Compassionate use of gene therapies in pediatrics: An ethical analysis

Semin Perinatol. 2018 Dec;42(8):508-514. doi: 10.1053/j.semperi.2018.09.010. Epub 2018 Oct 2.

Abstract

In this commentary, we raise concerns about the compassionate use of CRISPR-mediated gene therapies in pediatric and perinatal patients. There is already a precedent for obtaining gene therapies for pediatric patients through compassionate use programs, and the recent passage of a federal Right to Try law may contribute to an increase in the number of patients who seek access to investigational products outside of a clinical trial. Clinicians, nurses, drug companies, and parents need support as they grapple with whether compassionate use of CRISPR-mediated gene therapies is the right thing to pursue for a child. We raise three issues to consider in that decision: (1) the effects of compassionate use on scientific research; (2) hype and harms of gene therapies; and (3) the limits and scope of parental authority.

Keywords: Compassionate Use; Pediatric Ethics; Research Ethics; Right to Try.

Publication types

  • Review

MeSH terms

  • CRISPR-Cas Systems*
  • Compassionate Use Trials / ethics*
  • Decision Making
  • Ethical Analysis*
  • Genetic Therapy / ethics*
  • Humans
  • Infant
  • Leukemia / genetics
  • Leukemia / immunology
  • Leukemia / therapy*
  • Pediatrics
  • Remission Induction
  • Treatment Outcome