Bioethicist Complains that the Rich Are Getting Breakthrough Cancer Treatments First


By 2020?

Over at the New York Times, superb science journalist Gina Kolata is reporting a wonderful three-part series, Genetic Gamble, on how whole genome sequencing is dramatically personalizing cancer treatments with remarkable results. In the first part that ran on Sunday, Kolata detailed the story of Dr. Lukas Wartman who became ill with a hard-to-treat form of leukemia in his 20s. A team of his colleagues at Washington University in St. Louis decided to sequence all the genes in both his normal cells and his cancer cells and compare them. They hoped that the sequencing would reveal what had gone wrong and suggest ways to treat his cancer. As Kolata reports:

….they found a culprit — a normal gene that was in overdrive, churning out huge amounts of a protein that appeared to be spurring the cancer's growth.

Even better, there was a promising new drug that might shut down the malfunctioning gene — a drug that had been tested and approved only for advanced kidney cancer. Dr. Wartman became the first person ever to take it for leukemia.

And now, against all odds, his cancer is in remission and has been since last fall.

Hooray! Well, except of course for some bioethicists. As the Times reports:

Ethicists ask whether those with money and connections should have options far out of reach for most patients before such treatments become a normal part of medicine. And will people of more limited means be tempted to bankrupt their families in pursuit of a cure at the far edges?

"If we say we need research because this is a new idea, then why is it that rich people can even access it?" asked Wylie Burke, professor and chairwoman of the department of bioethics at the University of Washington.

That's the all-too-often knee jerk response from professional bioethicists – if we all can't have the treatment then none of us should have the treatment. We should all be equal in disease, disability, and death. However, Wylie does have a glimmer of a thought about why that might be wrong:

The saving grace, [Burke] said, is that the method will become available to all if it works.

Well, yes. Let's let the rich be guinea pigs for new biotech treatments for us all.

In any case, I highly recommend reading the whole series by Kolata, In Treatment for Leukemia, Glimpses of the Future from Sunday and today's A New Treatment's Tantalizing Promise Brings Heartbreaking Ups and Downs. The third part, A Game Changer in Revealing Cancer's Prognosis, which details a precise new genetic test that can tell a patient if his or her form of melanoma is likely to be curable or not, is now up on the Times' website.