Ruminations

Medical Professional Malfeasance

"What we need now is regulatory action -- we need Health Canada to be actually taking steps to shut down clinics that are providing unproven therapies."
"These are mostly for-profit clinics. I really think we need careful oversight by the regulatory bodies, like the colleges of physicians and surgeons."
"[Medical licensing colleges have a mandate to protect the public, and doctors seem to be common] purveyors [of unproven stem cell therapies so that] if it's not the colleges' obligation to stop doctors from misrepresenting the science, then whose responsibility is it?"
Timothy Caulfield, professor, health law and policy, Canada Research Chair, University of Alberta

A person injects something into a petri dish. Canada is doing less to protect Canadians from junk science — in this case, trendy, expensive and unproven stem cell therapies — than the U.S., a new paper argues.

A lab technician injects something into a petri dish. Canada is doing less to protect Canadians from junk science — in this case, trendy, expensive and unproven stem cell therapies — than the U.S., a new paper argues.

Everyone is eager to make a 'killing'. Where there's huge profits to be had, don't discount the flexible morals of professionals in the health field succumbing to the allure that their credentials can be leveraged into a hot business opportunity. And so it is that for-profit clinics are now proudly promoting unauthorized stem cell therapies to those who feel the risk is worth the money in the hopes that these therapies will offer them much in exchange.

A new study has linked such clinics to some results of these therapies ranging from blindness, serious blood infections, tumour development and even death as outcomes of some of these therapies. Clearly a threat to public health to say the very least. And Canada's health authority appears to be doing very little to protect Canadians from the conduct of doctors lacking professional ethics, preferring instead to portray themselves as what they evidently are not; healers. Whose primary interest is amassing wealth.

Dr. Mark Berman injects a patient with a solution he says is rich in adult stem cells at his practice in Beverly Hills, Calif., in this December 2014 file photo. (Raquel Maria Dillon/Associated Press)

In contrast, American regulators in recent years have worked toward permanent injunctions against clinics operating in Florida and California. Others have been fined for deceptive advertising in their aggressive enforcement efforts. New York Attorney General Letitia James in April filed a lawsuit against a Manhattan-based stem cell clinic. The response from Canadian regulators has been by comparison, "relatively mute", according to the paper published in BMO Medical Ethics.

Neither Health Canada nor the Competition Bureau have acted with determination to protect the public against unscrupulous clinics. Canadian medical colleges appear disinterested in instructing doctors to put a stop to their "evidence-free" therapies. The study authors point to what they consider a "simple lack of political will". The simple fact is that little scientific evidence exists to support such therapies beyond a few procedures like bone marrow transplants in treatment of specific cancers.

In 2018 a study identified 43 such clinics, 17 of which were located in the Greater Toronto Area. The clinics are obviously profitable, charging upwards of $3,500 per injection site. With multiple injection sites involved, discounts are available. Cells are harvested from an individual's belly fat or bone marrow, and after manipulation or processing "reintroduced" or injected back into the patient as purported treatment for arthritis, fractures, ligament or tendon injuries, tennis or golf elbow, rotator cuff tears and pitcher's elbow.

At some clinics stem cell therapy is promised as a healing solution for such conditions as ALS and Parkinson's disease, while at others wrinkles and "face/neck" sagging are treated, with any potential risks inherent in the process failing to be mentioned, or simply shrugged off as inconsequential. True, Health Canada issued a warning in May that unproven stem cell therapies might cause life-threatening or "life-altering" risks. Unauthorized "autologous" therapies making use of a person's own cells, despite marketing claims, have never been proven safe or effective, stressed the agency.

According to Blake Murdoch, a research associate at University of Alberta's Health Law Institute, the Competition Bureau would do well to isolate statements unsupported by science. Drs. Murdoch and Caulfield, authors of the new study had previously jointly filed a complaint with the Competition Bureau in August 2017 against a clinic claiming stem cell therapy "is the medical technique best approximating perfection" in the treatment of backaches and various sports and joint injuries. Nothing whatever came of it.

Referred to as the body's "master" cells, stem cells differentiate into many kinds of cells, useful for growing or regenerating tissue damaged by disease or injury, but few treatments, however hypothetically promising have yet been proven effective through scientific research.