Tag
#medical-ethics
4 articles
The Macchiarini Scandal and the Surgeon Who Sold a Miracle
Paolo Macchiarini arrived at Sweden's Karolinska Institute in 2010 trailing the aura of a medical pioneer — a charismatic thoracic surgeon who claimed to be doing the seemingly impossible: building new windpipes for patients whose own were failing, by seeding a scaffold with the patient's own stem cells so the body would not reject it. The most audacious version used a synthetic trachea, a tube of plastic, soaked in a bath of stem cells and implanted where a human windpipe should be. It was presented as the dawn of regenerative medicine, published in the world's most prestigious journals, and celebrated by the Karolinska Institute — the body that awards the Nobel Prize in Medicine — as a triumph that might one day grow organs to order. The reality was a catastrophe. The synthetic tracheas did not become living tissue; they degraded, collapsed, and festered inside the patients, who suffered terribly. Of the handful of people who received Macchiarini's plastic windpipes, almost all died. When four senior doctors at Karolinska examined the cases and concluded that he had endangered patients and misrepresented his results, the institute's leadership did not stop him — it cleared him, and turned its machinery against the whistleblowers who had spoken up. It took an American magazine's exposé of Macchiarini's astonishing private life, and a Swedish television documentary, to finally break the story open in 2016. The unravelling cost the careers of university and hospital leaders, produced a landmark reckoning over research fraud, and ended, in 2023, with Macchiarini convicted of bodily harm. This is the story of how a celebrated institution came to protect a man who was killing his patients, and of the colleagues who paid for telling the truth.
DES and the Cancer That Waited a Generation
Diethylstilbestrol — DES — was the kind of drug that seems, in hindsight, designed to teach a lesson about how medicine can fail. A cheap synthetic estrogen, first made in 1938 and never patented, it was prescribed from around 1940 onward to millions of pregnant women in the United States and elsewhere, marketed with the soothing promise that it would prevent miscarriage and make 'normal pregnancies more normal.' It did neither. As early as 1953, a careful controlled study showed that DES did nothing to prevent miscarriage — and yet doctors went on prescribing it to pregnant women for nearly two more decades. The true cost did not appear in the women who took it, or even in their pregnancies, but in the children those pregnancies produced. In 1971, doctors traced a sudden cluster of a rare vaginal cancer in young women — a cancer almost never seen in people that age — back to a single common factor: their mothers had taken DES while carrying them. It was the first time a drug had been shown to cause cancer not in the person who took it but in their child, years later, through the wall of the womb. The harm had waited a generation to appear. Behind it lay a tangle of failures — a drug sold without good evidence, kept on the market long after it was shown useless, and made by so many companies that, decades later, the women it injured often could not even prove whose pill their mothers had swallowed. This is the story of DES: what it was, why it was given, the delayed catastrophe it caused, and the lasting marks it left on medicine and the law.
The Guatemala Syphilis Experiments and the Deliberate Infection of the Powerless
Between 1946 and 1948, doctors working for the United States Public Health Service travelled to Guatemala and did something that even the medical ethics of their own era forbade: they deliberately gave people syphilis. Not by accident, not as a side effect of withholding treatment, but on purpose — infecting more than a thousand Guatemalan prisoners, soldiers, psychiatric patients, and commercial sex workers with syphilis, gonorrhea, and chancroid, in order to study how the diseases spread and whether the new wonder drug penicillin could prevent them. The subjects were chosen precisely because they were powerless: confined to a prison, a barracks, or an asylum, in a poor country far from American oversight, where no one would ask whether they had agreed. Many were never told what was being done to them. Some were infected by having the bacteria applied directly to abraded skin or injected into their bodies; psychiatric patients who could not possibly understand were among them. At least eighty-three of the people caught up in the studies later died, though the link to the experiments was never fully untangled. The work produced little usable science, was never published, and was quietly buried — its records filed away in the papers of the doctor who ran it, the same man who would go on to help direct the infamous Tuskegee study. It stayed hidden for over sixty years, until a historian found those records in 2010. This is the story of what the United States did in Guatemala, why it was done where it was done, and how a government came to apologise for a crime that almost no one had known about.
Henrietta Lacks and the Cells That Would Not Die
In the early months of 1951, a thirty-one-year-old Black woman named Henrietta Lacks went to the Johns Hopkins Hospital in Baltimore — one of the few hospitals in the segregated United States that would treat Black patients — with a cervical cancer that was killing her with frightening speed. During her treatment, a surgeon shaved two small samples from her cervix, one healthy and one cancerous, and sent them to a laboratory down the hall. No one asked Henrietta's permission, and no one told her; this was simply how things were done, especially to a poor Black patient in a charity ward. She died that October and was buried in an unmarked grave. But the cancer cells from that sample did something no human cells had ever reliably done before: they survived, and divided, and kept dividing, doubling every day, apparently without limit. They were the first immortal human cell line, and the scientist who grew them named them HeLa, after the first letters of her first and last names. Over the following decades those cells — descended from a woman almost no one knew anything about — would become one of the foundational tools of modern biology: used to develop the polio vaccine, to map the human genome, to test drugs and radiation and cosmetics, to study cancer and AIDS and the viruses that cause them, sent into space, and grown by the ton and sold around the world in a multi-billion-dollar industry. Henrietta's own family knew none of it for more than twenty years, received nothing, and in many cases could not afford the medicine her cells helped create. This is the story of the woman behind HeLa, of what was taken and what was built from it, and of a debt that the science of an era was structured never to pay.
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