Outrageous fortune: selling other people's cells.

Outrageous Fortune: Selling Other People's Cells All men are mortal. John Moore is a man. Therefore John Moore is mortal. This is uncontroversial. However, a cell line developed from John Moore's body, the "Mo" cell line, is described as immortal, and the lawsuit regarding John Moore's right to share in the profits produced by the cell line, although not immortal, may seem to be. A lower court previously rejected any claim Moore might have in a cell line developed from his diseased spleen, and an appeals court reversed this decision, holding that physicians and researchers could be held liable for conversion for using a patient's cells without permission. [1] The Supreme Court of California has now partially reversed the appeals court ruling, and the litigation is likely to live on. The Case of John Moore In 1976 John Moore's physician, David W. Golde, recommended that Moore's spleen be removed as a treatment for hairy-cell leukemia. After surgeons removed the spleen, Golde and others took cells from it and cultured them into an "immortal" cell line that produced a variety of useful products. In 1984 this cell line was patented, and Golde and others will reap substantial profits from it. Moore alleges that he was never informed of any of this and never agreed to it. Assuming this is true, the questions presented are: (1) can Moore sue Golde for failure to disclose his pecuniary interest in producing a cell line from Moore's spleen as a breach of his fiduciary duty to the patient; and (2) can Moore sue the research companies and others who have used the cell line for a share in their profits from it? In a five-to-two opinion, Justice Panelli, writing for the California Supreme Court, answered the first question affirmatively, but refused to grant the patient any ownership interest in his cells after they had been removed from his body. [2] The Doctor-Patient Relationship and Conflicts of Interests The California Supreme Court has been the nation's leader in the area of informed consent, deciding in 1972 that a physician had a "fiduciary" responsibility to the patient to disclose the nature of the proposed treatment, its alternatives, risks, and potential problems of recuperation. [3] Past cases have all concentrated on the patient's choice and enhancing that choice by providing "material" information to the patient that might cause him or her to accept or reject the proposed treatment. The California Supreme Court has now ruled that the doctrine of informed consent requires a full financial disclosure because failure to make a financial disclosure is a violation of trust that undermines patient autonomy. The goal is to protect patients from physicians whose judgment might be influenced by profit, and who might thus be in a conflict of interest position with their own patients. In the Court's words: a physician who treats a patient in whom he also has a research interest has potentially conflicting loyalties.... The possibility that an interest extraneous to the patient's health has affected the physician's judgment is something a reasonable patient would want to know in deciding whether to consent to a proposed course of treatment. It is material to the patient's decision and, thus, a prerequisite to informed consent. This is not to say that physician-researchers are evil-minded, or intentionally advocate procedures not in their patients' best interests, only that "consciously or unconsciously...the physician's extraneous motivation may affect his judgment." Selling Cells The remaining defendants, the Regents of the University of California, a researcher, and two corporations, are not physicians and thus have no independent fiduciary duty to the patient. The appeals court had found them potentially liable for conversion of Moore's property interest in his cells. The California Supreme Court, however, reversed this holding. …