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New Parkinsonís Study Raises Tough Ethical Questions

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Should scientists use tissue from an aborted human fetus in a medical experiment? And is it appropriate for some participants in the study to undergo a "placebo" brain operation? Both of those controversial issues were raised in a government-financed study involving Parkinsonís disease, the results of which were revealed on Wednesday. The study, which led a highly regarded U.S. research team to conclude that doctors may be able to improve the brain function of some Parkinsonís patients, involved transplanting fetal cells into half of the 40 subjects; the other 20 were operated on but received no cells.

The ethical questions raised by this study are extremely touchy. Unlike taking a placebo for a drug, an operation is not simply a passive exercise for the patient; it requires a person to undertake the risks associated with surgery without getting the expected benefits of the treatment. Still, "the encouraging results of this study argue that there is an important value to sham operations," says TIME science correspondent Dick Thompson. "Sometimes there may not be any other way to discover the benefits of a procedure." For instance, says Thompson, Parkinson's disease has a strong psychological component and also tends to wax and wane, making persons go through good and bad periods. Indeed, the researchers found that some subjects who underwent the sham operation experienced a "placebo effect" of feeling better simply because they believed they had been treated. Tracking that phenomenon was important to understanding the actual benefits of the fetal tissue transplants in the other patients.

The human fetal tissue aspect of the procedure raises more long-standing moral issues, especially in the highly politicized context of the national discourse on abortion. However, there is some hope that those issues may recede as a result of other scientific discoveries. Another Parkinsonís study in the current issue of the journal Neuron reported positive results by transplanting certain body cells of monkeys into their own brains. "The monkey study suggests that researchers may be able to use a personís own cells eventually," says Thompson. "There is evidence that the kind of all-purpose, or stem, cells used for these kinds of operations also exist in the brain and elsewhere in the human body." But until such other techniques are developed, who is to tell Parkinsonís patients -- and whose standards should determine -- that certain research avenues should be closed for now? The answer is neither evident nor easy.

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