Gene therapy sparks sharp exchange

In what turned into a highly emotional debate involving audience members as well as scheduled speakers, the Penn Humanities Forum hosted Arthur Caplan, Ph.D., director of Penn’s Center for Bioethics, and Stephen Eck, M.D., Ph.D., of the Institute for Human Gene Therapy (IHGT) Feb. 8.

Eck, the codirector of the Cancer Gene Therapy Programs of IHGT and the Ann B. Young Assistant Professor of Medicine, stood in for James Wilson, M.D., director of IHGT, who was originally scheduled to speak. Because of issues surrounding the Sept. 17 death of 18-year-old Jesse Gelsinger, a participant in an IHGT experimental gene therapy trial,Wilson was unable to attend.

The speakers touched only lightly on the specific subject of Gelsinger’s death, which caused the federal Food and Drug Administration to shut down human trials at IHGT Jan. 21. The hour-and-a-half forum, titled “Will the Re-Engineering of Human Beings Re-Engineer Human Nature?,” covered subjects such as discrimination based on genetics, eugenics, and human nature and its malleability, as well as some general topics related to Gelsinger’s death — whether human trials were properly monitored and whether subjects were sufficiently informed of possible dangers.

Caplan, who is also chief of bioethics at the Health System and Trustee Professor of Bioethics, stated, “It would be a miracle” if any subject in a Phase I clinical trial, the type Gelsinger participated in, received any benefit from the experiment. He said that scientists do not do enough to inform their subjects about the risks in these trials. He stated that the monitoring of human subjects overall, not only in gene therapy trials, was “very poor.”

These statements drew sharp criticism from audience member Matthew During, M.D., director of Jefferson Medical College’s Gene Therapy Center and a professor of neurosurgery. “A Phase I trial does not mean an individual will not get any benefit,” he said. Human trials have “tighter regulations and control over them than any other trials,” he said.

Eck characterized some of Caplan’s statements as “purely ridiculous.” He said, “There is a grain of truth in what Arthur said, but it’s not the whole truth and nothing but the truth.”