Wednesday, August 03, 2011

Sports Medicine and Medical Ethics

I ran across this very bizarre article on about stem cell research and sports medicine. Particularly, the article is a first person account of a former pitcher's attempt to basically rebuild his arm after injury through a strange concoction of stem cell therapy and PRP therapy. I have read through the article more than once, and I still don't know what I think about, other than to say that I think it brings up a whole host of medical ethics questions.

From a sheer medical standpoint, the whole procedure sounds almost fantastical, to the point of being some combination of crackpot medicine and science fiction. A scant $5000 for a miracle one time therapy that can allow a washed up pitcher to regain throwing ability in the 90+ MPH range in six weeks? That seemed kind of out there to me, but there was just enough logic to it that maybe there is medical merit to the procedure. I'm not a doctor, so I can't really speak to that other than from a common sense "if it sounds too good to be true, it probably is" standpoint. But, for sake of argument, I will assume that the doctor and the whole procedure is on the up and up.

Two things really caught my attention though in that the procedure used stem cells and, particularly, what he starts advocating at the very end of the article. Stem cell research has been mired for years in ethical and moral debates. These debates stem (no pun intended) from where some stem cells are harvested from: unborn human embryos. Personally, I do have some issues with research in this manner because it is always posited as an ends-justifies-the-means ethical logic. In my experience, when that starts happening in scientific research, bad things usually start happening, particularly as unforeseen byproducts. Of course, also at play is the issue of when life begins. Is the embryo a human being, and if so, isn't harvesting an embryo (and necessarily destroying it), also destroying human life.

Though I have moral opinions on such issues, I try to avoid getting into those kinds of pro-life/pro-choice/pro-abortion arguments because those arguments ceased to be open ended debates long ago. In short, what else is there to be said on the issue of abortion? People are dug in and unwilling to be open to even the possibility of changing their own views on the issue. When that happens, further debate is really pointless. Best case scenario is stalemate, and worse case scenario (which is often what happens) is name calling, ad hominem attacks, and people screaming at each other. That is neither debate nor is it educationally edifying. What it is is pointless polemics. I have better things to do with my theological time and repeat the same arguments and points over and over.

What struck my attention in the article, however, was that the therapy in question involved harvesting the guy's own stem cells. The way people on both sides carry on in the stem cell debate, one would think that human embryos are the only source of stem cells, which is simply not the case. I see no ethical issues doing stem cell research when stem cells can be gotten from completely ethical means, provided the research stays within the normal bounds of not playing God by creating Frankenstein monsters and cloned humans.

Case in point: what struck me most about the article is the bit at the end where the author raises the spectre of using such stem cell therapy, not as reconstructive therapy on an injured arm, but on an otherwise healthy arm to make a strong arm even stronger. In other words, to use the therapy itself as a performance enhancing means to an end. The author couches it in a way that suggests such a therapy would be for long term health, not necessarily performance enhancement. The author even ends with the classic pro-stem cell argument, "it will also take time, but progress always does..."

What this article touches on briefly is that the pitching motion of Major League pitchers in largely a motion the human body is not intended to do on a regular basis. As such, ligaments tears and arms were out. Perhaps this is nature's way of telling people, "Hey, it's time to stop. Your body isn't getting any younger."

This is why we have moral and ethical discussions on things of this nature because those in favor automatically assume that newer is better. Or, to put it in the words of Dr. Malcolm from Jurassic Park, "Scientists are so fixated on whether or not they could, they don't stop to think if they should." For that matter, what is the fundamental difference between using this kind of therapy to lengthen a career and using steroids to lengthen a career? Just because we have a therapy for something does not necessarily mean everyone should use it, whether they need it or not.

Food for Thought...

No comments: