Cancer Research & Red Tape
by Chris MacDonald
It’s always newsworthy when an eminent senior scientist comments on the current state of science policy. They’re not always right, of course, but always worth listening to — even if only to hear the sorts of messages and signals they are sending to those who are going to put stock in what they say.
James Watson (co-discoverer of the double-helix shape of the DNA molecule) has recently argued that ethics boards are hampering research — cancer research in particular. See this piece, posted by Eoin Lettice on The Guardian‘s Science Blog: James Watson: ‘cancer research is over regulated’. Here’s the key paragraph:
…Watson told journalists that he was in favour of less regulation for clinical trials as this could speed up the process of finding a cure for cancer: “We’re terribly held back on clinical tests by regulations which say that no one should die unnecessarily during trials; but they are going to die anyway unless we do something radical. I think the ethics committees are out of control and that it should be put back in the hands of the doctors. There is an extraordinary amount of red tape which is slowing us down. We could go five times faster without these committees….”
Now, all we have here is a fragment in a blog entry, so we should be careful about taking this as constituting Watson’s full, considered view on the role of ethics committees. But if, for the sake of argument, we take his view as presented, we can point out the following gaps:
- It’s just not true that, in most cases anyway, “they’re going to die anyway.” For many cancers, there are effective treatments, and we need to be cautious about subjecting patients to treatments that might well be inferior.
- The claim that “We could go five times faster without these committees” is entirely without support, and seems a gross exaggeration. I’d be surprised to find that ethics board ‘red tape’ made more than a few percentage points difference in the amount of time it takes to get a new idea translated into a new cancer drug.
- Watson is only counting the costs (in delayed research), and not the benefits (e.g., patients’ rights protected, methodologically-suspect trials weeded out), of the involvement of ethics boards in the cancer research process.
Research Ethics Blog 
I’m the individual that the mcf10 cell line was derived from. Much of what happened to Henrietta Lacks happened to me. The Detroit Free Press did a article on me Feb.20th, 2011. I think you may be interested in my “consent form”, which was handed to me seconds before they took my blood.
I’m pleased to see how things are finaly starting to change. I must admit, I’m surprised how much power “special interests” have in research. Feel free to contact me if interested.
In a way, it’s worse than Watson said. It’s not that we could go X times faster without a committee, but that a committee could never, given infinite time, allow development of standard treatments, like VAMP for childhood leukemia. That couldn’t be tested in animals because it was highly unlikely to work in them, which would stop it from being tested today in children. And that was developed in the early 1960’s, when there already was adult supervision. Development of the individual agents in VAMP, notably by Sidney Farber starting in the 1940’s, had even fewer controls.
Right now I’m most of the way through John Laszlo’s book of interviews with top twentieth century researchers, “The Cure of Childhood Leukemia (1995).” While Laszlo is no Watson-like fire-breather, it seems like almost everyone he interviews talks about how they could only succeed by walking up the edge of being fired for ethical lapses, or over it. In the 1960’s, M. C. Li could get fired for aggressive experimentation, and go on, at another hospital, to come up with a cure for a large portion of testicular cancer patients, and win the Lasker. Today, no grant committee would give him a second chance.
Does anyone think that cortisone could be approved today? No, and not in infinite time, because the first indication the drug company thought of for it was mistaken (rheumatoid arthritis) despite turning out to have many important uses in cancer treatment and elsewhere. A drug where it takes a decade or two to work out the uses now has zero chance of approval.
There has to be a middle ground between Farber, in 1950, subjecting every child to experiments, without really asking parents for permission, and, today, having multiple institutional review boards oversee the same study. True, Watson has said some off the wall stuff over the years. But he is damn right to be frustrated at the rapidly declining rate of diseases being cured, and to blame gatekeepers. Although not a great book overall, the “Rise and Fall of Modern Medicine,” by James Le Fanu, has reasonable statistics on the declining rate at which medical science is developing new cures.
Thanks for the opportunity to rant. Perhaps in the several years since Dr. MacDonald wrote this, his views have shifted a bit, so I don’t presume to be disagreeing with anyone in particular. What I got from “The Truth in Small Doses (2013)” is that most of the top researchers, even in the current century, have such concerns. But given that each bureaucratic obstacle, by itself, seems so reasonable, it’s hard to know which half of the barriers to progress need to go.