Letters - February 2010
Tex Med . 2010;106(2):7-8.
No to Embryonic Stem Cell Research
The article by Ken Ortolon (See " Back to Work ," November 2009 Texas Medicine , pages 53-55) regarding research on embryonic stem cells was misleading and an affront to conscientious physicians and researchers.
Conflating embryonic stem cells with stem cells derived from bone marrow obfuscates the fundamental difference between the two: One involves the destruction of human life, the other does not.
Mr. Ortolon's article originally addresses the lifting of the federal ban on embryonic stem cell research; however, the article uses a bone marrow-derived stem cell success story to illustrate the benefits of stem cell therapy. The inattentive reader is left to suspect that embryonic stem cells played a role in the patient's recovery; in fact, the clinical benefit was due to the patient's own bone marrow-derived stem cells.
The clinical benefits from stem cells derived from bone marrow, skin cells, umbilical cord cells, and induced pluripotent stem cells (iPSCs) have been studied, trialed, and published. ( Science , Dec. 21, 2007). These stem cells do not involve the destruction of human life, provoke no controversy, and continue to prove beneficial in clinical trials and direct patient care as Mr. Ortolon's article indicates.
Experimentation with human embryonic stem cells, by the very nature of their being human, directly involves the destruction of human life. Regardless of the promised benefits of research, it is never permissible to destroy human life to achieve a desired end.
Following World War II, the Nuremberg trials highlighted the horror of human experimentation. A result of the trials was the development of the Nuremberg Code -- an outline for medical research that remains with us today. Article 1 of the code states: "The voluntary consent of the human subject is absolutely essential." Human embryonic research explicitly violates the fundamental underlying principle of the code by destroying human life as a means to achieve an end.
In 2004, the Texas Medical Association House of Delegates adopted a policy supporting, in part, embryonic stem cell research. This policy underscores the need for physicians to educate themselves and their colleagues of the benefits of iPSCs and other licit stem cell research and therapy. The TMA's policy also will be long remembered as a blatant rejection of the Hippocratic Oath and a replay of the dark days of human experimentation this generation once thought conquered.
MARC D. PECHA, MD , San Antonio
Educate, Don't Punish
As a way of introduction, I am a retired cardiovascular surgeon from the Rio Grande Valley now practicing phlebology in the Brownsville-Harlingen area. I have been practicing in the Valley for more than 30 years.
I am writing in response to an article in Texas Medicine , August 2009 (" Getting Ready for RACs ," pages 49-52). If I interpret correctly, a private concern, Connolly Health Care, has been contracted to audit Medicare payments to Texas physicians. Audits shouldn't be a problem in a well-run practice, but the alarming issue is that the RACs work on a contingency basis and receive a percentage of the overpayments they recover. Therefore, they are more likely to subject physicians to the recoupment of overpayments. There is certainly a financial incentive to find fault. This appears be a clear conflict of interest with potentially devastating consequences to any physician practice made up of a large Medicare population.
Since 2003, we have been relieved of a large part of the malpractice problems that plagued us in the past. Since that time, we now have an overzealous Texas Medical Board with a huge task force of investigators who can bring a great deal of grief to a doctor over even a trivial complaint. Now with the onset of RACs, a physician needs not only malpractice insurance, but also additional fraud and abuse insurance and a law firm prepared to deal with the onerous audit process. I envision tripling my legal defense premium in order to be prepared for the possible consequences of any of the actions involving the above threat.
I strongly plead that we involve our very strong and effective TMA in a process to make our system less punitive and geared to education and not destruction.
THOMAS A.CLARK, MD , Harlingen
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