An end to the stem cell ‘hammer’ and ‘nail’

Medical Files By Rafael Castillo M.D. Philippine Daily Inquirer

(Conclusion)

A saying goesif youre a hammer, you see everything as a nail.

This may symbolize whats happening to our practice of stem cell medicine in our country. Because of the media hype focusing on testimonials of celebrities on supposed spectacular healing or rejuvenation, stem cell practitioners coming from various medical practices have suddenly become overenthusiastic of the things stem cells could do for their patients. In every Tom, Dick and Harry, one or another indication for stem cell therapy can be seen at the end of a 5-minute consultation. It has been estimated that nine out of 10 Filipino patients administered stem cell treatment receive it for unproven and still experimental indications.

A neurosurgeon colleague asked the young doctor-son of a patient (who appeared to be fresh out of medical school) what his line of practice was, and he confidently replied that he administers stem cell medicine. When told that it seems to be a pretty complicated specialty, he answered without batting an eyelash that its not.

All of a sudden, a few hundred physicians from several specialtiesinternists, oncologists, surgeons, neurologists, dermatologists, OB-gynecologists, family medicine and practically all othershave seemingly converged to make stem cell medicine their specialty or subspecialty. I know that the doctors mean well. Most of them (including those who sent me angry SMS or e-mail messages after reading the first part of this column last week) sincerely believe they could offer something short of miraculous healing for their patients.

Not hammers at all

I dont doubt their well-meaning intentions but they just have to stop acting like a hammer, finding everything like a nailjudging practically everyone who comes to them as a potential stem cell treatment candidate. In fact, many colleagues who practice stem cell medicine should realize theyre not hammers at all. They should be honest enough to admit that they do not possess the competence to administer such a complicated therapy to their patients.

Being interested in stem cell medicine and considering oneself as an eager student wanting to learn more about this promising experimental form of treatment is good. But thinking that one can be good enough to administer it to patients after observing how others do it several times is definitely betraying ones sworn duty as a physicianto make patients well and not to administer anything that can potentially cause him or her more harm than good.

When I was a medical student at the University of Santo Tomas, every morning I would be reminded by the sculpted Latin phrase on the faade of the Medicine Building which said, Primum non nocere (First, do no harm). This is one of the principal precepts of medical ethics that all medical practitioners pledge to adhere to.

Excerpt from:
An end to the stem cell ‘hammer’ and ‘nail’

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