Incidental findings in biomedical research

June 16, 2015

Investigations such as genome sequencing and brain imaging have the potential to reveal details about the patient of research subject which were not the principal reason for the study. The ethical issues associated with such “incidental findings” is the subject of this short film, made by students at the University of Leicester.

The video was rated the third best produced by students in the 2014-15 cohort.

People interested in knowing more about the topic might also like to read:
Green et al. (2013) ACMG recommendations for reporting of incidental findings in clinical exome and genome sequencing Genetics in Medicine 15:565-574

Vernooji et al. (2007) Incidental Findings on Brain MRI in the General Population New England Journal of Medicine 357:1821-1828


Dark Matters: An archive of research ethics mistakes

December 20, 2013
darkmatter

Stories discussed in Dark Matters could prove useful when teaching about research ethics

I discovered recently that the Discovery Science channel has an interesting little series called Dark Matters: Twisted but true. Started in 2011, to date there have been two series of the show. Typically each 45 minute episode looks at three separate examples of “strange science”. The standard format for each tale includes historical reenactment and soundbite interviews with experts from the field.

In truth the choice of incidents discussed is patchy; some aligning poorly with the definition of “science”, or “strange”, or both. The subtitle “Twisted but true” gives insight into the audience for whom the series may be targeted.  We also need to be slightly cautious about putting too much reliance on the validity of docudrama versions of events.

Having said that, however, there are plenty of examples here which could be used as introductions to some of the more notorious breaches of research ethics. For example, Season 2 Episode 2 (TRILT 02F8C452) discusses Louis Pasteur’s testing of an experimental rabies vaccine on Joseph Meister. Episode 2.6 (TRILT 02FB2D0F) includes recreation of the notorious Stanford prison experiment, and 2.7 (TRILT 02FD7B36) discusses the Tuskegee syphilis experiment in which poor sharecroppers with syphilis were deliberately kept untreated, even after the efficacy of penicillin for treating the illness had been demonstrated.


Cognitive enhancement: less sleep = more done?

February 25, 2009

In Make me… stay awake, the final part of an engaging series of three documentaries (following Make me… smart and Make me… live forever), Michael Mosley investigates the effects of sleep deprivation and ways in which these symptoms may be alleviated. As he puts it in the introduction to the film, he wants to know if there are ways of “conquering… my need and my urge for sleep” (01:40).

Several sections of the programme brought bioethical themes into sharp focus – including the use of model organisms in research (17:53-20:47) and the use of drugs to stay awake longer (26:42- end).

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Science and Ethics of Drug Trials – Class Clips

July 21, 2008

The BBC’s Class Clips series does exactly what it says on the tin – the programmes are collections of short clips for use in classroom teaching. New in 2007, Class Clips programmes on a variety of subjects have since been transmitted overnight in the Learning Zone on BBC2 on several occasions and it looks like the website is gearing up to offer them via iPlayer, which will be a bonus in terms of availability (although, at the time of writing, the links are not yet active). The intended audience is advertised as Key Stage 3, but they could certainly be used with older students too.

The Biology section of Class Clips Science 2 is the most directly relevant for bioethics education since it includes two short sections on drug trials; one looks more at the procedures, the second at the ethics. However, if you are teaching at other times about modern medicine then don’t be put off by the physics-only sounding section on the electromagnetic spectrum – each of the clips on waves of different lengths (from gamma rays through to radiowaves) is looked at with explicit reference to their medical applications. Read the rest of this entry »


WIT: A window on tensions in clinical trials

June 12, 2008

(Warning: contains plot spoilers!) Adapted from Margaret Edson’s 1999 Pulitzer Prize winning play, Wit tells the tragic story of Professor Vivian Bearing (Emma Thompson). Vivian, a ruthless scholar of 17th Century English poetry, is diagnosed with advanced stage 4 metastatic ovarian cancer. Dr Harvey Kelekian (Christopher Lloyd), Vivian’s consultant physician and leading figure in this area of medical research, explains that the most effective treatment option she has is an aggressive experimental chemotherapy at the full dose.

Professor Vivian Bearing

 
Professor Vivian Bearing (Emma Thompson)  

She cautiously consents to the therapy and embarks on a degrading regime of eight cycles, which no other patient has completed before. With a fearless determination, Vivian does everything the doctors ask of her, and as such illustrates the central ethical issue observed in this film; the conflict of interest witnessed between clinical therapy and clinical research. Throughout, this is entangled with clinical incompetence, issues of informed consent, end of life decisions and Vivian’s frustration with the hospitals insensitive mechanistic approach to their patients, having been asked repeatedly “How are you feeling today?” (00:04:10 – 00:05:25) Read the rest of this entry »


The vivisection debate: Animals (More4)

October 16, 2007

Part of a season of programmes about aspects of animal use in research, this drama/documentary was first broadcast in December 2005. In the fictional story we are introduced to a research scientist involved in animal testing and to an animal rights activist intent on stop him.  The narrative develops from about 1997, when a TV documentary exposed genuine mistreatment of some animals at Britain’s largest animal research facility, Huntingdon Life Sciences (HLS), see 00:16:07 – 00:17:31. Throughout the programme, Animals examines real life actions taken by animal rights activists and incorporates them in the plot of the story. A series of interviews with people who were directly involved in these events is also interspersed, and provides interesting insights into their personal experiences. Read the rest of this entry »


Animal Research – Monkeys, Rats and Me

October 8, 2007

In the spring of 2004, work started on the new Oxford University Biomedical research laboratory, which would be partially used for animal experimentation. From the very first day of construction, the site was bombarded with verbal abuse and relentless physical damage to machinery, offices and supplies by animal rights protestors. This subsequently forced the building work to be halted for 18 months. Monkeys, Rats and Me, a documentary commissioned by the BBC, joins the story when construction is restarted in November 2005, and follows the activities of those who campaign for and against the use of animals in medical experimentations. The site of the new facility had become the epicentre for a grand battle between the two polar views of experiments on animals. On the one side you have those who wish for total abolishment of vivisection and on the other there are those who see animal experimentation as an essential tool for advancing science and developing new cures. The narrator suggests that this dispute revolves around the central ethical question of whether “the benefits to patients justify the harms to the animals”. To address this, the documentary attempts to see if animal experimentation works and even, if it does, “is it ethical?” Read the rest of this entry »