, School of Biomedical Sciences, University of Melbourne, Melbourne, Vic, Australia
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9
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Sleeboom-Faulkner M. Regulatory brokerage: Competitive advantage and regulation in the field of regenerative medicine. SOCIAL STUDIES OF SCIENCE 2019; 49:355-380. [PMID: 31185876 PMCID: PMC6566457 DOI: 10.1177/0306312719850628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This article concerns the roles of entrepreneurial scientists in the co-production of life science research and regulation. Regulatory brokerage, defined as a mode of strategic planning and as the negotiation of regulation based on comparative advantage and competition, is expressed in scientific activities that take advantage of regulatory difference. This article is based on social science research in Japan, Thailand, India and the UK. Using five cases related to Japan's international activities in the field of regenerative medicine, I argue that, driven by competitive advantage, regulatory brokerage at lower levels of managerial organization and governance is emulated at higher levels. In addition, as regulatory brokerage affects the creation of regulation at national, bilateral and global levels, new regulation may be based on competition in regulatory advantage rather than on ethical and scientific values. I argue that regulatory brokerage as the basis for regulatory reform bypasses issues that need to be decided by a broader public. More space is needed for international and political debate about the socio-political consequences of the global diversity of regulation in the field of the life sciences.
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Abstract
New health technologies are rapidly emerging from various areas of bioscience research, such as gene editing, regenerative medicine and synthetic biology. These technologies raise promising medical possibilities but also a range of ethical considerations. Apart from the issues involved in considering whether novel health technologies can or should become part of mainstream medical treatment once established, the process of research translation to develop such therapies itself entails particular ethical concerns. In this paper I use synthetic biology as an example of a new and largely unexplored area of health technology to consider the ways in which novel health technologies are likely to emerge and the ethical challenges these will present. I argue that such developments require us to rethink conventional attitudes towards clinical research, the roles of doctors/researchers and patients/participants with respect to research, and the relationship between science and society; and that a broader framework is required to address the plurality of stakeholder roles and interests involved in the development of treatments based on novel technologies.
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11
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Lipworth W, Kerridge I, Ghinea N, Zalcberg J. Clearing the air: towards agreement about access to high cost cancer medicines. Ann Oncol 2019; 30:143-146. [PMID: 30339243 DOI: 10.1093/annonc/mdy459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- W Lipworth
- Sydney Health Ethics, University of Sydney, Sydney.
| | - I Kerridge
- Sydney Health Ethics, University of Sydney, Sydney; Department of Haematology, Royal North Shore Hospital, Sydney
| | - N Ghinea
- Sydney Health Ethics, University of Sydney, Sydney
| | - J Zalcberg
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
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12
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Datta S. An endogenous explanation of growth: direct-to-consumer stem cell therapies in PR China, India and the USA. Regen Med 2018; 13:559-579. [PMID: 30129871 DOI: 10.2217/rme-2017-0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The recent expansion of direct-to-consumer stem cell therapies (DSCTs) across nations where medical malpractice laws are the strongest globally challenges the causal assumption that low regulatory standards in developing countries bolster DSCTs. Drawing on firm-level data of existing biopharmaceuticals, approved stem cell therapies (SCTs) and DSCT clinics across the USA, PR China and India, this paper provides an innovation studies perspective of the ways in which the paradigmatic shift in fundamental knowledge production - from in vitro to in vivo stem cells - is transforming SCT discovery and delivery. It argues that the endogenous and inherent disruptive attributes of SCTs, rather than exogenous conditions like regulations, provide a substantive explanation for the recent expansion of DSCTs and urges regulatory adaptation to endogenous imperatives for effective governance of SCTs.
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Affiliation(s)
- Saheli Datta
- King's College London, Global Health & Social Medicine Strand, London WC2R 2LS, UK
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13
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Salter B, Salter C. The politics of ageing: health consumers, markets and hegemonic challenge. SOCIOLOGY OF HEALTH & ILLNESS 2018; 40:1069-1086. [PMID: 29740838 DOI: 10.1111/1467-9566.12743] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
In recent years ageing has travelled from the placid backwaters of politics into the mainstream of economic, social and cultural debate. What are the forces that have politicised ageing, creating a sustained opposition to the supply side hegemony of pharmaceuticals, medicine and state which has historically constructed, propagated and legitimised the understanding of ageing as decline in social worth? In addressing this question, the paper develops Gramsci's theory of hegemony to include the potentially disruptive demand side power of consumers and markets. It shows how in the case of ageing individuals acting in concert through the mechanisms of the market, and not institutionalised modes of opposition, may become the agents of hegemonic challenge through a combination of lifecourse choice and electoral leverage. In response, the hegemony is adapting through the promotion of professionally defined interpretations of 'active ageing' designed to retain hegemonic control. With the forces of hegemony and counter-hegemony nicely balanced and fresh issues such as intergenerational justice constantly emerging, the political tensions of ageing are set to continue.
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14
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15
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Datta S. Emerging dynamics of evidence and trust in online user-to-user engagement: the case of ‘unproven’ stem cell therapies. CRITICAL PUBLIC HEALTH 2018. [DOI: 10.1080/09581596.2018.1446509] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Saheli Datta
- Department of Global Health and Social Medicine, King’s College London, London, UK
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16
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de Solà-Morales O, Cunningham D, Flume M, Overton PM, Shalet N, Capri S. DEFINING INNOVATION WITH RESPECT TO NEW MEDICINES: A SYSTEMATIC REVIEW FROM A PAYER PERSPECTIVE. Int J Technol Assess Health Care 2018; 34:224-240. [PMID: 29987996 DOI: 10.1017/s0266462318000259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The aim of this study was to investigate how innovation is defined with respect to new medicines. METHODS MEDLINE, Embase, and EconLit databases were searched for articles published between January 1, 2010 and May 25, 2016 that described a relevant definition of innovation. Identified definitions were analyzed by mapping the concepts described onto a set of ten dimensions of innovation. RESULTS In total, thirty-six articles were included, and described a total of twenty-five different definitions of innovation. The most commonly occurring dimension was therapeutic benefit, with novelty and the availability of existing treatments the second and third most common dimensions. Overall, there was little agreement in the published literature on what characteristics of new medicines constitute rewardable innovation. CONCLUSIONS Alignment across countries and among regulators, health technology assessment bodies and payers would help manufacturers define research policies that can drive innovation, but may be challenging, as judgements about what aspects of innovation should be rewarded vary among stakeholders, and depend on political and societal factors.
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18
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Abstract
Many countries have identified regenerative medicine as a strategic priority, and have thus launched a range of initiatives to facilitate innovation in the field. This perspective paper argues that several initiatives involve resource distributions that could impinge on widely accepted egalitarian notions of fairness and justice that underpin current healthcare systems. Specifically, this paper focuses on five initiatives, and argues that these initiatives reflect a largely unacknowledged utilitarian perspective on distributive justice. The intention of this paper is not to argue against these initiatives, but rather to stimulate an open discussion on what qualifies as a just and fair system of resource distribution, so that the regenerative medicine field can responsibly deliver on its clinical potential.
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Affiliation(s)
- John Gardner
- Department of Sociology, School of Social Sciences, Monash University, W414 Menzies Building, 20 Chancellors Walk, Clayton, Melbourne, 3800, Australia
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19
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Tanner C, Petersen A, Munsie M. ‘No one here's helping me, what do you do?’: addressing patient need for support and advice about stem cell treatments. Regen Med 2017; 12:791-801. [DOI: 10.2217/rme-2017-0056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: This article examines how those who contemplate purported stem cell treatments (SCTs) negotiate available information sources and the adequacy of current approaches to guidance and support. Materials & methods: Qualitative interviews undertaken with people who had contemplated or undergone purported SCTs for a range of conditions (n = 24 and n = 27, respectively), as well as professionals who are frequently asked about SCTs (n = 20) were analyzed. Results: Our findings reveal the difficulties for individuals in discriminating between different sources of information on SCTs and the limitations of current responses. Conclusion: In the context of contending information about SCTs informal (‘accidental’) advisors potentially play a crucial role in supporting patients. Additional approaches are also required to better address patients’ needs.
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Affiliation(s)
- Claire Tanner
- Department of Anatomy & Neuroscience, Center for Stem Cell Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Alan Petersen
- Sociology, School of Social Sciences, Monash University, Clayton, Victoria, Australia
| | - Megan Munsie
- Department of Anatomy & Neuroscience, Center for Stem Cell Systems, The University of Melbourne, Parkville, Victoria, Australia
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20
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Chan S. Current and emerging global themes in the bioethics of regenerative medicine: the tangled web of stem cell translation. Regen Med 2017; 12:839-851. [PMID: 29119870 PMCID: PMC5985499 DOI: 10.2217/rme-2017-0065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/08/2017] [Indexed: 12/21/2022] Open
Abstract
Probably the most serious problem facing the field of regenerative medicine today is the challenge of effective translation and development of viable stem cell-based therapies. Particular concerns have been raised over the growing market in unproven cell therapies. In this article, I explore recent developments in the stem cell therapy landscape and argue that while the sale of unproven therapies undoubtedly poses ethical concerns, it must be understood as part of a larger problem at the interface between biomedicine, healthcare, publics, policy and the market. Addressing this will require a broader perspective incorporating the shifting relationships between different stakeholder groups, the global politics of research and innovation, and the evolving role of publics and patients with respect to science.
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Affiliation(s)
- Sarah Chan
- Usher Institute for Population Health Sciences & Informatics, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
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21
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Hauskeller C. Can harmonized regulation overcome intra-European differences? Insights from a European Phase III stem cell trial. Regen Med 2017; 12:599-609. [DOI: 10.2217/rme-2017-0064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Harmonized regulation of research with human stem cells in Europe has shaped innovation in regenerative medicine. Findings from a Phase III academic clinical trial of an autologous cell procedure illustrate the obstacles that a multinational trial faces. A typology of the obstacles encountered, may help other teams embarking upon trials. The findings throw light on the situation of clinician-scientists in clinical innovation, as the expertise to run scientific trials is very complex. The innovation route of clinical translation takes insufficient account of the interdependencies between multiple social and cultural factors from outside the laboratory and the clinic. For ethical reasons, however, academic and business routes to stem cell treatments ought to be enabled by the regulators. Suggestions arise, how academics can prepare for trials, that academic research needs better institutional support and that new models of medical innovation may need to be developed for regenerative medicine.
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Affiliation(s)
- Christine Hauskeller
- Department of Sociology, Philosophy & Anthropology, University of Exeter, Byrne House, St Germans Road, Exeter EX4 4PJ, UK
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22
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Exploring the boundaries of autonomy and the ‘right’ to access innovative stem cell therapies. Asian Bioeth Rev 2017. [DOI: 10.1007/s41649-017-0001-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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23
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Rosemann A, Bortz G, Vasen F, Sleeboom-Faulkner M. Global regulatory developments for clinical stem cell research: diversification and challenges to collaborations. Regen Med 2016; 11:647-57. [DOI: 10.2217/rme-2016-0072] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
In this article, we explore regulatory developments in stem cell medicine in seven jurisdictions: Japan, China, India, Argentina, Brazil, the USA and the EU. We will show that the research methods, ethical standards and approval procedures for the market use of clinical stem cell interventions are undergoing an important process of global diversification. We will discuss the implications of this process for international harmonization and the conduct of multicountry clinical research collaborations. It will become clear that the increasing heterogeneity of research standards and regulations in the stem cell field presents a significant challenge to international clinical trial partnerships, especially with countries that diverge from the regulatory models that have been developed in the USA and the EU.
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Affiliation(s)
- Achim Rosemann
- Centre for Education Studies, Faculty of Social Sciences, University of Warwick, Coventry, CV4 7AL, UK
- Centre for Bionetworking, School of Global Studies, University of Sussex, Brighton, BN1 9SJ, UK
| | - Gabriela Bortz
- Institute of Science & Technology Studies, National University of Quilmes (IESCT-UNQ), Roque S. Peña 352, (1876) Bernal, Buenos Aires, Argentina
- National Council of Scientific & Technical Research (CONICET), Godoy Cruz 2290, C1425FQB Buenos Aires, Argentina
| | - Federico Vasen
- Institute of Science & Technology Studies, National University of Quilmes (IESCT-UNQ), Roque S. Peña 352, (1876) Bernal, Buenos Aires, Argentina
- Institute of Social Research, National Autonomous University of Mexico, Circuito Mario de la Cueva s/n, Ciudad Universitaria, Coyoacán, 04510 Ciudad de México, México
| | - Margaret Sleeboom-Faulkner
- Centre for Bionetworking, School of Global Studies, University of Sussex, Brighton, BN1 9SJ, UK
- Department of Anthropology, University of Sussex, Arts C 206, Brighton, BN1 9SJ, UK
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Ballantyne PJ. Understanding Users in the 'Field' of Medications. PHARMACY 2016; 4:E19. [PMID: 28970392 PMCID: PMC5419342 DOI: 10.3390/pharmacy4020019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/04/2016] [Accepted: 05/03/2016] [Indexed: 12/30/2022] Open
Abstract
The numbers of medicinal drugs available for human consumption have increased rapidly in the past several decades, and physician prescribing practices reflect the growing reliance on medicines in health care. However, the nature of medicines-as-technology makes problematic taken-for-granted relationships among actors involved in the delivery, or who are the recipients of medicines-reliant health care. In this article, I situate the medicine user in the 'field' of medications-where interests, actions and outcomes are continually negotiated among and between the various players-physicians, pharmacists, government regulatory bodies, the pharmaceutical industry and users of medicines. The objective of the paper is to illuminate the complex context in which the medicine-user-the target of the pharmacy profession's service to the public-accesses and uses medicines.
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Affiliation(s)
- Peri J Ballantyne
- Department of Sociology, Trent University, 1600 West Bank Drive, Peterborough, ON K9J 0G2, Canada.
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Comparing national home-keeping and the regulation of translational stem cell applications: An international perspective. Soc Sci Med 2016; 153:240-9. [PMID: 26921839 DOI: 10.1016/j.socscimed.2016.01.047] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 01/23/2016] [Accepted: 01/25/2016] [Indexed: 11/21/2022]
Abstract
A very large grey area exists between translational stem cell research and applications that comply with the ideals of randomised control trials and good laboratory and clinical practice and what is often referred to as snake-oil trade. We identify a discrepancy between international research and ethics regulation and the ways in which regulatory instruments in the stem cell field are developed in practice. We examine this discrepancy using the notion of 'national home-keeping', referring to the way governments articulate international standards and regulation with conflicting demands on local players at home. Identifying particular dimensions of regulatory tools - authority, permissions, space and acceleration - as crucial to national home-keeping in Asia, Europe and the USA, we show how local regulation works to enable development of the field, notwithstanding international (i.e. principally 'western') regulation. Triangulating regulation with empirical data and archival research between 2012 and 2015 has helped us to shed light on how countries and organisations adapt and resist internationally dominant regulation through the manipulation of regulatory tools (contingent upon country size, the state's ability to accumulate resources, healthcare demands, established traditions of scientific governance, and economic and scientific ambitions).
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