Drug development raises ethical issues
Reported February 24, 2009
The possibility that one day a drug could cure learning disabilities may have massive societal implications. But as that drug moves slowly from theory to reality, it’s also unleashing a host of ethical challenges, including safety issues related to testing drugs on children.
The biggest ethics issue is how to go forward with this particular drug development, said Trudo Lemmens, an associate professor in the faculties of law and medicine at the University of Toronto. We have to be very careful not to create more problems than a drug can solve.
A Toronto research team, working with mice, recently connected a single protein with the brain’s power to learn. The scientists have also found that a medication, now being tested in Alzheimer’s patients, may fix the problem, opening the door to the possibility that learning disabilities could one day be treated using a drug.
But that outcome is still far away, and between now and then lie a series of ethical hurdles. And while officials from some learning disability groups have expressed optimism at the potential for such a drug, others are less receptive to the idea of treating learning disabilities as medical conditions in need of a cure.
Many learning disabilities are not medical conditions, in my opinion, said Sue Hall, founder of The Whole Dyslexic Society. A learning disability such as dyslexia arises because of a particular way of learning.
The process of developing and testing a drug that may be used on children involves myriad safety checks, including multiple phases of tests on healthy subjects and adults, Prof. Lemmens said. Once researchers have a good idea of how the drug works and how it is absorbed by the body, they may move to testing its effects on children. However, Prof. Lemmens said that in cases where there is more than a minimal risk to the subject the majority of trials there must be a clear expectation that the drug will have a direct benefit.
Recently, some drugs that affect mental wellbeing have shown drastically different effects on adults and youths. A study published earlier this month showed that a particular class of antidepressants can significantly lower the risk of suicide in some adult subjects who suffer from major depression even as it revealed the potential to significantly raise suicide risk among youths.
While it is still far too early to judge what other kinds of effects a drug aimed at curing learning disabilities may show, Prof. Lemmens said other drugs that operate on mental functions have the potential to be used for significantly different purposes than they were first intended.
Many of these drugs that were originally designed to treat illnesses are sometimes used for intellectual enhancement, he said. That is another societal debate: How flexible do we want to be?