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Bioethics at the Movies: Dallas Buyers Club

by Leah Greene, JD, LLM on February 27th, 2014

Dallas Buyers ClubDallas Buyers Club, which is based on a true story, stars actor Matthew McConaughey, who has won several acting awards for his portrayal of the movie’s main character, Ron Woodruff. Mr. Woodruff was diagnosed with AIDS at a time when it could result in death in a matter of months. Mr. Woodruff believed the side effects of the FDA-recommended dosage of AZT were harming his health (his white blood cell count decreased significantly). The movie suggests the FDA knew its recommended dosage of AZT was harmful but refused to change its recommendation. Through Mr. Woodruff’s own research, he learned of alternative drugs available in other countries with less harmful side effects and potentially better efficacy in treatment. He then illegally imported those drugs to the U.S. to sell to other HIV and AIDS patients.

Dallas Buyers Club raises bioethical questions about drug trials for those with terminal illnesses. To evaluate those issues, consider the bioethical principle of autonomy: a patient’s right to make decisions independently after disclosure of the risks and benefits. The following questions are a starting point in considering some issues related to the FDA’s approach to treatment for terminal illnesses:

  • If a patient suffers a drug’s side effects which could be hastening death or putting him at risk for other significant illnesses, should resources be provided for alternative treatments, even if those alternatives involve unproven drugs or unconventional treatment (e.g., Eastern medicine, etc.)?
  • In the case of a terminally ill patient, should drug testing on humans be allowed before animal (or other) testing evaluates its efficacy or side effects?
  • How should the FDA choose which drugs to fast track for terminal illnesses when their efficacy and side effects are still being researched and / or are unknown?

If you do not have time (or the desire) to see Dallas Buyers Club at the movie theater, consider renting Lorenzo’s Oil, which addresses orphan drugs and involves similar bioethical issues. In this movie, a young boy develops ALD, a severe central nervous system disorder, which was so rare, almost no research was being conducted on its cause or treatment. After learning of this lack of research, the boy’s parents essentially taught themselves medicine, and then badgered scientists and physicians to develop a drug to treat ALD.

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