Review of Chasing Medical Miracles by Anthropologist Joan C. Stevenson
This is my site Written by Alex on August 11, 2011 – 10:03 am   

Anytime you get a review in which the reviewer says, “I could not put this book down,” it’s a good day. When that praise comes from an anthropologist and is followed with, “This book is a must read for those contemplating volunteering for a clinical trial (advice in the Afterward), and it also provides discussion starting points for those who teach classes on ethics in research and medicine, global health, the pharmaceutical industry, and the business of medical research,” it’s even better.

Here’s a link to the pdf and the review is below.

Chasing Medical Miracles: The Promise and Perils of Clinical Trials.

By Alex O’Meara. 264 pp. New York,

NY: Walker and Company. 2009. $25.00 (cloth),

$16.00 (paper).

O’Meara immediately caught my attention, when he noted that the number of clinical

trials worldwide has increased 300% since 1998 and 20 of 50 million clinical trial

participants live in the United States. O’Meara tells two stories in Chasing Medical

Miracles. The first is a critical evaluation of clinical trials and their slow but perhaps

steady contributions to scientific progress in medicine and human biology, and the other

story is about the author who wanted to cure his worsening type 1 diabetes by

participating in a clinical trial. I could not put this book down.

He says on page 3 of the introduction that he does not ‘‘advocate for or against

clinical trials’’ but instead desires to simplify the complex clinical trial business for

readers. He also views the clinical trials of today to anticipate aspects of future US

medical care.

Chapter 1 details what it means to volunteer for a trial or to become a ‘‘guinea

pig.’’ Chapter 2 is a spectacular discussion of the ‘‘therapeutic misconceptions’’ that

guinea pigs have, and the history of (e.g., Josef Mengele and Tuskagee) and the ethical

issues that arise when people are experimental subjects. Chapter 3 follows the money and

describes how clinical trials were initially dominated by universities that have been partly

replaced by more ‘‘efficient’’ private businesses and the conflicts of interest that can put

clinical trial participants at risk. (I also wondered about the drain of personnel from

patient care at this time of acute shortages in general practitioners, nurses, etc.)

Chapter 4 details a few of the lawsuits that have ensued.

Chapter 5 describes the typical subjects of these clinical trials from hopeful

individuals with health problems to the professional guinea pigs who may not represent

your average person anywhere. (What does that mean for medication dosages?)

Chapter 6 critiques how the business of trials has moved from the United States to

other nations in which human subjects protection can be weaker than in the United States

(e.g., the continuing use of placebos rather than comparing standard treatment protocol to

experimental protocol).

Uganda is the focus of Chapter 7 and serves as a model for a sophisticated effort

to grapple with the ethical issues and the logistics of monitoring and enforcing rules

during clinical trials.

Chapter 8 explains why specific individuals participate in clinical trials; O’Meara

includes success stories as well as failures. The book finishes with his personal

experience participating in a clinical trial to receive pancreatic islet cells from several

deceased donors. He was not cured, but he ends his tale and the critique of clinical trials

on a cautiously positive note.

This book is a must read for those contemplating volunteering for a clinical trial

(advice in the Afterward), and it also provides discussion starting points for those who

teach classes on ethics in research and medicine, global health, the pharmaceutical

industry, and the business of medical research.

JOAN C. STEVENSON

Department of Anthropology

Western Washington University

Bellingham, Washington

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