Berman Institute Hosts Working Group On Chemotherapy Shortage

So much effort, angst, and money is expended in the fight against cancer, it is a terrible irony that effective treatments – many of which are critical components in life-saving regimens for pediatric cancer—have become so affordable as to be uneconomical to produce, creating a supply shortage.  Consequently, physicians are faced with grim ethical choices of how to apportion these drugs among equally deserving patients.

A team from the Johns Hopkins Berman Institute of Bioethics, led by Yoram Unguru, MD, MS, MA, also a pediatric hematologist / oncologist at the Herman and Walter Samuelson Children’s Hospital at Sinai, will gather a distinguished group of experts for the working group meeting, to be held January 30, 2013 at the Berman Institute in Baltimore, MD.  The group will work to develop ethical frameworks for decision-making both within and between healthcare institutions related to drug shortages.

“This is a real and significant problem with far-reaching impact on clinical care and research.  Children’s lives are at stake,” says Unguru.  “Physicians are in an untenable position; imagine having to decide which child will receive a necessary treatment and which will not, knowing that this decision will have a negative impact on a child’s life.  Our hope is that this meeting will offer clinicians substantive guidance as they grapple with these and related tragic choices.”

Unguru will be joined by a team from the Berman Institute, including director Ruth R. Faden, as well as an impressive list of experts that includes: 

  • Conrad Fernandez, Professor and head of the division of pediatric hematology/oncology in the Department of Pediatrics, IWK Health Centre, Canada
  • Steven Joffe, Associate Professor of Pediatrics and of Global Health and Social Medicine, Dana-Farber Cancer Institute, Boston Children’s Hospital, and Harvard Medical School 
  • Peter C. Adamson, Chair of the Children’s Oncology Group (COG); Professor of Pediatrics and Pharmacology, University of Pennsylvania School of Medicine; Chief of the Division of Clinical Pharmacology and Therapeutics, Children’s Hospital of Philadelphia
  • Lisa Bomgaars, Director of Clinical Research Operations, Texas Children’s Cancer and Hematology Centers 
  • Eduvigis Cruz-Arrieta, Assistant Clinical Professor of Medical Psychology in Psychiatry and Pediatrics, Columbia University 
  • Eric Kodish, Director of Cleveland Clinic’s Center for Ethics, Humanities, and Spiritual Care 
  • Robert “Skip” Nelson, Deputy Director and Senior Pediatric Ethicist in the Office of Pediatric Therapeutics, Office of the Commissioner, U.S. Food and Drug Administration
  • A. Kim Ritchey, President, American Society of Pediatric Hematology/Oncology; Board of Directors, American Board of Pediatrics;  Professor of Pediatrics, University of Pittsburgh School of Medicine
  • Christine Grady, Chief, NIH Clinical Center Department of Bioethics
  • I. Glenn Cohen, Assistant Professor, Harvard Law School and Co-Director, Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics
  • Carol Taylor, Senior research scholar and professor of nursing, Kennedy Institute of Ethics at Georgetown University 


Media Contact:
Leah Ramsay

Johns Hopkins Berman Institute of Bioethics

Working group contact:
Yoram Unguru,

Feeding The World Fairly

December 18, 2012

A Stavros Niarchos Foundation grant will fund planning by a multidisciplinary group of scholars at Johns Hopkins University for an ethical framework to address food shortages and maldistribution.

Fair access to good food is a challenge as old as civilization, and failing to meet it contributed to the fall of the French monarchy (‘let them eat cake’), Babylon, Athens and the Roman Empire. As the global populace climbs toward an expected nine billion by 2050, an $800,000 grant from the Stavros Niarchos Foundation will fund collaborative work by three divisions of Johns Hopkins University to develop ethical guidelines to help meet the challenge in our day.

“There is something profoundly wrong about a world in which nearly two billion people are undernourished while another two billion people are overweight,” says Ruth Faden, PhD, MPH, director of the Johns Hopkins Berman Institute of Bioethics.  Faden will jointly lead the project along with Alan Goldberg, PhD, from the Johns Hopkins Bloomberg School of Public Health and Robert Thompson, PhD, of Johns Hopkins’ Nitze School of Advanced International Studies.  Yashar Saghai, a post-doctoral fellow at the Berman Institute, will be project director.

“This collaboration among Johns Hopkins institutions will examine one of the fundamental obstacles to achieving global food security: profound disagreement about what it means to feed the world ethically,” Faden says.

The project leaders will recruit diverse experts and stakeholders from around the world to characterize differences in ethical assumptions and aims, and to search for moral common ground, Faden says. Participants will include those involved in high and low yield farming, agricultural technology and the welfare of animals, the environment and workers.

“We expect that there will be negotiation and conflict among competing interests, but all the players need to be at the table,” says Thompson. A working, weeklong conference is planned for 2014.

“The goal of this meeting is to produce a document of shared moral principles or commitments that will provide the understanding of the basic issues that must be included to identify fair or ethical food guidelines,” says Goldberg.

The Stavros Niarchos Foundation funds diverse non-profit organizations and projects around the world that have the potential for broad, lasting and positive social impact, according to the foundation. In the 1930s, Niarchos expanded his family’s grain business by thinking globally, buying the ships that transported wheat.

“Mark Twain wrote that hunger is the handmaid of genius; I do believe that if we bring committed people together and treat these issues with the gravity they deserve, we will find a way to narrow what are now broad differences of opinion on a profoundly important question: how to feed everyone, ethically. It is doable,” Faden says.


Media Contact: Leah Ramsay 202.642.9640