Case Study 1: AN ALL-TO-REAL EXCERCISE
Ex vivo gene therapy is an expensive and time-consuming technique and consequently it
requires that candidates for receiving gene therapy be ranked in the following manner: first,
medical urgency and second, time on the waiting list. When these factors are relatively equal,
other factors may be considered.
You are in charge of a clinical trial using ex vivo gene therapy for treating familial
hypercholesterolemia, a liver disease, caused by a defective low-density lipoprotein receptor.
At the moment, you have eight patients who are candidates for this gene therapy trial. Luckily,
they are all about as healthy as can be expected. They are being maintained by diet, medication,
and some other rather unpleasant procedures. It is just about impossible to predict which one
will need this gene therapy the most. Yet, you must rank them!
BIOGRAPHICAL PROFILES OF THE CANDIDATES FOR THIS EX VIVO GENE
THERAPY CLINICAL TRIAL
THOMAS: White, male, American, age 48. Married for 24 years. Two children (boy 21, girl
19). Both in college. Spouse: high school English teacher. Education: Ph.D. and M.D. Holds
joint professorships in the University's College of Medicine and College of Arts and Sciences.
Researcher in molecular and cellular biology with a focus on cancer research. Regarded by his
colleagues as one of the world's leading experts on the treatment of lung cancers. He may be
on the verge of an important breakthrough. Member of a local church and several service
organizations, including a Boy Scout leader for 10 years.
ROBERT: White, male, American, age 31. Married for 6 years. One child (girl 5). Spouse:
part-time secretary, three months pregnant. Education: high school drop-out, but has been
attending night school to learn a trade in electronics. Has been working as a laborer for a local
construction firm. No religious affiliation or community service organizations listed.
AHMlR: White, male, Saudi Arabian, age 25. Single. Education: enrolled in Ph.D. program in
Computer Science in the University. His father, a wealthy sheik and alumnus of the University,
is seriously considering a donation of ten million dollars to the University for support of
medical research. A devout Muslim. Member of several international student groups.
YVONNE: Black, female, American, age 34. Single. Education: graduate of selective liberal
arts college and the University's Law School. Recently admitted as a partner in one of the state's
small but prestigious law firms. A major organizer of a counseling service for rape and wifeabuse victims. Member of local choral society; was alto soloist in Christmas production of
Handel's Messiah. Active in the local Baptist church and several charitable
