Designer Medicine ahead? Stay tuned, experts say.
This year’s Nobel Conference focused on medical advances
We’re on the edge of an era when medical treatment will be tailored to each person’s genetic makeup, economist Henry J. Aaron told the 5,000-member audience at the 42nd annual Nobel Conference. Sessions were held at Gustavus Adolphus College, October 3-4. “But tomorrow’s promise will be only a tease if we can’t pay for it,” Aaron said.
“We risk being impoverished mendicants (beggars) looking through the window at goodies we can’t afford,” Aaron, of the Brookings Institution, Washington, D.C., said dramatically.
Ethicist Daniel Callahan, founder of New York’s Hastings Center and responsible for establishing bio-ethics as a field, explained, “We’ve been trying to contain medical costs since the Nixon administration. The United States spends more per capita than other industrialized nations, but we are by no means the leader in quality of care or in life expectancy. We have 46 million people who are uninsured.”
This year’s conference, “Medicine: Prescription for Tomorrow,” invited prominent scientists to speak about the hope implicit in their cutting-edge research. A sobering note was added by Aaron, Callahan and also Michael Osterholm, director of the Center for Infectious Disease Research and Policy, University of Minnesota, who warned of uncontrollable pandemics.
J. Michael Bishop, chancellor of the University of California, San Francisco, and 1989 Nobel laureate in physiology and medicine, opened the two-day conference by detailing what has been learned from the Human Genome Project and the doors it is opening to understanding and treating cancer. He spoke optimistically of both prevention and cure.
“We’re finding that cancer may result from perturbation of adult stem cells,” Bishop said. “We’re discovering several causes of this cellular aberration: viral, bacterial, environmental and hormonal. It’s likely that not only one, but many cures will be found. A promising therapy that is having some success is to target only cancer cells, not the healthy cells.”
Bishop believes gene study has settled the evolution question. “The history of evolution is set forth in the genomic record more clearly than in fossilized remains.” He finds it perplexing that on a list of industrialized nations ranked according to their acceptance of evolution, the United States falls next to last, between Cyprus and Turkey.
Jennifer West, Rice University, Houston, Texas, spoke about bioengineering, and Dame Julia Polak, Imperial College, London, a leading stem cell researcher, described her work in regenerative medicine. “If we can repair damaged tissue and even regenerate organs by stimulating stem cells that can go to the site of the injury, we can project a long, healthy life for everyone.”
“We’ll all die,” Osterholm countered during a discussion period. “If we tinker with cures for the top ten diseases, may we then survive only to die of causes that are far less desirable?”
Callahan called for a cultural shift in attitude. “Both the Left and the Right love technological innovation, but there’s a tension between progress and equitable access. We keep raising the bar, so that the healthier we become, the more we spend, feeling better but doing worse. Is there a point when we can say we’ve had enough good health or that we’ve lived long enough?”
“We must have universal medical coverage,” Aaron said. He believes that the United States can afford the necessary 6-7% budget increase by making cuts at the margins. ”We have to deal with the health care system as a whole, not just the public portion.”
Dr. Steven Miles, University of Minnesota physician who has worked internationally with the American Refugee Commit-tee, concluded the conference by speaking for the world’s less advantaged populations, lauding the spirit and ingenuity of refugees. “Every time we’ve turned to the refugees, they’ve shown the ability to find creative solutions for their medical problems. They just need help with organization and materials.”