The myth of the biotech revolution

Public alignment with longevity biotechnology: an analysis of framing in surveys and opinion studies

This article examines the framing and public perception of longevity biotechnology, or geroscience, which aims to extend both healthspan and lifespan by targeting the biological processes of aging. Although often seen as moving into the mainstream, questions remain about its ability to meet these ambitious goals, given the complexities of understanding and manipulating aging biology. Drawing on an analysis of qualitative studies and surveys conducted over the past two decades, this paper explores how public attitudes toward anti-aging science are framed, suggesting that studies often emphasize life extension over healthspan gains. Findings reveal mixed reactions, with both interest in and ambivalence about the desirability of extended lifespans. In response, this paper recommends that stakeholders in longevity biotechnology engage with the public by understanding unmet health needs rather than assuming a widespread embrace of lifespan extension. The article underscores the importance of aligning public engagement strategies with realistic scientific expectations to foster credibility and trust; promises should be grounded in current scientific evidence and tempered by feasibility. Addressing societal concerns and fostering dialogue on the ethical and social implications of manipulating aging processes could lay a foundation for responsible progress in geroscience and biogerontology, supporting a more informed, inclusive conversation between science and society as these fields advance.

The pharmaceutical productivity gap - Incremental decline in R&D efficiency despite transient improvements

Rising research and development costs, currently exceeding $3.5 billion per novel drug, reflect a five-decade decline in pharmaceutical R&D efficiency. While recent reports suggest a potential turnaround, this review offers a systems-level analysis to explore whether this marks a structural shift or transient reversal. We analyzed financial data from the 200 largest pharmaceutical firms, novel drug approvals, and more than 80 000 clinical trials between 2012 and 2023. Our analysis revealed that despite recent stabilization, the pharmaceutical industry continues to face challenges, particularly due to elevated late-stage clinical attrition, suggesting that a sustained turnaround in R&D efficiency remains elusive.

Speed, accuracy, and efficiency: The promises and practices of digitization in pathology

Digitization is often presented in policy discourse as a panacea to a multitude of contemporary problems, not least in healthcare. How can policy promises relating to digitization be assessed and potentially countered in particular local contexts? Based on a study in Denmark, we suggest scrutinizing the politics of digitization by comparing policy promises about the future with practitioners' experience in the present. While Denmark is one of the most digitalized countries in the world, digitization of pathology has only recently been given full policy attention. As pathology departments are faced with an increased demand for pathology analysis and a shortage of pathologists, Danish policymakers have put forward digitization as a way to address these challenges. Who is it that wants to digitize pathology, why, and how does digitization unfold in routine work practices? Using online search and document analysis, we identify actors and analyze the policy promises describing expectations associated with digitization. We then use interviews and observations to juxtapose these expectations with observations of everyday pathology practices as experienced by pathologists. We show that policymakers expect digitization to improve speed, patient safety, and diagnostic accuracy, as well as efficiency. In everyday practice, however, digitization does not deliver on these expectations. Fulfillment of policy expectations instead hinges on the types of artificial intelligence (AI) applications that are still to be developed and implemented. Some pathologists remark that AI might work in the easy cases, but this would leave them with only the difficult cases, which they consider too burdensome. Our particular mode of juxtaposing policy and practice throws new light on the political work done by policy promises and helps to explain why the discipline of pathology does not seem to easily lend itself to the digital embrace.

Patenting Foundational Technologies: Lessons From CRISPR and Other Core Biotechnologies

In 2012, a new and promising gene manipulation technique, CRISPR-Cas9, was announced that seems likely to be a foundational technique in health care and agriculture. However, patents have been granted. As with other technological developments, there are concerns of social justice regarding inequalities in access. Given the technologies' "foundational" nature and societal impact, it is vital for such concerns to be translated into workable recommendations for policymakers and legislators. Colin Farrelly has proposed a moral justification for the use of patents to speed up the arrival of technology by encouraging innovation and investment. While sympathetic to his argument, this article highlights a number of problems. By examining the role of patents in CRISPR and in two previous foundational technologies, we make some recommendations for realistic and workable guidelines for patenting and licensing.

“Invasive” and “Non-invasive” Technologies in Neuroscience Communication

This paper analyzes a common distinction in neuroscience communication: the labels “invasive” and “non-invasive” attributed to brain-observation technologies. Because an implicit or explicit value judgment accompanies the term “non-invasive,” it has been used to promote technological progress, especially new brain-imaging techniques that have appeared in recent decades. This study’s material comes from interactions between some expert scientists and the political sphere. Expert reports on neuroscience from different advisory bodies in the French public sector have been collected and analyzed for use of the distinction between invasive and non-invasive. The paper shows that the meaning of these widely used labels varies according to the context, e.g., status of discourse, technologies compared, or stakeholders engaged in the discussion. The definition of what is understood as invasive or non-invasive becomes a strategic issue and can thus vary according to the methodologies favoured by experts participating in national advisory boards or councils.

Relating business model innovations and innovation cascades: the case of biotechnology

This article conceptualizes innovation as a process, where the scientific and industrial application of technological knowledge nurtures new routines and institutions, in order to relate changing business model innovations to innovation cascades. Innovation in science-based, high-tech sectors is changing its tempo, from the evolutionary pace of incremental novelties punctuated by occasional radical novelties, to innovation cascades. These cascades involve a long series of interlinked radical innovations, which can be traced through various scientific and technological indicators like patents and publications. Innovation cascades are relevant to industry, because they make the future less predictable. They are particularly interesting because these changes also enable the testing an abundance of new business models. Innovation cascades have a major impact on the number and sustainability of business models and on strategy. Business model innovations are visible not only in the existing organizations that undergo change, but also new organizational models appear. The case of biotechnology after the 1980s is used to illustrate our conceptualization.

(Dis)entangling Barad: Materialisms and ethics

In the wake of the widespread uptake of and debate surrounding the work of Karen Barad, this article revisits her core conceptual contributions. We offer descriptions, elaborations, problematizations and provocations for those intrigued by or invested in this body of work. We examine Barad's use of quantum physics, which underpins her conception of the material world. We discuss the political strengths of this position but also note tensions associated with applying quantum physics to phenomena at macro-scales. We identify both frictions and unacknowledged affinities with science and technology studies in Barad's critique of reflexivity and her concept of diffraction. We flesh out Barad's overarching position of 'agential realism', which contains a revised understanding of scientific apparatuses. Building upon these discussions, we argue that inherent in agential realism is both an ethics of inclusion and an ethics of exclusion. Existing research has, however, frequently emphasized entanglement and inclusion to the detriment of foreclosure and exclusion. Nonetheless, we contend that it is in the potential for an ethics of exclusion that Barad's work could be of greatest utility within science and technology studies and beyond.

The Route to Sustainability—Prospects and Challenges of the Bio-Based Economy

The bio-based economy has been increasingly recognized in the sustainability debate over the last two decades, presented as a solution to a number of ecological and social challenges. Its premises include climate change mitigation, cleaner production processes, economic growth, and new employment opportunities. Yet, a transition to a bio-based economy is hampered by risk factors and uncertainties. In this paper, we explore the concept of a bio-based economy, focusing on opportunities of achieving sustainability, as well as challenges of a transition. Departing from an understanding of sustainability provided by the weak and strong sustainability paradigms, we first outline the definition and development of the bio-based economy from a theoretical perspective. Second, we use Sweden as an example of how a transition towards a bio-based economy has been evolving in practice. The review indicates that the proposed direction and strategies of the bio-based economy are promising, but sometimes contradictory, resulting in different views on the actions needed for its premises to be realized. Additionally, current developments adhere largely to the principles of the weak sustainability paradigm. In order for the bio-based economy to develop in accordance with the notion of strong sustainability, important steps to facilitate a transition would include acknowledging and addressing the trade-offs caused by biophysical and social limits to growth.

Rethinking Value in the Bio-economy: Finance, Assetization, and the Management of Value

Current debates in science and technology studies emphasize that the bio-economy-or, the articulation of capitalism and biotechnology-is built on notions of commodity production, commodification, and materiality, emphasizing that it is possible to derive value from body parts, molecular and cellular tissues, biological processes, and so on. What is missing from these perspectives, however, is consideration of the political-economic actors, knowledges, and practices involved in the creation and management of value. As part of a rethinking of value in the bio-economy, this article analyzes three key political-economic processes: financialization, capitalization, and assetization. In doing so, it argues that value is managed as part of a series of valuation practices, it is not inherent in biological materialities.

Controlling new knowledge: Genomic science, governance and the politics of bioinformatics

The rise of bioinformatics is a direct response to the political difficulties faced by genomics in its quest to be a new biomedical innovation, and the value of bioinformatics lies in its role as the bridge between the promise of genomics and its realization in the form of health benefits. Western scientific elites are able to use their close relationship with the state to control and facilitate the emergence of new domains compatible with the existing distribution of epistemic power - all within the embrace of public trust. The incorporation of bioinformatics as the saviour of genomics had to be integrated with the operation of two key aspects of governance in this field: the definition and ownership of the new knowledge. This was achieved mainly by the development of common standards and by the promotion of the values of communality, open access and the public ownership of data to legitimize and maintain the governance power of publicly funded genomic science. Opposition from industry advocating the private ownership of knowledge has been largely neutered through the institutions supporting the science-state concordat. However, in order for translation into health benefits to occur and public trust to be assured, genomic and clinical data have to be integrated and knowledge ownership agreed upon across the separate and distinct governance territories of scientist, clinical medicine and society. Tensions abound as science seeks ways of maintaining its control of knowledge production through the negotiation of new forms of governance with the institutions and values of clinicians and patients.

The moderating role of absorptive capacity and the differential effects of acquisitions and alliances on Big Pharma firms' innovation performance

In the context of increased pharmaceutical innovation deficits and Big Pharma blockbusters' patent expirations, this paper examines the moderating role of firms' absorptive capacity in external innovation activities of Big Pharma firms. The study indicates a rising interest of Big Pharma in acquisitions of and alliances with biotechnology companies. Unfortunately, this increased interest is not reflected in the number of new drugs generated by Big Pharma. We find that acquisitions of biotech companies have negatively affected Big Pharma firms' innovation performance on average but these acquisitions might have a positive effect at higher levels of acquiring firms' absorptive capacity. Moreover, also acquisitions of pharma companies and alliances with biotech companies only have a positive effect on innovation performance at sufficiently high levels of absorptive capacity. The moderating role of absorptive capacity implicates that a tight integration of internal R&D efforts and (unrelated) external knowledge is crucial for harnessing complementarity effects.

Project Management between Will and Representation

This article challenges some deep-rooted assumptions of project management. Inspired by the work of the German philosopher, Arthur Schopenhauer, it calls for looking at projects through two complementary lenses: one that accounts for cognitive and representational aspects and one that accounts for material and volitional aspects. Understanding the many ways in which these aspects transpire and interact in projects sheds new light on project organizations, as imperfect and fragile representations that chase a shifting nexus of intractable human, social, technical, and material processes. This, in turn, can bring about a new grasp of notions such as value, knowledge, complexity, and risk.

Polypharmacology in Drug Development: A Minireview of Current Technologies

Polypharmacology, the process in which a single drug is able to bind to multiple targets specifically and simultaneously, is an emerging paradigm in drug development. The potency of a given drug can be increased through the engagement of multiple targets involved in a certain disease. Polypharmacology may also help identify novel applications of existing drugs through drug repositioning. However, many problems and challenges remain in this field. Rather than covering all aspects of polypharmacology, this Minireview is focused primarily on recently reported techniques, from bioinformatics technologies to cheminformatics approaches as well as text-mining-based methods, all of which have made significant contributions to the research of polypharmacology.

Cell injury, retrodifferentiation and the cancer treatment paradox

This “opinion article” is an attempt to take an overview of some significant changes that have happened in our understanding of cancer status during the last half century and its evolution under the progressive influence of molecular biology. As an active worker in cancer research and developmental biology during most of this period, I would like to comment briefly on these changes and to give my critical appreciation of their outcome as it affects our knowledge of cancer development as well as the current treatment of the disease. A recall of my own contribution to the subject is also included. Two subjects are particularly developed: cell injury and cell-killing therapies. Cell injury, whatever its origin, has acquired the status of a pivotal event for the initiation of cancer emergence. It is postulated that cell injury, a potential case of cellular death, may also be the origin of a process of stepwise cell reversion (retrodifferentiation or retroprogrammation) leading, by division, mature or stem cells to progressive immaturity. The genetic instability and mutational changes that accompanies this process of cell injury and rejuvenation put normal cells in a status favourable to neoplastic transformation or may evolve cancer cells toward clones with higher malignant potentiality. Thus, cell injury suggests lifestyle as the major upstream initiator of cancer development although this not exclude randomness as an unavoidable contributor to the disease. Cell-killing agents (mainly cytotoxic drugs and radiotherapy) are currently used to treat cancer. At the same time, it is agreed that agents with high cell injury potential (ultraviolet light, ionising radiations, tobacco, environmental pollutants, etc.) contribute to the emergence of malignant tumours. This represents a real paradox. In spite of the progress accomplished in cancer survival, one is tempted to suggest that we have very few chances of really cure cancer as long as we continue to treat malignancies with cell-killing therapies. Indeed, the absence of alternatives to such treatments justifies the pursuit of current procedures of cancer care. But, this should be, precisely, an urgent stimulus to explore other therapeutic approaches. Tumour reversion, immunotherapy, stem cell management and genomic analysis of embryo-foetal development could be, among others, appropriated candidates for future active research.

Therapeutic misconception: hope, trust and misconception in paediatric research

Although the therapeutic misconception (TM) has been well described over a period of approximately 20 years, there has been disagreement about its implications for informed consent to research. In this paper we review some of the history and debate over the ethical implications of TM but also bring a new perspective to those debates. Drawing upon our experience of working in the context of translational research for rare childhood diseases such as Duchenne muscular dystrophy, we consider the ethical and legal implications of the TM for parental consent to research. In this situation, it is potentially the parent who is vulnerable to TM. In our analysis we not only consider the context of informed consent for research but also the wider environment in which the value of research is promoted, more broadly through the media but also more specifically through the communication strategies of patient organizations. All dissemination about developments in research for health runs the risk of portraying an overly optimistic view of the promise of biotechnological solutions and has the potential to encourage a 'collective' TM. In this paper we consider the challenge that TM presents to parents as well as explore the ethical and legal responsibilities of researchers to ensure an appropriately informed consent: compatible with a hopeful disposition of parents who consent for the their children whilst avoiding a blind and misleading optimism.

Reflecting on public engagement and science policy

This article presents a personal reflection on the evolution of thinking about public engagement with science in the UK, with a particular emphasis on the experience with nanotechnology.

Translational research policies: disruptions and continuities in biomedical innovation systems in Austria, Finland and Germany

Increasing the rate of biomedical research that is relevant to clinical innovation has been an intensifying concern of the research community and of policy-makers. In response, some of these actors have recently promoted varied approaches they label as translational research (TR) and translational medicine. This movement started in the USA in the early 1990s, and has since evolved to encompass large and ambitious initiatives. Its advocates contend that the productivity of biomedical innovation systems can be bolstered by: (1) the extension of large-scale development collaborations; (2) the strengthening of clinical experimental platforms; (3) training and supporting dedicated human capital; (4) achieving higher collective coordination of research teams than was previously common practice. In this paper, we examine to which extent these objectives have been put into practice by communities of biomedical actors and policymakers, by characterizing current translational initiatives in three European countries—Austria, Finland and Germany. This research draws on an analysis of policy documents and 26 semi-structured interviews conducted with policy-makers and TR advocates from these countries. Traditions of science and technology policy-making in each country have made them differentially receptive to the TR movement. German biomedical actors have most fully put into practice TR propositions, while Finland has seen policy-level debate of the notions but little in the way of concrete implementation and Austria appears to be a middle case.

Rise and demise of bioinformatics? Promise and progress

The field of bioinformatics and computational biology has gone through a number of transformations during the past 15 years, establishing itself as a key component of new biology. This spectacular growth has been challenged by a number of disruptive changes in science and technology. Despite the apparent fatigue of the linguistic use of the term itself, bioinformatics has grown perhaps to a point beyond recognition. We explore both historical aspects and future trends and argue that as the field expands, key questions remain unanswered and acquire new meaning while at the same time the range of applications is widening to cover an ever increasing number of biological disciplines. These trends appear to be pointing to a redefinition of certain objectives, milestones, and possibly the field itself.

The pharmaceuticalisation of society? A framework for analysis

Drawing on insights from both medical sociology and science and technology studies this article provides a critical analysis of the nature and status of pharmaceuticalisation in terms of the following key dimensions and dynamics: (i) the redefinition or reconfiguration of health 'problems' as having a pharmaceutical solution; (ii) changing forms of governance; (iii) mediation; (iv) the creation of new techno-social identities and the mobilisation of patient or consumer groups around drugs; (v) the use of drugs for non-medical purposes and the creation of new consumer markets; and, finally, (vi) drug innovation and the colonisation of health futures. Pharmaceuticalisation, we argue, is therefore best viewed in terms of a number of heterogeneous socio-technical processes that operate at multiple macro-levels and micro-levels that are often only partial or incomplete. The article concludes by drawing out some broader conceptual and reflexive issues this raises as to how we might best understand pharmaceuticalisation, based on our analysis, as a framework for future sociological work in this field.

Learning lessons from drugs that have recently entered the market

Which projects in the drug discovery field are most likely to be successful? In this article, I provide guidelines for answering this question by examining recent drug market entrants in detail, in particular their route of administration, trial design, novelty, therapeutic target and toxicities. I identify targets, trials and organizations as the key issues that are currently leading to the poor productivity in the pharmaceutical industry. Here, I outline some solutions and reasons for optimism, and suggest that the key determinants for success in drug discovery can be defined by studying recently launched drugs.

Inter-epistemic Power and Transforming Knowledge Objects in a Biomedical Network

We examine a multidisciplinary network established to translate genetics science into practice in the British NHS. Drawing on theory about epistemic communities and objects, we describe three stages in their lifecycle (vision/formation, transformation and reincarnation) and epistemic clashes over knowledge objects. Medical academics captured jurisdiction over the network at formation, through their superior knowledge of the nascent genetics discipline, producing epistemic objects reflecting their interests. A governmental community challenged medical academics for jurisdiction but, unable to transform objects by changing their space of representation in performance reporting, ceased funding the network, which then closed. Afterwards, however, a NHS community successfully ‘reincarnated’ a discarded epistemic object into a technical object in NHS practice. We make a theoretical contribution by developing a processual framework for understanding biomedical innovation, focusing on transforming objects situated between different wider knowledge/power structures. This explains how objects were transformed at micro-level through the interaction and relative power of local communities, influenced by macro-level rules about knowledge formation in wider epistemic, organizational and governmental communities.

When Policy meets Practice: Colliding Logics and the Challenges of ‘Mode 2’ Initiatives in the Translation of Academic Knowledge

Institutional change has been characterized as the outcome of a dialectical process whereby different constituent communities within an organizational field promote competing institutional logics (Seo and Creed 2002). However, the dynamics of this dialectical process are poorly understood. In this paper, we examine this dialectical process by drawing upon a longitudinal study of a policy intervention in the UK aimed at promoting a logic of knowledge production in genetics science (termed here as ‘Mode 2’; cf. Nowotny et al. 2001) that was co-present, and competing, with the dominant logic surrounding the production of academic science (‘Mode 1’). We highlight the tensions and interplays that occurred between these competing institutional logics by examining the rhetoric that was propounded, and the actions incurred, and their effects, amongst constituent communities of policy makers and scientists. Our findings demonstrate, first, that tensions can exist within as well as across constituent communities within the organizational field; and, second, how mobilizing a new institutional logic related to knowledge production may produce its own contradictions that can, paradoxically, lead to the simultaneous resurrection (and reinforcement) of the old logic. We discuss the implications for managing projects where these different logics are co-mingled.

Where are you going, where have you been: a recent history of the direct-to-consumer genetic testing market

In recent years, various private companies have been marketing and offering genetic tests directly to consumers. This article reviews the recent history of this commercial phenomenon. In particular, we discuss and describe the following subjects: (1) the factors that allowed for the creation of the direct-to-consumer (DTC) genetic testing (GT) market; (2) information regarding the size and potential success or failure of the DTC GT market; (3) recent changes in the DTC GT market; and (4) the recent events that may have an impact on the regulatory oversight of DTC genetic testing and the future evolution of this market. This review of factors suggests that despite the possibility of a change of business model as well as increased regulation, the commercialization of genetic testing is here to stay. As such it is important to pay close attention not only to the science underlying these tests but also to the ethical, legal, and social issues.

Bioethics and the reinforcement of socio-technical expectations

Over the past few years, considerable interest has been paid to the way in which social expectations (hopes, hypes, fears) about new genomic technologies help shape, and in themselves are shaped by, emerging technologies, regulatory regimes and social concerns. In comparison, little attention has been paid to the role of expectations in related, but non-scientific discourses, such as bioethics. Drawing on a review of publications addressing the ethical issues associated with pharmacogenetics, this paper presents a detailed critique of bioethicists' contribution to these debates. The review highlights how, almost a decade after bioethical debate around pharmacogenetics started, and in contrast to the profession's self-perception as a form of regulator, bioethicists still largely restrict themselves to reviews of possible ethical issues raised by this technology, rather than critiquing others' positions and arguing for specific points of view. In addition the paper argues that bioethicists tend to: accept unquestioningly scientists' expectations about the development and ethical issues raised by pharmacogenetics; ignore contributions from bioethicists who do question these expectations; and engage in an ethical debate, the boundaries of which have been laid down and defined by academic and industry scientists. The paper concludes by offering some possible explanations for why the bioethical discourse has taken this form.

Exploring the resilience of Bt cotton's "pro-poor success story"

Expectations play a powerful role in driving technological change. Expectations are often encapsulated in narratives of technological promise that emphasize potential benefits and downplay potential negative impacts. Genetically modified (GM, transgenic) crops have been framed by expectations that they would be an intrinsically "pro-poor" innovation that would contribute powerfully to international agricultural development. However, expectations typically have to be scaled back in the light of experience. Published reviews of the socio-economic impacts of GM crops among poor, small-scale farmers in the developing world indicate that these effects have been very mixed and contingent on the agronomic, socio-economic and institutional settings where the technology has been applied. These conclusions should modulate expectations about the pro-poor potential of GM crop technology and focus attention on the conditions under which it might deliver substantial and sustainable benefits for poor farmers. However, the idea of GM crop technology as an intrinsically pro-poor developmental success story has been sustained in academic, public and policy arenas. This narrative depends upon an analysis that disembeds the technology from the technical, social and institutional contexts in which it is applied. Agricultural development policy should be based on a more rigorous and dispassionate analysis, rather than optimistic expectations alone.

Risk assessment and communication tools for genotype associations with multifactorial phenotypes: the concept of "edge effect" and cultivating an ethical bridge between omics innovations and society

Applications of omics technologies in the postgenomics era swiftly expanded from rare monogenic disorders to multifactorial common complex diseases, pharmacogenomics, and personalized medicine. Already, there are signposts indicative of further omics technology investment in nutritional sciences (nutrigenomics), environmental health/ecology (ecogenomics), and agriculture (agrigenomics). Genotype-phenotype association studies are a centerpiece of translational research in omics science. Yet scientific and ethical standards and ways to assess and communicate risk information obtained from association studies have been neglected to date. This is a significant gap because association studies decisively influence which genetic loci become genetic tests in the clinic or products in the genetic test marketplace. A growing challenge concerns the interpretation of large overlap typically observed in distribution of quantitative traits in a genetic association study with a polygenic/multifactorial phenotype. To remedy the shortage of risk assessment and communication tools for association studies, this paper presents the concept of edge effect. That is, the shift in population edges of a multifactorial quantitative phenotype is a more sensitive measure (than population averages) to gauge the population level impact and by extension, policy significance of an omics marker. Empirical application of the edge effect concept is illustrated using an original analysis of warfarin pharmacogenomics and the VKORC1 genetic variation in a Brazilian population sample. These edge effect analyses are examined in relation to regulatory guidance development for association studies. We explain that omics science transcends the conventional laboratory bench space and includes a highly heterogeneous cast of stakeholders in society who have a plurality of interests that are often in conflict. Hence, communication of risk information in diagnostic medicine also demands attention to processes involved in production of knowledge and human values embedded in scientific practice, for example, why, how, by whom, and to what ends association studies are conducted, and standards are developed (or not). To ensure sustainability of omics innovations and forecast their trajectory, we need interventions to bridge the gap between omics laboratory and society. Appreciation of scholarship in history of omics science is one remedy to responsibly learn from the past to ensure a sustainable future in omics fields, both emerging (nutrigenomics, ecogenomics), and those that are more established (pharmacogenomics). Another measure to build public trust and sustainability of omics fields could be legislative initiatives to create a multidisciplinary oversight body, at arm's length from conflict of interests, to carry out independent, impartial, and transparent innovation analyses and prospective technology assessment.

"You are our only hope": trading metaphorical "magic bullets" for stem cell "superheroes"

In the wake of two recent developments in stem cell research, it is a fitting time to reassess the claim that stem cells will radically transform the concept and function of medicine. The first is the U.S. Food and Drug Administration's decision in January 2009 to approve Geron Corporation's Phase I clinical trial using human embryonic stem cells for patients with spinal cord injuries. The second is the National Institutes of Health's decision to permit federal funding of research using donated IVF human embryos in their July 2009 Guidelines on Human Stem Cell Research. We are now poised to see whether stem cell research can deliver on what it promises. However, what exactly does it promise and how? Moreover, who is doing the promising? Turning to the use of metaphor can help us to answer these questions and enable us to develop a better appreciation of the unique features of promised stem cell therapies. Indeed, metaphors have exerted profound influence in medicine, and it is fitting that we seek new metaphors for new therapies where appropriate. In this case, other metaphors such as magic bullets or the Holy Grail cannot capture what is unique about stem cells. Accordingly, I propose a new metaphor: the stem cell superhero. Stem cell superheroes are characterized by the following traits: they are seemingly capable of fighting the evil of virtually all disease (unlike "magic bullets") and they seem to be our only hope of doing so, although to summon them we must make difficult moral choices. In the course of assessing the merits of three recent yet covert references to the superhero metaphor, I conclude that this powerful new paradigm employs a problematic logic (i.e., we cannot know that something is "our only hope"), but that the aspiration as such is a good one.

Encounters with medical professionals: a crisis of trust or matter of respect?

In this paper I shed light on the connection between respect, trust and patients' satisfaction with their medical care. Using data collected in interviews with 49 women who had managed, or were in the process of managing, their risk of ovarian cancer using prophylactic surgery or ovarian screening, I examine their reported dissatisfaction with medical encounters. I argue that although many study participants appeared to mistrust their healthcare professionals' (HCPs) motives or knowledge base, their dissatisfaction arose not from a lack of trust, but from HCPs' failure to treat them as persons or take their concerns seriously. I conclude by describing how respect, as evidenced by "being taken seriously", is important for the development of trusting Patient-HCP relationships.

Banking expectations: the promises and problems of biobanks

In the last decade, governments, medical charities, pharmaceutical companies and disease advocacy organizations have spent considerable time and money developing biobanks to aid drug discovery and the investigation of disease. This article identifies and assesses the various expectations that have driven the investment in different types of biobanks. It suggests that they have been the focus of unrealistic promises about producing a ‘biobank revolution’ that will transform biomedicine and healthcare. We need more modest expectations about what can be achieved, and need to tackle certain conceptual and methodological challenges for biobanks to fulfill their potential.

BNDB - the Biochemical Network Database

Background

Technological advances in high-throughput techniques and efficient data acquisition methods have resulted in a massive amount of life science data. The data is stored in numerous databases that have been established over the last decades and are essential resources for scientists nowadays. However, the diversity of the databases and the underlying data models make it difficult to combine this information for solving complex problems in systems biology. Currently, researchers typically have to browse several, often highly focused, databases to obtain the required information. Hence, there is a pressing need for more efficient systems for integrating, analyzing, and interpreting these data. The standardization and virtual consolidation of the databases is a major challenge resulting in a unified access to a variety of data sources.

Description

We present the Biochemical Network Database (BNDB), a powerful relational database platform, allowing a complete semantic integration of an extensive collection of external databases. BNDB is built upon a comprehensive and extensible object model called BioCore, which is powerful enough to model most known biochemical processes and at the same time easily extensible to be adapted to new biological concepts. Besides a web interface for the search and curation of the data, a Java-based viewer (BiNA) provides a powerful platform-independent visualization and navigation of the data. BiNA uses sophisticated graph layout algorithms for an interactive visualization and navigation of BNDB.

Conclusion

BNDB allows a simple, unified access to a variety of external data sources. Its tight integration with the biochemical network library BN++ offers the possibility for import, integration, analysis, and visualization of the data. BNDB is freely accessible at .