Commentary

Three recent reports describe the first in vivo attempts at fetal gene therapy. The results underline the need for more intensive studies of the scientific and ethical implications of this new and perhaps more preventive approach to gene therapy.

Full analysis of two microbial genomes points towards complete catalogues of virulence and disease genes while tracking the course of evolution.

The current resurgence of interest in xenotransplantation will result in better definition of the mechanisms responsible for xenograft rejection and should facilitate appropriate therapeutic strategies to provide for long-term graft survival.

Randomized clinical trials are powerful tools to refute old prejudices and establish new therapeutic regimes. We propose that they should be afforded a more widespread application in modern clinical medicine.

Should anyone be denied the freedom to commit suicide?

By integrating concepts of computer graphics and artificial intelligence, novel ways of representing medical knowledge become possible. They allow unprecedented possibilities ranging from three-dimensional interactive atlases to systems for surgery rehearsal

The prevailing view is that a physician can simultaneously husband economic resources to control health care costs and fulfill a doctor's traditional responsibility to put the patient first. I disagree.

ECT can be life-saving for patients with certain mental illnesses, such as severe depression, but that is no reason to allow ECT without informed consent. Nor is there general medical justification for the use of ECT on children, a practice in the United Kingdom that is out of control.

In all nations that do science, researchers need support not only for the direct costs of experimentation, but also for the direct costs of their institutions. The US is about to see a vast change in the system for such costs that will affect its ability to do science and, quite possibly, limit the opportunities for researchers from other countries who are studying or working in US laboratories.

Contemporary psychiatric misdirections derived primarily from standard medical errors of oversimplification, misplaced emphasis, and invention are reviewed. These particular errors, however, were in part prompted and sustained by the sociocultural fads and fashions of the day. The results have been disastrous for everyone — patients, families, the public and psychiatry itself.

Although Japan's clinical trial system mimics that of the United States, there are certain flaws in the Japanese regulations that prevent it from working effectively.

Graduate education in the sciences is not doing its job. By preparing students only for academic research, the system neglects the range of opportunities for work in science that young scientists want and society needs.