Here comes the fear again

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 Bioscience holds out the prospect of medical breakthroughs that can transform our lives – but it has to contend with traditional fears about ‘interfering with nature’. Maxine Vaccine asks whether fear itself might not be the greatest danger.

Everybody’s talking about biotechnology and its implications for medicine. Even the UK Government, hardly the brightest light on the Christmas tree, recently identified stratified medicine as a crucial area for medical innovation. The idea that drugs can be tailored to the specific genetic characteristics of a patient group is powerful and opens up a new vision of ‘personalised medicine’.

But with that comes the familiar fear among doctors and patients that the new therapies are ‘interfering with nature’. It’s a fear that runs through the history of medicine. Before the invention of the microscope, some doctors who argued that diseases could be spread by ‘germs’ were hounded out of their profession. Body fluids are ‘natural’ – how could they possibly pose a danger? The argument ‘it’s not natural’ has been used against hygiene, antiseptics, antibiotics, vaccines, transplants, transfusions, hormonal treatments…

But that’s all long in the past, you might say. These days we’re enlightened, we have evidence, we don’t listen to superstition. Well… maybe. Back in 1998 a doctor fabricated evidence that the MMR vaccine caused autism. He has now been convicted of fraud, but thousands of doctors believed him. Only this year, a critical analysis of the Million Woman Study by scientists who are not clinicians concluded that it had failed to prove a causal link between hormone replacement therapy (HRT) and increased risk of breast cancer – a causal link that had been broadly accepted by the medical profession across Europe and the USA, despite the persistent voices of a sceptical minority.

Is it just possible that where biopharmaceuticals are concerned, a significant proportion of clinicians are primed to believe scare stories because, at a deep level, they suspect that such therapies are ‘against nature’? Where HRT was concerned, after all, many thousands of women had been enabled to continue successful midlife careers without being nudged by the menopause and its traumatic sequels into early retirement. How could that be right?

Many people – and doctors are not only not immune to this, they may be more prone to it than patients – are driven by an uncritical reverence for ‘nature’s way’ to fear and resist the changes we can make to our own lives as our scientific knowledge develops. The recent decision of a European court to deny patents to medical therapies developed from stem cell research shows that the power of fear is still sometimes greater than the will to heal.

Of course there are valid fears about potential harm arising from science and technology. But the danger lies in the abuse of scientific knowledge for purposes of exploitation and social control. Where valid questions need to be asked about the ethics of medical science, those are not questions about the dangers of scientific knowledge. They are questions about us.